Nose Reshaping: Rhinoplasty & Septoplasty
Since the nose is the most prominent facial feature, it plays a major role in determining how we look. A nose that is too large or misshapen can disrupt the symmetry of an otherwise pleasant appearance. A person who is unhappy with his or her nose, often spends a great deal of time thinking about changing it. A procedure called rhinoplasty makes aesthetic and structural changes of the nose possible.
The nose is corrected in both profile and frontal views. At Beverly Hills Physicians will evaluate the structure of your nose in relation to the shape of your face, the thickness of your skin, and your age. We will work with you to try to make your nose complement your other facial features.
At your consultation, your surgeon will first carefully listen to your desires and goals. He will then examine you and make suggestions for improvement based on his assessment of your nose, your facial features and your desires. He will help you understand the surgery. This new technology helps At the end of your consultation, you will have a much clearer idea of what can be achieved so that you can make this very important decision. What is the goal? After surgery, people will say “Hey, you look great!” but they won’t know you had nasal surgery!
About the Procedure
Your doctor may prefer an open- tip technique for rhinoplasty. With this technique, a small incision is made across the columella, the vertical strip of tissue separating the nostrils. The open- tip technique allows for a more direct view of the nasal structures thus more predictable result.
You can choose to reduce or increase the size of your nose, change the tip or the bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip.
When the surgery is complete, a splint may be applied to keep the nasal structures immobile and help the nose maintain its new shape.
Rhinoplasty can be performed in an outpatient surgical facility or a hospital. We usually recommends general anesthesia for most rhinoplasty procedures.
The procedure usually takes about two hours, though complicated procedures may take longer. Rhinoplasty can also be performed in combination with other procedures designed to relieve nasal obstruction.
Rhinoplasty is not usually advised until a person has reached the mid-teenage years, when growth of the nose is nearly complete. This usually means 14 to 15 years of age for a girl and 16 for a boy.
Recovery & Healing
Nasal surgery produces minimal discomfort that can usually be controlled by pain medication. You will need to keep your head elevated and apply cold compresses to your eyes to reduce postoperative bruising and swelling.
A little bleeding is common during the first few days following surgery, and you may continue to feel some stuffiness for several weeks.
We try to avoid “packing” the nose after surgery. Patients, therefore, are more comfortable and generally less swollen. With the elimination of nasal packing, pain, swelling, bleeding, discoloration, etc., are dramatically reduced making the recovery period much more pleasant for the patient. By the end of one week, or occasionally two weeks, all dressings, splints, and stitches should be removed.
Avoid hitting or rubbing your nose, or getting it sunburned, for six months. You must remember that for the initial period after surgery your nose will be more sensitive to the sun and you will have to take special precautions. Be gentle when washing your face and hair or using cosmetics.
Most rhinoplasty patients are up and about within two days, and able to return to school or sedentary work a week or so following surgery. It will be several weeks, however, before you’re entirely up to speed.
The early results of this surgery are evident in two to three weeks. However, you will continue to notice an improvement in the contour and form of your nose for six to 12 months, as most of the swelling disappears. Healing is a slow and gradual process.
FUNCTIONAL NASAL SURGERY
There are structures within the nose, namely the septum and turbinates, which affect the airflow through the nose. Your surgeon will examine the internal structure of your nose at the time of consultation and provide information about possible improvement. Oftentimes, there is blockage of one or both of the nasal passages which results in decreased airflow. Surgery to correct these problems can be performed either alone or in combination with cosmetic nasal surgery. There is no effect on the external appearance of the nose if surgery is performed for functional reasons only.
While there is no insurance coverage for cosmetic nasal surgery, there may be available insurance coverage for functional nasal surgery. We will discuss this with you and cooperate in obtaining pre-certification for the functional surgery. Please bear in mind that insurance companies oftentimes require extensive x-rays and other tests as well as a six month trial of medications before they may approve coverage for this surgery. In essence, they will do everything they can to delay and/or prevent you from having this operation.
CAN I CHOOSE JUST A PART OF MY NOSE FOR IMPROVEMENT?
Yes you can! Frequently a patient will request treatment of a bulbous tip only. Or one may wish to shave down a small bump or reduce some nostril flare. And sometimes one desires to narrow the bony upper part of the nose but leave the tip alone. Your doctor will discuss the pros and cons of your request and together a plan for surgery can be made.
REVISION NASAL SURGERY
Plastic surgery is one of the few surgical specialties where one can get a second chance if the first operation was not totally successful. This is called secondary or revision surgery. That being said, revision surgery is always more difficult and less predictable due to the scar tissue resulting from the original surgery. In essence, you do not have a “virgin” nose. Therefore, improvement and not perfection, is the goal for these operations.
In nasal surgery, revision is even more difficult because it may require replacement of cartilage that was over-zealously removed during the first procedure. All of this mandates that you carefully choose your surgeon, for the first operation is always the best opportunity to get the best result. Everything after that is playing “catch up.”
It is important to inject some philosophy here – which is every bit as important as the hands which perform the operation. There are some operations in plastic surgery where you want to see substantial differences (like making a breast larger or smaller). There are other procedures, such as cosmetic nasal surgery, where subtlety is essential. The ideal male nose is strong: straight, symmetric, somewhat narrow and not uptilted – definitely not small, delicate and feminine. The ideal female nose is delicate, very slightly uptilted and appropriate for the face. One wants to look normal, not overdone. In nasal surgery, the difference between success and failure is measured in tiny millimeters of tissue removed or changed. All of this goes towards artistic judgment. You can be assured that Beverly Hills Physicians will bring this philosophy of subtle surgery to the performance of your procedure.