Rhinoplasty (Nose Job)
Rhinoplasty is a procedure performed to reshape the nose. The procedure can make your nose smaller or bigger, change the shape of the tip of the nose, the nasal hump and the philtrum or can widen or narrow your nostrils. It could also fix deformities, whether congenital or not, and breathing problems.
Who Is A Good Candidate For A Rhinoplasty?
Everyone who is not happy with the shape of their nose, who has a deformity after a physical trauma and has realistic expectations is eligible for a rhinoplasty. What is important is that the patient discusses what they want with the surgeon. After the patient’s expectations are met with what could be achieved with the surgery, the procedure takes place. The aim of the procedure is to have a nose that is both elegant and proportional with the face. A nose shape that may look attractive in one person, may not look the same on another.
What Should I Do Before The Surgery?
Before a rhinoplasty surgery, the patient has to keep in mind the following;
-The patient must arrive at the hospital with an empty stomach and shouldn’t eat anything for 6 hours before the surgery.
-Smoking should be stopped 15 days before the surgery.
-Smoking after the surgery may affect the recovery process.
-The patient is advised to wear comfortable clothes ie. casual, wide-neck clothing or buttoned shirts that don't touch the nose when wearing or removing.
-The patient should inform the surgeon if she is on her period.
-The patient must inform the surgeon if they underwent a rhinoplasty surgery before.
-Having a flu, a cold or similar diseases can affect the surgery. Such respiratory diseases may cause problems under anesthesia and thus the surgery should be postponed until the patient gets better completely.
-The patient must cease taking any anticoagulants (aspirin, warfarin etc), and multivitamins containing vitamin E 10 before the surgery.
Is It Possible To Correct A Deviation Or To Have A Turbinate Reduction Surgery In Conjunction With A Rhinoplasty?
Problems related to nasal congestion, such as turbinate hypertrophy or nasal deviation, could be fixed during a rhinoplasty.
How Is A Rhinoplasty Performed?
A rhinoplasty procedure lasts about 1-2 hours. There are two different rhinoplasty methods, a closed rhinoplasty and an open rhinoplasty.
In cases where there is minimal deformity in the nose ( e.g a slight hump) a closed rhinoplasty is sufficient. However, if the overall shape of the nose is going to be changed that also affects the nasal tip, then an open rhinoplasty is necessary. In an open rhinoplasty, an incision is made under the nose, in a part called the columella right in the middle of the nostrils, to separate the skin, the ligaments and the bone .
The biggest advantage of the open rhinoplasty is that it provides the surgeon with a better view of the nose and there is more room for operating. Nevertheless, compared to a closed rhinoplasty, the recovery period will be longer as the swelling and the bruising will take longer to heal.
A plaster cast will be placed on your nose after the surgery that will preserve the new shape of the nose. Tampons or soft surgical plastics could be placed inside your nose to keep the septum, the bone that is inside your nose that separates the two nostrils, straight as it heals.
-Your face may get swollen, you may feel discomfort in your nose or feel slightly dizzy in the first 24 hours after the surgery, all of which could be remedied with medicine.
-In the first 24 hours after the surgery, try to remain in bed, keeping your head high and straight, only getting up to go to the bathroom.
-The swelling and the bruising around your eyes may be more noticeable after 2-3 days; applying a cold compress will help ease the discomfort.
-Most of the swelling and the bruising will disappear in a week or two and will barely be noticeable. In about 1-3 months, there won’t be any more swelling or bruising.
-In the first couple of days after the surgery, there might be slight nasal discharge or you might feel as if your nose is clogged for the first couple of weeks.
-The surgeon will ask you not to blow or wipe your nose for a week or more, as the force exerted may impact the healing of the tissues. The tampons, if placed, will be removed after a couple of days and you will breathe much more easily. After 1-2 weeks, all the bandages and the casts will have been removed.
When Can I Return To My Everyday Life?
