The Nose Job

  • Thursday June 22, 2006 | Posted in: Plastic Surgery Procedures

    Technorati Tags: nose job, nose surgery, rhinoplasty, plastic surgery

    More commonly called “nose job,” rhinoplasty falls under reconstructive surgery if the procedure is done to improve the function such as correcting birth defects or breathing problems. If the goal is to enhance the appearance (to improve the shape of the nasal tip, for example), the procedure is carried out by experts in the field of cosmetic or aesthetic surgery.

    By the way, the first “nose job” was a reconstructive surgery (intranasal operation). It later expanded to accommodate the aesthetic demands of patients who felt that the shape or size of their nose caused them embarrassment and social discomfort. Whatever is the purpose, rhinoplasty, or precisely the success of the procedure is considered to be one of the most gratifying plastic surgeries to receive because a patient often will find his or he entire facial aesthetic modified.

    The actual procedure

    Prior to surgery a patient is restricted to consume any aspirin products for it may cause excessive bleeding. Depending on patient or doctor preference, rhinoplasty can be performed under local anesthesia (usually lidocaine or marcaine with epinephrine), with IV sedation, or under general anesthesia. In addition, a combination of cocaine and/or epinephrine to shrink the mucous membranes and control bleeding is applied.

    A rhinoplasty specialist will make incisions inside the nostrils to accommodate the separation of the soft tissues of the nose from the underlying structures. The bone and cartilage causing the perceived deformity is then reshaped accordingly. Where necessary, unremarkable, tiny incisions are also made on the columella, the bit of skin that separates the nostrils.

    In some cases, the surgeon may shape a small piece of the patient's own cartilage to add to, reinforce, or augment the structure of the nose. If the normal structure of bone and cartilage is badly damaged or weakened, a synthetic implant may be used. Alloplastic synthetic materials have been blamed for long-term complications such as migration and extrusion. Alternatively, cartilage taken from the ear, septum or rib may be devised. To improve nasal function, a septoplasty may be performed, with or without aesthetic changes. The cartilage that is removed may be used as a graft to improve the structure and appearance of the nose. Depending on the complexity, the whole “job” takes anywhere from two to four hours.

    Intermittently throughout the operation, the surgeon will frequently check the patient's facial profile, the symmetry of the nose tip, and the improvement after each small change is done. Even slight changes consisting of one to two and up to four millimeters can make considerable changes in the overall appearance of the nose.

    At the end of the surgery, the surgeon will reassess the size of the nostril. A few more cut may be needed if the nostril base is wide. Finally, the nose is packed and kept protected for seven to ten days.

    After Surgery/Recovery

    After surgery, patients should stay on antibiotics to prevent the onset of any infection. The patient is likewise advised to keep his or her head elevated for the next 48 to 72 hours (two to three days) to prevent swelling. Bruising is expected around the eyes for seven to ten days. It is very likely that the patient will feel heaviness between the eyes and a headache (similar to the feeling of a bad cold). Pain killers can alleviate the condition. They are further cautioned not to bump their nose and to keep partners, children, or pets at an arm's length.

    It will also do well for a patient to stay out the sun and avoid high-intensity activities (such as exercise, sex, etc) for three to four weeks. Very rarely, revisions are needed (refinements of bony tissues or little bumps) and usually carried out under local anesthesia in an office setting.

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