What is a Rhinoplasty?
A rhinoplasty is a surgical procedure performed for creating an aesthetic appearance to your nose while improving the breathing through your nose. While the main objective is to create a nose that suits your face and is pleasing to both you and the observer, when performing a rhinoplasty the act of creating an open airway through your nose is never compromised.
A rhinoplasty can be performed for one or more of the following reasons:
- to create an aesthetic appearance to a nose deformed by previous trauma
- as a plastic surgical procedure if you are unhappy with the appearance of your nose
- to create an aesthetic appearance to a congenitally deformed nose (birth defects)
- as an accompanying procedure to cleft lip repair
Could I benefit from a rhinoplasty?
You may be an appropriate candidate for a rhinoplasty for one of the following reasons:
- you are unhappy about the appearance of your nose
- previous trauma or infection has changed the shape of your nose
- you have a congenital (birth) defect of your nose
- you are unhappy with the way aging has changed the shape of your nose
What is the most appropriate age for a rhinoplasty?
Desirably an age of 18 and over is preferred as the bony structures of the face near completion at this age and the shape of the bony appearance of your face will not change much after this age.
How is rhinoplasty surgery performed?
There are two major techniques in rhinoplasty surgery. The first is the open technique in which a small incision is placed on the undersurface of your nose, on the small strip of skin that separates the nostrils. The second is the closed technique where no incision is placed on the skin. Both of these techniques may be performed under general or local anesthesia with sedation.
After anesthesia and sterilization in the open technique a small incision is placed on the underside of your nose on the small strip of skin between the nostrils and connected with incisions placed inside your nose. In the closed technique incisions are placed inside your nose and no external incision is placed. After this the surgeon will re-shape your nose by removing, adding or sculpting the cartilages, bones and soft tissues of your nose. After completing the framework of your nose the skin will be re-draped and the incisions will be closed.
What can I expect before surgery?
Your photographs will be taken prior to surgery in different planes and you may discuss your outcomes with the surgeon on these photographs.
The main goal of rhinoplasty is aesthetic improvement with enhancement in nose breathing. Your physician will discuss with you the reasonable expectations from surgery and ascertain whether or not your goals are realistic.
Your surgeon will also talk to you about the risks, benefits and possible complications of rhinoplasty procedures. The discussion includes the type of anesthesia you will undergo. General anesthesia is more frequently performed; local anesthesia with sedation may also be utilized.
If you have previously undergone a rhinoplasty or your surgeon feels that the cartilage obtainable from your nose will not be sufficient for shaping and reconstructing your nose, your surgeon may need to harvest cartilage either from your ear or you rib cartilage. You will be informed of this before your operation.
The operation may be performed as an outpatient procedure or you may be admitted to the hospital for observation and dressing changes.
Can I see what I will look like after the operation?
Computer imaging can give you an idea of what you will look like after surgery. Remember that the result will almost always differ somewhat from the computer generated outcome, regardless of the surgeon’s expertise.
What can I expect after surgery?
You can typically get up and walk around the evening of the surgery or the following morning, initially with assistance. You should be prepared for moderate swelling and the ecchymosis of the skin while degree differs markedly from patient to patient. A cold mask is placed over your eyes for the first two days to decrease swelling and bruising. Generally speaking most of the swelling and bruising will subside in 7-10 days although some swelling can persist for up to 2-3 months.
You should expect to see the final appearance of your nose at the end of 1 year. You may have some bleeding from the nose which is generally mild and will subside on its own or with sprays that your surgeon will give to you. During the first week after surgery you may not be able to breathe through your nose but this usually resolves after the first week.
Will I have a bandage or dressing after surgery?
During surgery at the end of the procedure your surgeon will typically place small strips over your nose and place a splint on these strips. Dr. Cakmak does not prefer any nasal pack or dressing, uses absorbable sutures instead to prevent blood accumulation (hematoma) that do not require removal. The splints on the outside of your nose are removed 7-8 days after the surgery.
Do you need to remove the sutures?
If you have undergone an open rhinoplasty the sutures on the skin will be removed 5-7 days after surgery. If absorbable sutures are used for skin closure these do not have to be removed. The incisions inside of the nose are made from absorbable material and do not need to be removed.
Will I be in pain after the surgery?
After surgery pain is minimal to moderate and is usually well managed with pain medications. Severe pain is not expected and if you are experiencing this then you should visit your doctor as soon as possible.
What are possible risks and complications of rhinoplasty?
Rhinoplasty is one of the most demanding operations in facial plastic surgery and like every other surgery complications may occur. Risks and complications are listed below;
Bleeding: may occur after the surgery and last for up to 4 weeks. Most bleeding is self contained but if your nose is bleeding uncontrollably then you should talk to your surgeon
Infection: the risk of infection is very low after rhinoplasty and you will be started on a course of antibiotics after surgery. If your nose begins to ooze of smell badly you should contact your surgeon immediately.
Hypertrophic scars: if you have undergone a closed technique rhinoplasty your scars will be hidden inside your nose. If an open technique rhinoplasty has been performed you will have a small scar that is usually hardly visible after 1-2 years at the base of your nose on the small strip of skin that separates the nostrils. Rarely this scar may not heal properly and leave a big scar requiring scar revision.
Discoloration: after surgery there will be bruising around the eyes and occasionally on the nose. This bruising usually subsides after 2-4 weeks. Very rarely the color of the nose skin may become darker or redder and may persist up to a year.
Loss of smell: this may occur after surgery and is almost always temporary and can last 3-6 months.
Numbness of the nose: a certain amount of numbness on the nose is expected after surgery and is almost always temporary. The numbness usually subsides after 3-6 months.
Asymmetries and irregularities: rhinoplasty is the art of re-creating your nose and multiple procedures are performed during surgery. All these procedures carry there own risk of causing irregularities or asymmetries or just “not looking right”. There are a wide range of deformities that may occur after surgery and after a certain period of time if they persist you may talk to your surgeon about revision surgery. You should keep in mind it will take from 1-2 years for your nose to take its final form and previous deformities that you do not like can change during this period.
Is it possible that I will need revision surgery?
Rhinoplasty has the highest rate of revision in all facial plastic surgery procedures. You should be aware that it will take 1-2 years for your nose to heal completely and takes its’ final form. If after surgery there is a deformity of asymmetry of your nose your surgeon will advise you to wait 6-12 months for the swelling and healing of your nose. After this period if there is still asymmetries or deformities then you should discuss with your surgeon the options available.
How long will I be off from work?
Generally speaking the swelling and bruising around your eyes and nose may last up to 7-10 days. The splints on and inside your nose will be removed 1 week after surgery but if you feel comfortable you may start working with the splints as soon as 3 days after surgery.
Can I wear glasses?
You will be asked to refrain from using glasses for a period between 6 weeks. You may use your contact lenses 2-3 days after the surgery
Can I do sports?
You should refrain from strenuous exercise 2-3 weeks after the surgery. You should refrain from contact sports for 6 weeks.
Can I sunbathe?
Yes, but only after applying copious amounts of sunscreen on your nose. As direct sunlight may cause discoloration of the skin on your nose. This risk can last a year.