Rhinoplasty

Rhinoplasty is a plastic surgery that is used to improve the function (reconstructive surgery) or appearance (cosmetic surgery) of your nose. Rhinoplasty can be used for cosmetic reasons, correction of birth defects, or breathing problems. It reshapes or repairs. There is no visible scarring when rhinoplasty is performed from inside the nose. Small scars may show at the base of the nose when the procedure calls for the narrowing of large nostrils. These are usually not noticeable. There may be bruising in the skin following your surgery. These are minor but permanent. Rarely, another procedure is necessary to correct a minor deformity following surgery.

Rhinoplasty is used to:

  • Change the size.

  • Correct birth defects and injuries.

  • Change the shape.

  • Correct breathing problems.

When cosmetic surgery is done only to change the shape of the nose, age is a consideration. It is usually not done until the nasal bone growth is complete. This is about age 14 or 15 for girls, and a little later for boys.

To ensure the best result stop smoking at least four weeks before surgery. Smoking impairs wound healing. This is an excellent time to get help with a smoking cessation program from your caregiver or surgeon and stop smoking forever.

PROCEDURE

  • Rhinoplasty can be performed under a general anesthetic or with local anesthetic. When local anesthesia is used, your nose and the surrounding area is numbed with a medication like Novocaine. You are usually lightly sedated for the surgery. This keeps you relaxed while the Novocaine keeps you pain free. General anesthesia allows you to sleep through the operation. This is commonly used in children. This is usually done as an outpatient procedure but may require a brief hospital stay if the surgery is more complex. Incisions are hidden inside the nostrils and sometimes are made on skin between the nostrils. Through these incisions, your surgeon is able to reshape the cartilage and bone.

  • Sometimes a piece of your own cartilage or bone is used to strengthen or improve the build of the nose. This is also done for cosmetic reasons or to improve breathing.

  • Rarely man-made (synthetic) implants are used to reconstruct the nose when the normal structure is badly damaged or weakened. This is sometimes associated with long-term complications such as movement or your body trying to get rid of the foreign body. Using cartilage from the septum, ear, or rib overcomes this problem.

  • Improving nasal breathing is sometimes accomplished with a septoplasty. This may be done in combination with cosmetic changes. Cartilage removed can be used to improve the looks and framework of the nose.

RISKS

The risks for any anesthesia are:

  • Reactions To Medications.

  • Breathing Problems.

  • Heart Attack or Stroke.

The risks for any surgery are:

Generally the risks from rhinoplasty are small but some of the risks which may happen include the following:

  • Swelling.

  • Bruising.

  • Airway obstruction.

  • Burst blood vessels.

  • Heavy scar (keloid formation).

  • Loss of structural support.

  • Numbness (permanent risk is very small).

  • Perforation of septum.

  • Slow healing.

  • Infection (pain, swelling, warmth, redness).

  • Skin necrosis or skin death which is many times more likely in smokers.

  • Sinusitis.

  • Failure to correct the problem.

  • Asymmetry or abnormal shape.

  • Extrusion of implants.

  • Loss of smell.

  • Nerve Damage.

  • Pain.

  • Septal hematoma.

  • Toxic Shock Syndrome.

  • Bleeding (may require nasal packing).

  • Small burst vessels on the skin, minor but permanent.

HOME CARE INSTRUCTIONS

  • Your nose and face will be swollen after surgery. Headaches and facial pain are common. Pain medications are given to control this.

  • Minor bleeding from the nose is common the first couple days after surgery. Do not blow or pick at your nose until healing is complete.

  • A splint is used to maintain the new shape of the nose after surgery. Splints or nasal packs may also be placed inside the nostrils. This keeps the center of your nose(septum) in place. When the packing is removed after four or five days you will be much more comfortable.

  • Swelling and bruising around the eyes increases for about two to three days. Keep your head elevated on a couple pillows and sleep with your head elevated. Cold packs to your face will also help keep swelling down. For a cold pack, put some ice cubes in a plastic bag and apply this to your face after wrapping the ice pack in a towel to prevent frostbite. Most swelling and bruising is nearly gone in a couple weeks. The little that remains is generally unnoticeable to anyone but you.

AFTER THE PROCEDURE

  • Usually you are able to return to school or work within about a week. Full recovery may take several weeks.

  • Avoid strenuous activities for 2 to 3 weeks. Protect your nose. Avoid unprotected sun exposure for a couple months. Be gentle with bathing.

  • Tape your glasses to your forehead or support them with your cheeks until your nose is completely healed.

  • If you are a little depressed following surgery, take heart. Day by day your nose will look better. In a couple weeks, cosmetics can be used to cover up signs of the operation. Healing is slow and gradual and final results may not be evident for up to a year.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop increased pain or swelling in your face or around your eyes.

  • You develop a temperature over 101° F (38.3° C).

  • You have increased bleeding from your nose or a pus-like discharge from your nose.

  • You lose your nasal pack prior to the time your surgeon says it is to be removed.

  • You do not get relief from your headache or facial pain with medications or the problems seem to be getting worse.