Rhinoplasty is a surgical procedure in which deformities of the nose are corrected by removing, rearranging, or reshaping bone and cartilage. Typical reasons for this surgery include, improving the angle, reducing the size of the nose, or removing a bump. Both profile and frontal face views can be altered through rhinoplasty. This surgery can be performed in conjunction with procedures designed to relieve nasal obstructions.
The patients medical history will be acquired before the surgery in order to evaluate the general health of the patient. A careful examination is also conducted. Dr. Graper and patient will then discuss how they want the nose to look in relation to the patients other facial features. It is important for the patient to understand that the goal of the surgery is not to achieve perfection but rather to improve the appearance. Photographs of the patients face will be taken; this allows Dr. Graper to evaluate the appropriate procedure to achieve the desired results. After the examination Dr. Graper will explain the type of anesthesia that will be used, the procedure, the expected results, and the possible risks and complications. The patient will then be given their preoperative instructions and antibiotics may be prescribed to prevent infection.
Rhinoplasty can be done under general anesthesia with the patient asleep or under light sedation. The procedure is determined by the type of correction to be made. In most cases involving a reduction in size or shape of the nose, the removal of a hump or the improvement of an angle, incisions are made inside the nose. Working through these incisions, the physician is able to cut bone and cartilage, the soft, movable tissue inside the nose, to reshape it.
To remove a nasal hump, a special file or chisel is used. A narrower nasal bridge is then formed by bringing together the bones on either side of the face. In patients in whom the size of the nasal tip is too large, cartilage is removed through the inside incision. The angle between the nose and the upper lip can be improved by elevating and trimming the septum, the dividing wall between the two chambers of the nose.
In some cases, it is necessary to narrow the base of the nose. This procedure involves removal of skin from both sides of the nostrils at the center. In order to improve the contour of the noses of some patients, it is sometimes necessary to add tissue.
These procedures can last from one and a half to two hours or more depending up the extent of surgery.
Following surgery, a lightweight splint is applied to maintain the new shape of the nose; the splint is usually removed within a week. Nasal pads may also be inserted at the time of surgery to protect the septum; this packing is removed within a day or two. Before and even after the packing is removed, there is frequently some stuffiness of the nose, particularly when work has been done in the nasal septum. Dr. Graper will advise when it is permissible to gently blow the nose.
Pain connected with the surgery is minimal to moderate and is controlled with oral medication. Bruising around the eyes occurs but begins to fade within a few days. Discoloration usually disappears in two to three weeks. Swelling around the treated areas slowly diminishes and can be reduced by keeping the head in a slightly elevated position when reclining. Cold compresses may be recommended. Slight swelling may be present for as long as two to four months.
During the healing process, great care must be taken to protect the nose from injury. Eye glasses should be adjusted in order to minimize pressure on the nose. Dr. Graper advises contact lenses can be worn. Although patients are usually up and around a day or two after the procedure, strenuous exercises, particularly those which might elevate blood pressure, must be avoided for several weeks. Dr. Graper will determine when normal activities may be resumed.