Surgery of the Nose

Rhinoplasty is the name of the operation designed to improve deformities of the nose with plastic and reconstructive surgical techniques. The operation consists of carefully removing any “excess” bone and / or cartilage while rearranging or reshaping the remainder.

Most rhinoplasties are performed because the patient desires an improvement in appearance and / or nasal function. On the other hand, it may be, that the nose is becoming progressively more disfigured the older the patient becomes until breathing difficulty occurs.

Every nose is different, some are too long, some too wide, and others have large humps or may project away from the face. Rarely are any two noses identical. The plastic surgeon strives to make each patient’s nose fit his or her face. No patient wants an assembly line “nose job”. They want a nose individually tailored to their own features.

  
At what age can Rhinoplasty be done?

Certain limitations exist in children, which precludes performing the definitive correction prior puberty. But, if a severe deformity or a breathing problem is present, it should be corrected in childhood. Ordinarily, a girl’s nose is “mature” enough by the age of fourteen and a boy’s at sixteen. At these ages they are ready to have surgical correction. However, it is necessary to individualize this factor because some people “mature” at earlier ages.

Early correction of unwanted nasal deformities can often give young people more self-confidence and improved self-esteem. On the other hand, about thirty percent of the rhinoplasties we perform are on patients over the age of forty.  Many remark that they have disliked their noses “all their life”, and now wish to have corrective surgery. If the patient is in good health it is never too late to have a Rhinoplasty. It is often done as a part of a facial rejuvenation program to improve the undesirable signs of aging.

Our Surgery Protocol

Prior to surgery, medication is given to calm the patient, promote healing and help hold the nose to minimum amount of swelling.

The patient usually is admitted to the clinic in the morning of surgery. The average patient can be discharged six hours after the surgery. Out of town patients usually stay twenty-four hours in the clinic.

We generally prefer “twilight” anesthesia, in which the patient receives sleeping medications supplemented by local anesthesia. In an uncomplicated case, the actual surgery takes about an hour or so. After the completion of surgery, a small protective adhesive dressing is applied to the nose. We rarely use splints or casts over the nose. The external protective tape is to remain in place for about one week.

Although a drip dressing is applied which obstructs the nostrils we do not ordinarily “pack” the nose after surgery. Patients, therefore, are more comfortable and generally less swollen. This technique has been one of the greatest advances is nasal surgery, reducing much of the undesirable post-operative discomfort. 

After Nasal Surgery

It is unrealistic for a patient to expect an immediate transformation after surgery. Normal healing is a gradual process.

At the end of one week, most of the swelling and discoloration has disappeared. The patient can usually return to work or school at this time. Generally speaking, about 80% of the swelling disappears by two weeks, 90% by two months. The remainder inflammation will decline at the rate of about 1% per month. The “final” result is not present for about one year, occasionally longer.

The degree of improvement depends on the extent of the corrective work undertaken and basic structure of the nose and skin. An obviously disfigured nose will show dramatic results. A slight bump and a tip that is a bit too large may be successfully corrected, yet the results may be subtle. The intention is not to create a “new” nose that draws attention to itself, but rather one that blends subtly into the overall features of the face in the proper proportions.