of the Nose
year, half a million people who are interested in improving
the appearance of their noses seek consultation with
facial plastic surgeons. Some are unhappy with the noses
they were born with, and some with the way aging has
changed their nose. For others, an injury may have distorted
the nose, or the goal may be improved breathing. But
one thing is clear: nothing has a greater impact on
how a person looks than the size and shape of the nose.
Because the nose is the most defining characteristic
of the face, a slight alteration can greatly improve
you have wondered how nose surgery, or rhinoplasty,
could improve your looks, self-confidence, or health,
you need to know how rhinoplasty is performed and
what you can expect. No pamphlet can answer all your
concerns, but this one can provide answers to many
of the questions you may have.
facial plastic surgery is a result of good rapport
between patient and surgeon. Trust, based on realistic
expectations and exacting medical expertise, develops
in the consulting stages before surgery. Your surgeon
can answer specific questions about your specific
Rhinoplasty For You?
with all facial plastic surgery, good health and realistic
expectations are prerequisites. Understanding nasal
surgery is also critical. Since there is no ideal
in rhinoplasty, the goal is to improve the nose aesthetically,
making it harmonize better with other facial features.
type, ethnic background, and age are important factors
to be considered in discussions with your surgeon
prior to surgery. Before the nose is altered, a young
patient must reach full growth, usually around age
fifteen or sixteen. Exceptions are cases in which
breathing is severely impaired.
deciding on rhinoplasty, ask your facial plastic surgeon
if any additional surgery might be recommended to
enhance the appearance of your face. Many patients
have chin augmentation in conjunction with rhinoplasty
to create a better balance of features.
the Decision For Rhinoplasty
Whether the surgery is desired for functional or cosmetic
reasons, your choice of a qualified facial plastic
surgeon is of paramount importance. Many facial plastic
surgeons are trained in both ear, nose, throat, and
facial cosmetic surgery, which provides you, the patient,
with the highest level of training and expertise.
Your surgeon will examine the structure of your nose,
both externally and internally, to evaluate what you
can expect from rhinoplasty. You are most likely to
be pleased with the results of your surgery if you
have a realistic idea of what nasal surgery can and
can expect a thorough explanation of the surgeon's
expectations and the risks involved in surgery. Following
a joint decision by you and your surgeon to proceed
with rhinoplasty, the surgeon will take photographs
of you and discuss the options available. Your surgeon
will explain how the nasal structures, including bone
and cartilage, can be sculpted to reshape the nose
and indicate how reshaping the chin, for example,
could enhance the desired results.
conducting a thorough medical history, your surgeon
will offer information regarding anesthesia, the surgical
facility to be used, and the costs for the procedure.
definition of rhinoplasty is, literally, shaping the
nose. First, incisions are made and the bone and cartilage
support system of the nose is accessed. The majority
of incisions are made inside the nose, where they
are invisible. In some cases, an incision is made
in the area of skin separating the nostrils. Next,
certain amounts of underlying bone and cartilage are
removed, added to, or rearranged to provide a newly
shaped structure. For example, when the tip of the
nose is too large, the surgeon can sculpt the cartilage
in this area to reduce it in size. The angle of the
nose in relation to the upper lip can be altered for
a more youthful look or to correct a distortion.
tissues are then redraped over the new frame and the
incisions are closed. A splint is applied to the outside
of the nose to help retain the new shape while the
nose heals. Soft, absorbent material may be used inside
the nose to maintain stability along the dividing
wall of the air passages called the septum. Alternatively,
soft nasal supports that permit nasal breathing post-operatively
can be placed.
to Expect After the Surgery
Immediately after surgery, a small splint will be
placed on your nose to protect it and to keep the
structure stable for at least five to eight days.
If packing is placed inside the nose during surgery,
it is removed the morning following the surgery. Your
face will feel puffy,especially the first day after
surgery. Pain medication may be required. Your surgeon
will advise you to avoid blowing your nose for seven
days after surgery. In the immediate days following
surgery, you may experience bruising and minor swelling
in the eye area. Cold compresses often reduce the
bruising and discomfort. Absorbable sutures are usually
used that do not have to be removed. Nasal dressing
and splints are usually removed six or seven days
It is crucial that you follow your surgeon's directions,
especially instructions to keep your head elevated
for a certain period after surgery. Some activities
will be prohibited in the weeks after the procedure.
Sun exposure, exertion, and risk of injury must be
avoided. If you wear glasses, special arrangements
must be made to ensure that the glasses do not rest
on the bridge of the nose. Tape and other devices
are sometimes used to permit wearing glasses without
stressing the area where surgery was performed.
Follow-up care is vital for this procedure to monitor
healing. Obviously, anything unusual should be reported
to your surgeon immediately. It is essential that
you keep your follow-up appointments with your surgeon.
does not generally cover surgery that is purely for
cosmetic reasons. Surgery to correct or improve nasal
function or surgery for major deformity or injury
may be reimbursable in whole or in part. It is the
patient's responsibility to check with the insurance
carrier for information on the degree of coverage.
Copyright 2002 American Academy of Facial and Reconstructive