Rhinoplasty Surgery : Indications, Steps & Recovery

Rhinoplasty, commonly known as a “nose job," is a type of cosmetic surgery to change the shape, size, or proportion of the nose. It can change any part of the nose, including the skin, bones, and cartilage (the flexible connective tissue that protects your bones and joints). Rhinoplasty is employed to improve the appearance or function of the nose or both. In terms of nasal functioning, rhinoplasty can help correct birth defects, improve breathing, or repair deformities from an injury. 

The major types of rhinoplasty include

Open rhinoplasty: This is the type of rhinoplasty used for major nose reshaping. Here, an incision is made across the base of your nose between the nostrils. The skin of your nose is separated from the bone and cartilage so that the nasal anatomy is visible to the surgeon.

Closed rhinoplasty: This is the type of rhinoplasty used for minor nose reshaping. The incisions in this type of rhinoplasty are made on the inside of the nostrils and are thus hidden inside the nose. 

Other, less common types include:

Cosmetic rhinoplasty: This type of rhinoplasty improves the appearance of your nose and face.

Filler rhinoplasty: Also called nonsurgical rhinoplasty, this type of rhinoplasty uses injectable dermal fillers to temporarily fill depressions and correct irregularities in your nose. 

Functional rhinoplasty: This type of rhinoplasty is useful in correcting a deviated septum or congenital defects and restoring the form and function of the nose after injury, disease, or cancer therapy. 

Secondary rhinoplasty: Also called revision rhinoplasty, this type of rhinoplasty is used to correct any problems that occur or persist after the first rhinoplasty. Secondary rhinoplasty is considered to be more difficult than the first rhinoplasty as the problems may be more complex in nature. 

Let us see what happens before, during, and after a rhinoplasty procedure:

Before the Procedure:

• Consultation and discussion of medical history: Before you go ahead with a rhinoplasty, you will talk to your surgeon to discuss the procedure, its results, your expectations from the surgery, and your medical history, including a history of nasal obstruction, surgeries, and medications. 
• Physical examination: Your doctor will conduct a complete physical examination, including that of your facial features and nose. The doctor may also prescribe laboratory tests, such as blood tests. 
• Photographs: During the pre-surgery discussion, your nose will be photographed from different angles and used for before-and-after analysis, reference during surgery, and long-term assessment. The surgeon may alter the photos using software to show you the kinds of results possible from the surgery. You can also bring photographs to show the surgeon how you would like your nose to look after the surgery. 
• Pre-procedure instructions: You may be advised to avoid certain medications and supplements for two weeks before and after the surgery (eg:blood thinners). You will also be asked to stop smoking as it can delay healing.
• Post-surgery arrangements: You may have to arrange for someone to drive you home after the procedure, and help you with tasks as you recover.

During The Procedure

• Anesthesia: Rhinoplasty can be performed under general anesthesia or local anesthesia with intravenous sedation. 
• Incision: A closed procedure or an open procedure may be employed for rhinoplasty. Through an incision, the skin covering the nasal bones and cartilage is raised so that the structure of the nose can be reshaped.
• Reshaping: The shape of your nasal bones or cartilage is reshaped depending on your nose’s structure and how much alteration is required. The surgeon may use cartilage from inside your nose, ear, or rib. If the septum (the wall between the two sides of the nose) is deviated (bent or crooked), the surgeon can also straighten it during this step to improve your breathing.
• Closing the incision: After the structure of the nose is reshaped as desired, the nasal skin and tissue are replaced and the incisions are closed. Small stitches are used to secure the skin in place. Splints and gauze packing may be added to provide support to your nose for one to seven days as it heals. 

After The Procedure

• Swelling and bleeding: Expect some swelling and bruising around your nose and eyes, which could take a few weeks to resolve. When resting, keep your head raised higher than your chest, to reduce bleeding and swelling. Do not put ice or cold packs on your nose after surgery.
• Congestion: Your nose may be congested because of swelling or due to the splints placed inside your nose during surgery.
• Drip pad: Your doctor may place a small piece of gauze under your nose to absorb drainage. This is called a drip pad. 
• Post-surgery instructions: Follow the doctor’s instructions about caring for the surgical site, medications to be applied or taken, signs to look out for at the surgical site, and follow-up appointments. 
• Recovery time: It can take up to a year to fully recover from a rhinoplasty. The timeline for recovery may vary from person to person

For a few weeks after surgery, the doctor may ask you to AVOID:

• Blowing your nose. 
• Brushing your teeth aggressively. 
• Indulging in extreme facial movements, such as due to smiling or laughing. 
• Performing strenuous activities such as aerobics and jogging.
• Showering while the nose is bandaged. Take baths instead. 
• Straining due to constipation. Eat high-fiber foods such as fruits and vegetables to avoid being constipated. 
• Wearing clothes that you have to pull over your head such as sweaters or t-shirts.
• Resting eyeglasses on your nose for at least a month after the surgery. 
• Exposing yourself to too much sunlight. Use sunscreen on your nose when you are outside.

Benefits

Undergoing a rhinoplasty procedure can benefit you in several ways, including

• Enhancing your facial appearance and aiding your confidence. 
• Correcting structural abnormalities of your nose like a deviated septum.
• Improving your breathing.

Risks

Like all surgical procedures , rhinoplasty also carries the risk of potential complications, including:

• Infection
• Bleeding
• Pain
• Poor wound healing
• Scarring
• Skin discoloration
• Altered sense of smell
• A hole in the nasal septum
• Dissatisfaction with appearance after surgery
• Requirement of additional surgery

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