Rhinoplasty, or surgery to reshape the nose, is one
of the most common of all plastic surgery procedures. Rhinoplasty can
reduce or increase the size of your nose, change the shape of the tip or
the bridge, narrow the span of the nostrils, or change the angle between
your nose and your upper lip. It may also correct a birth defect or
injury, or help relieve some breathing problems.
Rhinoplasty can enhance your appearance and
your self-confidence, but it won't necessarily change your looks to
match your ideal, or cause other people to treat you differently. Before
you decide to have surgery, think carefully about your expectations.
The best candidates for rhinoplasty are people who
are looking for improvement, not perfection, in the way they look. If
you're physically healthy, psychologically stable, and realistic in your
expectations, you maybe a good candidate.
Rhinoplasty can be performed under local or general
anesthesia, depending on the extent of the procedure . With local
anesthesia, you'll usually be lightly sedated, and your nose and the
surrounding area will be numbed; you'll be awake during the surgery, but
relaxed and insensitive to pain. With general anesthesia, you'll sleep
Rhinoplasty usually takes an hour or two, though
complicated procedures may take longer. During surgery the skin of the
nose is separated from its supporting framework of bone and cartilage,
which is then sculpted to the desired shape. The nature of the sculpting
will depend on your problem and your surgeon's preferred technique.
Finally, the skin is redraped over the new framework.
When the surgery is complete, a splint will
be applied to help your nose maintain its new shape. Nasal packs or soft
plastic splints also may be placed in your nostrils to stabilize the
septum, the dividing wall between the air passages.
After surgery--particularly during the first
twenty-four hours--your face will feel puffy, your nose may ache, and
you may have a dull headache. You can control any discomfort with the
pain medication .
Plan on staying in bed with your head
elevated (except for going to the bathroom) for the first day. You'll
notice that the swelling and bruising around your eyes will increase at
first, reaching a peak after two or three days. Applying cold compresses
will reduce this swelling and make you feel a bit better. In any case,
you'll feel a lot better than you look. Most of the swelling and
bruising should disappear within two weeks or so. (Some subtle
swelling--unnoticeable to anyone but you and your surgeon--will remain
months.) A little bleeding is common during the first few days following
surgery, and you may continue to feel some stuffiness for several weeks.
Do not blow your nose for a week or so, while the tissues heal. If you
have nasal packing, it will be removed after a few days and you'll feel
much more comfortable. By the end of one or,occasionally, two weeks, all
dressings, splints, and stitches should be removed.
Most rhinoplasty patients are up and about within two
days, and able to return to school or sedentary work a week or so
following surgery. It will be several weeks, however, before you're
entirely up to speed.
Avoid strenuous activity (jogging, swimming,
bending, sexual relations--any activity that increases your blood
pressure) for two to three weeks.
Avoid hitting or rubbing your nose, or
getting it sunburned, for eight weeks. Be gentle when washing your face
and hair or using cosmetics. You can wear contact lenses as soon as you
feel like it, but glasses are another story.
In the days following surgery, when your face is
bruised and swollen, it's easy to forget that you will be looking better.
In fact,many patients feel depressed for a
while after plastic surgery, it's quite normal
and understandable. Rest assured that this stage will pass. Day by day,
your nose will begin to look better and your spirits will improve.
Within a week or two, you'll no longer look as if you've just had
surgery. Still, healing is a slow and gradual process. Some subtle
swelling may be present for months, especially in the tip. The final
results of rhinoplasty may not be apparent for a year or more.
In the meantime, you might experience some
unexpected reactions from family and friends. They may say they don't
see a major difference in your nose. Or they may act resentful,
especially if you've changed something they view as a family or ethnic
trait. If that happens, try to keep in mind why you decided to have this
surgery in the first place. If you've met your goals, then your surgery
is a success.
Complications are infrequent and usually minor.
Nevertheless, there is always a possibility of complications, including
infection, nosebleed, or a reaction to the anesthesia.
When rhinoplasty is performed from inside the nose,
there is no visible scarring at all; when an "open" technique is used,
or when the procedure calls for the narrowing of flared nostrils, the
small scars on the base of the nose are usually not visible. In about
one case out of ten, a second procedure may be required--for example, to
correct a minor deformity. Such cases are unpredictable and happen even
to patients of the most skilled surgeons. The corrective surgery is
There are several factors that can influence the
procedure and the results. These factors include the structure of your
nasal bones and cartilage, the shape of your face, the thickness of your
skin, your age, and your expectations.
stay 10 days after surgery in Costa Rica.
I recommend the Las Cumbres
Inn where you will receive personal attention, required medication and
transportation to and from surgery. I visit my patients at Las Cumbres
frequently following surgery to check on your recovery.