Listen to Dr. Smith's explanation of this patient's rhinoplasty. Note: the previous rhinoplasty procedure mentioned at the beginning of this video was not perfomred by Dr. Smith.
Nasal Surgery (Rhinoplasty)
What is Rhinoplasty?
Rhinoplasty is a nasal surgery that is performed to enhance the shape or features of a nose. The technique involves first accessing the bone and cartilage support of the nose. This is achieved through incisions made inside the nose, where they are invisible. In some cases, an incision is made in the area of skin separating the nostrils. Next, the underlying bone and cartilage is reduced, augmented, or rearranged to create a newly shaped structure. For example, if the tip of the nose is too large, Dr. Dale Smith can sculpt the cartilage in this area to reduce it in size. If the bridge of the nose has a prominence, this can be reduced to yield a more pleasing profile. If any portion of the nose appears disproportionately small, cartilage or soft tissue grafts can be placed to create better harmony. The angles of the nose in relation to the upper lip or forehead can be altered by further sculpting the nasal support structure.
The tissues are then draped over the new frame and the incisions are closed. A small plastic splint is applied to the outside of the nose to minimize swelling and to help maintain the new shape while the nose heals. Soft, absorbent material may be used inside the nose to maintain stability along the dividing wall of air passages called the septum. Alternatively, soft nasal supports that permit nasal breathing post-operatively can be placed.
Is Rhinoplasty for you?
As with all facial plastic surgery, good health and realistic expectations are prerequisites. Understanding the nuances of nasal surgery is also critical. As everyone’s facial anatomy is different, the goal in rhinoplasty is not to create a “stylized” nose but rather to improve the nose aesthetically and create harmony with other facial features while maintaining proper nasal function.
Skin type, ethnic background, and age are important factors to be considered in discussions with your surgeon prior to surgery. Before the nose is altered, a young patient must reach full growth, usually around age fifteen or sixteen. Exceptions are in cases of severely impaired breathing where functional procedures can be considered at a younger age.
Insurance does not cover surgery that is purely for cosmetic reasons. Cosmetic surgery fees are the responsibility of the patient, and the total amount of the surgery must be paid in full two weeks prior to the date of your surgery.
Making the decision for Rhinoplasty
Whether the surgery is desired for functional or cosmetic reasons, both Dr. Smith have been trained in both Otolaryngology (ear, nose and throat surgery) and Facial Cosmetic Surgery, which provides you the benefits of both functional and aesthetic expertise. Dr. Smith will examine the structure of your nose, both internally and externally to determine which combination of techniques will yield the most pleasing appearance while maintaining or enhancing your nasal breathing. Realistic expectations coupled with the proper analysis and surgical execution assures the greatest success in Rhinoplasty.
What to expect after the surgery
Upon completion of the surgery, you will be monitored in the post anesthesia recovery area until you feel well enough for discharge home. The majority of our patients do not experience any significant pain, however, analgesic medications can be given as needed for post-operative discomfort. Whether we have used packing in the nose or not, most patients will comment that their nasal breathing is limited in the first few days after surgery. This is a result of intranasal swelling and as the swelling subsides, the breathing improves. Your face will feel puffy, especially the first day after surgery. Some patients develop swelling and/or bruising around the eyes. This generally subsides in the first 2-5 days after surgery. Cold compresses will help minimize and reduce the bruising and any discomfort. Absorbable sutures are generally used inside the nose and do not need removal. Any external sutures, if required, are removed in 5-8 days. Nasal dressings and splints are also removed at 5-10 days after surgery.
It is imperative that you follow our post-operative instructions. Keeping your head elevated will minimize swelling. It is important not to blow your nose and to avoid any impact to the nose while the structures inside and out are healing. Activities such as heavy lifting, excessive exertion, sun exposure or any activity that would increase the risk of injury should be avoided. If you wear glasses, you must be careful not to exert excess pressure on the bridge of the nose. Tape and other devices are sometimes used to permit wearing glasses without stressing the area during healing.
Follow-up care is crucial to success in rhinoplasty. Any concerns regarding your post-operative course such as excess bleeding, unexpected swelling, fever or significant pain should be reported to our office immediately. It is essential that you keep your follow-up appointments with our office. As your healing is being monitored, there may be techniques such as massage or use of nasal sprays that can further enhance the desired result.
With proper analysis, realistic patient expectations and the skills of our experience surgeons make rhinoplasty a very rewarding procedure.
After: 6 months