Rhinoplasty is a surgical intervention performed in order to correct deformities of the nose, and is one of the most frequently performed surgical procedures in plastic surgery.
Rhinoplasty can:
- Decrease or increase the size of the nose.
- Change the shape of the tip or dorsum.
- Narrow the nostrils or change the angle between the nose and the upper lip.
It also corrects congenital problems, trauma and some respiratory problems.
The Ideal Candidate for Rhinoplasty
The ideal candidates for rhinoplasty are those who are looking for improvement, not absolute perfection, in their appearance. The patient must be in good general health, psychologically stable, and realistic in his or her expectations.
Age should also be taken into account. Most plastic surgeons prefer not to perform rhinoplasty until 14 or 15 years of age in girls and slightly older for boys. Likewise, it is important to consider the emotional and social adjustments of adolescents, and to be sure that it is they, and not their parents, who want to undergo rhinoplasty.
The rhinoplasty process
Rhinoplasty is always performed in the operating room, in a clinic or hospital. Normally, the patient stays in the clinic the night after surgery and is discharged the next day.
Rhinoplasty can be performed under local anesthesia plus sedation, or more frequently, under general anesthesia, depending on the complexity of the surgery and your surgeon’s preferences. If performed under local anesthesia plus sedation, the patient feels relaxed and the nose and its surroundings are insensitive to pain; with general anesthesia the patient is asleep during the operation.
Rhinoplasty surgery usually lasts between 1 and 2 hours, although in complex cases it may take longer. During surgery, the skin of the nose is separated from its support, composed of bone and cartilage, which is sculpted to the desired shape. Finally the skin is redistributed over this new support.
Sometimes this procedure is performed from inside the nose, through small incisions inside the nostrils; or there is also the option of open rhinoplasty, especially for more complex cases, in which a small incision is made in the columella.
When the surgery is completed, a plaster cast or other material is placed, which will help maintain the new shape of the nose. Nasal packing is also placed in both nostrils to prevent bleeding and stabilize the nasal septum.
Getting back to normal
After surgery, and especially during the first 24 hours, the patient’s face will feel swollen, discomfort over the nose and headache, but these will subside with medication.
Some actions to take into account are:
- Remain lying down with the head elevated during the first day (except to go to the bathroom).
- Apply cold compresses to reduce swelling and bruising around the eyes. Most of the bruising and swelling will disappear in about 2 weeks (minimal swelling, almost only noticeable to your surgeon, may last for a few months).
- Do not blow your nose vigorously for a week or so until the tissues heal. In the case of having plugs in the nose, they will be removed in a few days, after which you will feel much better. It is normal to have a slight nosebleed during the first few days. After a week, or at most two, the cast, and skin stitches, if any, will be removed.
Most patients who undergo rhinoplasty are well within 2 days, being able to return to work or school in a week or so. Although your plastic surgeon will provide you with specific instructions are:
- Avoid strenuous activities (jogging, swimming, doing push-ups,…) for 2 to 3 weeks.
- Avoid bumps on the nose and sunbathing for 8 weeks, wash your face and apply makeup carefully.
- You can put contact lenses back in as soon as you want, but if you wear glasses you must take certain precautions.
Are there any risks involved in rhinoplasty?
When rhinoplasty is performed by a qualified plastic surgeon complications are infrequent and minor. However, there are always possibilities of complications such as:
- Infection
- Nosebleeds
- Reactions to anesthesia
Risks can be minimized by carefully following your plastic surgeon’s instructions both before and after surgery.
Results after rhinoplasty
In the first few days after surgery, when the face is swollen and bruised, it is easy to forget that our appearance is going to improve and many patients may feel somewhat depressed; this is a normal feeling. In 1 to 2 weeks, it will not look like you have had surgery. Improvement is progressive and gradual, although minimal swelling may remain, especially at the tip, for a few months. The definitive result is obtained in about 1 year.