Rhinoplasty, or nose surgery, can be done for cosmetic reasons, functional reasons and a combination of both. For the purposes of cosmeticsurgeryguide.com, we'll focus on cosmetic rhinoplasty surgery.
Men and women seek rhinoplasty for a variety of cosmetic reasons: They feel their nose is out of proportion with their facial features, their nose is crooked, the nostrils are too wide, the bridge is too long, the tip is bulbous, etc.
Rhinoplasty can be performed using open or closed techniques (described below) and using implants or inserts. Nonsurgical rhinoplasty involves using injectable fillers to correct small flaws in the nose.
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In closed rhinoplasty, the cosmetic surgeon makes small incisions inside the nose, which leaves scars that are not visible. This technique is ideal for patients who have minor corrections.
An open rhinoplasty is used when the cosmetic surgeon needs to do extensive work and, therefore, needs maximum visibility of the tissues and cartilage that make up the nasal structures. The physician makes a small incision at the base of the nose between the nostrils and "peels" back the skin to expose the cartilage. Choosing a skilled cosmetic rhinoplasty surgeon will help minimize scarring.
Revision rhinoplasty is used for patients who are not satisfied with the results of the initial rhinoplasty. It is not common for rhinoplasty patients to see revision; however, it does happen. Factors that contribute to rhinoplasty revision include build up of scar tissue, break down of implants or grafts or dissatisfaction with the results.
Other rhinoplasty techniques:
- Rasping, which is using a file or rasp tool to file down small bumps on the bridge of the nose
- Spreader grafts, which are used to correct narrow, wide or long noses
- Cephalic resection, which alters the tip of a bulbous nose
- Sutures, which are used not only to seal incisions but also to change the shape of cartilage
- Struts and grafts, which are pieces of cartilage taken from behind the ear or from the septum and used elsewhere, such as to strengthen a nasal tip
- Base resection is used to narrow a wide nose
- Plumping grafts soften a nose that has an overly sharp angle
- Osteotomy involves cutting the bones
Ethnic rhinoplasty is a term used to describe nasal surgery on patients in the United States who are of Hispanic, African-American, Asian or other ethnicity. People of these descents have similar complaints as Caucasian patients, but they want corrections that maintain their ethnic identities. Patients of non-Caucasian backgrounds should seek rhinoplasty experts who are skilled and experienced in ethnic nose surgery. Ask to see before-and-after photographs of patients of similar backgrounds who presented with similar complaints.
The procedure is performed on an outpatient basis, and, depending on the extent and technique of the surgery, uses general anesthesia or local anesthesia with sedation.
After the surgery, the patient will awaken with the nose bandaged. The splint or bandage will remain in place for one or two days, until the patient sees his or her doctor for a follow-up visit. Activity in the first weeks after rhinoplasty will be restricted. The patient should sleep upright to minimize swelling, bleeding and pain.
There will likely be swelling, redness and bruising immediately following surgery. Resist the urge to blow the nose, and try not to sneeze. Follow all post-operative instructions from the rhinoplasty surgeon.
The effects of rhinoplasty are intended to be permanent. The patient will notice a difference immediately, and within about six months the full effect of the nose surgery will be evident.