Rhinoplasty is cosmetic surgery
of the nose. It is also known as nasal refinement and
the layman's term nose job. With rhinoplasty, 'defects'
from either birth or trauma can be corrected by infracturing
or breaking the bones of the nose and re-setting them
in the desired shape, often narrow and straight.
A hump may be removed to give a more pleasing, symmetrical
look. The cartilages of the nose can be molded and trimmed
to create a more compact or pleasing shape. Rhinoplasty
can soften an otherwise beautiful face by refining one's
features.
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| First, your doctor will discuss
your goals with you and he will explain what can be achieved
realistically. A good doctor will not just slim your nose
or shorten it, rather he will take into account what your
facial features and bone structure would benefit from. Be
it a slimmer more defined or perhaps more turned up. Perhaps
it is only a hump that is desired to be removed, making
it unnecessary to even have a Full Rhinoplasty. There is
no "one size fits all" when it comes to this procedure.
It is all individual. Just like you! |
After your surgery
your surgeon will have placed a pressure dressing over
your eyes and a gauze pad underneath your nose to catch
blood and mucous. You will remove the pressure dressing
after a few hours or as specified by your surgeon. You
may become sick from ingested blood during the procedure
and vomit, expelling a black mixture of stomach acid and
blood. This will pass as soon as the blood is expelled.
It really isn't that much so you shouldn't be sick for
long unless you were under general anesthesia -- you may
become sick from this alone. Your doctor can give you
special medications to remedy or prevent this. If you
continue to vomit and/or run a high fever, contact your
doctor immediately.You nose will be sensitive for approximately
a month and a half although patients report no serious
pain or discomfort. However, patients do report the discomfort
of breathing with the packing and cast on the nose. Some
patients feel claustrophobic feeling as if they cannot
breathe. This feeling widely resembles a head cold or
sinus infection. Only when the cast is removed do you
feel slight discomfort, unless you bump it accidentally.
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The cast is removed approximately
5 days post-operatively. You may feel a slight stiffness
in the upper lift as the swelling moves downward. This will
subside in a matter of hours. you must be very careful not
to bump it as it is vulnerable to breakage. It isn't a bone
china figurine but it isn't as strong as your nose was before
the rhinoplasty either. Don't worry, the bones will completely
mend within 2 months.
If you had a rhinoplasty where the nostrils were narrowed
(in the case of flared nostrils) you will have your sutures
removed. This may sting a bit, especially since it is in
a sensitive area. Although most patients still feel numb
in the tip area and report only minor discomfort. |
The nose will be
very sensitive for approximately a month and a half. The
patient will start to see a difference immediately but
it will still be swollen. The swelling starts to generally
disappear about a week after the cast is removed. Approximately
80% of the swelling and 100% of the discoloration are
usually gone by 2 weeks after surgery. 90% of the swelling
is gone by two months after surgery and the rest slowly
disappears over the next year. Although the nose is still
swollen after the first month, most people would not recognize
this fact. The patient will not notice this swelling.
Instead the patient will notice that the nose becomes
more refined with better definition over the first year.
The inside of the nose may be swollen for approximately
three weeks after the surgery. Nasal breathing may be
difficult during this time. If surgery is performed to
straighten the nasal septum, an improvement in breathing
will be appreciated at about 3 weeks.
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There are many ways to fix a septum.
Generally cautery is used only on the turbinates or the
initial incision on the columella in open techniques. The
septum is like a wall frame in a house. The skin (mucosa)
over it is like wall paper, and the cartilage on the inside
is like drywall. You place an incision in the front part
of the nose where it is hidden and raise the wallpaper off
the wall. Then you can perform the necessary correction
to the drywall (cartilage) and when you put the "wall
paper" (mucosa/skin) back it looks like nothing was
done.
Usually packing will be required however, some patients
are eligible for tubes or straws placed in the center of
the packing on each side so that direct airflow through
the nose is possible. Most patients find this a psychological
discomfort rather than a physical. |
Usually, there is no visible scarring
unless it is an open rhinoplasty. Some surgeons perform
all of their rhinoplasties, open -- some, all closed. It
solely depends upon the surgeon. You will find that most
surgeons tend to disagree when it comes to technique. They
either prefer open or they prefer closed, OR if they are
highly skilled, know that it is case-dependent and different
patients have different needs. If it is an open rhinoplasty
the scar would be on the columella (the skin that separates
the nostrils) sometimes resembling a straight line or a
flattened z.
You can expect swelling, especially in the tip if you are
having tip work performed. The swelling usually begins to
subside within the first month but the end result may not
be seen until at least 9 months [post-operatively. Although
this time period tends to lean towards a year and over. |
| For many patients with thick skin,
the skin is thinned out in the surgery as the tip is worked
on. This really adds a lot to help with definition . Excess
skin length just shrinks away as the swelling decreases.
Also, many patients with thick skin actually do better with
rhinoplasties because the flaps that are elevated are so
firm that you can do a lot more with the cartilages and
it is better hidden. Very thin skin, shows every little
imperfection. |
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