Rhinoplasty refers to any reshaping of the nose. Rhinoplasty can
be performed for cosmetic reasons or as part of a reconstruction
after trauma, cancer resection, or congenital malformation. In
this article, we will cover some basics about rhinoplasty and
some considerations if you are considering having a rhinoplasty
surgery.
Regardless of the reason for rhinoplasty, there are two
approaches – the open approach and the closed approach. The closed
approach is generally undertaken when minimal changes are desired.
The closed approach involves making incisions just on the inside
of the nose around the edges on one or both sides. Through these
incisions, the surgeon is able to elevate the skin off the deeper
supporting structure of the nose, the cartilage and bone, and
effect the change that is desired. In the open approach, the same
incisions are made and an additional incision is made through the
skin of the middle part of the nose known as the columella. This
incision, when healed, is barely perceptible. With the addition
of the skin incision, the surgeon is able to lift the skin off the
nose and have better access to the underlying structural supports.
This is often required in cases where more work must be done to the
structure of the nose or extensive work is required to the tip of
the nose. It is always necessary to consult with an experienced
rhinoplasty surgeon to discuss the risks and benefits of the
procedure before any surgery is to be performed. The most important
thing to remember when considering rhinoplasty is that the
function of the nose must be preserved regardless of what is
changed with the appearance of the nose – simply put – you must
be able to breath through your nose after surgery.
Other things to consider with rhinoplasty surgery include how long
before you can return to normal activity, expected bruising and
swelling, and will additional support material be needed. Depending
on the extent of surgery, the bones of the nose may need to be
repositioned. If this is the case, your surgeon may suggest that
you stay away from contact activities for at least 6 weeks. As with
any surgery, bruising and swelling are expected and are variable
between patients. With an open approach rhinoplasty surgery, some
swelling can be expected for up to a year after surgery. When
dealing with reconstruction of the nose, and some cosmetic nasal
procedures, it may be necessary to obtain additional support
material for the nose. At times, this material can be obtained
from the nasal septum, the middle part on the inside of the nose.
If this material is not adequate for the reconstruction needed, it
may be necessary to obtain additional cartilage from either the ear
or the ribs. If additional cartilage is necessary, this may prolong
healing time and additional risks will need to be discussed.
Generally, rhinoplasty surgery is performed on an outpatient basis.
There may be a dressing on the outside of the nose and a dressing
on the inside of the nose. The dressing on the inside of the nose
is usually not uncomfortable and does not involve completely
packing off the nose as some older procedures involved. The
dressings are generally removed in about a week after surgery.
D.J. Verret, MD
Facial Plastic & Reconstructive Surgery
www.innovationsfps.com
