Rhinoplasty is the most common of all plastic surgery procedures. It can reduce or increase the size of your nose, change the shape of the tip or bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip. It may also correct a birth defect or injury, or help relieve some breathing problems.
Who’s a Candidate?
The best candidates are people who are looking for improvement in the way they look. Age may also be a consideration. Many plastic surgeons prefer not to operate on teenagers until after they’ve completed their growth spurt.
What Are the Risks?
After surgery, small burst blood vessels may appear as tiny red spots on the skin’s surface. These are usually minor but may be permanent. As for scarring, when rhinoplasty is performed from inside the nose, there is no visible scarring. When an "open" technique is used, there will be small scars at the base of the nose.
Preparing for Surgery
The surgeon will ask you what you’d like your nose to look like, evaluate the structure of your nose and face and discuss the possibilities with you. He or she will also explain the factors that can influence the procedure and the results, including the structure of your nasal bones and cartilage, the shape of your face, the thickness of your skin, your age and expectations.
Be sure to tell your surgeon if you’ve had previous nose surgery or an injury to your nose, even if it was quite some time ago. You should also inform him or her about any allergies or breathing difficulties you may have.
The Surgery
Rhinoplasty is usually performed on an outpatient basis under local anesthesia, depending on the extent of the procedure.
During the surgery, the skin of the nose is separated from its supporting framework of bone and cartilage, which is then sculpted to the desired shape. The nature of the sculpting will depend on the nature of your problem and your surgeon’s preferred technique. The skin is then redraped over the new framework.
Many plastic surgeons perform rhinoplasty from within the nose, making the incisions inside the nostrils. The "open" procedure is often used in more complicated cases.
Once the surgery is complete, a splint will be applied to help your nose maintain its new shape. Nasal packs or soft plastic splints may be placed in your nostrils to stabilize the septum, the dividing wall between the air passages.
After Your Surgery
After surgery, particularly during the first 24 hours, your face will feel puffy, your nose will ache and you may have a dull headache. Plan on staying in bed with your head elevated for the first day.
You’ll notice that the swelling and bruising around your eyes will increase at first, reaching a peak after two or three days. You may apply a cold compress to reduce the swelling. Most of the swelling and bruising should disappear within two weeks. Some subtle swelling may remain for months, especially in the tip. The final results of rhinoplasty may not be apparent for a year or more.
A little bleeding is common during the first few days following surgery, and you may continue to feel some stuffiness for several weeks. Your surgeon may ask you not to blow your nose for a week or so while the tissues heal.
If you have nasal packing, it will be removed after a few days. All dressings, splints and stitches should be removed within one or two weeks. You can wear contact lenses as soon as you feel like it; however, if you wear glasses, they will have to be taped to your forehead or propped on your checks until your nose is completely healed in approximately seven weeks.
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