Rhinoplasty is an operation designed to improve and refine the shape of the nose. It may also address and correct post-traumatic deformities and breathing abnormalities. Plastic surgeons usually recommend that patients wait until they are at least 14 or 15, and possibly older for boys, before undergoing rhinoplasty. This is because the nose may not be fully developed at a younger age.
During the initial consultation, you may be asked to look in a mirror and point out exactly what you would like to see improved. It is important for both you and your surgeon to understand your expectations and determine whether they can be achieved.
It is not a good idea to have a rhinoplasty if you do not know what it is about your nose that bothers you. It is also important to have the rhinoplasty because your nose bothers you and not because it was suggested by another person in your life, such as your spouse.
You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions you may have, medical treatments you have received, previous surgeries including repair of nasal injuries, and medications that you currently take. Your plastic surgeon may also ask whether you have difficulty breathing through your nose, suffer from allergies that may cause nasal stuffiness, or are a chronic user of nasal spray. You will be asked whether you use or have used recreational drugs, as this has implications for the surgery. It is important for you to provide complete information.
In evaluating you for rhinoplasty, a routine and painless examination of your internal nasal structures will be performed. Your skin quality as well as the size and shape of your nose and its relationship to your other facial features will be carefully studied.
In most cases, medical aid will not assist with the costs of having a rhinoplasty as it is a cosmetic procedure.
There are generally two approaches to a rhinoplasty. The first approach is called a “closed rhinoplasty” where the incisions are all made inside the nostrils. The second approach is called an “open rhinoplasty” where there are incisions made inside the nostril as well as across the tissue separating the nostrils which is called the columella. There are different indications to these approaches and the choice between them depends on your nose and the goals set out for the procedure. Through these approaches various reshaping procedures can be performed including:
Decreasing a dorsal hump Refining the nasal tip Elevating a drooping nasal tip Refining the lateral nostril walls (nasal alae) Refining the columella Refining the bony upper part of the nose You may not need all the above procedures and it is important to understand what the exact operative plan is tailored specifically to your nose.
After the procedure, you will have a nasal splint in place which covers your nose. In some cases, there will be a need to insert nasal plugs in the nostrils but these will be removed 24 hours after the surgery. The first couple of days after surgery, you should restrict your activities and sleep with your head elevated. This will help minimize swelling and reduce the possibility of minor bleeding, which is not uncommon. Remember, you must not take aspirin, certain anti-inflammatory medications or herbal supplements prior to your surgery. Generally, bruising around the eyes and cheeks is most apparent during the first three days following surgery. Most discoloration will disappear within a week. A few days after surgery, you can begin to use makeup as a concealer, if desired. Noticeable swelling may last for several weeks. Minor residual swelling, most frequently affecting the nasal tip, may continue for many months, but generally this should not be apparent to others. If packing was used, it will either dissolve by itself or be removed three to seven days after surgery. Stitches may also be removed at that time. You may need to continue wearing the nasal splint for up to a week, during which time you should avoid getting it wet.
Straining, bending and lifting should be avoided during the early postoperative period. In many instances, you may be able to return to work within ten days after surgery. Most normal activities including exercise can usually be resumed within four to six weeks.It will be a few months before you can expose your reshaped nose to direct sunlight during which time you should use sun-blocks. Your nose will be sensitive during this time, and you must be conscientious about using a sunblock to protect your skin. If the bones of your nose were altered, it may be a number of weeks before you can wear glasses without special support such as tape. The goal of rhinoplasty is a nose that looks natural and blends harmoniously with your other facial features.Since the healing process is gradual, you should expect to wait one to three years to see the final results of your rhinoplasty. You are likely, however, to begin enjoying your new look within weeks of your surgery. Occasionally, a touchup may be desired to further improve the results. If this is the case, the additional procedure is usually less extensive than the original operation.
Some of the common indications/ reasons why people request a rhinoplasty include:
Your nose appears too large for your face
There is a bump on the nasal bridge when viewed in profile
Your nose seems too wide when viewed from the front
The nasal tip droops or plunges
The tip is thickened or enlarged
Your nostrils are excessively flared
Your nose is off-center or crooked
Previous injury has made your nose asymmetrical. It is important that you have a clear idea of how you would like your nose to look and, at the same time, realize that there are limitations to the procedure. A rhinoplasty can usually enhance self-image and people who undergo the procedure for that reason are usually happy with the outcome.
It is also important to understand that the shape of your nose can be changed to a degree, but the extent to which that can be done is dependent on the initial shape of the nose. Mostly problematic areas can be improved rather than give you a totally different nose.
Disadvantges / Complicatiions
Complications are usually rare but some that may occur include:
Bruising and long-term swelling
Patient dissatisfaction / unsatisfactory results
Numbness of the nose
Overcorrection of the problematic area such as the dorsal hump
Damage to deeper structures such as nerves and tear ducts These complications may require further surgery