Plastic Surgery

Plastic Surgery

Cosmetic plastic surgery includes surgical and nonsurgical procedures that enhance and reshape structures of the body to improve appearance and confidence. Healthy individuals with a positive outlook and realistic expectations are appropriate candidates for cosmetic procedures. Plastic surgery is a personal choice and should be done for yourself, not to meet someone else’s expectations or to try to fit an ideal image. Because it is elective, cosmetic surgery is usually not covered by health insurance.

WHAT IS RINOPLASTY?

Rhinoplast enhances facial harmony and the proportions of your nose. It can also correct impaired breathing caused by structural defects in the nose.

Rhinoplasty surgery can change:
•    Nose size in relation to facial balance
•    Nose width at the bridge or in the size and position of the nostrils
•    Nose profile with visible humps or depressions on the bridge
•    Nasal tip that is enlarged or bulbous, drooping, upturned or hooked
•    Nostrils that are large, wide, or upturned
•    Nasal asymmetry

If you desire a more symmetrical nose, keep in mind that everyone’s face is asymmetric to some degree. Results may not be completely symmetric, although the goal is to create facial balance and correct proportion.

Rhinoplasty to correct a deviated septum

Nose surgery that’s done to improve an obstructed airway requires careful evaluation of the nasal structure as it relates to airflow and breathing.

Correction of a deviated septum, one of the most common causes of breathing impairment, is achieved by adjusting the nasal structure to produce better alignment.

Rhinoplasty to correct a deviated septum

Nose surgery that’s done to improve an obstructed airway requires careful evaluation of the nasal structure as it relates to airflow and breathing.

Correction of a deviated septum, one of the most common causes of breathing impairment, is achieved by adjusting the nasal structure to produce better alignment.

Rhinoplasty candidates

You may be a good candidate for rhinoplasty if:
•    Your facial growth is complete
•    You are physically healthy
•    You don’t smoke
•    You have a positive outlook and realistic goals in mind for the improvement of your appearance

Rhinoplasty recovery

During your rhinoplasty recovery, a splint and/or packing will likely be placed inside your nose and a splint or bandages placed on the outside to support and protect the new structures during initial healing.

While initial swelling subsides within a few weeks, it may take up to a year for your new nasal contour to fully refine. During this time you may notice gradual changes in the appearance of your nose as it refines to a more permanent outcome.

Swelling may come and go and worsen in the morning during the first year following your rhinoplasty surgery.

You will be given specific instructions that may include:
•    How to care for the surgical site
•    Medications to apply or take orally to aid healing and reduce the potential for infection
•    Specific concerns to look for at the surgical site or in your general health
•    When to follow up with your plastic surgeon.

Be sure to ask your rhinoplasty surgeon specific questions about what you can expect during your individual recovery period:
•    Where will I be taken after my surgery is complete?
•    What medication will I be given or prescribed after surgery?
•    Will I have dressings/bandages after surgery?
•    When will they be removed?
•    Are stitches removed? When?
•    When can I resume normal activity and exercise?
•    When do I return for follow-up care?

Rhinoplasty procedure steps

Rhinoplasty surgery includes the following steps:

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation or general anesthesia. Your doctor will recommend the best choice for you.

Step 2 – The incision

Rhinoplasty is performed either using a closed procedure, where incisions are hidden inside the nose, or an open procedure, where an incision is made across the columella, the narrow strip of tissue that separates the nostrils.

Through these incisions, the skin that covers the nasal bones and cartilages is gently raised, allowing access to reshape the structure of the nose.

Open rhinoplasty incision across the columella

Step 3 – Reshaping the nose structure

An overly large nose may be reduced by removing bone or cartilage. Sometimes surgery of the nose may require the addition of cartilage grafs.

Most commonly, cartilage from the septum, the partition in the middle of the nose, is used for this purpose. Occasionally cartilage from the ear or rarely a section of rib cartilage can be used.

Step 4 – Correcting a deviated septum

If the septum is deviated, it can be straightened and the projections inside the nose reduced to improve breathing.

Step 5 – Closing the incision

Once the underlying structure of the nose is sculpted to the desired shape, nasal skin and tissue is redraped and incisions are closed.

Additional incisions may be placed in the natural creases of the nostrils to alter their size.

Step 6 – See the results

For a few days splints and gauze packing will likely support the nose as it begins to heal. Get more information about rhinoplasty results.

Rhinoplasty risks and safety

The decision to have plastic surgery is extremely personal. You will have to decide if the benefits will achieve your goals and if the risks and potential complications of rhinoplasty are acceptable.

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks or potential complications.

Rhinoplasty surgery risks include:
•    Anesthesia risks
•    Bleeding (hematoma)
•    Infection
•    Poor wound healing or scarring
•    Change in skin sensation (numbness or pain)
•    Nasal septal perforation (a hole in the nasal septum) is rare. Additional surgical treatment may be necessary to repair the septum but it may be impossible to correct this complication
•    Difficulty breathing
•    Unsatisfactory nasal appearance
•    Skin discoloration and swelling
•    Possibility of revisional surgery

These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your plastic surgeon.

Your rhinoplasty consultation

During your rhinoplasty consultation be prepared to discuss:
•    Your surgical goals, with regard to both appearance and breathing
•    Medical conditions, drug allergies, and previous medical treatments
•    Current medications, vitamins, herbal supplements, alcohol, tobacco, and drug use
•    Previous surgeries

Your rhinoplasty surgeon may also:
•    Evaluate your general health status and any pre-existing health conditions or risk factors
•    The options available to you for nose reshaping
•    Examine and measure your face
•    Take photographs
•    Discuss your nose surgery options
•    Recommend a course of treatment
•    Discuss likely outcomes of a nose surgery and any risks or potential complications

Be sure to ask questions. To help, we have prepared a checklist of questions to ask your rhinoplasty surgeon that you can take with you to your consultation.

It’s very important to understand all aspects of your rhinoplasty procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.

Preparing for rhinoplasty surgery

In preparing for rhinoplasty surgery, you may be asked to:
•    Get a lab test
•    Take certain medications or adjust your current medications
•    Stop smoking
•    Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding

Your plastic surgeon will also discuss where your procedure will be performed.

Rhinoplasty may be performed in an accredited office-based surgical facility, a licensed ambulatory surgical center or a hospital. Be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.