Surgical Cosmetic Procedures Blepharoplasty-Eyelid Lift Brow/Forehead Lift Cheiloplasty-Lip Reshaping Liposuction

Malarplasty-Cheek/Mid-Face Lift

Mentoplasty-Chin Reshaping

Otoplasty-Ear Reshaping

Rhinoplasty-Nose Reshaping

Rhytidectomy-Face Lift

 

What to know
before your first procedure

Surgical Cosmetic Treatments

RHINOPLASTY: Surgery to improve the shape of the nose

Refining the shape of the nose is as much an art as it is a science. It is also one of the most commonly performed plastic surgical procedures. Every nose is as unique as the individual, and our ultimate goal is to shape a nose that most appropriately harmonizes with the other facial features. We attempt to avoid the "operated look" or stereotyped nasal features. There are limits to what can be achieved with rhinoplasty. Improvement can be achieved in most every case, but absolute perfection is not a realistic goal. This is where computerized imaging technology allows the physician and patient to have a "meeting of the minds" and set realistic goals.

Rhinoplasty is often performed both for functional as well as cosmetic purposes. The crooked, obstructed nose will often require internal as well as external correction. Nasal obstruction leads to chronic sinus problems as well as headaches. Whenever nasal obstruction is a part of the problem, your health insurance may cover part of the cost of surgery. In cases of severe sinus disease, surgery on the sinuses themselves may be necessary. This can often be done at the same time as the rhinoplasty.

How is the procedure performed?

The surgery is usually performed on an out-patient basis.  Either "twilight sleep" or a general anesthetic is satisfactory. Both techniques are painless and "twilight sleep" has perhaps an easier, faster recovery. You will be seen the next morning in the office, and post-operative instructions will be reviewed. A commonly asked question is whether the nasal bones are broken during the surgery. We use delicate instruments to actually incise the nasal bone and cartilage so that precise manipulation can be carried out. No nasal packing is usually required, but a small dressing is applied to collect any drainage. A small, skin-tone dressing is applied to the outside of the nose to protect the new nasal shape. This dressing will remain in place for one week. Ice cold compresses will be used to prevent swelling.

Will there be a lot of pain and swelling?

Most patients are surprised at the lack of significant pain from this surgery. Most patients report some discomfort during the first few days, but this is mostly comparable to the discomfort from a head cold. Pain medicine is provided in any case. All surgery causes some swelling and occasionally some bruising. This is limited, however, by the dressing and preventative measures such as ice compresses and medications to fight swelling. As previously mentioned, we no longer routinely use nasal packing.  This decreases the discomfort and swelling considerably.

What is the best age for corrective nasal surgery?

Most physicians feel that any nasal surgery is best delayed until the age of 15 or 16 years. People mature at different rates and this is obviously an individual decision. On the other hand, health permitting, no age is necessarily too late to proceed with rhinoplasty. Some of the most satisfied of all patients are those who "disliked their nose all their life" and finally got around to doing something about it. Correction of a drooping nasal tip can add considerably to other rejuvenation procedures.

How long will my recovery period be?

In general, the first few days after the procedure should be spent resting on the couch or in bed. After this, light activity such as desk work or light housework is acceptable for the next two weeks. As far as appearance goes, once the dressing is removed at one week, only slight and imperceptible swelling remains around the nose. Most of the swelling is gone in two weeks, but the nose continues to undergo changes during the healing process for a full year. For this reason, the tip of the nose often appears to be turned up immediately after removal of the dressing. This will come down with time. The decrease in swelling will result in a gradual refinement of the features. The nasal bones themselves do not completely heal for two months, therefore one must be careful to avoid blows to the nose or undue pressure, such as heavy glasses frames. Supports for glasses will be provided.

Where are the incisions made?

In most cases, all incisions are made on the inside of the nose. Occasionally, it will be necessary to make an incision on the outside of the nose in an area that is well concealed. This will be discussed at the time of your consultation.

What are the possible complications?

The most common problem after rhinoplasty is bruising and swelling. This happens to some extent in all patients, but is usually minimal as long as the post-operative instructions are adhered to. Bleeding can occur in the post-operative period if too great a level of activity is started too soon. Occasionally, a particularly deformed nose may require more than one operation to correct.