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Rhinoplasty is the operation to correct a deformity of the nose. The primary purpose is to improve the appearance of the nose and in some cases to improve nasal breathing. The procedure is performed by removing excess cartilage and /or bone and reshaping the nose. After alteration of these structures the skin is allowed to re-drape over the newly shaped framework. This will give the nose its new appearance. These changes will be subtle or dramatic depending on the needs of the patient. The goal of a rhinoplasty is a nose that appears natural, functions properly and is in balance with the rest of the face. The patient's wishes with regard to the type of nose desired are always considered. There are however limiting factors. The texture and thickness of the skin, previous injury, individual differences in healing and differences in facial proportions play an important role in what can be achieved.
Surgery Depending on the individual patient additional procedures may be combined with rhinoplasty. Since your entire face will be assessed at the time of your consultation we can discuss these options. The most commonly performed additional procedures are septoplasty, chin augmentation to correct a weak or receding chin or cheek implants to enhance the appearance of the cheek bones. Occasionally, the nostrils may also be wide and require a reduction to bring the entire nose into the best balance possible. Anesthesia In most instances surgery is performed under general anesthesia. You will recover easily usually with no side effects. In certain circumstances the surgery may be performed under local anesthesia. The anesthesiologist's services are billed separately. Duration of Operation The procedure will last from 30 minutes to 2 hours depending on what areas and are treated. Hospitalization Vs Office Surgery Nasal surgery is usually performed on an out patient basis. You come to the surgical facility on the day of the procedure and return home several hours after the procedure. In certain cases, hospitalization may be necessary. Before Surgery It is imperative that aspirin or products containing aspirin not be taken at least 3 weeks prior to surgery. Also refrain from any herbal supplements, as some may have an effect on increasing bleeding during the course of surgery. Remove all makeup and mascara from your eyelids. If you wear contacts lenses, it would be preferable that you wear glasses when you arrive to the surgery center. You should shower well on the day of surgery prior to coming to the surgery center. It is okay to brush your teeth the morning of surgery.
After Surgery There is little discomfort associated with a rhinoplasty. Most of the discomfort is due to not being able to breathe through your nose. Oral pain medication is all that is necessary to control the discomfort. The nose is usually packed with a minor sponge-like gauge for about 3 days. If septal surgery is also performed, then the packing will stay in for about 5-7 days. Internal incisions are closed with stitches that dissolve; the external incision may have stitches that need to be removed in 5 to 7 days. Some swelling and bruising of the nose and around the eyes is expected after rhinoplasty. This peaks at 48 to 72 hours after surgery and then starts to subside. Crushed ice applied to the eyes will help during this time. The external splint will be removed in approximately one week. Some swelling will still be present at this time. Most of the visible swelling will disappear by 2 weeks. There will still be a feeling of numbness and stiffness at the tip of the nose, which means that some swelling is still present. It will take several months before the last bit of swelling has resolved. Patients may go back to school or light work one week after surgery. You should avoid strenuous activity for 2 weeks. After 2 weeks you may gradually increase your activity so that you are back to your usual routine by 3 weeks. You should avoid sun exposure (use sun block), avoid getting your nose hit, and avoid letting glasses rest on your nose for 8 weeks. Photographs Photographs are taken at the time of your consultation. These are important aids in the preparation of surgery and become a permanent part of your record. Post-surgical photographs are also taken. Scars Incisions may be located inside the nose, however, occasionally a small incision is necessary on the column of skin between the nostrils on the under surface of the nose. This incision usually heals very well. In some cases the nostrils may be too wide and is narrowed by making incisions in the crease between the nostril and the cheek. The scars are rarely problematic. Nevertheless, you should be aware that all scars are permanent and their height, width and final color are unpredictable.
Complications Some swelling and bruising of the nose and around the eyes is expected after a rhinoplasty. This peaks at 48 to 72 hours after surgery and then starts to subside. Complete resolution of swelling may take several months. Bleeding This is unusual but may occur after rhinoplasty. This may have to be treated with additional nasal packing; however, in some cases additional surgery may be necessary. Asymmetry Occasionally, a minor deformity may persist following surgery. Usually this problem is correctable with another smaller procedure, which requires at least a local anesthetic.
Dr. Morales Recommends Theraderm Skin Products for his patients before and after surgery.
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