Nose that is
cosmetically unattractive or does not "fit" with other facial
features.
This is a surgical procedure which
is done to improve the appearance of the nose and/or the ability
to breathe through the nose. The operation, therefore, may be
considered cosmetic, functional, or for some patients both.
Nasal deformities may be present at birth or develop with aging
and growth. Traumatic injuries (broken nose) or changes from
previous surgeries may result in significant deformity. Chin
augmentation with a small synthetic implant may help create
better facial harmony and an improved profile when used.
Most
often, patients request removal of a "hump" on the nose,
refinement of a round nasal tip or elevation of a drooping
tip. Noses which are crooked, too wide, long, pointy or flat
may be improved. Realistically, there are limitations in
achieving the final goal and the ultimate outcome will vary
from patient to patient.
Frequently,
the nasal septum (the cartilage separating the right and
left nasal passages) is deviated and needs to be corrected.
A crooked nose may worsen this disorder and, therefore, require
correction at the same time. This operation is called a septo-rhinoplasty.
Turbinates are parts of the nose which help to add moisture
and filter inspired air. These structures can be enlarged
for many reasons and contribute to airway blockage. When
this occurs, the doctor will recommend their removal as part
of the nasal surgery. Other problems, such as narrowed passages
and airway "collapse", may require placement of cartilage
grafts for structural support. On rare occasions, scar tissue
within the nose from previous injury or surgery may block
air flow and require correction.
INTENDED RESULT
More attractive nasal shape. Nose
in better proportion to other facial features.
PROCEDURE DESCRIPTION
Cosmetic rhinoplasties are frequently
done with local anesthesia and intravenous sedation in our surgery
facility or other outpatient surgery centers. General anesthesia
may be used upon patient request or physician recommendation.
Functional surgeries with septal turbinate, scar correction
or the need for grafts usually require general anesthesia. These
operations most often are outpatient procedures, but on occasion
an overnight hospital stay may be required for unusually long
or difficult cases.
Cosmetic
rhinoplasties have incisions hidden within the nostrils inside
the nose. A small "nick" in
the skin is sometimes placed at the upper nose near the corner
of the eye. More complex nasal operations often require a small
incision in the skin at the base of the nose (columella). This
tiny scar is barely visible, yet it allows the surgeon to "lift"
the nasal skin and directly view all of the cartilage and bone
requiring correction. This is termed an "open rhinoplasty".
To narrow the base of the nose, small incisions (Weir incisions)
are placed in the groove where the nostril meets the cheek.
Cartilage and bone grafts are
often taken from within the nose (septum). Ear cartilage, rib,
hip, or outer portion of the skull are other possible grafts.
Synthetic nasal implants may also be used to build-up portions
of the nose.
RECUPERATION AND HEALING
You will go home with an external
cast or splint in place. The nose may be packed for 24-48 hours.
The cast or splint is usually removed in 7-10 days. Internal
splints may be used for septoplasties and remain in place for
1-3 weeks.
Initial discomfort is easily controlled
with oral medication.
Majority of swelling and bruising
subsides progressively over 2-4 weeks.
External sutures (if any) are
removed in 4-6 days. Internal sutures dissolve.
Seminal result is evident in 3
months. Final result is evident in 12-14 months which is the
tune necessary for complete tissue softening.
Areas
of sensitivity or numbness will slowly resolve; the tip of
the nose will feel stiff or
"woody" and this will improve over the first several months.
Other temporary conditions may include some airway or sinus
blockage, nasal drainage, lumps and irregularities.
OTHER OPTIONS
An additional procedure that may
enhance the result is a chin enlargement.
If you need to improve breathing,
correction of a deviated septum (Septoplasty) and enlarged turbinates
may also be appropriate.
INSURANCE GUIDELINES
Changes necessary to correct functional
breathing problems or deformity from an injury should be covered
by insurance. The insurance carrier will not cover charges which
they determine are cosmetic in nature. Often this will not be
determined until the insurance company reads the operative report
and compares pre-operative and post-operative photos. When possible,
we will obtain pre-authorization from your insurance company.
Pre-authorization information
can be obtained from your insurance company.
NOTE
The specific risks and the suitability
of this procedure for you may be determined only at the time
of consultation. All surgical procedures have some degree of
risk. Minor complications that do not affect the outcome occur
occasionally. Major complications are unusual.
