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Rhinoplasty

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Rhinoplasty

Rhinoplasty, commonly known as a “nose job”, is one of the most common types of plastic surgery to change the shape and appearance of the nose, or improve cosmetic issues and deformities resulted from an injury.

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People get rhinoplasty to repair their nose after an injury, to correct breathing problems or a birth defect, or because they are unhappy with the appearance of their nose.

Rhinoplasty can be undertaken to:

  • increase or decrease the size of the nose
  • improve the shape of the nasal tip
  • refine the shape of the bridge of the nose
  • reduce the hump
  • improve a crooked nose
  • increase or decrease the base width of the nose
  • change the size and position of the nostrils
  • correct breathing problems due to irregularities with internal nose structure

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Rhinoplasty Techniques

  1. Open Rhinoplasty
  2. Closed Rhinoplasty

In an open rhinoplasty procedure, a small incision is made in the columella, the soft tissue that separates the nostrils, so that gives the rhinoplasty surgeon access to perform the necessary reshaping. An open rhinoplasty has historically been the rhinoplasty for patients who need extensive work done to their nose. This approach has made it easier for surgeons to tackle more difficult problems than they could in the past during rhinoplasty.

The closed rhinoplasty technique differs from the open procedure in that the incisions are made inside of the nostrils rather than on the exterior of the nose and there is no visible scarring. Under skillful hands, this technique is just as capable of delivering superb results as that of the open procedure, though in some cases, it may not be the ideal treatment option.

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Who Are Ideal Candidates for Rhinoplasty?

You may be a good candidate for rhinoplasty if:

  • you are physically healthy
  • your facial growth is complete
  • you are non-smokers
  • you have a positive outlook and realistic goals in mind

Preparation

In preparing for rhinoplasty, you may be asked to:

  • Get a lab test
  • Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
  • Stop smoking because it slows the healing process after surgery
  • Take certain medications or adjust your current medications
  • Plan for at least two weeks away from your job
  • Shower the morning of your procedure, but do not apply deodorant, creams, lotions, powders or oil to your skin

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Steps of a Rhinoplasty Procedure

Step 1 – Anesthesia

Rhinoplasty requires local anesthesia with sedation or general anesthesia, depending on how complex your surgery is and what your surgeon prefers.

If it is a simple procedure, you will receive local anesthesia to your nose, which will also numb your face.

With general anesthesia, you will inhale a drug or get one through an IV that will make you unconscious.

Step 2 – The incision

Rhinoplasty can be divided into open rhinoplasty, where an incision is made across the columella, and closed rhinoplasty, where incisions are hidden inside the nose. The surgeon will make a choice between the two depending on your anatomy and the result required from the surgery.

Through these incisions, the skin that covers the nasal bones and cartilages is gently raised, giving the rhinoplasty surgeon access to perform the necessary reshaping.

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Step 3 – Reshaping the nose structure and Correcting nose defects

After making incisions, the surgeon separates the skin from the cartilage or bone and then starts the reshaping. An overly large nose may be reduced by removing bone or cartilage. Sometimes surgery of the nose may require the addition of cartilage grafts. If the new nose needs a small amount of additional cartilage, the surgeon may use cartilage taken from the ear or deep inside the nose. If more is needed, the surgeon can use cartilage from the rib, implants or bone from other parts of the body. A bone graft is additional bone that is added to the bone in the nose.

In addition to reshaping, any defect, such as a deviated septum, nasal hump, nasal polyps, etc. can be corrected or removed in this step.

Step 4 – Closing the incision

Once the underlying structure of the nose is sculpted to the desired shape, nasal skin and tissue is redraped and incisions are closed.

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Recovery and What to Expect after Rhinoplasty Surgery

Every individual recovers differently when it comes to the time and healing process. The time can vary from patient to patient depending on the extent of the surgery and other factors. Generally, the average recovery time is about two to three weeks, but the complete process can take up to a year. During your rhinoplasty recovery, a splint and/or packing may be placed inside your nose and a splint or bandages placed on the outside to support and protect the new structures during initial healing. You will feel stuffiness, discomfort, tired and tenderness inside and around your nose as well. Other common symptoms are swelling, pain, and oozing of the nose. Swelling can last days or weeks depending on how your body reacts to the healing process. The doctor will prescribe pain medication to take while you recover at home.

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Post-Operative Instructions

  • Place ice packs or cold compresses across your eyes and over your nose for 15 minutes at a time for up to 3 days that can speed reduction of the swelling.
  • Do not blow or sniff your nose.
  • Avoid laughing, smiling, or other facial expressions that require lots of movement.
  • When resting, try to remain in an elevated position to avoid increasing pressure on the nose.
  • Avoid excessive chewing.
  • Avoid any strenuous activities or playing any contact sports.
  • Try to avoid all smoke because it can delay and cause damage to the healing process.
  • Brush your teeth gently to limit movement of your upper lip.
  • Do not wear eyeglasses directly on the nose for about six weeks.

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Risks

  • Difficulty breathing
  • Nosebleeds
  • Scarring
  • Permanent numbness in and around your nose
  • Pain, discoloration or swelling that may persist
  • Possibility of an uneven-looking nose
  • Asymmetrical nose
  • Septal perforation (a hole in the septum)
  • A need for additional surgery

 

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