Rhinoplasty (nose surgery) is a procedure that involves changing the shape and size of the nose by reshaping the nasal bones and/or cartilage. The goal of nose surgery is to improve the appearance and symmetry of the face, and in many cases correct breathing problems. The final result is a nose that is attractive, natural looking, functions properly, and is balanced with the rest of the face.
This is one of the most technically difficult and complex procedures in cosmetic surgery. The final result should look good and function properly, allowing the patient to breathe well. After all, improved breathing is essential for a good night sleep and helps to maintain a healthy heart.
Common concerns patients have with their nose can be placed into three general categories: dorsum (bridge), nostrils, and the tip. Each one of these characteristics help to define the entire nose and have their own underlying issues that include length, width, depth, size, etc. For instance, the dorsum can have a bump or be crooked, be too wide, too narrow, or too high; the tip can be droopy, bulbous, boxy, or too high; and the nostrils can be too wide or narrow. Any combination of these issues can result in a disproportionately large or small nose that doesn’t quite fit the face.
Aside from cosmetic concerns, rhinoplasty can also be used to correct birth defects, problems that effect breathing (such as a deviated septum or sinus condition), or injuries.
The ideal rhinoplasty candidate is healthy and doesn’t have any illnesses that would impede the healing process. They must also have realistic expectations and an understanding of the physical limitations of this procedure.
Rhinoplasty is performed as an outpatient procedure using general anesthesia (you will be asleep during surgery) and consists of two different techniques, open and closed.
During an open rhinoplasty, a small incision is made under the tip of the nose, allowing the surgeon to pull back the skin covering the nose. The bone and tissue can then be sculpted and reshaped to produce the desired result. This technique also allows the surgeon the access needed to build up nose tissue using grafts or cartilage, if needed.
A closed rhinoplasty includes small, well-hidden incisions made inside the nostrils, but no incisions on the outside of the nose.
In either case, fine stiches are used to close incisions, resulting in nearly invisible scars. Once complete, the surgeon will fit a soft splint to help the nose keep its new shape, and in some cases nasal packs will be placed inside the nose.
Each technique offers advantages and disadvantages and patients may benefit more from one than the other. During your consultation, the surgeon will explain which technique will work best to accomplish your individual goals.
Recovery following a rhinoplasty is different for all patients and may take several months.
One of the first things patients notice immediately following rhinoplasty is improved nasal breathing. However, by the first night after surgery, swelling will obstruct the nasal passages and remain for the first three to four days. Nasal breathing will improve gradually over the following two to three weeks.
Patients may notice light bleeding from the nose for the first couple of days after surgery. Bruising and swelling will most likely occur under the eyes, and could linger for a few weeks. Minor swelling in the nose will remain for six to eight weeks.
Stiches, surgical splints, and nasal packing are typically removed within the first week after the procedure. If the closed rhinoplasty method is used, stiches inside the nose will dissolve after about one week.
The day of surgery, patients should plan to rest with their head in an elevated position. Headaches, puffiness and pain around the eyes are common, and can be managed with medication. A cold compress may also be used to manage facial discomfort.
Light activity may resume two weeks after surgery. Vigorous exercise should be avoided for at least four to six weeks. Your surgeon will discuss an individualized recovery plan during your pre-op visit.