Rhinoplasty (Nose Re-shaping)
Rhinoplasty, or reshaping the nose, is one of the most commonly performed plastic surgery procedures. The goal of nose re-shaping is to provide a cosmetic improvement and at times to relieve breathing difficulties. This information will give you a basic understanding of the procedure. You will learn when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since much depends on the individual patient. Please ask Dr. Baroody about anything you don't understand about Rhinoplasty.
THE BEST CANDIDATES FOR NOSE SURGERY
Nose surgery may enhance your appearance and your self-confidence, but it will not necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Baroody. 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. Dr. Baroody prefers 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 really want.
ALL SURGERY CARRIES SOME UNCERTAINTY AND RISK
When Rhinoplasty is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including infection, nosebleed, or a reaction to anesthesia. You can reduce your risks by closely following Dr. Baroody's instructions both before and after surgery. 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 with an "open" technique or when the procedure calls for the narrowing of flared nostrils, the small scars are usually not visible. In about one case out of ten, a second procedure may be required. One example, to correct a minor deformity. Such cases are unpredictable and happen even to patients of the most skilled surgeons. The corrective surgery is usually minor.
PLANNING YOUR SURGERY
Good communication between you and Dr. Baroody is essential. In your initial consultation, Dr. Baroody 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. If you require correction of a deviated septum, this portion of the procedure may be covered. Be sure to tell Dr. Baroody if you've had any previous nose surgery or an injury to your nose, even if it was many years ago. You should also inform Dr. Baroody if you have any allergies or breathing difficulties; if you're taking any medications, vitamins, or recreational drugs; and if you smoke. Don't hesitate to ask Dr. Baroody any questions you may have, especially those regarding your expectations and concerns about the results.
PREPARING FOR YOUR SURGERY
Dr. Baroody will give you specific instructions on how to prepare for surgery, including guidelines on eating, drinking, smoking, and avoiding certain supplements/medications. Carefully following these instructions will decrease your surgical risks and shorten your recovery time. While you're making preparations, be sure to arrange for someone to drive you home after your procedure.
WHERE YOUR SURGERY WILL BE PERFORMED
Rhinoplasty may be performed in an outpatient surgery center or a hospital. It's usually done on an outpatient basis.
TYPES OF ANESTHESIA
Rhinoplasty can be performed under local with sedation or general anesthesia.
Rhinoplasty usually takes two to three hours 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. Dr. Baroody prefers an "open" procedure. He makes 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.
AFTER YOUR SURGERY
After surgery 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 Dr. Baroody. Plan on staying in bed with your head elevated (except for going to the bathroom) 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. Applying cold compresses will reduce this swelling and make you feel a better. In any case, you'll feel a lot better than you look. Most of the swelling and bruising should disappear within two weeks. Some subtle swelling, unnoticeable to anyone but you and Dr. Baroody, will remain for several months. A little bleeding is common during the first few days following surgery, and you may continue to feel some stuffiness for several weeks. Dr. Baroody does not want you to blow your nose for a week or so, while the tissues heal. If you have a nasal splint, it will be removed after five to seven days and you'll feel much more comfortable. By the end of one week, all dressings, splints, and stitches should be removed.
GETTING BACK TO NORMAL
Most Rhinoplasty patients return to school or sedentary work a week after surgery. It will be several weeks, however, before you're entirely back to normal. Dr. Baroody will give you more specific guidelines for gradually resuming your normal activities. You should avoid strenuous activity (jogging, swimming, bending, sexual relations). Be gentle when washing your face and hair. 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 has completely healed. Dr. Baroody will schedule frequent follow-up visits in the months after surgery, to check on the progress of your healing. If you have any unusual symptoms between visits, or any questions about what you can and can't do, don't hesitate to call Dr. Baroody.
YOUR NEW LOOK
In the days following surgery, when your face is bruised and swollen, it's easy to forget that you will be looking better. In fact, many patients feel depressed for a while after plastic surgery which is normal and understandable. Rest assured that this stage will pass. Day by day, your nose will begin to look better and your spirits will improve. Within a week or two, you'll no longer look as if you've just had surgery. Still, healing is a slow and gradual process. Some subtle swelling may be present for months, especially in the tip. The final results of rhinoplasty may not be apparent for a year or more. In the meantime, you might experience some unexpected reactions from family and friends. They may say they don't see a major difference in your nose. Or they may act resentful, especially if you've changed something they view as a family or ethnic trait. If that happens, try to keep in mind why you decided to have this surgery in the first place. If you've met your goals, then your surgery is a success.