Rhinoplasty

Rhinoplasty is a nose job cosmetic procedure to bring the shape and size of the nose in symmetry and balance with the rest of the face.

Not all of us get the perfect nose at the time of our birth. However, due to the advancements in plastic surgery, the nose could be made as perfect as possible if the surgeon is a skilled one.

The surgeon would be able to alter the angle between the upper lip and the nose, increase or reduce the size of the patient’s nose, reshape the tip of the nose, or narrow the nostrils of the nose.

Open Rhinoplasty

Procedure In open rhinoplasty nose procedure, the surgeon would administer a mild sedation or a local anesthetic to the patient. Then, the surgeon would make an incision across the columellar area of the nose and reconstruct the cartilage to alter the shape and size of the nose.

Sutures would be put in place to close the incision and a splint would be set on the nose for a week so that the new shape stabilizes. When the swelling subsides, the new shape of the nose would be visible. However, in open rhinoplasty, a small scar would be visible on the underside of the nose.

Closed Rhinoplasty Procedure

In closed rhinoplasty, the incisions are made within the nostril and there would no visible scars after this delicate face procedure. This procedure would be the best one when artificial implants are placed inside or cartilage and bone taken from another part of the body are added to provide better support and shape to the nose.

This nose job could be performed for removing excess cartilage and bone also successfully. Closed rhinoplasty nose procedure does not give the surgeon the freedom that open rhinoplasty provides. Still, many skilled plastic surgery experts resort to this cosmetic procedure as a good option.

Rhinoplasty can be performed to meet aesthetic goals or for reconstructive purposes to correct birth defects or breathing problems. It can be combined with other surgical procedures such as chin augmentation to enhance the aesthetic results.

The procedure can reduce or increase the size of the nose, narrow the span of the nostrils, change the angle between the nose and upper lip, and/or change the tip or bridge of the nose. It can also correct some breathing problems.

Where is Nose Surgery performed?

Simple rhinoplasty is usually performed in an outpatient surgery center or in the surgeon`s office. Most procedures take only an hour or two, and patients go home right away. Complex procedures may be performed in a hospital and require a short stay. Rhinoplasty is usually performed by a surgeon with advanced training in plastic and reconstructive surgery.

How rhinoplasty is performed

Rhinoplasty involves the re-sculpting of the bone and cartilage. When operating on the nose, the surgeon can either work from within the nose by making an incision inside the nose, or work from the outside by making a small incision across the tissue that separates the nostrils. The latter is known as an “open” procedure.

It can be performed under a general anesthetic or with local anesthetic, depending on patient or doctor preference. Incisions are made inside the nostrils (closed rhinoplasty). Sometimes, tiny, inconspicuous incisions are also made on the columella, the bit of skin that separates the nostrils (open rhinoplasty). The surgeon first separates soft tissues of the nose from the underlying structures, then reshapes the cartilage and bone causing the deformity.

In some cases, the surgeon may shape a small piece of the patient`s own cartilage or bone to strengthen or increase the structure of the nose. Sometimes this is done for cosmetic reasons (to improve the shape of the nasal tip, for example), or it may be done to improve breathing and function of the nose.

In rarer cases, a synthetic implant may be used to reconstruct the nose if the normal structure of bone and cartilage is badly damaged or weakened.

Alloplastic synthetic materials are often associated with long-term complications such as migration and extrusion. Alternatively, cartilage from the septum, ear or rib may be used.

To improve nasal breathing function, a septoplasty may be performed, with or without cosmetic changes. The cartilage that is removed may be used as a graft to improve the appearance and structure of the nose.

Possible complications

Re-operation: although not common, sometimes a second surgery may be required to correct a minor deformity that occurs as a result of the initial rhinoplasty.

Surgery complications: as in any surgery there are some risks involves, including: infection; reaction to the anesthesia; nose bleeding.
Burst blood vessels: sometimes small blood vessels may burst causing tiny red spots on the nose to surface. The spots are usually minor in appearance but can be permanent.

Scarring: with the “open” procedure there is the possibility of scarring on the base of the nose.

Length of procedure: about two hours

Recovery

It usually takes around a few days. Return to work / school is usually within a week. Back to other normal activities according to surgeon’s guidelines.

Side effects (short-term)

• Small amount of bleeding in first few days;
• Splint applied to nose to help maintain new shape, nasal packs or soft plastic splints may be placed in nostrils to stabilize septum;
• Face will feel puffy;
• Nose may ache;
• Some headache;
• Swelling around the eyes, bruising around the eyes;
• Small burst blood vessels may appear as tiny red spots on the skin`s surface.

Ethnic Nose Rhinoplasty

Many African-Americans or Asian-Americans, or those who have an “ethnic nose” choose to have an aesthetic rhinoplasty.

Although techniques and methods employed during rhinoplasty surgeries are the same regardless of race, there are some trends that apply to patients of certain ethnic backgrounds.

Revision rhinoplasty

Revision rhinoplasty is a nose operation carried out to correct or revise an unsatisfactory outcome from a previous rhinoplasty. It is also known as secondary rhinoplasty or tertiary rhinoplasty.

There are two main reasons for performing secondary or tertiary rhinoplasty. The first is purely cosmetic. A patient may be unsatisfied with all or part of a previous nose “job” because of the way their nose appears after rhinoplasty surgery.

A nasal hump may not have been reduced enough, or too much. A prominent or bulbous nasal tip may have not been addressed appropriately, or over-aggressively. The nose may looked pinched, it may look like a parrot’s beak, or like a boxer’s nose. There are many ways in which previous nose surgery may have left a nose aesthetically unappealing to a patient.

The second reason is functional.

The original nasal surgery may have been carried out to help with difficulties in breathing, and the outcome may have been unsatisfactory. Alternatively, the original surgery may have been performed for cosmetic reasons, but may have disrupted a normal physiologic mechanism involving the inspiration or expiration of air, making it difficult to breathe.

Secondary rhinoplasty, and especially tertiary rhinoplasty, are extremely complicated procedures. This is self-evident because it is clear that even when the patient was operated upon for the first time, even when the tissues were “virginal,” and untouched the desired result could not be obtained.