a) “What is the difference between open and closed rhinoplasty?”
In a closed rhinoplasty, the incisions (cut) are taken within the nostrils so that the final scars are hidden inside the nose. However, this approach limits the surgical exposure and does not permit precise shaping of the underlying cartilage. In an open rhinoplasty, in addition to the incisions taken within the nostrils, there is a small cut across the columella (skin between both nostrils).
The final scar is rarely objectionable and settles to a barely visible scar. The open rhinoplasty approach has a major advantage that it provides excellent exposure to the cartilage framework and therefore allows greater precision in modifying the nasal framework.
b) “I am scared of general anesthesia, is there any other option possible?”
I prefer to perform a nose-job surgery under general anesthesia as the patient is absolutely relaxed and not aware about the surgery happening. This allows me to perform my job in a focused manner. However, some patients are either not fit for general anesthesia or paranoid about general anesthesia. In such cases, a nose job can be performed under local anesthesia and sedation. You will be sedated during the surgery so as to keep you relaxed and your surgeon can do his work after giving local anesthesia. However, in all cases I have a qualified anesthesiologist present in the operation room to closely monitor your vital parameters at all stages.
c) “Do I have to stay in the hospital after surgery?”
A straightforward nose-job can be performed as a day-care surgery i.e. you may go home the same day evening. However, in more extensive cases I would prefer that you stay in the hospital the first night after surgery.
Let me explain the reason for this – your aesthesia effect wears off in 4 to 6 hours after surgery. However, as the healing process begins, there is inflammation and swelling that starts to develop in the operated area. Controlling this inflammation is of paramount importance as it may otherwise compromise the surgical result. Any strenuous activity – carrying bags, climbing stairs, vomiting, pain or anxiety or any increase in your blood pressure will increase the swelling and bruising. If you are in the hospital, you can be given appropriate medicines to control any unwanted symptom.