Rhinoplasty, or Nose Surgery, improves the appearance and proportion of your nose, enhancing facial harmony and self confidence. Surgery of the nose may also correct impaired breathing caused by structural abnormalities in the nose.
While the shape of your nose is usually the result of heredity, the appearance may have been altered in an injury or during prior surgery.
Nose surgery can change:
- Nose size, in relation to the other facial structures
- Nose width, at the bridge
- Nose profile, with visible humps or depressions on the bridge
- Nasal tip, that is large or bulbous, drooping, or too upturned
- Nostrils that are large, wide or upturned
- Nasal asymmetry and deviation
About the Procedure
Rhinoplasty improves the proportion of your nose in relation to the rest of your facial features. The shape of your nose is usually hereditary and can be changed to enhance your features. In addition, those who have sustained injury to the nose or have breathing issues may find rhinoplasty as a perfect solution.
Your consultation is your time to ask the doctor about the procedure you’re considering, how he thinks it will work for you and any concerns you may have. We suggest you come prepared with your questions on paper so you’re sure not to forget to ask the questions that are important to you.
Questions to consider:
- What is the simplest and safest surgery to help me achieve my goals?
- How is the surgery performed?
- What is the expected length of operation?
- Are other options available?
- What results can I expect, and how long do the typical results last?
- Where will scars be located, and how noticeable will they be?
- Will scars fade over time, and how long will this take?
When you arrive at the office, you will be asked to fill out a few pieces of paperwork. It is very important when asked about medications to put down all medications you take, including any supplements or aspirin-type regimens, since these items can impact your blood clotting and pressure. In addition, you need to be truthful about your use of tobacco and alcohol since this will affect your recovery and incision healing.
Before you see the doctor, a nurse or nurse practitioner will do an initial exam. You may be able to get a number of your questions answered while with the nurse.
Your surgeon will discuss several factors regarding surgery during your initial consultation, including your procedure, location, anesthesia and recovery. In addition, the surgeon will inquire about your concerns, priorities and motivations for pursuing surgery, as well as your fears.
The doctors are sure to address reasonable expectations for the outcome of your desired procedure, and they should explain what is possible and what is not possible.
After your consultation with the physician, you will meet with the practice manager to discuss procedure costs.
There are a number of things to do prior to your procedure that will make your recovery as smooth as possible and ease your pre-procedure anxiety.
Your surgeon will give you instructions on what medications to stop taking and when prior to your surgery to prevent any unwanted side effects. Medications you shouldn’t take up to two weeks prior to your surgery include, but are not limited to, aspirin and products containing aspirin, alcohol and herbal supplements. Your surgeon may advise you to take Arnica Montana, Bromelain or vitamins A or K for swelling, bruising and to promote general healing.
It is important to remember to only take a supplement or herbal remedy if your surgeon advises it.
Your Pre-Op Checklist
- Take pictures and make notes to discuss with your doctor. You know what you want, and he knows how to make it possible.
- Make a list of post-op projects and gather what you need. Stop taking blood-thinning medications and supplements two weeks prior to surgery (aspirin, Motrin, fish oils, vitamin E) and don’t take them two weeks after surgery.
- Books to read
- Photo projects
- Vacation planners
- Start using anti-bacterial soap in the shower a few days before surgery and following surgery.
- Remove all fingernail and toenail polish.
- Fill prescriptions you’ll need, including antibiotics and pain medications.
- Purchase over-the-counter eye drops and eye gel for overnight (GenTeal seems best and it is found at major drug stores like Walgreens).
- Pick up Bacitracin for incision areas and Colace to keep your bowels moving during recovery.
- Clear your calendar for a month post-op.
- Arrange for caretakers: you, kids, plants and pets need to be taken care of during your recovery. You will not be able to lift, reach, bend over or be too active for some time.
- Prepare your recovery area so your head is elevated. A recliner works wonders for this. Also stock your recovery area with:
- Remote control
- Reading material
- Any other item that will make you feel comfortable during your recovery
- Make a to-do list of things you want to get done prior to surgery and start! You won’t be able to accomplish as much post-surgery. Some items you may want to get done include:You will want to stock up on groceries or cook meals prior to your surgery. Many patients enjoy the ease of frozen meals, yogurt, pudding, fruits, soups and anything else that is easy to prepare.
- Clean the house
- Catch up on gardening
- Give the dog a bath
- Clean the litter box
- Wash your car
- Stock up on ice packs, frozen peas and frozen gel packs. You’ll want to use them early and often on your face, neck and ears. It will definitely feel good and keep the swelling down.
- Pack a receptacle with a lid and towel in your car for the ride home from the hospital just in case you feel nauseous. You may want to add a pillow and blanket, but be sure to set up on the ride home to help with the nausea and swelling.
- Get your hair and nails done since it will be a while before you can do either.
- Prepare Power of Attorney for Medical Care and Advance Directives, just in case. Give copies to your doctor and/or surgical center.
- Breathe and relax! Stress can adversely affect your recovery. Try to remember that you will heal, the soreness will subside and you will look great.
During Your Procedure
Anesthesia: Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation or general anesthesia. Your doctor will recommend the best choice for you.
The Incision: Surgery of the nose is performed either using a closed procedure, where incisions are hidden inside the nose, or an open procedure, where an incision is made across the columella, the narrow strip of tissue that separates the nostrils.
Through these incisions, the soft tissues that cover the nose are gently raised, allowing access to reshape the structure of the nose.
Reshaping the Nose Structure: Surgery of the nose can reduce or augment nasal structures with the use of cartilage grafted from other areas of your body.
Most commonly, pieces of cartilage from the septum, the partition in the middle of the nose, is used for this purpose.
Occasionally a piece of cartilage from the ear and rarely a section of rib cartilage can be used.
Correcting a Deviated Septum: If the septum is deviated, it is now straightened and the projections inside the nose are reduced to improve breathing.
Closing the Incision: Once the underlying structure of the nose is sculpted to the desired shape, nasal skin and tissue is redraped and incisions are closed. Additional incisions may be placed in the natural creases of the nostrils to alter their size.
See the results
Recovery is an important part of any surgery, and you must take the doctor’s orders to heart if you want to heal as quickly as possible.
You will be given specific instructions that may include: how to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in overall health, and when to follow up with your plastic surgeon.
Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.
- Where will I be taken after my surgery is complete?
- What medication will I be given or prescribed after surgery?
- Will I have dressings/bandages after surgery? When will they be removed?
- Are stitches removed? When?
- When can I resume normal activity and exercise?
- When do I return for follow-up care?
Splints and internal tubes will likely support the nose as it begins to heal for approximately one week.
While initial swelling subsides within a few weeks, it may take up to a year for your new nasal contour to fully refine.
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 nose surgery.
As with every surgery, there are risks involved. Be sure to ask your surgeon about all possible risks and if this procedure is appropriate for you. Risks associated with rhinoplasty include:
- Rupture of small surface vessels of the nose
- Poor wound healing
- Anesthesia risks
- Bleeding (hematoma)
- Nose asymmetry
- Cardiac and pulmonary complications can occur in longer surgical procedures and may be associated with the formation of, or increase in, blood clots in the venous system
- Change in skin sensation (numbness)
- Nasal airway alterations may occur after a rhinoplasty or septoplasty that may interfere with normal passage of air through the nose
- Nasal septal perforation (a hole in the nasal septum) may develop but is rare; additional surgical treatment may be necessary to repair the nasal septum but in some cases, it may be impossible to correct this complication
- Pain, which may persist
- Unfavorable scarring
- Skin contour irregularities
- Skin discoloration and swelling
- Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
- Possibility of revisional surgery