Rhinoplasty (nose surgery, nose reshaping or nose job) is a surgical procedure for correcting and reconstructing the form, restoring the functions or aesthetically enhancing the appearance and proportion of nose. Rhinoplasty may also correct impaired breathing caused by structural abnormalities in the nose.
Indications for rhinoplasty can be divided into
- Reconstructive reasons: deformities arising from birth, hereditary or trauma
- Cosmetic reasons: to enhance facial harmony and proportion
Rhinoplasty can change
- Nose size, in relation to the other facial structures
- Nose width, at the bridge
- Nose profile, with visible humps or depressions on the bridge
- Nasal tip, that is large or bulbous, drooping, or too upturned
- Nostrils that are large, wide or upturned
- Nasal asymmetry and deviation (deviated nasal septum)
PRE-OPERATIVE EVALUATION
Communication is vital in order to achieve the patient’s goals. During the initial consultation, patients should discuss their goals and expectations with the plastic surgeon. The plastic surgeon will work closely with the patients to reach an agreement about the desirable results from the surgical procedures involved and their long term benefits. Every patient is different, therefore a specific treatment regimen is planned to suit an individual’s need.
- Discussion about expectation and desired outcome
- Medical conditions, drug allergies and previous medical or surgical treatment
- Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs should be revealed
- Discussion of type of anaesthesia
- Examination and measurement of the face and nose
- Photography for preoperative and postoperative evaluation
RISKS AND SAFETY
The practice of medicine and surgery is not perfect science therefore some risks may occur even in the hand of an expert. Although good results are usually achievable, there are some potential risks that may occur such as
- Infection
- Bleeding
- Poor wound healing
- Numbness (temporary)
- Scarring
- Skin discoloration
- Skin contour irregularities
- Post rhinoplasty swelling
- Nasal asymmetry
- Alteration in the nasal airway
- Possibility of revision surgery
- Anaesthesia risks
1. Augmentation Rhinoplasty
Augmentation rhinoplasty is a surgical procedure that can be performed for both aesthetic and functional reasons. Functional reasons for augmentation include providing structural support for deficient areas of the nose such as the upper or lower lateral cartilages. Augmentation can also be performed to enhance the appearance and proportion of nose in relation to the face to restore facial harmony.
There are varieties of materials that can be used for augmentation rhinoplasty. An autologous graft is made from materials harvested from your own body. For example, cartilage grafts may come from your ear, ribs or nasal septum. Bone grafts may come from your leg or hip. When tissues from your own body are used, there is a reduced risk of complications. Non-autologous or artificial materials used for implants or grafts include medical-grade silicone, medpore or Gore-Tex.
IDEAL CANDIDATES
- Completion of facial growth (preferably 13 years of age or older)
- Healthy individuals who do not have life threatening illnesses or medical conditions
- Preferably non-smokers
- Individuals with realistic goals in mind for the improvement of appearance
POST-OPERATIVE EXPECTATIONS
A splint or bandage is usually placed on the outside the nose to support and protect the new structures during the initial healing phase. After the surgery there may be swelling, bruises or discomfort, irritation for several days that can be controlled with oral medications, cold compression and ointment. Oral antibiotics and analgesics will be prescribed to reduce the risk of infection and postoperative pain respectively. Any external sutures on the nose will be removed about 7-10 days after the surgery. It may take several months for swelling to resolve and up to a year for the shape of the new nose to be fully refined.
2. Reduction Rhinoplasty
Reduction rhinoplasty corrects the structural framework of the nose itself by removing or re-arranging the nasal cartilage and/or bone to achieve the desired nose shape and size. This procedure can be performed via incisions placed inside the nostrils without leave behind any visible stitches or scars (closed rhinoplasty). In condition where the nasal tip or the lower third structure of the nose need to be re-shaped, a tiny incision is made on the underside of the nose just between the nostrils (open rhinoplasty). This technique will leave a small scar and its location makes scar inconspicuous.
Indications for reduction rhinoplasty include:
- To alter the hump at the bridge of the nose
- To reshape the tip of the nose
- To change the length or width of the nose
- To change the width of the nostrils
- To remove excess fibrofatty tissue or skin on the nose.
Occasionally chin augmentation can be performed to complement a rhinoplasty. These procedures are popular with both men and women to create facial harmony. For men, creating a stronger or shorter nose, along with a stronger jawline, is often the objective. Women sometimes wish to have a more petite nose and less pointy chin.
POST-OPERATIVE EXPECTATIONS
Recovering from reduction rhinoplasty usually takes about 7-14 days in most cases. After the surgery there may be swelling, bruises, numbness or discomfort for several days which can be controlled with oral medications, cold compression and ointment. Some patients may experience nose stuffiness or nose bleeding. A splint or bandage is usually placed on the surface of nose for a short period of time to assist the nose to retain its new shape will it heals. Oral antibiotics and analgesics are prescribed to reduce the risk of infection and postoperative pain respectively. Any external sutures on the nose will be removed about 7-10 days after the surgery.
