Rhinoplasty

As the nose is the centre of the face, any deformity of the nose is very prominent & evident. Due to this reason, nasal deformity correction is one of the most popular cosmetic surgery performed in any cosmetic surgery clinic. Deformity of the nose may be at the level of

• Dorsum of Bridge.
• Tip of the Nose.
• Base of the Nostril

These deformities may or may not be associated with the septal deformity.

Procedure

Common rhinoplasty procedures which are done include -

• Removal of the nasal hump.
• Reshaping of the nose tip.
• Reshaping or resizing the nostrils.
• Increasing or decreasing the nose’s overall size and projection.
• If the wall between the two sides of the nose (septum) is bent or crooked (deviated), the surgeon can also correct it to improve breathing.
• Correction of the depressed nose with augmentation-Augmentation can be done with the patient's bone, cartilage, or implants.

Sources:

• Cartilage - Nasal septum, ear, rib cartilage, etc.
• Implants – Silicon, Hydroxy appetite medpore®.

How can Your Doctor Approach (Open vs Closed)?

Open Rhinoplasty

In open rhinoplasty, an incision is given along the nostril margin (internal) & columella (skin between two nostrils) which results in an almost invisible scar. Open rhinoplasty is a 3D visualization of cartilage & soft tissue, so correction is easy & perfect but there is long downtime (swelling of the nose).

Closed Rhinoplasty

Closed Rhinoplasty is better for rasping, bridge augmentation, etc. Small hump, bridge deformity can be corrected with bone rasping and severe deformity as a crooked nose require breaking of the nose - (Fracturing osteotomy). Small procedure can be performed under local anaesthesia (minor deformities) as a day-care procedure but major deformity requires admission and is done under general anaesthesia.

Post Surgery

• After the surgery. small dressing with or without a splint is put over the nose which is removed after 5 – 7 days depending upon the surgery.
• For a few days after your surgery, you might experience drainage and bleeding. A piece of gauze taped below your nose can absorb blood and mucus.
• Rhinoplasty can affect the area around your eyes, and you might have temporary numbness, swelling, or discoloration around your eyelids for a few weeks. In rare cases, this can last for six months, and slight swelling could persist even longer. You can apply cold compresses or ice packs to decrease discoloration and swelling.
• Follow-up care is important after rhinoplasty.
• The final appreciable result comes only after 10 – 12 weeks.

Complications

• Unsatisfactory result: Sometimes outcome may be appreciable but a patient may not be satisfied because of his / her expectation (compared with any celebrity nose).
• Sometimes patients may require secondary correction because of his / her original deformity which may require retouching after 6 months – 1 year.
• Resorption of part of bone or cartilage graft is very common which does not happen with silicon/hydroxyapatite implant but if this gets infected for any reason, requires removal & revision surgery.

Precautions to be taken after the procedure

Avoid the following for a few weeks after your surgery:

• Running and other strenuous physical activities.
• Swimming
• Blowing your nose.
• Excessive chewing.
• Pulling clothing over your head.
• Resting eyeglasses on your nose.
• Too much sun exposure could permanently discolor the skin around your nose. Apply sunscreen generously.

You should be able to return to work in a week.

The nose is a complex structure made up of delicate cartilage and bone. A small change to one part of the structure affects the rest of the nose, so rhinoplasty requires expertise to achieve a natural, functional outcome. If you are considering rhinoplasty, visit our expert Plastic Surgeon, Dr. Shishir Agrawal.