The nose is a very prominent part of the face. A disproportion in any of its parts can cause deformity to some degree. It plays a part in the senses of taste and smell, as well as assisting in humidifying the air that we breathe and serving as a voice resonance chamber.
Rhinoplasty improves the relation of one’s nose to his or her facial features. There is usually little pain and complications are rare. In most cases, the results are very good and patients are very satisfied.
Surgery on the nose may be done for functional, reconstructive, or aesthetic reasons. Functional rhinoplasty is aimed at improving the physiology of the nose by modifying the positioning of anatomical structures to relieve a nasal obstruction. Reconstructive rhinoplasty is done to correct congenital or traumatic malformation of the nose. Aesthetic rhinoplasty is performed to modify the shape of the nose so that it is more aesthetically pleasing.
During your consultation, your doctor will examine all elements of your face and explain how corrections can be made. Any modification of the structure of the nose is done after examining the shape of your face, age, ethnic identity, the structure of your nasal bones and cartilage, as well as the thickness and condition of your skin. The bones and cartilage of the nose contribute to its size and shape. The upper half of the nose is supported by the nasal bones, while the lower part is supported by the cartilage.
The skin is a very important element of your nose. A thick skin will not drape itself well over the remodeled cartilage at the tip. The skin will take months to adapt to the new shape of the underlying structures.
It is essential to respect the harmony of the nose in relation to the other facial features. Your surgeon specifically adapt to your profile, the occlusion of your teeth and shape of your chin. Occasionally, simultaneous corrections to the nose and chin will produce a better result than surgery on the nose alone. Allergy problems must be discussed with your surgeon.
Recovery
Nasal packing
We usually are able to avoid nasal packing after surgery. We may occasionally use packing if you bleed slightly more than usual during the operation or if there is some other reason for its need. With packing in place, you will have to breathe through your mouth and you will have more swelling than usual. We usually remove such packing after 24-48 hours.
Internal splints
If your operation includes surgery on your septum as part of the rhinoplasty, plastic splints will be sutured inside your nose. Although these take up room, your nasal passages should not be totally obstructed. The doctor will usually remove the splints 7 to 14 days after surgery.
Cast
The splint put on your nose at the end of surgery is intended to provide protection and serve as a type of small external skeleton. We will change it in the office as needed. Do not sit in a hot tub and expose the splint to steam.
Position
Keep your head and nose elevated in order to reduce swelling. If possible, sleep on two or three pillows.
Dried blood in the nostrils. After surgery, some oozing and bleeding usually occurs for a day or two, and dried blood will collect in the nostrils. The use of nasal spray will help clean the area; debris can be removed with an infant aspiration bulb. Do not use any other nose drops for 2 weeks.
Washing hair
You may wash your hair on the second day after surgery not including the day of surgery, provided that it can be washed in a face-up position. If you bend forward, your nose could bleed. Dry your hair with a towel or cool dryer, but do not sit under a hot dryer.
Diet
You should begin with a soft diet that requires very little chewing. Be sure to get enough liquids. Avoid all foods and liquids that are hot.
Ice
You should use cold compresses across your eyes. Do not place hot or warm compresses to you face.
What to expect
Initially, the nose bleeds for about 4 hours. Change “drip pad” gauze under your nose as needed. If you have moderate discomfort, use pain medication when discomfort is first noticed. Swelling with black and blue discoloration around your eyes, as well as blood shot eyes, are normal and typically increase on the 2nd or 3rd day after surgery.
The first week
Restrict talking and walking. Do not bend your head down, strain or anything else that requires significant effort. Avoid smoking because it irritates the lining of the nose and causes coughing, both of which could bring on a nosebleed.
Alcohol
No alcohol for 10 days after surgery.
Blowing your nose
If you happen to sneeze, it usually causes no harm. However, do not blow your nose for 2 weeks after surgery. During the first week, you can gently cleanse your nostrils with a Q-tip moistened with hydrogen peroxide.
Activity/Sun exposure
Avoid strenuous activity for 4 weeks and prolonged exposure to the sun and/or heat for 3 months to prevent prolonged swelling.
Numbness and swelling
You may experience some numbness at the tip of your nose for as long as one year after your surgery. You may have some swelling for 12-36 months, and the incision site inside the nose may be swollen or feel swollen for many months after surgery.
Increased swelling
Intermittent swelling will occur for the first few weeks after surgery.
Dripping
You may want to carry some tissues with you for a few weeks after surgery because your nose may drip.
Activities
Nasal surgery normally hurts very little. Many people feel quite “normal” within a day or two. If you sit at work, you may return when you are able. Heavy exercise or straining can cause bleeding or swelling during the first 2-3 weeks. Please be careful!