Rhinoplasty ( Nose Surgery )
Plastic surgery of the nose is an exciting and challenging branch of surgery for the patient as well as the doctor. Rhinoplasty is clearly the most elegant and sophisticated of all facial plastic surgical procedures. With modern surgical refinements, uniformly better results are obtained than were possible in past decades. It is obvious that the best results in rhinoplasty are the nose simply appear naturel and in harmony with the other facial features.
Rhinoplasty surgery is a highly delicate and technical form of plastic surgery and enjoys a very high rate of success and patient satisfaction. Although usually performed on the younger age groups, excellent results may be obtained on patients in their fifties and sixties.
Rhinoplasty surgery is performed from inside the nose by using special delicate instruments. The bone, cartilage, and soft tissues of the nose are reduced in size, rearranged, or sculptured to obtain a desirable natural appearing result. No external scars are left, unless excessively large nostrils require reduction in size. If any external incisions are necessary, we will discuss them with you and camouflage them through tiny incisions in natural skin creases.
The resulting improvement in appearance may be psychologically beneficial, almost always bringing increased self-satisfaction and self-confidence. Patients, however, should not always expect universal approval from all of their family members, friends, and acquaintances following surgery since they may not be aware of your reason and motivation for a change in your appearance. It is more important that patient and surgeon be pleased with the eventual surgical outcome. Ethically no surgeon can guarantee the results of any cosmetic surgery he can only promise to do everything possible to do his best to correct the patient's problem.
Plastic surgical correction of the nasal deformities should never be performed without contemplating and analyzing the surrounding facial features. In our discussions we will explain to you how we can best accomplish the changes you desire, always keeping in mind the need to keep the nose in harmony with your particular individual facial features. At times, as your surgical advisor, we may recommend other subtle changes in your face (chin contour, lip shape, etc), to help you look your very best following surgery.
All surgical procedures carry some degree of risk. Fortunately, tile risk factors in rhinoplasty surgery are quite small. The vast majority of patients undergo surgery and postoperative healing with no significant complications of any kind. Rarely and infrequently, complications such as some degree of postoperative bleeding, delayed healing, and small irregularities and slight asymmetries of the nose can occur, since not all of these factors are under the control of the surgeon.
In some patients with badly deformed noses (severely twisted, badly fractured, etc.) it is not always possible to correct all nasal deformities in one single operation; occasionally a second "touch-up" minor procedure might be required several months following the initial major operation to improve the result and/or correct inappropriate healing. Generally, small "touch-up" procedures do not require hospitalization and under most circumstances will be performed as an outpatient procedure.
SURGERY
Plans will be made for your admission to the hospital the morning of your surgery for a general physical examination by the anesthesiologist, appropriate blood tests, and occasionally nasal and sinus x-ray films. These are certainly important and necessary preoperative studies to ensure your well being during surgery.The operation is usually performed under general anesthesia. Almost all patients are discharged a few hours following surgery feeling quite comfortable and generally free of pain.
Aesthetic rhinoplasty typically is performed to reduce the overall size of the nose, reshape a tip, remove a nasal hump or improve a poor angle between the nose and the upper lip. In sone patients it is necessary to add tissue in order to improve contour. One or all of these changes can be made during a single operation.
You will find your operation essentially a comfortable experience, generally with little or no discomfort. Anesthesiologists will administer intravenous sedatives and tranquilizers before the operation to keep you very comfortable. Happily, little if any pain occurs after rhinoplasty. Pain medication, however, is always available should you find it necessary.
The small bandage protecting the outside of the nose remains in place for 5 to 7 days. We generally don’t place intranasal packs or splints. If they are placed all internal nasal dressings placed at surgery are ordinarily removed the morning after surgery. We will provide you with a detailed list of "do's and don'ts" to optimize your postoperative course. The patients are advised not to take aspirin—it may precipitate bleeding—and take care to not hit your nose in any way and to keep the nasal splint bandage dry.
At approximately 1 week from the date of surgery, nasal splint is removed. Generally patients are able to return to normal activities such as work or school at this time. Strenuous sports, exercises, swimming, or other physical activities should be curtailed for approximately 3 to 6 additional weeks.
Although the new shape of nose is apparent rather quickly after removal of the splint, it takes several weeks for the majority of the swelling to disappear and shrinkage of the new nasal configuration to occur. This is a gradual process that cannot be hurried. Small, subtle, and generally favorable changes take place over a period of several months.
The degree of improvement depends on the extend of the corrective work undertaken and basic struture of your nose and skin. An obviously disfigured nose will show dramatic results. On the other hand, a slight bump and a tip that is a bit too large may be succesfully corrected, yet the results may be subtle. It is common after some types of rhinoplasty for relatives or friends to remark that they do not see a major difference. Do not consider such a reaction an indication of failure. On the contrary, if it looks better and natural, it may go unnoticed. The intention, after all, is not to create a "new" nose that draws attention to itself, but rather one that blends subtly into the overall features of the face in the proper proportions.