Surgery News & Resources
Learn more about
the unique cosmetic surgery procedure: rhinoplasty.
Our noses are the most prominent feature of our faces. Many feel that changing the appearance of their nose will enhance their self-confidence. Rhinoplasty is surgery to re-shape the nose and may be combined with procedures to enhance breathing through the nose.
What situations does rhinoplasty address?
Most modern rhinoplasty surgery is done for cosmetic reasons. But in some cases it’s performed to correct defects arising from heredity, injury, or previous rhinoplasty.
Structure of the nose
Our noses are thought of as including 4 main areas:
1. The upper third (the bony part near the eyes);
2. The middle third (called the middle vault);
3. The lower third (the tip); and
4. The septum (the bone and cartilage that divides the two nostrils).
Talking with your plastic surgeon
Since the nose performs the vital function of breathing, it has to retain certain anatomical features, regardless of its cosmetic appearance. So while you may approach your surgeon with cosmetic concerns, and of course he’ll listen to them and consider them, he’ll be approaching the conversation with anatomical requirements in mind as well as cosmetic considerations.
He’ll study your face from all angles and make suggestions as to how he could achieve the look you want. Your discussions should continue until the two of you arrive at a mutual understanding and realistic goal.
Over the years, many people (doctors, sociologists, psychologists, artists) have studied the human face from an aesthetic viewpoint and have come up with desirable angles, ideal dimensions, pleasing ratios etc.
Your rhinoplasty surgeon will want to achieve the following:
· Harmony with the rest of your face
· Adequate air passages
· Satisfaction on your part with the outcome
Approaches to rhinoplasty
There are two approaches to rhinoplasty: the closed technique and the open technique, and a competent rhinoplasty surgeon can use either one. They have a lot in common. It’s a matter of where the incisions are made.
Closed technique (endonasal rhinoplasty)
The incisions are all made inside the nose. Supporters of this technique maintain that (among other things) it reduces post-op swelling, takes less time to perform, and leaves no visible scar.
Incisions are made both inside the nose, and outside it, usually across the columella (the fleshy area between the nasal openings on front view). Proponents of this technique cite the direct exposure it gives them to nasal tissue, and the ease with which they can see what they’re doing. And this in turn allows for greater accuracy in their modifications.
However, the downside includes factors such as the residual scar at the columella, increased surgical time, and increased post-op swelling, numbness and healing time at the tip of the nose.
Local anesthetic and IV sedation or general anesthesia may be used and the procedure takes from 1 to 3 hours, depending on what exactly is being done. After the modifications are completed, the incisions are sutured and a splint is applied to the outside of the nose to give support while it heals in its new shape.
The splint will remain in position for about a week or so. The sutures inside the nose will dissolve. Any external sutures will be removed. Your plastic surgeon will prescribe pain medication. You’ll need to keep your head elevated, even while you sleep and avoid blowing your nose for about a week. In fact, you’ll be away from your normal daily activities for about a week. There’ll be swelling and bruising for about 2 weeks and you might feel stuffed up for several weeks.
All surgery brings a certain amount of risk and your plastic surgeon will have discussed this with you beforehand. After a rhinoplasty there could be some nose bleeding, which is why it’s important to rest and keep the head elevated. There could be infection, which you might notice first as an elevated temperature, or as nasal redness and pain. Little red spots could appear on the skin; these are burst blood vessels and if they occur are usually temporary. But sometimes they become permanent.
This refers to follow-up surgery for correcting the first one. Your rhinoplasty surgeon and his staff will monitor your post-op progress closely so if any further surgery is indicated, they’ll know what to do.
It will take close to a year before you will see the final results.
Finding a good cosmetic surgeon
Since cosmetic surgery has become so popular in the last 10 years or so, some doctors have taken short cut training to take advantage of this at a disservice to the general public. You want a properly trained and experienced surgeon, not one who might gain his basic experience on you! Choose a plastic surgeon who’s certified by the American Board of Plastic Surgery (ABPS), and one who’s a member of the American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS).
While you should by all means listen to your friends and acquaintances who may have had cosmetic surgery and want to recommend their doctor to you should do your homework too, and check the doctor’s credentials.
Some questions to ask when interviewing plastic surgeons
· Do you have hospital privileges, and if so, which hospitals?
· Can you do the procedure in the hospital if I want to?
· If you do surgery in other facilities, are they accredited?
· How many breast reductions have you done?
· Can I speak to some of your previous patients about their experience with it?
Article submitted by: Sara Goldstein, firstname.lastname@example.org, 17301 W. Colfax, Suite 275, Golden, CO, USA 80401
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