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Each year the
number of individuals who undergo cosmetic surgery of the face
increases at an incredible rate. The cosmetic procedure of
recontouring the nose is one of the most popular operations
performed by facial plastic surgeons today. The social and economic
influences which place emphasis on "appearances" are quite evident
at both ends of the age spectrum. Younger people seek peer
acceptances; older people face their own challenge in maintaining
positive attitudes for an extended period of time.
Rhinoplasty
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Rhinoplasty
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Rhinoplasty
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Rhinoplasty Post-Op
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After
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After
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Cosmetic surgery can truly satisfy many needs and often will
provide that extra measure of inner confidence, which might
otherwise be difficult to achieve. It requires no apologies, and is
understandably well accepted in all circles. It is, however, not the
answer to all of life’s problems. The purpose is to improve one’s
appearance as much as possible. It can do no more, and if one
expects a transforming miracle, they will be undoubtedly
disappointed.
Most patients understand these limitations and view the
potential benefit realistically, and if generally healthy,
emotionally stable, and properly motivated, are good candidates for
facial cosmetic surgery. Under these circumstances, the true
objectives can be accomplished and yield final results that are
predictably accurate.
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After (Rhinoplasty & Chin Implant) |
The decision to undergo any surgical procedure is one that
must be made by the patient alone, and should not be undertaken at
the suggestion or at the encouragement of others. Well-meaning
friends or relatives sometimes misinterpret the patient’s desire for
assistance, and express negative attitudes without basis. However,
if those persons understand that improved self-confidence is the
essential need, and if their interest is truly in the patient’s
behalf, they will usually be supportive.
While the patient’s specific desires will be given important
consideration, the method of achievement requires professional
judgment in evaluating functional and aesthetic goals within the
anatomical limitations. Certainly, the patient’s desires regarding
what kind of improvement he would like will be taken into
consideration. The basic aim is to improve the nose such that it
will not, itself, be the center of one’s attention on the face, but
rather will blend harmoniously with the overall appearance, and will
not look "surgically created or plastic".
The purpose of this web page is to inform you of the
fundamental concepts and bring to your mind questions, which I will
be happy to answer. Also, it will permit careful review of this
information at home, apart from the office atmosphere, where anxiety
or embarrassment may be overriding and perhaps distracting. It may
also be useful as a reference in discussion with family members who
cannot be present at the time of consultation. It should be
understood that its sole purpose is information.
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GENERAL INFORMATION
This operation is designed to improve the general cosmetic
appearance by reducing, recontouring, and reshaping the external
nose. It is occasionally done in conjunction with a procedure on the
nasal septum, the dividing wall between the two sides of the nose,
for changing its size, configuration, or alignment from the septum
to use as a graft in the external nose.
There are many irregularities in a normal nose beneath the
skin. Some irregularities may persist even after a surgical
procedure. It is unnatural for a nose to be exactly perfect. The
nostrils are never exactly the same shape. These facts may become
more apparent after surgery as the patient is more critical of the
appearance of their nose following a rhinoplasty.
Many patients have a fear that the nasal change will be so
great as to create a subject of discussion among his family or
friends. Psychologically, neither the patient nor their friends or
relatives really remember the original shape of their nose a few
weeks following such surgery. The patient should be warned that
there are individuals who will not wish to acknowledge that the
patient’s appearance has improved, and will disappoint the patient
by making an unrestrained comment such as "I liked your nose better
the way it was before", or "I didn’t see anything wrong with your
nose before". Such comments are usually just an expression of that
person’s acceptance of the patient even without the new improvement
in his appearance.
Occasionally, a revision procedure may be done later if
necessary. Nationally, approximately 10 to 15 % of all rhinoplasties
require a revision.
When considering facial harmony, it is often apparent that
one’s chin is disproportionately small or large, and a suggestion
may be made to correct this as to achieve an overall balanced, and
pleasing appearance.
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Pre-Op
You will have an appointment approximately one week prior to
surgery. This will allow you to ask questions before your procedure.