After a rhinoplasty, most patients can walk after 1-2 days and may return to their job or school, as long as it is not physically demanding. All heavy activity, such as running, swimming, gymnastics, intercourse, any kind of activity that could raise your blood pressure, should be avoided for 2-3 weeks. You should protect your nose from physical trauma, avoid rubbing your nose and protect it from the sun for 8 weeks. Be careful and gentle when washing your face or your hair and while applying makeup.
Post-Operative Care Guide
You have to be patient and careful during the recovery period. Applying correct post-operative care is as important as the surgery itself.
Please follow all the steps mentioned below. Do not hesitate to contact your surgeon if you’re not certain of something.
1-You may not breathe through your nose due to the tampons inside. Until they are taken out, you have to breathe through your mouth. Your surgeon will decide when they will have to be taken out.
2-Adequate fluid intake is important. In cases of a dry mouth, sipping juice, water or soft drinks may relieve your discomfort. Do not use a straw. Eat soft and easily chewable foods. Use a moisturizing lipstick or cream to keep your lips from drying.
3-Only use the medicines that are prescribed by your surgeon. Do not use anticoagulants like aspirin, warfarin etc.
4-If you have bandages or tampons, keep your head high during sleep or rest, using two pillows. Try to keep your head high as much as possible during the day; doing so will maintain normal blood circulation and will lessen any swelling or bruising that may occur after the surgery.
5-It is normal to have a slight nasal discharge that has a pinkish hue. However, contact your surgeon if there is too much bleeding.
6-Your nose will be covered with a plaster cast after the surgery. This will help your nose maintain its new shape. Do not touch or move the cast, as it will be removed by the surgeon in one week.
7-The small tampon under the nose could be replaced if necessary. It could be discarded if there is no bleeding.
8-Do not touch your nostrils, try to wipe or blow your nose. Always try to keep your hands out of your nose. Always protect your nose from physical trauma. Wear buttoned shirts. Avoid wearing clothing with tight necks.
9- Use a soft toothbrush and brush your teeth gently. Do not purse your lips and try to move your upper lip as little as possible.
10-Avoid bending over, lifting heavy objects, exercising and strenuous activities for 2 weeks after the surgery.
11-Avoid direct sunlight for a month.
12-You may notice some swelling or discoloration after the bandages are taken out. Your nasal tip may be swollen and may look too upright, all of which will be resolved over time.
13-You may feel numbness on your nasal tip or your upper lip that will go away in a couple of weeks.
14-After the tampons are taken out, you may clean your nose 2-3 times a day with a cotton swab and water. Do not stick the cotton swab deep inside your nostrils.
15-Even after the tampons are taken out,your nose may still be clogged. This is a normal part of the recovery period. Do not blow your nose for a week. If you feel the need to sneeze, cough or blow your nose, do it gently with your mouth open and without covering your nostrils. Do not use nasal sprays or drops.
16- The sedating drugs given during the surgery may make you drowsy and sleepy afterwards. You will start to feel better after a day or two. You may have trouble sleeping. Your surgeon may prescribe you a medicine to resolve this issue.
17- It is normal to feel depressed 12-36 hours after the surgery. You may be shocked by how your nose looks immediately after the surgery. Don’t forget that you have to be patient as it will take some time to see the real results of your surgery. As time passes, your nose will look more elegant and proportionate. It may take 6-12 months before your nose is fully recovered.
18- As long as the surgeon approves it, you may apply makeup to cover the discolorments and you may return to work after the bandages and the cast are taken out.
19-Make sure that you attend all your appointments after the surgery. Doing so, the surgeon will keep a better track of your recovery. The surgeon may ask for post-operative pictures of your nose to evaluate the progress. The check-up appointments are usually scheduled for a week, a month, 3 months or 6 months after the surgery.
20-Try not to use glasses for 2 months after the operation. Glasses could only be worn when the cast is in place. After the cast is removed, the glasses must be taped to the temples or the forehead. You will be shown how to do it by the surgeon.