What is a Rhinoplasty?

A rhinoplasty (commonly known as a nose job) is surgery on the nose to change its shape or improve its function.
It can be done for medical reasons such as to correct breathing problems related to the nose or correct disfigurement resulting from trauma or birth defects.
It can also be done for cosmetic reasons, which will change the nose’s shape and appearance.

Who is it for?

The following are some common reasons why you may want to consider rhinoplasty:

  • Your nose is too large or too small
  • Your nose does not seem to fit with the rest of your face
  • Your nose is crooked, badly shaped, or out of alignment
  • You have nasal blockage inside your nose and have trouble breathing
  • You have a birth defect that you would like improved
  • You would like improvement, not perfection, in the appearance of your nose

Pre-op essentials

In advance of your procedure, your surgeon will ask you to:

  • Stop smoking at least six weeks before undergoing to promote better healing.
  • Avoid taking aspirin, nonsteroidal anti-inflammatory medications (NSAIDs: Advil, Motrin, Aleve), and vitamins/homeopathic regimens that can increase bleeding.
  • Regardless of the type of surgery to be performed, hydration is very important. Appropriate hydration before and after surgery is critical for safe recovery and optimal outcomes.
  • Be sure to arrange for someone to drive you home after surgery and to stay with you at least for the first night following surgery.

What to expect during surgery

After numbing the area, your surgeon will make incisions to access the bones and cartilage that support the nose. There are two general techniques for making the incisions: open and endonasal.

For an open rhinoplasty, the incisions are made outside the nose with a small access incision on the underside of the nose between the nostrils that then connects with other incisions hidden inside the nose.

For an endonasal rhinoplasty, the incisions are made inside the nasal passages. Because these incisions are hidden, they are invisible after surgery.

By adding or removing bone and cartilage and adjusting the supporting structures inside the nose, the size of your nose can be reduced or increased and the nose may be shortened or lengthened.

Tip grafts made of cartilage can be used to remodel the tip of your nose, making it more uplifted, longer, shorter, or thinner.

Your skin and other soft tissues will remodel to assume the shape of the underlying structure.
In some patients, tissue fillers or fat grafts can be added to increase volume in desired areas.

After Surgery

  • After surgery you may be asked to wear a nasal splint over your nose for support. The splint will protect your nose while you sleep and shield it from accidental bumps. You may also have a small triangular bandage beneath the tip of your nose.
  • Expect some swelling and bruising and possibly some discomfort. Your face will be puffy, and the areas around your nose and eyes will be bruised and swollen after surgery.
  • You may need to keep your head elevated and relatively still for the first few days after surgery.
  • Your doctor may prescribe a pain medication to deal with any pain you may experience.
  • You will have to limit your activities for a few days to weeks.

Limitations and Risks

All surgical procedures have some degree of risk. Some of the potential complications of all surgeries are:

  • Adverse reaction to anesthesia
  • Hematoma or seroma (an accumulation of blood or fluid under the skin that may require removal)
  • Infection and bleeding
  • Changes in sensation
  • Scarring
  • Allergic reactions
  • Damage to underlying structures
  • Unsatisfactory results that may necessitate additional procedures.

You can help minimize certain risks by following the advice and instructions of your board-certified plastic surgeon, both before and after your eyelid surgery.

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