Rhinoplasty is the most commonly performed cosmetic surgery procedure in the United States. The procedure can be performed to reduce the size of the nose, to narrow a “wide” nose, to accentuate aesthetic features with or without changing the size, to straighten a “crooked” nose, or to correct deformities resulting from prior surgery.
Intrinsic to Rhinoplasty is a regard for breathing abilities. While striving for the desired aesthetic result, an equal significance is placed on maintaining adequate nasal airflow. Some older techniques stressed only the aesthetic, resulting in breathing obstruction. Fortunately, with better understanding of nasal anatomy and function, Rhinoplasty procedures performed today yield a desirable appearance while maintaining normal breathing. In fact, many procedures performed today are aimed at correcting breathing difficulties or contour irregularities resulting from prior “older style” Rhinoplasty procedures.
Prior to any Rhinoplasty procedure, the nasal contour, anatomy, and function need to be meticulously examined. This includes examination of the upper nose (nasal bones), the middle, and the lower nose (nasal cartilage). The thickness and quality of the nasal skin is similarly important, as this will dictate the type of procedure that will be best suited for the patient. Exam of the inside of the nose is crucial as the internal structure may be contributing to the undesirable external appearance. Internal examination also alerts the surgeon to any allergic conditions and guides the surgeon with regard to maintaining adequate nasal passages for breathing.
Rhinoplasty can be performed endonasally (from inside the nose) or through a small incision under the tip of the nose. The approach is dictated by the extent of modification to be made and, fortunately, neither approach leaves any visible scars. The nasal septum (partition between the left and right side of the nose) is treated at the same time from inside the nose to further improve nasal breathing.
Rhinoplasty is an outpatient procedure that generally takes between 1-3 hours and can be performed under sedation anesthesia or general aesthesia. Tape and a molded plastic dressing are applied for a period of 5-7 days to limit swelling. Intranasal packing is very rarely used, hence there is very little discomfort associated with rhinoplasty. Moderate bruising may occur around the eyes, particularly if the shape or position of the nasal bones has been modified.
The dressing and sutures are removed 5-7 days after surgery. At this point post-operatively, the nose will still be somewhat swollen although the proposed contour improvements will be visible. Gradual improvement in swelling can be expected over the first 1-3 weeks following surgery. Final results may take as long as 1-3 months in many cases and as long as 4-6 months in more complicated or revision cases.