rhinoplasty
The nose is perhaps the most defining feature of the face. That’s why 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. In some instances it may be covered by insurance.
While rhinoplasty can enhance your appearance and self-confidence, it won't necessarily change your life. It’s very important to think carefully about your expectations and discuss them with Dr. Chariker before deciding to have this surgery. 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. Younger patients must wait to have this procedure until they have completed their growth spurt – around 14 or 15 for girls and a little older for boys.
- Planning
- In/Out Patient
- During/After
- Side Effects
- Recovery
- Duration
Planning Your Surgery
Open communication is essential. In your initial consultation, Dr. Chariker will evaluate the structure of your nose and face, in light of what you want your nose to look like, and will frankly discuss the possibilities with you. He will consider and share with you factors that can influence the procedure and results – such as the structure of your nasal bones and cartilage, the shape of your face, the thickness of your skin and your age. Together you will decide on the best shape for your face.
In/Outpatient, Anesthesia, Length of Procedure
Dr. Chariker generally performs nose surgery in our state-of-the-art outpatient surgical center. Rhinoplasty can be performed under local or general anesthesia, depending on the extent of the procedure. With local anesthesia, you'll usually be lightly sedated, and your nose and the surrounding area will be numbed; you'll be awake during the surgery, but relaxed and insensitive to pain. With general anesthesia, you'll sleep through the operation. Rhinoplasty usually takes an hour or two, though complicated procedures may take longer.
During and After
During surgery, Dr. Chariker separates the skin of the nose from its supporting framework of bone and cartilage, then sculpts the cartilage to the desired shape. Then the skin is redraped over the new framework. Typically, he performs this procedure from within the nose, with the incision inside the nostrils. However, in more complicated cases, he sometimes may make a small incision across the columella – the strip of tissue separating the nostrils. Some patients will require supplemental tissue to support the inside of the nose. This material may consist of a plastic material such as Medpore, or may be harvested from a rib, the nose or the ear. When the surgery is complete, he will apply a splint to help your nose maintain its new shape.
After surgery, particularly during the first 24 hours, your face will feel puffy, your nose may ache, and you may have a dull headache. Dr. Chariker will prescribe pain medication to manage your discomfort. 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 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. If you have nasal packing, it will be removed after a few days and you'll feel much more comfortable. By the end of one or, occasionally, two weeks, all dressings, splints, and stitches should be removed.
Side Effects and Risks
The most common post-surgery side effects are temporary swelling, bruising around the eyes and nose, and headaches. You also may experience some bleeding and stiffness. Sometimes 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. 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. As with all surgery, infection can occur. Occasionally, the improvement is incomplete, requiring additional surgery to achieve the desired result.
Recovery
Most rhinoplasty patients are up and about within two days, and are able to return to school or sedentary work within a week or two. More strenuous activities – jogging, swimming, bending, sex, or any activity that boosts your blood pressure – should be avoided for two to three weeks. Avoid hitting or rubbing your nose or getting it sunburned for eight weeks. After this type of surgery, it is important to remember that healing is a slow and gradual process. Subtle swelling may be present for months, especially in the top of the nose, and final results of your surgery may not be apparent for a year.
Duration of Results
Permanent.