What is Rhinoplasty?

RHINOPLASTY

NOSE RESHAPING Surgery to reshape the nose is one of the most popular procedures. Rhinoplasty is an extremely satisfying procedure due to the psychological improvements that come with physical reshaping of the nose. Due to the delicate underlying structures, rhinoplasty is one of the most complex procedures performed in cosmetic surgery. It is extremely important to find a doctor who has the combined medical and artistic skill that will produce a pleasing result. People of all ages request the procedure. Facial boney growth should be complete before surgery is contemplated. This happens at age 16-18 years. The hump can be removed or the nose made smaller, narrower or shorter, but not always wider or larger without extensive surgery. Cartilage grafts are sometimes necessary to change certain aspects of the nose. Cartilage may be removed from one part of the nose (the septum) and grafted to another (usually the tip); cartilage or bone from ear, or rib may also be used.  It's not unusual to have a chin augmentation or reduction in conjunction with a rhinoplasty to bring the profile into balance. The goal is to achieve harmony of the facial structure.  If breathing is obstructed, airway obstruction surgery can be done at the same time.

ALTERNATIVES TO SURGERY

There is no non-surgical method of reshaping the nose.

PREPARING FOR SURGERY

Bring magazine pictures of noses that you like to your initial consultation. That helps us understand your sense of beauty. Your new nose has to fit the shape and size of your face. This procedure requires an in-depth evaluation of your nose, facial structure, and skin type. This allows for communication with Dr. Shureih as to your sense of a beautiful nose. Computer imaging is another method of communications that is used during the consultation. To bring your profile into balance and harmony, it's not unusual to have a chin augmentation or reduction in conjunction with a rhinoplasty. Also, if your breathing is obstructed due to a deviated septum, your surgeon may recommend that it be straightened at the same time. You will also be given pre-and postoperative instructions which will include information on eating drinking and what prescription medications to take and those to avoid. Be sure you and your physician agree on the surgical approach and understand the potential risks and complications involved with the procedure.

THE PROCEDURE

Rhinoplasty can change the size of your nose, change the shape of the tip or the bridge, narrow the nostrils or change the angle between your nose and upper lip. It may also correct a birth defect or injury, or help relieve some breathing problems. Two techniques are currently available; With the traditional "closed " technique, all incisions are made inside the nostrils. Incisions made using the newer "open " technique are made on the central portion below the tip of the nose between the nostrils then inside the nose. If a reduction in nostril size is desired, incisions are made in the crease where the side of the nostril meets the upper lip and cheek. The incision(s) usually heals to a very fine, inconspicuous scar. The boney pyramid of the nose can be narrowed or lowered. Removing the hump of the nose will cause the bridge to widen. To narrow the bridge the nasal bones have to be moved. The nasal tip is sculpted by modifying the cartilage and suture repositioning of the tip. If the bridge of the nose is too low, the bridge is built up with a graft.

Anesthesia

Rhinoplasty can be performed under intravenous sedation with local anesthesia or under general anesthesia. The type of anesthesia depends on the extent of the procedure to be performed, the patient's preference.

Length of Surgical Procedure

Rhinoplasty can take from one and one half to four hours, depending on the extent of the surgery to be done. The time can be increased if the surgery is a revision or a reconstructive procedure.

Level of Pain/Discomfort Pain tolerance is different for everyone. Generally, there can be minimal to moderate discomfort. Some people experience absolutely no discomfort at all. Most discomfort can be controlled with prescribed pain medications. You may find you only need pain medication for the first day or two.

PRE- AND POSTOPERATIVE INSTRUCTIONS

These suggestions are intended to make you more comfortable and help you heal:

Stop smoking, discontinue the use of alcohol, and stop taking vitamin E and any medications containing aspirin or ibuprofen (two weeks pre- and post-operative is usually recommended).

Check with your doctor regarding any other medications (including homeopathic/herbal products) you are currently taking.

Have someone stay with you the first night after surgery (the first twenty-four hours, optimally). 

Dressings - if the procedure requires a splint, this is applied by the doctor immediately after the procedure. This must be kept dry and intact.

Nasal packing when used, are removed in about two to three days.

Sunbathing and tanning beds must be avoided for a minimum of two weeks prior to surgery (for optimal skin care and health, these should be avoided completely).

After surgery, you must protect your nose from the sun for at least six weeks. The longer, the better. 

Do not wear glasses for the first two weeks unless Okayed by your doctor (and then they must be taped to your forehead). Some glasses are heavy and could cause a groove at the bridge or place unnecessary pressure on the new structure. 

Do not blow your nose until instructed. Then, blow very gently with mouth open. 

Sneeze with your mouth open to minimize pressure.

Cold compresses to be applied for twenty minutes every hour for a minimum of forty-eight to seventy two hours.

Consider sleeping alone for the first week or so to protect against accidental blows to the nose while sleeping.

RECOVERY

While everyone heals differently, you should plan on approximately seven days for the initial healing period. Your nose will be stuffy, your mouth dry, and you could be swollen and bruised around the eyes. A little bleeding is common. Your nose will remain stuffy for about two to three weeks. Swelling in the center of your face should lessen in the first week, with some minor swelling remaining for weeks. However, it can take up to a year for all the swelling to disappear, especially at the tip. Packing is very rarely used these days. If packing is used, it's usually removed one to three days. Sutures are removed in about a week, along with the splint.

RISKS/COMPLICATIONS

After rhinoplasty, as in all surgeries, there is the potential for infections, nosebleed, or numbness. Sometimes a secondary procedure or a revision may be required to correct minor problems, asymmetry, or a collapse in nasal passages.

NEW_YOU ONLY BETTER

Most rhinoplasty patients eagerly await the removal of the splint to unveil the new nose they have probably been dreaming about for years. Although the swelling is still marked after the first week, the new shape of the nose is easily identifiable. Rhinoplasty is a satisfying procedure and the new shape will last a lifetime.