Rhinoplasty
Rhinoplasty also termed as a nose job, is a surgery that is performed to change the shape of the nose. It can be performed to change the appearance of the nose, to improve breathing or both. The bone is the upper portion of the structure of the bone, while the lower part is cartilage, skin or all three. Your surgeon considers your other facial features, including the skin on your nose while rhinoplasty is planned. Once you are considered as a candidate for the surgery, a customized plan will be developed for you by your surgeon.
Preparation
First, you need to meet with your surgeon and discuss whether you are a proper candidate for this procedure. You need to discuss why you require the surgeon and what expectations you have from it.
Your medical history will be examined by your surgeon, after which he will ask you about any current medications you might be taking as well as medical conditions that you might be having. Your surgeon might recommend against taking it if you suffer from hemophilia, a condition that causes excessive bleeding.
A physical exam will be performed by your surgeon, after looking closely at the skin on the inside and outside of your nose in order to determine the kind of changes that can be made. Your surgeons can order blood tests as well as other lab tests. Some people also get a chin augmentation, a procedure which defines the chin better along with rhinoplasty. Your surgeon can suggest whether such additional surgery should be performed at the same time.
This consultation will also include photographing your nose from various angles. These shots will be used to assess the long-term results of your surgery and might be referred to during the surgery as well.
It is important that you avoid painkillers that contain ibuprofen or aspirin for two weeks after your surgery. This kind of medications can slow down the blood-clotting process and make you even bleed more. It is important that you let your surgeon know the kind of medications and supplements that you are taking so that they are able to advise you regarding whether you should continue them or not.
Also, make sure that you understand the costs of your surgery. If your rhinoplasty is due to cosmetic reasons, it is a lot less likely that insurance is going to cover it.
People who are smokers can have more difficulty healing from rhinoplasty, as cigarettes are known to slow the recovery process. Nicotine can constrict the blood vessels, which can result in less oxygen and blood getting to healing tissues. Therefore, it is quite important that you quit smoking before and after the surgery in order to help in the healing process.
Procedure
Depending on how complex your surgery is, your procedure will require either local anesthesia or general anesthesia. It’s best that you discuss it with your doctor, which is the most appropriate type of anesthesia for you.
Rhinoplasty can be done inside the nose or through a small external cut made at the base of your nose between the nostrils. The bone will be readjusted by your surgeon as well as the cartilage underneath your skin. For larger changes, the surgeon can use cartilage from your rib, implants as well as bone from another part of your body. Once these changes are made, your surgeon will place the skin and tissue of the nose back and stitch the incisions in your nose. Once the surgery is done, you will find yourself in a recovery room, where the staff will be monitoring you. You might be able to live the same day unless you have any other health issues.
Recovery
After the surgery, the surgeon might place a plastic or metal splint on your nose, which will help it retain its new shape while it heals. He might also place nasal packs or splints inside the nostrils in order to stabilize your septum, which is the part of your nose between the nostrils.
To reduce bleeding and swelling, it will be best for you to rest with your head elevated above your chest. If you find your nose swollen or packed with cotton, you might feel congested as well. People are generally required to leave splints and dressings in place for at least one week after surgery. You might also have absorbable stitches, which means they will dissolve and won’t require removal. If the stitches aren’t absorbable, you will need to see the doctor again a week in order to get stitches taken out.
Impaired judgment, memory lapses and slow reaction time are some common effects that can be caused by the medications which are used for surgery. If it is possible, try to have a relative or friend stay with you the first night after the surgery.
You might experience drainage and bleeding for a few days after the surgery. A drip pad, a piece of gauze taped below the nose, can help in absorbing blood and mucus. Your doctor will let you know how often you need to change your drip pad. If you get headaches, your face might feel puffy, due to which your doctor might prescribe pain medications.
You might need to avoid the following for some weeks after the surgery:
- Running and any such strenuous physical activities
- Blowing your nose
- Swimming
- Chewing excessively
- Laughing or smiling, or any facial expression that require too much movement in the face
- Resting your eyeglasses on your nose
- Pulling clothes over your head
- Vigorously brushing your teeth
You need to be careful about exposure to the sun as well as this could permanently lead to discoloring of the skin around the nose. Within a week you can return to your usual daily activities.
Rhinoplasty can affect the area around the eyes and you might experience temporary numbness, swelling or discoloration around your eyelids for a few weeks. Sometimes in rare cases, this might last up to six months and slight swelling can even persist longer. You can also choose to apply cold compressors or ice packs in order to decrease discoloration and swelling. The follow-up care after rhinoplasty is also very important. Make sure that you keep your appointments as well as follow the instructions provided by your doctor.
Risks
Like most major surgeries, rhinoplasty comes with risks such as bleeding, infection or adverse reaction due to the anesthesia.
There are also other possible risks which can come with rhinoplasty, which can include the following:
- Permanent numbness in and around the nose
- Difficulty breathing through the nose
- The possibility of having an uneven-looking nose
- Pain, discoloration or swelling which can be persistent
- A hole in the septum
- Scarring
- Requiring surgery again
Despite the risks involved, most of the time if your surgeon is experienced, you will end up with satisfactory results. The slight changes however aren’t enough in some cases and your surgeon might need to perform another surgery in order to make further changes. However, in such cases, you will need to wait for a minimum of one year for the next surgery, as during this time your nose can go through some changes.