The surgeon will make incisions to completely separate the skin of the nose from the bone and cartilage, allowing you to clearly see the underlying anatomy of the nose. The nose is supported by bone (on the back and on the bridge) and by cartilage (on the front). On the left, a woman's nose before rhinoplasty. On the right, the same woman photographed one year after surgery.
Rhinoplasty (RIE-no-Plas-Tee) is a surgical procedure that alters the shape of the nose. It can be done for aesthetic reasons, to improve breathing, or both. The upper part of the structure of the nose is composed of bone, while cartilage, skin, or all three can be changed during rhinoplasty. Before undergoing rhinoplasty, it is important to discuss your wishes and goals with your surgeon.
Your facial features, skin type, and desired outcome should all be taken into account. Insurance may cover part or all of the procedure in some cases. Rhinoplasty can change the size, shape, or proportions of the nose. It may be done to fix problems caused by an injury, correct a birth defect, or improve some respiratory problems.
During a physical exam, your facial features and inside and outside of your nose will be examined to determine what changes need to be made. This exam is also important to determine how rhinoplasty will affect breathing. Sometimes chin surgery is recommended to better balance facial features if you have a small chin. This is because a small chin can create the illusion of a larger nose.
Each rhinoplasty is customized to an individual's anatomy and specific goals. Rhinoplasty can be performed inside the nose or through an external incision at the base of the nose between the nostrils. The surgeon will likely readjust bone and cartilage under the skin. The shape of bones or cartilage in the nose can be changed in several ways depending on how much needs to be removed or added, as well as what materials are available.
Cartilage may be removed from the deepest part of the nose or ear for small changes, while rib cartilage, implants, or bones from other parts of the body may be used for larger changes. Once these changes have been made, skin and tissue are repositioned and incisions are sewn up. The nasal septum may also be straightened during surgery if it is bent or crooked (known as a deviated septum). This can help improve breathing.
After surgery, you need to rest in bed with your head raised higher than your chest as your nose may be blocked due to swelling or splints placed inside during surgery. Internal bandages usually stay in place 1-7 days after surgery and a splint may be placed on your nose for about a week for protection and support. You may have some bleeding and oozing of old mucus and blood for a few days after surgery or after removing dressing. An anti-drip pad may be placed under your nose to absorb discharge and should be changed as directed by your healthcare provider.
Do not put glasses or sunglasses on your nose for at least four weeks after surgery as they can put pressure on it; use armrests or tape glasses to forehead until nose heals instead. Use SPF 30 sunscreen when outside, especially on your nose as too much sun can cause permanent discoloration of skin on it. Swelling or black and blue color on eyelids may occur 2-3 weeks after surgery; swelling of nose can last up to a year but eating less sodium will help it go away faster. Do not put anything such as ice or cold packs on your nose after surgery as your nose changes throughout life whether you have surgery or not; most of swelling goes away within a year but very small changes in structure of nose (even few millimeters) can make big difference in appearance of it.
If small changes aren't enough you and surgeon may decide to have second surgery to make more changes; wait at least a year for follow-up surgery as your nose may undergo changes during this time.
