Rhinoplasty: What I Need to Know
The nose has a vital functional significance. It serves to humidify and filter the air that we breathe. In addition, all of our sinuses drain into the nasal cavity. So it is important to maintain and restore proper function of the nose to allow for optimal comfortable breathing.
It is true that generally, a nose that looks well breathes well. Certainly, function and appearance go hand in hand. The nose should not stand out but, rather should blend with and be in balance with your other facial features. If there is deviation of the root of the nose, it needs to be refractured and reset in the proper position. If there is a hump, it needs to be taken down in order to allow the nose to be reset properly. The nose needs to have good support in order to be stable over time but also for a more natural and functional appearance. Most of the time, we can obtain any cartilage we need from the septum. If this is not enough, then we can obtain it from either the back of the ear or the rib.
Rhinoplasty may be done either closed or open. Closed means that all the incisions are inside the nose. With an open or external approach there is a small incision across the columella between the nostrils. Closed approach is good when there is not much need for grafting or a lot of work that needs to be done on the tip of the nose. There is less swelling and a much shorter recovery. The open approach allows the surgeon to visualize all the cartilages directly and allows for more precise extensive reconstruction. The drawback of the open approach is prolonged swelling that may last up to a year. It is howevere, the best way to approach someone with severe deformities or needing a lot of tip work.
It should be remembered that there is, as with any surgery, a need for revision in a small percentage of patients. In rhinoplasty, between 5-10 percent of patients need a revision or touchup procedure. We usually defer any such surgery for one year until the swelling has resolved.
This is generally not a painful procedure, with most patients taking only Tylenol for their discomfort. There is often a small cast on the nose for 2-3 weeks. It needs to stay dray but light activity even a day after surgery is otherwise fine.
Each nose is unique as is each face it has to be matched to. Thus, it is important for us to evaluate and share with you exactly what can and should be done to improve the appearance of your nose and its function. We look forward to meeting with you in the office for an evaluation.