Nose Reshaping Surgery (Rhinoplasty)

Benefits

Rhinoplasty is aimed for one's look improvement rather than for its perfection. Some persons may not like their nose from various reasons, either because of its length or of its unaesthetic appearance.

Therefore the benefits are sometimes more of a psychological nature, involving emotional and social adjustment, especially in the case of teenagers.

The best candidates for this kind of surgery are the persons who are healthy, psychologically stable and realistic in their expectations.

Operation

There are two types of rhinoplasty procedures: the closed and the open technique. The first one is performed inside the nostrils where a few tiny incisions are made. The latter one supposes an incision across the vertical strip of skin between the nostrils. In this way, the surgeon has a better view of the nasal deeper structures. The patient's individual nose and personal preferences will be taken into consideration before deciding which procedure to perform.

Below are some of the operation steps. Each patient may undergo a few or all the steps, depending on the changes to be done.

• The profile may be modified by reducing the height of the nasal bridge. This can be done by "shaving" the upper cartilages and septum.
• For decreasing the nose length, the surgeon resects the terminal part of the septum and corrects the upper lateral cartilage.
• The rounded appearance of the nose can be reduced by cutting a portion of the alar cartilage
• Sometimes the septum needs to be trimmed to obtain a shorter nose.
• To narrow the nostrils a wedge can be removed by a skin excision. The scars resulted from performing this technique will be hardly noticeable.
• In order to narrow the bridge of the nose, the surgeon will cut the nasal bone and gently push the bones together (this technique is called infracture).
• Occasionally, grafts of cartilage (taken from the septum, the ear or the ribs) may be used to correct or build out or up the nose by highlighting the bridge line or nasal tip.

Following the surgery, a splint will be applied to support and maintain the new shape. This will be removed after 7-14 days.

The operation is performed under general anesthesia, meaning that the patient will be asleep throughout the entire procedure.

Rhinoplasty usually takes between two and three hours.

Risks

As with any surgery, there are possible risks to consider. It is well known that surgical complications happen infrequently. Although they are more likely in patients with compromised immune system, bleeding disorders or conditions that interfere with wound healing, the patient should be aware of them.

The risks that may occur following rhinoplasty are listed below:�

Infection

It happens in less than one percent of the cases. If the patient experiences pain or redness following the surgery, the surgeon should be told straight away. The patient is given antibiotics in order to prevent this risk.

Bleeding and haematoma

This occurs immediately after the operation and is expected to stop in a few hours. This is normal bleeding. However, a blood clot may form under the skin or between the skin and cartilage. A return visit to the surgery is necessary then. If the patient experiences serious pain after the surgery, the surgeon should be notified as soon as possible.

Eye injury

This may occur because of the damage to the tear drainage apparatus during the operation performance. Eye injury can be avoided by carefully protecting the eyes during the surgery.

Intracranial Complications

Meningitis (an infection in the cranial cavity) is a possible complication due to the nasal injuries caused by rhinoplasty. As soon as the meningitis symptoms (severe headaches, neck stiffness or intolerance to light) are recognised, the surgeon must be urgently announced.

Skin problems

This complication is minor and temporary. The skin may be affected by the tape that is applied to the nose beneath the splint.

Broken capillaries/small thread veins

This condition may already exist on the nose and can be treated with laser.

Scarring

The small incisions on the columella and nostrils will heal very well, so the scars will be hardly visible. They are almost unnoticeable after one month.

Bone irregularities

These may occur because of the nasal bone reshaping. It is recommended to wait at least one year before having repeat surgery.

Nasal obstruction

This complication is very rare and is due to the temporary decrease in the nasal airway. However, it may disappear in a few weeks and months. If not, the surgeon will recommend the right treatment or maybe a new operation together with a E.N.T surgeon.

A retracted or hanging columella

This may require a new minor operation.

Decreased sense of smell

This is rather a theoretical possibility and may be a potential source of irritation.

Dark circles under the eyes

They may occur as a result of the blood pigments retention in the skin around the eyes. Fortunately, there are special creams that can bleach the skin and makeup can be used as well. In time, the darkness beneath the eyes will improve, depending on each patient.

Questions

For the first consultation with the surgeon, you are advised to prepare a set of questions that might help you better understand the benefits, risks and performance of the procedure.

Here is a list of questions related to rhinoplasty:

• Am I a good candidate for rhinoplasty surgery?
• What should I avoid prior to the operation?
• Can you explain the intervention to me in detail?
• What benefits can I expect from the surgery?
• Will my nose look totally different?
• How will I look like? Can you show me on your computer?
• hat side effects and complications may I experience by undergoing the procedure?
• Will I have pains during or after the procedure?
• How long will it take before I can resume my normal activities following rhinoplasty?
• How long will the results last?
• What cannot be achieved by having rhinoplasty?