Rhinoplasty

Rhinoplasty

The nose is the central and most prominent part of the face. An aesthetically appealing nose adds character and beauty to the face. Nose surgery involves reshaping the nose and is one of the most technically challenging cosmetic surgery operations. Rhinoplasty, also referred to as “nose job” is a procedure which can improve the appearance and proportion of your nose, or correct a breathing problem associate with the nose.

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The goal of rhinoplasty is to improve the nose aesthetically without creating a “surgical” look and create a sense of harmony in the facial features. The benefits of nose surgery include: improved appearance and proportion of your nose, enhanced facial harmony and improved self esteem.

When used for medical reasons rhinoplasty can facilitate improved breathing by correcting anatomical abnormalities in the structure of the nose: these abnormalities can be due to hereditary reasons or caused by trauma.

Ideal Candidate for a Nose Job?

Surgery of the nose is generally suitable for patients whose facial growth is complete and are 18 years of age or older or adults in good physical health without any serious medical problems. Non smokers have an increased risk of complications. Also the patient must have realistic goals and expectations from the surgery.

Nose surgery can correct the following characteristics of the nose:

  • Size, in relation to the other facial structures
  • Wide nose
  • Dorsal Humped Nose
  • Depressed Nasal bridge/Flat Nose
  • Large Boxy or Bulbous Nasal Tip
  • Drooping or upturned Nasal Tip
  • Nostrils that are large, wide or upturned
  • Nasal asymmetry and deviation
  • Obstruction of the nasal passages

Not all of these procedures need to be corrected in each individual. You should inform your surgeon if there is a specific feature about your nose which concerns you.

The First Consultation

During the first consultation Dr Biraj will understand your concerns about your particular condition and willdiscusshow Rhinoplasty surgery can enhance the appearance of your face. She will understand your goals and expectations from the surgery and determine if they can be achieved realistically.You will be evaluated for your general health condition and be well informed of the benefits, possible risks and potential complications of the operation.

General Guidelines prior to a Rhinoplasty

  • Detailed Nasal and Facial examination
  • Exact measurement of Nasal and Facial dimensions
  • Pre-Operative Photographs will be taken.
  • Pre-operative Anaesthetic assessment for fitness for surgery
  • Sign an informed Consent Form
  • Obtain laboratory testing or a medical evaluation
  • Take certain medications or adjust your current medications
  • Stop smoking well in advance of surgery
  • Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding.

Your Rhinoplasty Surgery

Rhinoplasty Surgery is usually performed under General Anaesthesia, in a major hospital setup for enhanced patient comfort. Occasionally, however it can also be done under Local Anaesthesia.

The technique and incisions for Rhinoplasty are dependent on which nasal features need to be corrected. There are two approaches to Rhinoplasty surgery.
1. In the traditional “Closed” approach all incisions are hidden inside the nose where they are invisible.
2. In the newer “Open” approach however a small incision may need to be given at the base of the underside of the nose. This heals very well and is not visible in the long run, but it gives better exposure and enables a precise correction under vision.

Reduction Rhinoplasty is done for the nose which is too wide at the base, has a bulbous or boxy nasal tip, a hanging nasal tip, a dorsal hump deformity and for wide nostrils. It involves removal/reshaping of underlying bone and cartilage. For example, when the tip of the nose is too large, the surgeon can sculpt the cartilage in this area to reduce it in size. Where the nose has a dorsal hump it can be reduced to give a straighter appearance.

Augmentation Rhinoplastyis done for the nose which is depressed or flat, or narrow at the base. Autologous Cartilage, Bone, or biocompatible nasal implants (Porex/Silicon) are used to augment or reshape and provide a newly shaped structure. The angle of the nose in relation to the upper lip can be altered for a more youthful look or to correct a distortion.

