Nose Surgery

Procedure

The anesthesiologist administers anesthesia during the surgical procedure for the patient’s comfort. While options include intravenous sedation or general anesthesia, the anesthesiologist will select the best option.

There are two typical approaches to rhinoplasty. In an open procedure, the surgeon will make an incision across the columella, the narrow strip of tissue that separates the nostrils. Alternatively, in a closed procedure, the surgeon hides the incision inside the nose.

The surgeon will gently raise the skin that covers the nasal bones and cartilage through the incisions, allowing access to reshape the structure of the nose.

It is possible to reduce an overly large nose by removing bone or cartilage. In some cases, rhinoplasty requires the addition of cartilage grafts, most commonly from the septum, the partition in the middle of the nose. Occasionally, your surgeon may graft cartilage from the ear or, rarely, a section of the rib cartilage can be used.

Preparing for Surgery

In preparing for rhinoplasty surgery, patients may be asked to:

• Get a lab test
• Take certain medications or adjust current medications
• Stop smoking
• Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding

We have noticed that preparing for surgery with a clear, complex-carb rich beverage will keep you strong and enhance your recovery. Drinking ClearFast PreOp prior to your medical procedure is a safe way to speed up recovery time, nourish your body, and reduce post-operative nausea and vomiting. It is available at Hometown Pharmacy on N. Sawyer Street, Oshkosh at $8 a bottle. The recommended dosage is one bottle the night before your surgery once you are in the fasting window. Then take the second bottle two hours before surgery. However, please get final clearance from the anesthesiologist before taking the beverage at all.

At this time, the surgeon may perform rhinoplasty in an accredited office-based surgical facility, a licensed ambulatory surgical center or a hospital. Patients should arrange for someone to drive them to and from surgery and to stay with them for at least the first night following surgery.

Contact Fox Valley Plastic Surgery today at 920-233-1540 to request a consultation.

Recovery

Your surgeon will place a splint and/or packing materials inside the nose and a splint or bandage on the outside of the nose. This supports and protects the new structures during initial healing and recovery. The recovery and downtime prognosis of your rhinoplasty is dependent on your unique case details, such as whether the surgery was performed open or closed, whether any tip work was performed, and whether the nasal bones were broken (osteotomies). For example, patients who undergo open rhinoplasty typically have more edema (swelling) which persists longer compared to patients who undergo closed rhinoplasty. Additionally, an osteotomy usually results in more swelling and bruising.

Patients typically take off one week from work after surgery. Then the surgeon will remove the cast after one week, although the nose will still be swollen. Most patients can gradually return to strenuous activities such as exercising after two weeks. By the end of the second week, the swelling and bruising have usually subsided enough so that the casual observer will not readily notice that the nose has been operated on.

However, to the patient, the nose will look swollen or puffy for several months. The swelling gradually dissipates over the first several months. Consequently, the appearance of the nose changes gradually. By about 3-4 months, the majority of the swelling will be gone, but the nose can look larger in some scenarios, such as in photographs. Ultimately, it can take as long as a year for the final shape to become apparent. Patience is paramount in this type of surgery.

Results

Swelling may come and go during the first year following rhinoplasty surgery. Many patients note swelling is worse in the morning. As such the care team gives patients specific instructions from their surgeon that include:

• How to care for the surgical site
• Medications to apply or take orally to aid healing and reduce the potential for infection
• Specific concerns to look for at the surgical site
• When to follow up with the office

The results of rhinoplasty surgery will be long-lasting.  As the body ages, it is natural to have some gradual changes to the face including the nose. But most of your improvement should be relatively permanent. Ultimately, a healthy lifestyle and life-long sun protection will help extend the results.

Potential Risks

Patients will sign consent forms to ensure that they fully understand the procedure and any risks or potential complications. Rhinoplasty surgery risks include:

• Anesthesia risks
• Bleeding (hematoma)
• Infection
• Poor wound healing or scarring
• Change in skin sensation (numbness or pain)
• Nasal septal perforation (a hole in the nasal septum) is rare. Additional surgical treatment may be necessary to repair the septum but it may be impossible to correct this complication
• Difficulty breathing
• Unsatisfactory nasal appearance
• Skin discoloration and swelling
• Possibility of revision

Are you ready to discuss rhinoplasty for yourself? Contact Fox Valley Plastic Surgery today at 920-233-1540 to schedule a consultation.