What is a rhinoplasty?
One of the most common plastic surgery procedures, rhinoplasty is performed to reshape, reduce or augment a person’s nose, remove a hump, narrow nostril width, change the angle between the nose and the mouth, or to correct injury, birth defects, or other problems that affect breathing. Results depend on the patient’s nasal bone and cartilage structure, facial shape, skin thickness and age (teenagers should have had their growth spurt). Insurance may cover rhinoplasty if it is done for reconstructive or medical reasons, but likely not for cosmetic purposes.
Rhinoplasty is usually an outpatient procedure performed under either local or general anesthesia and lasts one to two hours unless more extensive work needs to be done.
Dr. Orseck may use one of two techniques: the incision is either made within the nostrils, thus hiding scars after surgery, or across the columella (the vertical strip of tissue separating the nostrils) in an “open” procedure, where scars are small and hidden on the underside of the base. In both procedures the skin is lifted, the bone and cartilage sculpted, and the skin replaced and stitched closed.
What can a rhinoplasty achieve?
Rhinoplasty has several specific goals. Some facilitate breathing as well as improve facial appearance. During a rhinoplasty, the surgeon may make your appearance more pleasing to you by:
- Removing a hump on your nose
- Modifying the bridge of your nose
- Reshaping the tip of your nose
- Reshaping or resizing your nostrils
- Repairing your nose after an injury
- Increasing or decreasing the size of your nose
Ideal Rhinoplasty Candidates
In order to be a candidate for a rhinoplasty procedure you must meet the following criteria:
- Be at least 13 years old so that facial growth is complete
- Be in overall good health
- Not be a smoker
- Have realistic expectations about the outcome of the surgery
Rhinoplasty is usually an outpatient procedure performed under IV sedation or general anesthesia. It usually takes from 1 to 2 hours to complete. Surgeons use one of two techniques when performing nose surgery. In a closed rhinoplasty, incisions are made within the nostrils. In an open rhinoplasty, the incision is made across the columella, the tissue between the nostrils.
With both methods, the surgeon gently lifts the soft tissues covering the nose. The surgeon sculpts the bone and cartilage to the desired shape. Any additional cartilage needed to augment the nose can often be taken from the septum. If the patient has a deviated septum, the surgeon will adjust the septum and the inner structures of the nose to improve breathing. Then the tissues are re-draped and stitched closed. If the patient desires nostril reshaping, this is done as the final stage of rhinoplasty.
Recovery After Rhinoplasty
Immediately after surgery, your nose and eyes are usually bruised and swollen. Splints and some packing material will remain inside your nose for a few days. During this period, you may experience some nasal pain or a dull headache, as well as some bleeding and drainage from your nose. Most patients are comfortable enough to return to regular activities in about a week. Contact lenses can be worn immediately after the procedure, but glasses may need to be taped to your forehead or propped on your cheeks for up to seven weeks.
Restrictions Following Rhinoplasty
While you will be able to resume normal activities about a week after surgery, you will have to protect your nose while it heals by observing the following directives during the post-operative period:
- Avoid strenuous activities
- Take baths instead of showers
- Avoid blowing your nose
- Avoid constipation
- Avoid making exaggerated facial expressions
- Brush your teeth gently
- Avoid pulling clothing over your head
- Use sunscreen of SPF 30 or higher
- Limit dietary sodium
- Do not use ice packs
Potential Risks and Complications of a Rhinoplasty
Complications arising from a rhinoplasty are rare and, when they do occur, usually minor. These may include infection, nosebleed, or a reaction to the anesthesia. Some few patients may experience recurring nosebleed or numbness in or around the nose. On rare occasions, the nasal septum may be perforated, but this can be repaired. In general, a rhinoplasty is considered a very safe surgical procedure.
What is revision rhinoplasty?
Revision, or secondary, rhinoplasty corrects deformities caused by a previous operation on the nose. It is a more difficult procedure to perform than primary rhinoplasty because there is less cartilage to work with and there may be scarring or tissue contracture. When performed by a highly skilled plastic surgeon, however, a revision rhinoplasty can improve both the appearance and the function of the nose.