nose surgery
Definition:
Rhinoplasty is surgery to repair or reshape the nose.
Alternative Names:
Rhinoplasty
Description:Rhinoplasty is one of the most
common of all plastic surgery procedures. It can be used to:
- Reduce or increase the size of the nose
- Change the shape of the tip or the nasal bridge
- Narrow the opening of the nostrils
- Change the angle between the nose and the upper lip
- Correct a birth defect or injury
- Help relieve some breathing problems
Rhinoplasty can be performed under local or general anesthesia,
depending on the extent of the procedure and the patient's
preference. It may be performed in a surgeon's office-based
facility, a hospital, or an outpatient surgery center. Complex
procedures may require a short inpatient stay. The procedure usually
takes an hour or two, but may take longer.
With local anesthesia, the nose and the surrounding area is numbed.
The patient will usually be lightly sedated, but awake during the
surgery -- relaxed and insensitive to pain. General anesthesia
allows the patient to sleep through the operation, and is typically
used in children.
The surgery is usually done through the incision inside the
nostrils.
Indications:Nose surgery is considered "elective" when it
is done for purely cosmetic purposes. In these cases, the purpose is
to change the shape of the nose to one that the patient finds more
desirable. Age may be a consideration. Many surgeons prefer not to
perform cosmetic nose surgery until the growth of the nasal bone is
completed (around 14 or 15 for girls, a bit later for boys).
In other cases, nose surgery may be needed for medical purposes.
For example, surgery may be needed to treat a serious breathing
problem or an injury. Age may be less of a factor.
Expectations after surgery:
A splint (metal or plastic) will be applied externally to
maintain the newly shaped bony structure when the surgery is
complete. Soft plastic splints or nasal packs may also be placed
within the nostrils to stabilize the septum (the dividing wall
between the air passages).
Immediately following surgery, the nose and face will be swollen and
painful. Headaches are common.
Pain
medications will control these discomforts.
Swelling and bruising around the eyes will increase and reach a
peak after 2 or 3 days. Keeping the head raised (elevated) and
placing cold compresses to the eyes can help reduce the swelling.
Within 2 weeks, most of the swelling and bruising disappears. Some
subtle swelling remains for several months, but this is generally
unnoticeable to anyone but the patient.
During the first few days, minor bleeding from the nose is common.
Do not blow the nose, pick the nose, or insert items into the nose
for the first week while tissues heal.
The nasal packing is usually removed after 3 to 5 days and the
patient will feel much more comfortable. All dressings, splints, and
stitches should be removed within 1 or 2 weeks.
Convalescence:
Within 2 days, most patients are up and about, and able to return to
school or non-strenuous work within about a week following surgery.
Full recovery takes several weeks.
Avoid strenuous activity (jogging, swimming, bending -- any activity
that increases blood pressure) for 2 to 3 weeks. Avoid rubbing or
bumping the nose. Avoid unprotected sun exposure, especially for the
first 8 weeks. Be gentle when washing the face and hair or using
cosmetics.
Glasses will have to be taped to the forehead or propped on the
cheeks for 4 to 6 weeks after the splint is removed and the nose is
completely healed.
The patient may feel depressed following surgery, but day by day the
nose will look better. Within a week or two, cosmetics will
camouflage signs of the operation. Healing is a slow and gradual
process. The tip of the nose may have subtle swelling and numbness
for months. The final results may not be apparent for up to a year.
The patient might experience some unexpected reactions from family
and friends. They may act resentful, especially if something they
view as a family or ethnic trait is altered. The patient should keep
in mind the reasons for the nasal correction, and if these have been
reached, then the surgery is a success.
Risks:
The risks for any anesthesia are:
- reactions to medications
- problems breathing
The risks for any surgery are:
- bleeding
- infection
- bruising
After surgery, small burst blood vessels may occasionally appear as
tiny red spots on the skin's surface and are usually minor, but
permanent. There is no visible scarring if the rhinoplasty is
performed from inside the nose. There may be small scars at the base
of the nose that are not usually visible when the procedure calls
for the narrowing of flared nostrils.
Rarely, a second procedure may be necessary to correct a minor
deformity.
