The most suitable candidates for rhinoplasty
Rhinoplasty improves your appearance, increases your self confidence; however, the outcome may not exactly correspond to your ideal. Consider your expectations very thoroughly before you decide on the operation and discuss with your surgeon
The most suitable candidates for rhinoplasty are those with obvious nose deformity who would like to have it corrected. If you are physically healthy and have realistic expectations, you may be a good candidate.
Rhinoplasty may be performed in order to achieve an aesthetic ideal or for reconstructive purposes, such as birth anomalies or correction of respiratory problems.
Age is a significant factor. Many surgeons prefer not to perform the operation on young people who have not fully completed their growth- this is around 15-17 years of age in girls and a little later in boys (17-19). It is important to consider the social and emotional adjustment of the young person and be sure that the operation is his/her own will and not that of his/her parents.
Provided that it is performed by a credentialed surgeon, rhinoplasty complications are rare and small-scale. Even so, there is always the probability of complication and these may include nose bleed, reaction to anaesthesia, and, in very rare cases, infection. You may reduce your risk by closely following your surgeon's instructions both prior to and after the operation.
When rhinoplasty is performed from inside the nose, there will be no visible scars; when "open" technique is used or large nostrils are narrowed down, there will be small, undetectable scars on the base of the nose which will generally be invisible.
Approximately one out of 15 patients may require a secondary/revision procedure- for instance; this may be corrective surgery on a small deformity. Such cases cannot be foreseen and may be required even for the patients of very experienced surgeons. Corrective surgery is usually a very minor surgery. Top
All operations involve risk
Provided that it is performed by a credentialed surgeon, rhinoplasty complications are rare and small-scale. Even so, there is always the probability of complication and these may include nose bleed, reaction to anaesthesia, and, in very rare cases, infection. You may reduce your risk by closely following your surgeon's instructions both prior to and after the operation.
When rhinoplasty is performed from inside the nose, there will be no visible scars; when "open" technique is used or large nostrils are narrowed down, there will be small, undetectable scars on the base of the nose which will generally be invisible.
Approximately one out of 15 patients may require a secondary/revision procedure- for instance; this may be corrective surgery on a small deformity. Such cases cannot be foreseen and may be required even for the patients of very experienced surgeons. Corrective surgery is usually a very minor surgery. Top
Planning the operation
Communication between you and your physician is essential. During your first visit, your physician will enquire about how you would like your nose to look, examine the structure of your nose and face and discuss with you the possibilities. Furthermore, your surgeon will be explaining you the factors which will have an impact on the operation and the outcome. These factors are the bone and cartilage structure of your nose, the shape of your face, the thickness of your skin, your age and your expectations.
At the same time, your surgeon will also be explaining you the technique and the kind of anaesthesia he will be using, the hospital where he will be performing the operation, the risks and the cost of the operation, and your options. Most insurance policies do not cover surgery performed for cosmetic purposes; however, if the operation is for reconstructive purposes aiming to correct respiratory problems or an obvious deformity which emerged following an injury, the procedure may be covered by the policy. Consult your insurance representative and obtain a pre-approval prior to the operation.
Your physician should be informed of any prior nose surgery or nose injury even if these have taken place years ago. If you are allergic or have respiratory problems, if you are on any kind of medication or drugs, or if you are a smoker, make sure your physician is fully informed of these.
Do not hesitate to consult your doctor about any questions you may have, particularly with regard to your expectations and your concerns about the outcome of the surgery. Top
Preparing for the operation
Your surgeon will be giving you special instructions about how to prepare for the operation, eating and drinking rules, smoking and about starting or interrupting the intake of certain vitamins and medications, and washing your face. Taking care to fulfil those instructions will allow for uneventful surgery.
When preparing for the operation, make sure you put someone in charge of taking you home after the procedure and helping you with going out for one or two days. Top
Where will the Surgery Take Place?
