(Plastic Surgery of the Nose)
Rhinoplasty is a surgery done on the nose. It is done to reshape the nose.
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Reasons for Procedure
- To change or improve appearance
- To improve breathing
- To correct an injury or birth deformity
A septoplasty can be done at the same time to open blocked nasal passages due to a deviated septum.
Complications are rare, but no procedure is completely free of risk. If you are planning to have a rhinoplasty, your doctor will review a list of possible complications which may include:
- Poor healing of the skin
- Unsatisfactory cosmetic result or scarring
- Increased risk of nosebleeds
- Reaction to anesthetic
- Puncture of septum or collapse of nose bridge—rare
Factors that may increase the risk of complications include:
- Age—recommended age is after teen growth spurts and before middle age
- Prior nose surgery
- Prior trauma to the nose
- Medical problems
What to Expect
Prior to Procedure
You may be asked to provide a picture of the nose shape you desire. You may also be given a book to look through to choose a nose shape. Computer software may be used to simulate desired results.
Your doctor will likely do the following:
- Blood tests
- Urine tests
- X-rays of the facial bones
- EKG or chest x-ray may be also required
- Take before pictures of your nose
Leading up to your procedure:
- Arrange for a ride to and from the procedure.
- If you are having general anesthesia, do not eat or drink anything for at least 8 hours before the procedure.
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure, like:
- Anti-inflammatory medications, such as ibuprofen
- Blood thinners
- Anti-platelet medications
You may have general or local anesthesia. You will be asleep with general anesthesia. Local anesthesia will numb the area. In this case, you may also be given a sedative. It will help you relax. The type of anesthesia used will depend on your procedure and general health.
Description of the Procedure
There are three main components of the procedure:
Lifting the Skin of the Nose from the Bone and Cartilage
The nose will be injected with a numbing medication and epinephrine. The epinephrine will prevent excessive bleeding. An incision will be made either inside the nostril or outside the nostril, across the ridge between the nostrils. The skin will then be lifted off the cartilage of the nose.
Remodeling Bone and Cartilage
Depending on the desired outcome, some nasal bone may be removed, or fractured and reset to a new shape. Cartilage may also be trimmed. Other techniques involve placement of tissue grafts of bone, cartilage, or mucosa from the patient, a donor, or a synthetic graft. They will be used to help remodel the shape of the nose. For example, the tip of the nose may be narrowed or raised, or the slope of the nose may be reduced or increased. The shape or size of the nostrils may also be changed.
Redraping Skin Over the New Base
When the procedure is finished, the incisions will be closed. The skin will be redraped over the new bone structure. The skin will be tightly taped to keep it in place. A protective metal splint will then be applied on the outside of the nose. It will help to maintain the positioning during healing. Either soft plastic splints or gauze packing coated with petroleum jelly will be used as nasal packs. They may also be inserted into the nostrils as support during healing.