What is Rhinoplasty?
Rhinoplasty is surgery that changes the shape of the nose. The upper portion of the structure of the nose is bone, and the lower portion is cartilage. Rhinoplasty can modify bone, cartilage, skin or all three. Talk with your surgeon about whether rhinoplasty is appropriate for you and what it can achieve.
The purpose of rhinoplasty may be to change the appearance of the nose, improve breathing or both.
When is Rhinoplasty needed?
Rhinoplasty can be done for medical reasons — such as to correct breathing problems related to the nose or correct disfigurement resulting from trauma or birth defects. It can also be done for cosmetic reasons, which will change the nose’s shape and appearance.
What should you know before undergoing Rhinoplasty?
Not everyone can safely undergo this procedure. You may be a good candidate for rhinoplasty if:
- Your facial growth is complete
- You are physically healthy
- You don’t smoke
- You have a positive outlook and realistic goals in mind for the improvement of your appearance
What are the complications and side effects?
You can expect swelling and some bruising around the eyes after surgery that will begin to improve after the third day. It can, though, last up to two weeks.
Expect your nose to have a little swelling, which probably only you and your surgeon will notice. This will go away over the next six months.
As with any major surgery, rhinoplasty carries risks such as bleeding, infection and an adverse reaction to the anesthesia. Other possible risks specific to rhinoplasty include:
- Recurring nosebleeds
- Difficulty breathing through your nose
- Permanent numbness in and around your nose
- A possibility of an uneven-looking nose
- Pain, discoloration or swelling that may persist
- Hole in the septum (septal perforation)
Talk to your doctor about how these risks apply to you.
It is important you understand the precautions and know the possible complication and side effects before having this Rhinoplasty. If you have any questions, please consult with your doctor or surgeon for more information.
How do I prepare for Rhinoplasty?
Your surgeon may give you instructions to follow before your surgery. You may need to:
- Stop any medicines that thin your blood. Your surgeon will give you a list of these medicines.
- See your regular health care provider to have some routine tests and make sure it is safe for you to have surgery.
- To aid with healing, stop smoking 2 to 3 weeks before and after surgery.
- Arrange to have someone drive you home after surgery.
What happens during Rhinoplasty?
The time a rhinoplasty takes depends on the extent of the changes being made to the nose. Minimal changes will generally take 1 to 1.5 hours. If there are more extensive changes taking place, then the surgery could last up to 3 to 4 hours.
Other contributing factors include:
- The method of rhinoplasty being performed. There are 2 types of procedures when it comes to rhinoplasty. One is open and the other is closed. While both require cutting inside the nose, open surgery requires an extra cut on the outside where the nostrils join together.
- The amount of grafting that needs to be done. If you are lengthening your nose or making it wider, you will probably need to have cartilage grafted in. The cartilage is taken from the nose, ears, or in some cases, a rib. This will add to the amount of time that the surgery will take.
- Procedures to address issues with breathing. If you have breathing issues that need to be addressed, the surgery can take longer than rhinoplasties dealing strictly with aesthetics. There are 4 types of rhinoplasty that can help correct breathing difficulties: nasal septoplasty straightens a deviated septum; turbinate reduction reduces the mucous membrane-covered “shelves” of bone that are usually a source of allergy irritation; polyp removal; and nasal valve collapse.
The amount of time that the procedure takes also depends on the surgeon who is performing the procedure and how he or she operates, how efficient or what type of rhythm he or she has, whether he or she has a good team of nurses, anesthesiologist, etc.
Nearly everyone who has rhinoplasty is able to safely leave the hospital after surgery. In very rare cases, you may stay in the hospital for one night if you are having a hard time with nausea or have other health problems that need to be monitored.
Plan to take a week off from work, school or other obligations. You will feel progressively better each day during the first week. By the one week appointment, people usually feel like they are themselves again.
After surgery, there will be some swelling. The swelling can take many months to resolve although most people stop noticing it after a couple of months. People are typically back to performing most activities after a week and resuming all activities after two to four weeks.
Rhinoplasty can be performed under local or general anesthesia, depending on the exact procedure and the person’s preference. It is performed in a surgeon’s office, a hospital, or an outpatient surgery center. Complex procedures may require a short hospital stay.
With local anesthesia, the nose and the area around it are numbed. You will probably be lightly sedated, but awake during the surgery (relaxed and not feeling pain). General anesthesia allows you to sleep through the operation.
The surgery is usually done through a cut (incision) made inside the nostrils. In some cases, the cut is made from outside, around the base of the nose. This type of cut is used to perform work on the tip of the nose or if you need a cartilage graft. If the nose needs to be narrowed, the incision may extend around the nostrils. Small incisions may be made on the side of the nose to break, and reshape the bone.
A splint (metal or plastic) may be placed on the outside of the nose. This helps maintain the new shape of the bone when the surgery is finished. Soft plastic splints or nasal packs also may be placed in the nostrils. This helps keep the dividing wall between the air passages (septum) stable.
What happens after Rhinoplasty?
After the surgery, you need to rest in bed with your head raised higher than your chest, to reduce bleeding and swelling. Your nose may be congested because of swelling or from the splints placed inside your nose during surgery.
In most cases, the internal dressings remain in place for one to seven days after surgery. Your doctor also tapes a splint to your nose for protection and support. It’s usually in place for about one week.
Slight bleeding and drainage of mucus and old blood are common for a few days after the surgery or after removing the dressing. Your doctor may place a “drip pad” — a small piece of gauze held in place with tape — under your nose to absorb drainage. Change the gauze as directed by your doctor. Don’t place the drip pad tight against your nose.
If you have any questions or concerns, please consult with your doctor or surgeon for more information.
What should you do after Rhinoplasty?
To further decrease the chances of bleeding and swelling, your doctor may ask that you follow these precautions for several weeks after surgery:
- Avoid strenuous activities such as aerobics and jogging.
- Take baths instead of showers while you have bandages on your nose.
- Don’t blow your nose.
- Eat high-fiber foods, such as fruits and vegetables, to avoid constipation. Constipation can cause you to strain, putting pressure on the surgery site.
- Avoid extreme facial expressions, such as smiling or laughing.
- Brush your teeth gently to limit movement of your upper lip.
- Wear clothes that fasten in the front; don’t pull clothing, such as shirts or sweaters, over your head.
In addition, don’t rest eyeglasses or sunglasses on your nose for at least four weeks after the surgery, to prevent pressure on your nose. You can use cheek rests, or tape the glasses to your forehead until your nose has healed.
Use SPF 30 sunscreen when you’re outside, especially on your nose. Too much sun may cause permanent irregular discoloration in the skin of your nose.
Some temporary swelling or black-and-blue discoloration of your eyelids can occur for two to three weeks after nasal surgery. Swelling of the nose takes longer to resolve. Limiting your dietary sodium will help the swelling go away faster. Don’t put anything such as ice or cold packs on your nose after surgery.
Your nose changes throughout your life whether you have surgery or not. For this reason, it’s difficult to say when you have obtained your “final result.” However, most of the swelling is gone at a year.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Review Date: September 26, 2018 | Last Modified: September 13, 2019
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