Rhinoplasty

Rhinoplasty is surgery to improve the function (reconstructive surgery) or change the appearance (cosmetic surgery) of your nose. This surgery also may be done to correct birth defects and injuries.

The surgery can sometimes be done through cuts (incisions) made inside the nose. In that case, there is no visible scarring. Other times, incisions may be needed at the base of the nose, especially if the procedure calls for narrowing of large nostrils. This may leave small scars, but they are usually not noticeable. 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 14–15 years for girls, and a little later for boys.

LET YOUR HEALTH CARE PROVIDER KNOW ABOUT:

  • Any allergies you have.

  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.

  • Previous problems you or members of your family have had with the use of anesthetics.

  • Any blood disorders you have.

  • Previous surgeries you have had.

  • Medical conditions you have.

RISKS AND COMPLICATIONS

Generally, this is a safe procedure. However, as with any procedure, complications can occur. Possible complications include:

  • Swelling and bruising.

  • Airway obstruction.

  • Burst blood vessels.

  • Heavy scar (keloid formation).

  • Loss of structural support.

  • Numbness.

  • Hole in the septum.

  • Infection.

  • Skin necrosis or skin death (more likely in smokers).

  • Sinusitis.

  • Failure to correct the problem.

  • Asymmetry or abnormal shape.

  • Falling out (extrusion) of implants.

  • Loss of smell.

  • Nerve damage.

  • Pain.

  • Septal hematoma.

  • Toxic shock syndrome.

  • Bleeding.

  • Small burst vessels on the skin (minor but permanent).

BEFORE THE PROCEDURE

  • Ask your health care provider about changing or stopping any regular medicines.

  • Shower the morning of surgery with antibacterial soap. Wear clean, loose-fitting clothing.

  • Avoid wearing makeup, jewelry, and hair accessories.

  • Stop smoking if you smoke. Stopping will improve the healing process after surgery.

  • Make plans to have someone drive you home after your hospital stay. Also, arrange to have someone help you with activities during recovery.

PROCEDURE

  • You may be given medicine to help you relax (sedative). You will also be given one of the following:

  • A medicine that numbs the nose and surrounding area (local anesthetic).

  • A medicine that makes you go to sleep (general anesthetic).

  • Incisions will be made inside the nostrils or on the skin between the nostrils. Through these incisions, your surgeon will 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 may also be done for cosmetic reasons or to improve breathing. The cartilage may be taken from your septum, ear, or rib. In rare cases, such as when the normal structure is badly damaged or weakened, man-made (synthetic) implants may be used to reconstruct the nose.

  • In some cases, the wall that divides the nostrils inside the nose (septum) may be reshaped, or part of the cartilage or bone of the septum may be removed. This is called septoplasty. It may be done to improve nasal breathing. Cartilage removed is sometimes used to improve the look and framework of the nose.

  • Incisions are then closed with absorbable stitches (sutures).

  • Packing or a nasal splint may be placed in your nostrils to prevent bleeding, and an aluminum splint may be put over your nose to protect it.

AFTER THE PROCEDURE

  • You will be taken to a recovery area where you will be monitored.

  • Your nose and face will likely be swollen.

  • You may have a headache and facial pain. You will be given pain medicines to control this.

  • A splint is used to maintain the new shape of the nose after surgery. You may also have splints or nasal packs placed inside the nostrils. This keeps the septum in place. The packing is usually removed after 4–5 days.

  • You may be allowed to go home the same day, or you may need to stay in the hospital overnight.