Rhinoplasty is a surgical procedure in which deformities of the nose are corrected by removing, rearranging or reshaping bone and cartilage. Appropriate goals for surgery include the following:
- Balance the size of the nose with the other facial features
- Modify the width of the nose at the bridge (dorsum)
- Improve the nasal profile, including removing humps or depressions
- Contour a nasal tip that is too large, “boxy,” drooping or upturned
- Change the angle between the nose and the mouth
- Narrow and reshape the nostrils
- Correct asymmetry or deviation
- Improve breathing through the nose
- Dissatisfaction with previous nose surgery
Conditions to be improved may be natural or due to facial trauma. The operation may also help patients who have difficulty breathing and may be performed on most age groups.
Dr. Wigod will discuss with you in great detail your desired changes. He will then examine your nose completely, including your internal nose to detect any breathing problems. Before proceeding to surgery, you and Dr. Wigod will develop and agree on a plan best suited to meet your expectations.
He may also use the VECTRA 3D Imaging System to optimize this important process. Your insurance company may pay for portion of the costs associated with your surgery if it is performed as a result of nasal obstruction or recent trauma. Insurance will not pay for cosmetic problems.
Surgery is usually performed under general anesthesia. In most cases, the skin of the nose is separated from the underlying skeleton of bone and cartilage by making an incision under the nasal tip and continuing it along the edge of the nostrils. The bone and cartilage are then reshaped and the skin re-draped over the surface. Patients who have a deviated septum which contributes to breathing difficulty or who require cartilage grafts will need a septoplasty. The nose is then carefully closed, and splintted. For nose problems involving only a dorsal hump with limited tip surgery, the rhinoplasty may occasionally be performed by making incisions inside the nose only. Rhinoplasty may be combined with chin augmentation to balance the nose with a small chin improve the overall profile.
Your OR time will vary depending on the operation as well as other factors. The operation commonly lasts from 2-5 hours and you will go home the same day.
You will be discharged with a plastic splint on your nose which should remain undisturbed and will be removed one week post op. Keep the splint dry until removal. You may also have a splint inside your nostrils which will also be removed at one week. You may have some oozing which is not unusual. Your skin sutures will be removed one week post op.
Expect pain and swelling. You may use cold packs periodically. Sleep with your head elevated for about 1 week to minimize the swelling. Bruising occurs around the eyes, but begins to fade within a few days and usually disappears in two weeks. Overall, your symptoms should improve rapidly during the first few postoperative days and then resolve more slowly. Pain should limit your activity. You may begin light exercise such as walking as soon as you feel able, but avoid sweating for 2 weeks post op. Eat soft foods only for the first week post op. If you have problems breathing, an antihistamine may help. Your nose may feel numb or swollen for weeks to months post op. You will not see your final result until 6 months to a year post op. Your nose will continue to change with time as the operation does not stop the normal aging process.
The chin is an often overlooked aesthetic unit of the face. Enlarging a small or weak chin to balance the nose and rest of the face may make tremendous difference in your profile. A proportionate chin may make the nose look smaller, take up flabby neck skin, or give a more masculine look for men. Placing a chin implant can accomplish all of these goals in a durable, cost-effective, and minimally invasive way. Patients with dental problems such as poorly aligned teeth (malocclusion) from a recessive mandible are best served by seeing an oral-maxillofacial surgeon to consider more invasive advancement procedures. The chin may also be accentuated neck muscle tightening (platysmaplasty).