Rhinoplasty, or nose surgery, is performed to change the size and/or shape of the nose.
Most cosmetic nose surgeries are performed because the patient desires an improved appearance. However, the surgery is frequently requested to repair injuries, to correct breathing problems or to minimize the increasing disfigurement of the nose that occurs as an individual ages.
The appropriate age for nose surgery depends on many factors. For children, cosmetic nose surgery should be delayed until facial development approaches maturity. This level of maturity is usually around the age of 16 for girls and 18 for boys. However, nose surgery may be performed at a younger age if a severe breathing problem is present. There is no upper age limit for nose surgery. Patients in their sixties and seventies elect to have this procedure with good results.
Since the nose is usually the most defining characteristic of the face, a slight alteration can result in a more pleasing look that compliments other facial features. Technical refinements in surgical procedures have allowed consistently better results; however, patients must recognize that the goal of the surgery is improvement, not perfection.
During a consultation, the surgeon assesses the patient's age, height, skin thickness, ethnic background and shape of other features such as the forehead, eyes and chin. Nose surgery is as much artistic in nature as it is technical, Dr. Meadows strives to make each patient's nose fit and compliment his or her face. The goal is a natural looking nose rather than one that appears to have been surgically altered. It is frequently necessary to correct a receding or protruding chin at the same time nose surgery is performed to provide harmony of the facial features.
Understanding the Procedure
Nose surgery is performed as an outpatient procedure using general anesthesia or local anesthesia with I.V. sedation. Incisions are usually made inside the nose where they will not be visible. In some cases, an incision is made in the area of the skin separating the nostrils and/or at the base of the each nostril (if narrowing the base of the nose is part of the procedure). Very fine, absorbable sutures are used to close the incisions. The sutures dissolve on their own, usually leaving an imperceptible scar.
At the completion of the surgery, a protective splint is placed on the outside of the nose and a small amount of soft absorbent material is placed inside the nose to maintain stability. The splint and absorbent material are removed six days after the surgery.
Understanding the Recovery
Swelling from the surgery usually peaks within 72 hours. Although most of the swelling resolves quickly, some lasts for several months. Bruising may develop in the face, particularly around the eyes, but usually resolves in three to six weeks. The patient may also experience nasal congestion due to swelling which may last four to twelve weeks. Numbness or tenderness may occur in the nasal tip or upper lip and may continue for six months to a year.
Some activities are limited during the weeks following the procedure to allow optimal healing of the nose. Exposure to the sun, physical exertion, and risk of injury must be avoided. Forceful coughing, sneezing, blowing the nose or sniffing should also be avoided for the first few weeks.
Since resolution of the swelling takes time, the final result may not be seen for months. In general, the appearance of the nose continues to improve for a year or more after surgery. It is particularly important to follow instructions after nose surgery to ensure the best result.
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