Rhinoplasty
What
is rhinoplasty?
Rhinoplasty
is a cosmetic
surgery procedure to change the
shape of the nose. Rhinoplasty can
increase or decrease the size of the
nose, change its profile, or expand
or narrow the nostrils.
Who
is a candidate for rhinoplasty?
Maturity
is the primary concern in determining
whether or not a patient should undergo
rhinoplasty. Patients should be at
least fifteen years old to ensure
that their features are fully developed
and that they are capable of making
the correct decision regarding surgery.
All patients, regardless
of age, should be physically healthy
and emotionally stable. It is also
important for patients to have a clear
image of how they want the nose to
look. Finally, it is important to
have realistic expectations.
For
healthy, informed individuals, rhinoplasty
can effectively alter certain characteristics
of the nose. Some of these include:
- Size
- Width
- Shape (crookedness, asymmetry,
etc.)
- A large bump on the nasal bridge
- A tip that is too large
- A tip that drops downward
- Flared nostrils
How is rhinoplasty
performed?
Preparation
for nose
surgery begins a few weeks prior
to the date. It is usually recommended
that the patient stop smoking
and stop taking certain vitamins and
drugs in advance of nose surgery.
Because they thin the blood, taking
anti-inflammatory drugs is
particularly ill-advised prior to
nose surgery.
Rhinoplasty
is typically done on an outpatient
basis. The nose
surgeon will either use general
anesthesia or local anesthesia in
conjunction with a sedative. In the
former case, the patient will sleep
through the surgery; in the latter,
he or she will remain awake but feel
minimal discomfort.
The
surgeon begins the procedure by making
small incisions inside the
nose. This is done to separate the
skin from the bone and cartilage that
make up the structure of the nose.
Depending upon the needs of the patient,
the incisions may or may not include
a snip in the columella – the
narrow piece of skin between the nostrils.
The nose surgery is termed “open”
if this incision is made and “closed”
if it is not. Once the skin is pulled
away, the surgeon reshapes bone
and cartilage. If tissue needs
to be added to the nose, cartilage
may be moved from other areas of the
nose, or from other areas of body.
After the structure has been reshaped,
the skin is draped back over it and
the incisions are stitched.
A
splint will be applied to
the bridge of the nose to stabilize
it as it heals. The surgeon may also
insert smaller plastic splints into
the nose if the tissue between the
nostrils needs to be stabilized.
What
is recovery like?
In
the days immediately following the
rhinoplasty procedure, the area surrounding
the patient’s nose is swollen
and sore. There are bruises
around the eyes and cheeks for the
first few days, most of which disappear
within a week. Nasal swelling actually
increases for a few days, then abates
over the course of a few weeks. For
a few months, the nose may retain
some slight swelling, but only the
patient will notice.
The stitches and internal
splints are removed within the first
week after surgery. The larger splint
is removed after a week or so.
Certain activities
such as strenuous bending and lifting
must be avoided for about a week.
The nose will also be sensitive to
sunlight for a few months. The patient
may also be advised not to wear glasses
for a few months after surgery in
order to avoid stress on the nose.
Side
effects from rhinoplasty are rare
and usually temporary. These include
small, broken blood vessels on the
surface of the skin, which show up
as small red marks. If the surgery
was open or if the flare of the nostrils
was adjusted, there may be scars around
the nostrils, though they will almost
always be unnoticeable. The patient
may suffer some hematoma, or buildup
of blood, but this can be drained.
Corrective surgery is sometimes necessary.
The patient can also experience infection
or reaction to the anesthesia.
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