Rhinoplasty
is usually done on an outpatient basis, for convenience and more affordable
costs. It may be performed in a surgeon's office-based operating room.
More complex procedures may require a short inpatient stay.
During
surgery, incisions are made to provide access to cartilage and bone.
The skin of the nose is separated from its supporting framework and
depending on your problem and your surgeon's preferred technique, the
new nose is sculpted to the desired shape. Finally, the skin is redraped
over the new framework.
Whenever
possible, incisions are made inside the nostrils but for more complicated
cases, a small incision is made across the columella, the vertical strip
of tissue separating the nostrils. If the nostrils are too wide, incisions
are made at the base of the nose.
When
the surgery is complete, a splint may be applied to help your nose maintain
its new shape. Nasal packs or soft plastic splints also may be placed
in your nostrils to stabilize the septum, the dividing wall between
the air passages.
Although
rhinoplasty usually takes only an hour or two, this operation is difficult
to learn and difficult to perform well. A skillful surgeon knows where
to make incisions so that they will be practically invisible after healing.
With proper technique, scar tissue doesn't interfere with achieving
the desired results. A skillful surgeon also knows where to make incisions
to minimize the amount of bleeding during the operation. The surgeon
can have better results when there is less bleeding because he can clearly
see what needs to be done. An experienced surgeon also knows how to
minimize intraoperative swelling. Swelling can make it hard for the
surgeon to see what the nose's final shape will be and what needs to
be done during surgery. Back Rhinoplasty
for Asians
Rhinoplasty
performed on Asians has the same goal as rhinoplasty performed on Caucasians,
which is to build a natural-appearing structure that blends harmoniously
with the face. Usually, Asians require augmentation of the nose, while
Caucasians usually require reduction. Southeast Asians (Filipino, Malay,
southern Chinese) typically require the most augmentation.
In Filipinos
and other Asians, the nasal bridge is often low. The nasal tip is also
low and thick, and the base of the nose is wide. Hence the most commonly
requested nasal surgery in the Philippines is the "noselift."
Most Filipino plastic surgeons use solid silicone L-shaped implants
in order to increase the height of the nasal bridge and to increase
the projection of the nasal tip. The bend of the L forms the new tip.
The skillful surgeon takes great care in creating the look and feel
that is most suitable to your face and features. Implants are individually
sculpted to personally suit the shape of your face, resulting in a more
"natural" look.
American
plastic surgeons generally prefer the use of cartilage grafts or bone
grafts to augment the nasal bridge and tip. However these kinds of grafts
have been known to resorb and decrease in size over a period of time.
Filipino patients also do not want an extra operation on another part
of their body in order to harvest cartilage or bone. Also, most American
patients request reduction rhinoplasty for large noses and hence American
plastic surgeons have less experience performing noselifts.
Many
Asian patients will also need an alar plasty operation to decrease the
wide nasal base. A skillful surgeon will use a technique to remove small
wedges of skin to bring the nostrils closer together and which will
result in natural looking nostrils. Back
Your
new nose
The
challenge in rhinoplasty is in creating a new nose that will look natural.
Your surgeon must have a fine aesthetic sense such that the surgical
results of your nose operation will appear natural and unnoticeable.
The new nose should look like it "fits" together with the
rest of your features. The nose should be symmetrical and nostrils should
have a natural curve.
A poorly
done noselift can be easily detected by an observer because of the visible
outlines of the silicone implant under the skin. The nose is also overly
prominent and does not blend in harmony with the contours of the rest
of the patient's face. In a poorly done alarplasty, nostrils look unnaturally
narrow when compared to the rest of the nose.
When
incisions are inside the nose, there is no visible scarring at all;
when an "open" technique is used, or when the procedure calls
for the narrowing of wide nostrils, the small scars on the base of the
nose are usually not visible. Back
After
surgery
After
surgery, your surgeon will instruct you to stay in bed with your head
elevated during the first twenty-four hours. Your face will feel puffy
and you may have a headache. Your nose may also ache. Take the pain
medication prescribed by your surgeon to control whatever discomfort
you feel.
It is
common to have a little bleeding during the first few days after surgery,
and you may continue to feel some stuffiness for several weeks. Your
surgeon will probably ask you not to blow your nose for a week or so,
while the tissues heal.
It is
normal to have some swelling and bruising around your eyes specially
after two or three days. Applying cold compresses will reduce this swelling
and relieve some of the discomfort. Most of the swelling and bruising
should disappear within two weeks or so.
In the
days following surgery, many patients feel depressed because of their
bruised and swollen faces. This stage will pass and your spirits will
improve as your nose heals.
If you
have nasal packing, it will be removed after a few days. Dressings,
stitches and splints are usually removed after one week and you can
usually return to school or sedentary work within this period.
Although
you will feel much better after two days, it may take several weeks
before you're back to normal. Your surgeon will give you guidelines
about when you can resume your normal activities. Usually, for two to
three weeks after surgery, he will ask you to avoid strenuous activities
such as sports or sexual relations as these will increase your blood
pressure.
You will
also have to be gentle with your new nose. If you wear glasses, you
will have to make sure they don't rest on your new nose until it is
completely healed. This will take about six to seven weeks. You should
also avoid hitting or rubbing your nose or getting it sunburned. Back
Follow-up
In
the months after surgery, your surgeon will schedule frequent follow-up
visits to check on the progress of your healing. In between visits to
your surgeon, if you notice anything unusual or have any questions about
symptoms, or what you are allowed to do, don't hesitate to call him.
RHINOPLASTY
SURGERY