Rhinoplasty procedure is performed in a hospital setting; it may be on a one-day surgery basis or may require one night of hospitalisation.Top
Kinds of Anaesthesia
Depending on the size of the procedure, you and your physician's preference, rhinoplasty may be performed under local or general anaesthesia. Top
Under local anaesthesia, you will be under light sedation (drowsy) and your nose and the area around your nose will be sedated(anesthesized); throughout the surgery, you will be awake but relaxed and insensitive to pain. Under general anaesthesia, you will be asleep throughout the surgery.
The Operation
Even though complicated procedures tend to last longer, rhinoplasty is generally performed within one and a half to two hours. During the operation, the bone and the cartilage supporting the skin of the nose are separated from the vault of the nose and this supportive structure is remodelled as desired. The structure of the new shape depends on the kind of problem you have been suffering from or the technique that your surgeon prefers. The final phase of the operation consists of spreading the skin upon the new vault of the nose.
Most surgeons perform rhinoplasty from within the nose by making an incision through the nostrils. Others prefer "open" surgery, particularly in more complicated cases; they make a small incision along the "columella", the vertical tissue line separating the nostrils.
When the operation is complete, some cast (a nasal cast will be put on your nose to preserve) will be added in order for your nose to preserve its new shape. Nasal packings, or, if needed, soft plastic layers(silicone sheets) are inserted up your nose to stabilise the septum which functions as a wall separating the air channels.
The surgery is performed from inside the nose or through the incisions made on the columella.
Following this, nasal bones are pulled together in order to narrow down the dorsal part of the nose. The cartilages on the tip of the nose are shaved off and shaped in order to remodel the tip of the nose.
The remodelling of the septum corrects the profile and the angle between the nose and the upper lip.
If the nostrils are too large, they can be narrowed down by removing triangular pieces from the base of the nostrils. Top
After the operation
Following the operation, particularly throughout the first 24 hours, you will be experiencing facial swelling. You may have light pain in your nose and a blunt headache. The nasal packings will prevent inhalation through your nose; please do not tamper with the nasal packings. Any discomfort you may be experiencing may be brought under control through the pain killers prescribed by your physician. On the first day after the operation, you should be lying in bed with your head in the elevated position (except for when you go the lavatory).
You will notice the swelling and the redness around your eyes increasing and peaking within two-three days. Cold compression will reduce swelling and make you feel better. In any case, you will be feeling a lot better than you look. Most of the swelling and redness will disappear within a period of two weeks (Some hardly-detectable swelling which no one else apart from you and your surgeon can notice will disappear within a few months). Due to oedema, the tip of the nose may initially appear to be more elevated than it actually is, this will pass once the oedema is lost.
You may experience a slightly runny nose during the first couple of days following the operation; this is expected. You will also be suffering from some nasal congestion for several weeks. As the tissues heal, your surgeon will ask you to refrain from blowing your nose for a period of one week.
The nasal packings will be removed within several days (this procedure is not painful) and you will be feeling much more comfortable. The cast will be taken out a week later; however, sometimes a second cast may be required. The sutures inside the nose disappear by themselves. The sutures on the columella (rhinoplasty with the "open" technique) will be removed within 5-7 days.
The shape or the position of the septum may be modified in order to open up the airways. Or the deviated part of the septum may be removed.
The nasal cast is used to preserve the new shape of the nose and to minimise swelling (oedema). Top
Back to Normal
Most rhinoplasty patients are able to stand up 3-5 hours after the operation and they can go back to school or to a desk job within a week. However, it will take a few weeks to fully return to your normal pace.
Your surgeon will make special recommendations to facilitate your return to your normal activities stage by stage. These are: Avoid strenuous activities for two-three weeks (jogging, swimming, kneeling down, sexual activity-any activity that will raise blood pressure). Protect you nose from blows, rubbing and sun burn for a period of eight weeks. Be careful while washing your face or your hair and while applying cosmetic products.
Do not wear eye glasses for a period of four weeks unless you absolutely have to. You may instead use your contact lenses whenever you wish. If you normally wear glasses, wear them the way your doctor recommends until you fully recover (6-7 weeks).
Your surgeon will ask you to make a follow up appointment to monitor your progress during the several months that you are recovering. In case of any unexpected developments in between appointments, or if you have any questions about what to do or not, do not hesitate to call your doctor. Top
Your New Appearance
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