Rhinoplasty / Nose Job

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Rhinoplasty / Nose Job

Cosmetic surgery of the nose, also called rhinoplasty, can improve the shape, size and general appearance of your nose. The goal is a nose that looks natural and achieves a harmonious balance with your other facial features.

Cosmetic surgeons usually recommend that patients wait until they are at least 14 or 15 years and possibly older for boys, before undergoing rhinoplasty.
Some of the indications that you may be a good candidate for rhinoplasty are:

  • Your nose appears too large for your face
  • In profile, there is a bump on the nasal bridge
  • From front, your nose seems too wide
  • Your nasal tip droops or plunges
  • The tip is thickened or enlarged
  • Your nostrils are excessively flared
  • Your nose is off-centre or crooked or deviated
  • Previous injury has made your nose asymmetrical

It is important that you have a clear idea of how you would like your nose to look and at the same time, realize that there are limitations to the procedure.

How is rhinoplasty performed?

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Anatomy of nose

Because of individual factors, not everyone will achieve the same results after rhinoplasty. Alterations may be made to increase or decrease the nasal bridge, reduce the size or width of the nose, narrow the nostrils, change the angle between the nose and upper lip or reshape the tip.

Rhinoplasty is performed in a hospital, under local or intra-venous sedation or generalanaesthesia. Your doctor will recommend the best choice for you.

Your surgeon will mark the areas and plan the extent of surgery for you pre-operatively in the upright position.

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Open rhinoplasty incision

In rare instances the incisions are placed inside the nose (Closed rhinoplasty). More commonly, a very short incision is made across the columella and then extended within the nostrils on either side (Open rhinoplasty).If the base of the nose is narrowed or the nostrils reduced small wedges of skin at the base of the nostrils will be removed.

The cartilages and bones that forms the framework of your nose are then modified. If your nose needs to be built up, this can be done using nasal cartilage, bone or cartilage from other sites or synthetic implants. The skin and soft tissues then re-drape themselves over this new scaffolding.

A splint may be placed on your nose for holding the tissues in place until they have stabilized. Packing or soft internal splints are sometimes used inside the nostrils, in which case you will have to breathe through your mouth for the first 24-48 hours.

Recovery

Open rhinoplasty incision

It is important to realize that the amount of time it takes for recovery varies from patient to patient. The first couple of days after surgery you should restrict your activities and sleep with your head elevated for the first 2 weeks. This will help to minimize swelling. Generally, bruising around the eyes and cheeks is most apparent during the first five days after surgery. Most discoloration will disappear within a couple of weeks.
Stitches may be removed by 5 to 7 days after surgery. You may need to wear the nasal splint for atleast 10-14 days, during which time you should avoid getting it wet.While initial swelling subsides within a few weeks, it may take up to 3 to 6 months for your new nasal contour to fully refine (sometimes even upto a year). During this time you may notice gradual changes in the appearance of your nose as it refines to a more permanent outcome. Swelling may come and go and worsen in the morning during the first year following your surgery. Straining, bending, sneezing and lifting of heavy objects should be avoided for a few weeks after surgery. You may be able to return to work within a week after surgery and resume most normal activities within 3 to 4 weeks. You must protect your reshaped nose from direct sunlight for several months.
Occasionally, a touchup may be desired to further improve the results. The results of rhinoplasty are permanent, except for possible changes associated with the normal aging process.

Recovery

Rhinoplastyis a surgical procedure and has some potential problems associated with it. You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks and potential complications.

Rhinoplasty surgery risks include:

  • Anesthesia risks
  • Bleeding (hematoma)
  • Infection
  • Poor wound healing or scarring
  • Change in skin sensation (numbness or pain)
  • Nasal septal perforation (a hole in the nasal septum) is rare. Additional surgical treatment may be necessary to repair the septum.
  • Difficulty breathing
  • Unsatisfactory nasal appearance
  • Skin discoloration and swelling
  • Possibility of revision surgery

Consultation

During consultation be prepared to discuss:

  • Your surgical goals
  • Medical conditions, drug allergies, and medical treatments
  • Current medications, vitamins, herbal supplements, alcohol, tobacco, and drug use
  • Previous surgeries

Your aesthetic surgeon will also:

  • Evaluate your general health status and any pre-existing health conditions or risk factors
  • Take clinical photographs
  • Discuss your rhinoplastyoptions
  • Recommend a course of treatment
  • Discuss likely outcomes of rhinoplastyand any risks or potential complications

It’s very important to understand all aspects of your procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your cosmetic surgeon.

Preparing for Rhinoplasty

In preparing for surgery, you may be instructed as follows:

  • Get lab testing or a medical evaluation. You may be advised for a CT Scan as well.
  • Take certain medications or adjust your current medications
  • Stop smoking
  • Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding

Be sure to arrange for someone to stay with you for at least the first night following surgery.

Preparing for Rhinoplasty

In preparing for surgery, you may be instructed as follows:

  • Get lab testing or a medical evaluation. You may be advised for a CT Scan as well.
  • Take certain medications or adjust your current medications
  • Stop smoking
  • Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding

Be sure to arrange for someone to stay with you for at least the first night following surgery.