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The Best Candidates For
Rhinoplasty Rhinoplasty
can enhance your appearance and your self- confidence, but it won't necessarily
change your looks to match your ideal, or cause other people to treat you
differently. Before you decide to have surgery, think carefully about your
expectations and discuss them with your surgeon. The
best candidates for rhinoplasty are people who are looking for improvement, not
perfection, in the way they look. If you're physically healthy, psychologically
stable, and realistic in your expectations, you may be a good candidate. Age
may also be a consideration. Many surgeons prefer not to operate on teenagers
until after they've completed their growth spurt - around 14 or 15 for girls, a
bit later for boys. It's important to consider a teenager's social and emotional
adjustment, too, and to make sure it's what they, and not their parents, really
want. All
Surgery Carries Some Uncertainty And Risk When
rhinoplasty is performed by a qualified plastic surgeon, complications are
infrequent and usually minor. Nevertheless, there is always the possibility of
complications, including infection, nosebleed, or a reaction to the anesthesia.
You can reduce your risks by closely following your surgeon's instructions both
before and after surgery. After
surgery, small, burst blood vessels may appear as tiny red spots on the skin's
surface; these are usually minor but may be permanent. As for scarring, when
rhinoplasty is performed from inside the nose, there is no visible scarring at
all; when an "open" technique is used, or when the procedure calls for
narrowing of flared nostrils, the small scars on the base of the nose are
usually not visible. In
about one case out of ten, a second procedure may be required - for example, to
correct a minor deformity. Such cases are unpredictable and happen even to
patients of the most skilled surgeons. The corrective surgery is usually minor. Planning
Your Surgery Good
communication between you and your physician is essential. In your initial
consultation, your surgeon will ask you what you would like your nose to look
like, evaluate the structure of your nose and face, and discuss the
possibilities with you. He will also discuss the factors that will influence the
procedure and the results. These factors include the structure of the nasal
bones and cartilage, the shape of your face, the thickness of your skin, your
age, and your expectations. Your
surgeon will also explain the techniques and the anesthesia he will use, the
type of facility where the surgery will be performed, the risks and costs
involved, and any options you may have. Most insurance policies don't cover
purely cosmetic surgery; however, if the procedure is performed for
reconstructive purposes, to correct a breathing problem or a marked deformity
following injury, the procedure may be covered. Check with your insurer, and
obtain pre-authorization for your surgery. Be
sure to tell your surgeon if you've had any previous nose surgery or an injury
to your nose, even if it was many years ago. You should also inform your surgeon
if you have any allergies or breathing difficulties; if you're taking any
medications, vitamins, or recreational drugs; and if you smoke. Don't
hesitate to ask your doctor any questions you may have, especially those
regarding your expectations and concerns about the results. Preparing
For Your Surgery Your
surgeon will give you specific instructions on how to prepare for surgery,
including guidelines on eating and drinking, smoking, taking or avoiding certain
vitamins and medications, and washing your face. Carefully following these
instructions will help your surgery go more smoothly. While you're making these
preparations, be sure to arrange for someone to drive you home after your
surgery and to help you out for a few days if needed. Where
Your Surgery Will Be Performed Rhinoplasty
may be performed in a surgeon's office-based facility, an outpatient surgery
center, or a hospital. It's usually done on an outpatient basis, for cost
containment and convenience. Complex procedures may require a short inpatient
stay. Types
of Anesthesia Rhinoplasty
can be performed under local or general anesthesia, depending on the extent of
the procedure and on what you and your surgeon prefer. With local anesthesia,
you'll usually be lightly sedated, and your nose and the surrounding area will
be numbed; you'll be awake during the surgery, but relaxed and insensitive to
pain. With general anesthesia, you'll sleep through the operation. The
Surgery Rhinoplasty
usually takes an hour or two, though complicated procedures may take longer.
During surgery the skin of the nose is separated from its supporting framework
of bone and cartilage, which is then sculpted into the desired shape. The nature
of the sculpting will depend on your problem and the surgeon's preferred
technique. Finally, the skin is redraped over the new framework.
Many
plastic surgeons perform rhinoplasty from within the nose, making their incision
inside the nostrils. Others prefer an "open" procedure, especially in
more complicated cases; they make a small incision across the columella, the
vertical strip of tissue separating the nostrils.
When
your surgery is complete, a splint will 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.
After
Your Surgery After
surgery – particularly during the first twenty-four hours – your face will
feel puffy, your nose may ache, and you may have a dull headache. You can
control any discomfort with the pain medication prescribed by your surgeon. Plan
on staying in bed with your head elevated (except for going to the bathroom) for
the first day. You'll
notice that the swelling and bruising around your eyes will increase at first,
reaching a peak after two or three days. Applying cold compresses will reduce
this swelling and make you feel a bit better. In any case, you'll feel a lot
better than you'll look. Most of the swelling and bruising should disappear
within two weeks or so. (Some subtle swelling unnoticeable to anyone but you and
your surgeon will remain for several months.) A
little bleeding is common during the first few days following surgery, and you
may continue to feel some stiffness for several weeks. Your surgeon will
probably ask you not to blow your nose for a week or so, while the tissues heal.
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. Your
surgeon will give you more specific guidelines for gradually resuming your
normal activities. They're likely to include these suggestions: Avoid strenuous
activity (jogging, swimming, bending, sexual relations - any activity that
increases your blood pressure) for two to three weeks. Avoid hitting or rubbing
your nose, or getting it sunburned, for eight weeks. Be gentle when washing your
face and hair or using cosmetics. You
can wear contact lenses as soon as you feel like it, but glasses are another
story. Once the splint is off, they'll have to be taped to your forehead or
propped on your cheeks for another six to seven weeks, until your nose is
completely healed. Your
surgeon will schedule frequent follow-up visits in the months after surgery to
check on the progress of your healing. If you have any unusual symptoms between
visits, or any questions about what you can and can't do, don't hesitate to call
your doctor. Your
New Look In
the days following surgery, when your face is bruised and swollen, it's easy to
forget that you will be looking better. In fact, many patients feel depressed
for a while after plastic surgery - it's quite normal and understandable. Rest
assured that this stage will pass. Day by day, your nose will begin to look
better and your spirits will improve. Within a week or two, you'll no longer
look as if you've just had surgery. Still,
healing is a slow and gradual process. Some subtle swelling may be present for
months, especially in the tip. The final results of rhinoplasty may not be
apparent for a year or more. In
the meantime, you might experience some unexpected reactions from family and
friends. They may say they don't see a major difference in your nose. Or they
may act resentful, especially if you've changed something they view as a family
or ethnic trait. If that happens, try to keep in mind why you decided to have
this surgery in the first place. If you've met your goals, then your surgery is
a success. © Copyright 2001, American Society of Plastic and Reconstructive Surgeons |
