Rhinoplasty, or surgery to reshape the nose, is one of the most common
of all plastic surgery procedures. Rhinoplasty can reduce or increase
the size of your nose, change the shape of the tip or the 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.
Best candidates for rhinoplasty
The best candidates for rhinoplasty are people who are looking for improvement,
not perfection, in the way they look. If you're physically healthy,
psychologically stable, and realistic in your expectations, you may
be a good candidate.
Rhinoplasty can
be performed to meet aesthetic goals or for reconstructive purposes-to
correct birth defects or breathing problems.
Age may also be a consideration. Many surgeons prefer not to operate
on teenagers until after they've completed their growth spurt-around
14 or 15 for girls, a bit later for boys. It's important to consider
teenagers' social and emotional adjustment, too, and to make sure it's
what they, and not their parents, really want.
Planning your
surgery
In your initial consultation, the surgeon will ask what you'd like
your nose to look like, evaluate the structure of your nose and face,
and discuss the possibilities with you. He will also explain the factors
that can influence the procedure and the results. These factors include
the structure of your nasal bones and cartilage, the shape of your face,
the thickness of your skin, your age, and your expectations.
Most insurance policies
don't cover purely cosmetic surgery; however, if the procedure is performed
for reconstructive purposes, to correct a breathing problem or a marked
deformity, the procedure may be covered.
Be sure to tell your surgeon
-
if you've had
any previous nose surgery or an injury to your nose, even if it
was many years ago
-
if you have
any allergies or breathing difficulties
-
if you're taking
any medications, vitamins, or recreational drugs
-
if you smoke
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
at all; when an "open" technique is used, or when the procedure
calls for the narrowing of flared nostrils, the small scars on the base
of the nose are usually not visible.
The procedure
Rhinoplasty usually takes an hour or two, though complicated procedures
may take longer. During 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 your
problem and your surgeon's preferred technique. Finally, the skin is
redraped over the new framework.
Many plastic surgeons perform rhinoplasty from within the nose, making
their incision inside the nostrils. Others prefer an "open"
procedure, especially in more complicated cases; they make a small incision
across the columella, the vertical strip of tissue separating the nostrils.
When the surgery
is complete, a splint will be applied to help your nose maintain its
new shape. Nasal packs or soft plastic splints also may be placed in
your nostrils to stabilize the septum, the dividing wall between the
air passages.
Getting back to normal
After surgery-particularly during the first twenty-four hours-your face
will feel puffy, your nose may ache, and you may have a dull headache.
You can control any discomfort with the pain medication prescribed by
your surgeon. Plan on staying in bed with your head elevated (except
for going to the bathroom) for the first day.
The swelling and bruising around your eyes will increase at first, reaching
a peak after two or three days. Applying cold compresses will reduce
this swelling and make you feel a bit better. Most of the swelling and
bruising should disappear within two weeks or so.
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 will probably ask you not to blow your nose for a week or so,
while the tissues heal.
Most rhinoplasty patients are up and about within two days, and able
to return to school or sedentary work a week or so following surgery.
It will be several weeks, however, before you're entirely up to speed.
Avoid strenuous activity (jogging, swimming, bending, sexual relations-any
activity that increases your blood pressure) for two to three weeks.
Avoid hitting or rubbing your nose, or getting it sunburned, for eight
weeks. Be gentle when washing your face and hair or using cosmetics.
You can wear contact lenses as soon as you feel like it, but glasses
are another story. Once the splint is off, they'll have to be taped
to your forehead or propped on your cheeks for another six to seven
weeks, until your nose is completely healed.
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