Rhinoplasty

Rhinoplasty is defined as changing the appearance of the external nose. Rhinoplasty is a common surgical procedure that is done for deformities of the nose either caused from trauma or as a result of hereditary.

The external nose is composed of skin, soft tissue, cartilage and bone. The nose is divided into two parts by a midline structure called the septum. The lower part of the nose, the soft tissue part is composed mainly of cartilage, skin and ligaments. A Rhinoplasty operation modifies almost all of the part of the nose. It does change the appearance and the function of the nose. Large noses can be made to fit the face more esthetically. Small noses cannot be made larger, but can be remodeled by augmentation procedures to increase their projection some. Breathing problems and cosmetic problems can be corrected at the same time. The operation is usually done in an outpatient facility so the patient can go home after the operation and does not have to spend the night in the hospital. Preoperative consultation in the doctor’s office is usually carried out some several days prior to the surgery. The patient’s problem is analyzed, x-rays are made, photographs are made and the discussion of the patient’s likes and dislikes are obtained. After this data is obtained, a surgical plan is outlined for the patient. The operation itself can be done under general anesthesia or under deep sedation called “twilight sleep”. The procedure itself is done either on the inside of the nose, which is called endonasal, or through a small incision on the base of the nose, called an external rhinoplasty. The components of the nose, including cartilage, bone, soft tissue and the septum are then modified until a new structure of the nose is obtained. Then the skin is redraped over this new framework. Sutures are placed and a splint is placed on the nose to help hold everything in place, (the inside of the nose is usually not packed, although occasionally with severe bleeding, packing is required). The patient is awakened from anesthesia and returned to recovery for subsequent discharge later the same day. Pain medications are usually required for the first two to three days. The patients state that they feel that they have a “bad cold” and cannot breathe through the nose and they feel sore in the face. There is very little toothache-like pain associated with a nose operation. After a week the cast is removed and the appearance of the new nose becomes apparent. However, the final result of the nose operation does not become completely apparent for about six months. That is because the swelling that occurs with the surgery takes a while to slowly absorb. Generally antibiotics are not required. It takes about a week of rest at home, following a nose operation, before you can return to light work such as office work and school teaching. Work that requires strenuous activity has to be limited at least two weeks to prevent post-operative bleeding. Following an operation of the nose, breathing is usually improved and the appearance of the nose has changed. Revisional surgery at the end of six months may require a small touch up operation to improve slight blemishes that persist. No operation is 100% perfect or 100% successful, however the vast majority show significant improvement over preoperative appearance.