Rhinoplasty (Nasal reshaping surgery)

Rhinoplasty refers to any reshaping of the nose. Rhinoplasty can

be performed for cosmetic reasons or as part of a reconstruction

after trauma, cancer resection, or congenital malformation. In

this article, we will cover some basics about rhinoplasty and

some considerations if you are considering having a rhinoplasty

surgery.

Regardless of the reason for rhinoplasty, there are two

approaches – the open approach and the closed approach. The closed

approach is generally undertaken when minimal changes are desired.

The closed approach involves making incisions just on the inside

of the nose around the edges on one or both sides. Through these

incisions, the surgeon is able to elevate the skin off the deeper

supporting structure of the nose, the cartilage and bone, and

effect the change that is desired. In the open approach, the same

incisions are made and an additional incision is made through the

skin of the middle part of the nose known as the columella. This

incision, when healed, is barely perceptible. With the addition

of the skin incision, the surgeon is able to lift the skin off the

nose and have better access to the underlying structural supports.

This is often required in cases where more work must be done to the

structure of the nose or extensive work is required to the tip of

the nose. It is always necessary to consult with an experienced

rhinoplasty surgeon to discuss the risks and benefits of the

procedure before any surgery is to be performed. The most important

thing to remember when considering rhinoplasty is that the

function of the nose must be preserved regardless of what is

changed with the appearance of the nose – simply put – you must

be able to breath through your nose after surgery.

Other things to consider with rhinoplasty surgery include how long

before you can return to normal activity, expected bruising and

swelling, and will additional support material be needed. Depending

on the extent of surgery, the bones of the nose may need to be

repositioned. If this is the case, your surgeon may suggest that

you stay away from contact activities for at least 6 weeks. As with

any surgery, bruising and swelling are expected and are variable

between patients. With an open approach rhinoplasty surgery, some

swelling can be expected for up to a year after surgery. When

dealing with reconstruction of the nose, and some cosmetic nasal

procedures, it may be necessary to obtain additional support

material for the nose. At times, this material can be obtained

from the nasal septum, the middle part on the inside of the nose.

If this material is not adequate for the reconstruction needed, it

may be necessary to obtain additional cartilage from either the ear

or the ribs. If additional cartilage is necessary, this may prolong

healing time and additional risks will need to be discussed.

Generally, rhinoplasty surgery is performed on an outpatient basis.

There may be  a dressing on the outside of the nose and a dressing

on the inside of the nose. The dressing on the inside of the nose

is usually not uncomfortable and does not involve completely

packing off the nose as some older procedures involved. The

dressings are generally removed in about a week after surgery.

D.J. Verret, MD

Facial Plastic & Reconstructive Surgery

www.innovationsfps.com