According to the American Society of Aesthetic Plastic Surgery, Rhinoplasty (nose reshaping) is the fourth most common procedure with 200,924 procedures performed in 2005, an increase of 21 percent over 2004. Rhinoplasty may be performed to improve your nose through better proportioning of size and shape. In essence, the rhinoplasty procedure ultimately adds balance and harmony to your face. People interested in rhinoplasty may wish to improve breathing that is compromised because the anatomical features of the nose. Others may wish to improve a birth defect or the result of a trauma to the nose.
Pre-Surgery
If you've thought about rhinoplasty before and are now approaching the serious stage, you must know that no information can replace the advice of a board certified plastic surgeon. It's important to be armed with a list of questions for the doctor and some knowledge about the expectations of the procedure- a thorough investigation. Initially, evaluations-including medical history, general health, examination of the nose-will be performed to determine the most effective surgical approach for the procedure. The surgeon will describe the procedure options, the methodology of the procedure that is available through their office, anesthesia, possible risks and complications as well as reasonable outcomes. This can be visualized by showing you before and after photos of the surgeon's patients. Preoperative instructions often include the temporary abstinence of certain drugs such as those which contain aspirin, birth control and other estrogen containing hormones. Antibiotics may be prescribed for a few days prior to surgery to help prevent infection.
The Procedure
A rhinoplasty procedure can be completed in a hospital or outpatient surgical center under general or local anesthesia. The determination of anesthesia type may coincide with the physician's choice of approach to the procedure as well as your personal preference. Pre-medication to relax you is administered before the procedure. The surgeon will also mark where the incisions will be located on you.
The Approach
Rhinoplasty is offered through two primary approaches, open or closed. Open rhinoplasty is called for when major reshaping of the nose is required. In this approach, incisions are made in the columella which is the skin that separates the nostril presenting itself as a vertical strip. Alternatively, the closed approach involves incisions within the nose and separation of the nose's skin from the bone and cartridge. Incisions can be hidden in the “natural” creases of the nose. Regardless of the approach, your surgeon will then reshape or remove necessary bone and cartilage to help produce the best outcome. Then, nose tissues are re-draped over your bone and cartilage. Or finally, a secondary rhinoplasty procedure may be required to improve functionality and provide better balance to your face. A secondary rhinoplasty utilizes the open method to reshape bone and cartilage through the use of cartilage grafts that may be transplanted from your ear or ribs Small sutures are used to close the incision. The length of the surgery is dependant upon the approach, taking up to two hours or more. Secondary rhinoplasty procedures are more complex, requiring at least two or more hours of time.
It's important to consider the most important considerations for you- for example, is decreased recovery time and healing due to local anesthesia and the closed approach most important and realistic for you? Will the doctor need to remove bone and cartilage? In fact, ask your doctor about risks associated with reduced cartilage and bone. Answers are best offered by a surgeon board certified by the American Board of Plastic surgery. The training of plastic surgeons can differ as well. So, ask the surgeon about their credentials.
Post-Op
Post operative instructions vary depending upon your particular situation and the surgeon you choose to perform your procedure. The following provides an overview of some of the common post operative instructions.
Day One: Patients can most often be released the day of surgery or otherwise may require an overnight stay. The doctor may place a soft cotton ball like material inside the nose to preserve reshaping. An external splint may also be used to support repositioning. Pain associated with rhinoplasty can vary dependant upon the approach and your body, but is typically minimal to moderate for two weeks or more. Instructions from the doctor will include, but not necessarily be limited to: 1) medication- antibiotic and pain relief 2) bed rest and limited activity. The physician will determine which activities are permissible thereafter. However, depending upon the approach and outcome, strenuous exercise and overhead lifting may be forbidden for several weeks.
Day Five-Eight: The external splint and cotton ball like material will be removed soon after the procedure. The doctor will determine this day and recommend any other aftercare necessary at that time. Sutures are removed as well. Swelling and discoloration should disappear in a few days after surgery. Some numbness may occur.
Inherent complications with any surgery do potentially exist and should be discussed with your doctor. Infection and slow healing can occur. Some patients have reported that the nose becomes too firm due to the formation of scar tissue or that there is increased sensitivity. Depending upon the approach and recovery outcome, scars from the incisions fade or are hidden in your skin's crease over time. Talk with your surgeon about recovery expectations to determine the length of your post-op recovery. And of course, list all the advantages that can occur post-op with an improved overall appearance, self-esteem and new image.
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Related Topics: Revision Rhinoplasty
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