Surgery of
the Nose
Every year, half a million people who are interested
in improving the appearance of their noses seek
consultation with facial plastic surgeons. Some
are unhappy with the noses they were born with,
and some with the way aging has changed their
nose. For others, an injury may have distorted
the nose, or the goal may be improved breathing.
But one thing is clear: nothing has a greater
impact on how a person looks than the size and
shape of the nose. Because the nose is the most
defining characteristic of the face, a slight
alteration can greatly improve one's appearance.
If you have wondered how nose surgery, or rhinoplasty,
could improve your looks, self-confidence, or
health, you need to know how rhinoplasty is performed
and what you can expect. No pamphlet can answer
all your concerns, but this one can provide answers
to many of the questions you may have.
Successful facial plastic surgery
is a result of good rapport between patient and
surgeon. Trust, based on realistic expectations
and exacting medical expertise, develops in the
consulting stages before surgery. Your surgeon
can answer specific questions about your specific
needs.
Is Rhinoplasty For You?
As with all facial plastic
surgery, good health and realistic expectations
are prerequisites. Understanding nasal surgery
is also critical. Since there is no ideal in rhinoplasty,
the goal is to improve the nose aesthetically,
making it harmonize better with other facial features.
Skin type, ethnic background, and
age are important factors to be considered in
discussions with your surgeon prior to surgery.
Before the nose is altered, a young patient must
reach full growth, usually around age fifteen
or sixteen. Exceptions are cases in which breathing
is severely impaired.
Before deciding on rhinoplasty,
ask your facial plastic surgeon if any additional
surgery might be recommended to enhance the appearance
of your face. Many patients have chin augmentation
in conjunction with rhinoplasty to create a better
balance of features.
Making The Decision For
Rhinoplasty
Whether the surgery is desired for functional
or cosmetic reasons, your choice of a qualified
facial plastic surgeon is of paramount importance.
Many facial plastic surgeons are trained in both
ear, nose, throat, and facial cosmetic surgery,
which provides you, the patient, with the highest
level of training and expertise. Your surgeon
will examine the structure of your nose, both
externally and internally, to evaluate what you
can expect from rhinoplasty. You are most likely
to be pleased with the results of your surgery
if you have a realistic idea of what nasal surgery
can and cannot do.
You can expect a thorough explanation
of the surgeon's expectations and the risks involved
in surgery. Following a joint decision by you
and your surgeon to proceed with rhinoplasty,
the surgeon will take photographs of you and discuss
the options available. Your surgeon will explain
how the nasal structures, including bone and cartilage,
can be sculpted to reshape the nose and indicate
how reshaping the chin, for example, could enhance
the desired results.
After conducting a thorough medical
history, your surgeon will offer information regarding
anesthesia, the surgical facility to be used,
and the costs for the procedure.
Understanding The Surgery
The definition of rhinoplasty is, literally, shaping
the nose. First, incisions are made and the bone
and cartilage support system of the nose is accessed.
The majority of incisions are made inside the
nose, where they are invisible. In some cases,
an incision is made in the area of skin separating
the nostrils. Next, certain amounts of underlying
bone and cartilage are removed, added to, or rearranged
to provide a newly shaped structure. For example,
when the tip of the nose is too large, the surgeon
can sculpt the cartilage in this area to reduce
it in size. The angle of the nose in relation
to the upper lip can be altered for a more youthful
look or to correct a distortion.
The tissues are then redraped
over the new frame and the incisions are closed.
A splint is applied to the outside of the nose
to help retain the new shape while the nose heals.
Soft, absorbent material may be used inside the
nose to maintain stability along the dividing
wall of the air passages called the septum. Alternatively,
soft nasal supports that permit nasal breathing
post-operatively can be placed.
What To Expect After The
Surgery
Immediately after surgery, a small splint will
be placed on your nose to protect it and to keep
the structure stable for at least five to eight
days. If packing is placed inside the nose during
surgery, it is removed the morning following the
surgery. Your face will feel puffy,especially
the first day after surgery. Pain medication may
be required. Your surgeon will advise you to avoid
blowing your nose for seven days after surgery.
In the immediate days following surgery, you may
experience bruising and minor swelling in the
eye area. Cold compresses often reduce the bruising
and discomfort. Absorbable sutures are usually
used that do not have to be removed. Nasal dressing
and splints are usually removed six or seven days
after surgery.
It is crucial that you follow your
surgeon's directions, especially instructions
to keep your head elevated for a certain period
after surgery. Some activities will be prohibited
in the weeks after the procedure. Sun exposure,
exertion, and risk of injury must be avoided.
If you wear glasses, special arrangements must
be made to ensure that the glasses do not rest
on the bridge of the nose. Tape and other devices
are sometimes used to permit wearing glasses without
stressing the area where surgery was performed.
Follow-up care is vital for this
procedure to monitor healing. Obviously, anything
unusual should be reported to your surgeon immediately.
It is essential that you keep your follow-up appointments
with your surgeon.
Insurance does not generally cover
surgery that is purely for cosmetic reasons. Surgery
to correct or improve nasal function or surgery
for major deformity or injury may be reimbursable
in whole or in part. It is the patient's responsibility
to check with the insurance carrier for information
on the degree of coverage.
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