Some pre-op testing may be required (blood work, EKG, etc,)
depending on medical history. All instructions and prescriptions
will be given.
1.
Discontinue aspirin products one week prior to surgery.
2.
Wash hair the night before surgery.
3.
No make-up should be worn.
4.
NOTHING TO EAR OR DRINK PAST MIDNIGHT THE NIGHT PRIOR TO
SURGERY.
5.
Please do not wear jewelry to surgery.
6.
Shorts are a good idea to wear.
7.
Please arrange for transportation after surgery.
8.
FEES FOR THE PROCEDURE ARE TO BE PAID IN FULL PRIOR TO THE
SURGERY.
Procedure
The operation is usually done in our accredited surgical suite
after which the patient returns home. The incisions for reducing or
recontouring the external nose are made inside the nose, or on the
skin at the bottom of the nose, and leave no noticeable scars.
Occasionally, it is necessary to narrow the nostrils leaving tiny
scars at the base of the nostrils. The nasal skin is lifted away
from the cartilage. The bone and the excess tissue are removed. The
cartilage of the tip of the nose may be changed, if necessary.
Frequently the nose is shortened as part of the recontouring. The
nasal bones are usually narrowed. The excess skin left by the
reduction of the underlying bone and cartilage is elastic, and
readapts itself to the new framework.
Anesthesia
Local anesthesia plus IV sedation or general anesthesia just
prior to surgery helps the patient to be completely relaxed. The
operation itself should not be painful.
Surgical Time
Approximately two and a half hours.
Discoloration and
Swelling
The eyelids may be discolored and swollen for a period of 7-14
days, depending upon the patient’s skin, age, healing ability, and
the amount of surgical correction necessary. Occasionally, the
whites of the eyes will be bloodshot, and the upper lip may feel
"stiff" and unnatural for several weeks to months. In addition, if
significant tip or major changes to the nose are made, some swelling
may last up to one year. If an operation is done on the chin, there
may be some numbness there also.
Postoperative Care
The following is a general idea of what to expect in the
postoperative period, and what restrictions may apply. Specific
instructions will be given at the time of pre-op.
Immediately after the surgery, a nasal splint is placed on the
nose, and will remain in position for a couple of days. Following
this, there may be tape on the nose for an additional week or two.
Generally, there will be no packing in the nose unless bleeding is a
problem after surgery. Patients will normally breathe through the
mouth following the surgery, as the nose will be stuffy for up to
two or three weeks.
This will give the feeling of having a minor cold, and may
cause drying of the mucous membranes of the mouth. Aquaphor ointment
will be used two or three times per day after surgery in the nose.
The operative procedure, and the postoperative period are not very
painful, however, a prescription for pain medication will be given.
The patient is requested to only perform very light activity
as needed for two to three weeks to avoid a possible nosebleed, or
accidental trauma to the nose. Although the major effect of the
nasal operation will be noted at two weeks, one can expect some
changes to occur for a period of 6-18 months.
Complications
Like any operation, there can be complications. With
rhinoplasties, these are quite unusual, and usually quite minor.
Such complications may include bleeding from the nose, or unusual
reactions to medications. Bumping the nose following surgery could
affect the final outcome. If any of these problems occur, they can
be appropriately managed. In addition, minor asymmetric "bumps" or
irregularities can become evident. This is usually caused by
protruding cartilage or bone. These may be minor, or necessitate a
revision procedure. Other rare complications include infection,
scarring, or skin necrosis (loss).
Make-up
Make-up may be utilized around the dressing. After dressing
removal make-up can be applied.
Shampoo
You may wash your hair normally after surgery once the splint
is removed, unless informed differently.
Showers and Baths
No restrictions; just keep the nasal splint dry.
Social Activities
Social activities should be limited for approximately ten days
to two weeks following surgery. Strenuous activities such as
gymnastics, body contact sports, and swimming should be avoided for
6 weeks. Glasses should be taped to forehead for eight weeks. Do not
let glasses rest on the nose.
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