Deviated Nasal Septum – Often the nose becomes deviated during development or becomes crooked due to injury. This can be straightened by removing the deviated part of the septum or putting straightening stitches and cartilage supports.
At the end of the procedure, the tissues are re-draped over the new frame and the incisions are closed. A splint is applied to the outside of the nose to help retain the new shape while the nose heals. Soft, absorbent material/ soft nasal supports may be used inside the nose to maintain stability along the dividing wall of the air passages called the septum.After your nasal surgery, your nostrils will be blocked by a pack for 24-48 hours for support and haemostasis.

Recovery Period

Recovery from Nose job typically takes about a week. Sometimes, the surgical trauma may cause swelling and bruising of the nose and around the eyes. This usually settles in two to three weeks. If you have had infractures of the nasal bridge, then you will have a splint on the nasal bridge, which will be removed in 7 days. Wounds normally heal in 7 – 14 days. The swelling around the tip of the nose tends to take the longest to resolve and may last for up to 3 months.

Most patients are required to remain in hospital for one night following surgery. All sutures will be removed on the 6thday. Splints if any will be removed after a week. You can return to normal activities within 2-3 day of your surgery and join back work within 7-10 days. Excessive physical activity should be avoided for the next 4-6 weeks, avoiding contact sports for 2 months. It is very important that you follow the advice of your surgeon which will enhance your recovery.

Schedule a Consultation

If you would like to schedule a breast lift consultation, please contact online or by phone today. Dr. Biraj will be happy to answer your questions and talk with you about all aspects of the procedure

Common Questions

Although there are very few risks associated with this procedure, an infrequent general risk includes bleeding and collection of blood under the skin (hematoma). Any surgery carries risks associated with anaesthesia. There are very few risks if the procedure is done under local anaesthesia. These risks will be fully discussed with you prior to your consent for surgery. Any surgery on the nose has a 10% risk of residual deformity, for which further revision surgery might be required.

After your nasal surgery, your nostrils will be blocked by a pack for 24-48 hours for support and haemostasis. This is removed in 48-72 hours. External nasal tapes/splints are removed after 5-7 days.

If your nose surgery is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

You can typically join back work in about a weeks time once all dressings have come off.

Most patients have mild discomfort, and many don’t even require pain medication. Patients are up and about the next day and have a rapid recovery with the exception of strenuous activity, vigorous exercise, or lifting over 10 lbs weight. These activities need to avoided for three weeks following surgery to minimize any risk of bleeding.

Patients can shower the next day, and exercises can be resumed three weeks after surgery. Most patients can join back work in 7 days timedepending on their recovery.

Your nose job scars are invisible as they are given in hidden areas inside your nostrils. In patients where open rhinoplasty is required a small scar is given at the base of the central columella which heals extremely well and is rarely a cause of concern as it settles down very nicely in a few months time and is not visible.

The results from a nose job surgery are usually noticeable straight after the first dressing is removed, but further refinement in the nasal features continues over the next 3 months. It may take several months for swelling to fully dissipate and up to a year – and sometimes longer – for the outcome of the surgery to fully refine. Although the results of nose surgery are usually permanent, very rarely cartilage may continue to reshape and move tissue that may change the outcome over time. What matters more is that the appearance of your face matches the way you feel inside – youthful, vital and alert.

The practice of medicine and surgery is not an exact science. Although good results are expected, they cannot be completely guaranteed. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Sometimes rarely another minor surgical procedure may be necessary to reach the intended aesthetic goal.

Risks and Potential Complications

Possible complications include bleeding and collection of blood under the skin (hematoma), fluid accumulation(seroma), infection or poor healing at the incision site. These risks are common to many operations and can be dealt with easily. Blood clots in the deep veins of the leg is a problem associated with lying still for too long for which adequate prophylaxis is taken prior to surgery. Rarely pulmonary and Fat embolism are risks associated with any major prolonged surgery. Any surgery carries risks associated with anaesthesia. These risks will be fully discussed with you prior to your consent for surgery. It is important that you understand these aspects of your surgery and that you seek clarification from your surgeon.

During the Operation: Reactions to Drugs, Bleeding
Later: Painful Scars, Abnormal Scars, Persistent Lower Abdomen Numbness and Swelling and Umbilical Deformity