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The
nose is made up of bone and cartilage. The size
and relationship of the bone and cartilage which
make up the nose determine the size and shape
of the nose.
Nose
surgery (rhinoplasty) offers improvement in
the appearance in cases in which the nose is
cosmetically unappealing. Age may also be a
consideration. Many surgeons prefer not to perform
cosmetic (elective) rhinoplasties until the
growth of the nasal bone is completed (around
14 or 15 for girls, a bit later for boys).
The
results of surgery are variable, depending on
the initial shape of the nose, but rhinoplasty
offers significant improvement in appearance
in many cases.
Alternative
names
Rhinoplasty
Definition
Rhinoplasty
is surgery to repair or reshape the nose. See
also septoplasty (nasal
septum repair).
Description
Rhinoplasty
is one of the most common of all plastic surgery
procedures. It can be used to:
- Reduce
or increase the size of the nose
- Change
the shape of the tip or the nasal bridge
- Narrow
the opening of the nostrils
- Change
the angle between the nose and the upper lip
- Correct
a birth defect or injury
- Help
relieve some breathing problems
Rhinoplasty
can be performed under local or general anesthesia,
depending on the extent of the procedure and
the patient's preference. It may be performed
in a surgeon's office-based facility, a hospital,
or an outpatient surgery center. Complex procedures
may require a short inpatient stay. The procedure
usually takes an hour or two, but may take longer.
With
local anesthesia, the nose and the surrounding
area is numbed. The patient will usually be
lightly sedated, but awake during the surgery
-- relaxed and insensitive to pain. General
anesthesia allows the patient to sleep through
the operation, and is typically used in children.
The
surgery is usually done through the incision
inside the nostrils.
Indications
Nose
surgery is considered "elective" when
it is done for purely cosmetic purposes. In
these cases, the purpose is to change the shape
of the nose to one that the patient finds more
desirable. Age may be a consideration. Many
surgeons prefer not to perform cosmetic nose
surgery until the growth of the nasal bone is
completed (around 14 or 15 for girls, a bit
later for boys).
In
other cases, nose surgery may be needed for
medical purposes. For example, surgery may be
needed to treat a serious breathing problem
or an injury. Age may be less of a factor.
Risks
The
risks for any anesthesia are:
- Reactions
to medications
- Problems
breathing
The
risks for any surgery are:
- Bleeding
- Infection
- Bruising
After
surgery, small burst blood vessels may occasionally
appear as tiny red spots on the skin's surface
and are usually minor, but permanent. There
is no visible scarring if the rhinoplasty is
performed from inside the nose. There may be
small scars at the base of the nose that are
not usually visible when the procedure calls
for the narrowing of flared nostrils.
Rarely,
a second procedure may be necessary to correct
a minor deformity.
Expectations
after surgery
A
splint (metal or plastic) will be applied externally
to maintain the newly shaped bony structure
when the surgery is complete. Soft plastic splints
or nasal packs may also be placed within the
nostrils to stabilize the septum (the dividing
wall between the air passages).
Immediately
following surgery, the nose and face will be
swollen and painful. Headaches are common. Pain
medications will control these discomforts.
Swelling
and bruising around the eyes will increase and
reach a peak after 2 or 3 days. Keeping the
head raised (elevated) and placing cold compresses
to the eyes can help reduce the swelling. Within
2 weeks, most of the swelling and bruising disappears.
Some subtle swelling remains for several months,
but this is generally unnoticeable to anyone
but the patient.
During
the first few days, minor bleeding from the
nose is common. Do not blow the nose, pick the
nose, or insert items into the nose for the
first week while tissues heal.
The
nasal packing is usually removed after 3 to
5 days and the patient will feel much more comfortable.
All dressings, splints, and stitches should
be removed within 1 or 2 weeks.
Convalescence
Within
2 days, most patients are up and about, and
able to return to school or non-strenuous work
within about a week following surgery. Full
recovery takes several weeks.
Avoid
strenuous activity (jogging, swimming, bending
-- any activity that increases blood pressure)
for 2 to 3 weeks. Avoid rubbing or bumping the
nose. Avoid unprotected sun exposure, especially
for the first 8 weeks. Be gentle when washing
the face and hair or using cosmetics.
Glasses
will have to be taped to the forehead or propped
on the cheeks for 4 to 6 weeks after the splint
is removed and the nose is completely healed.
The
patient may feel depressed following surgery,
but day by day the nose will look better. Within
a week or two, cosmetics will camouflage signs
of the operation. Healing is a slow and gradual
process. The tip of the nose may have subtle
swelling and numbness for months. The final
results may not be apparent for up to a year.
The
patient might experience some unexpected reactions
from family and friends. They may act resentful,
especially if something they view as a family
or ethnic trait is altered. The patient should
keep in mind the reasons for the nasal correction,
and if these have been reached, then the surgery
is a success.
Introduction
Rhinoplasty, or surgery to reshape the nose,
is one of the most common of all plastic surgery
procedures. Rhinoplasty can reduce or increase
the size of your nose, change the shape of the
tip or the bridge, narrow the span of the nostrils,
or change the angle between your nose and your
upper lip. It is a reshaping of the cartilage,
bone and sometimes the soft tissues of the nose.
What does the rhinoplasty surgery involve?
The skin of the nose is separated from the supporting
bone and cartilage which is sculpted to the
desired shape using the technique your surgeon
has decided on. The bone and cartilage of the
nose are altered to the desired shape and the
skin repositioned over them giving a most pleasing
result. As most surgery is carried out internally
there are rarely any visible scars following
a nose reshaping procedure.
How long does the rhinoplasty surgery take?
The procedure will require an overnight stay
in hospital, although occasionally, where minor
corrections to the nose tip alone are required,
it may be possible to return home the same day.
Rhinoplasty usually takes an hour or two.
What will happen in the recovery period?
For the first 24 hours after surgery your face
will feel puffy and your nose may ache however
prescribed pain medication will control this.
You will have bruising and swelling around the
eyes, which lasts for 2 -3 weeks.
A little bleeding is common in the early days
after surgery and you may be asked not to blow
your nose for a week or so to allow the tissues
to heal. By the end of one week, all dressings,
splints, and stitches should be removed. For
2 -3 weeks you'll be asked to avoid strenuous
activity with no contact sport for 6 weeks.
You will have frequent follow-up visits in the
months after surgery to check on your progress.
What is the recovery time?
Each patient is individual so no definite timescale
for recovery can be given. However most rhinoplasty
patients are up and about within a couple of
days after surgery, and are able to return to
work after just a week. Your surgeon may recommend
that you take 10-14 days off from work.
What can I expect from the rhinoplasty surgery?
Your expectations need to be realistic. Day
by day, your nose will begin to look better
and you can expect a nose that looks natural
and blends harmoniously with your other facial
features. The vast majority of patients undergoing
rhinoplasty gain a feeling of increased self-confidence
with improvement in their body image.
Need more information about rhinoplasty surgery?
If you would like more information about rhinoplasty
surgery offered by our NHS Consultant, or whether
rhinoplasty surgery is right for you, please
contact
us today.
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