Rhinoplasty- Ear Nose And Throat (ENT)

Rhinoplasty is a surgical procedure that alters the shape of your nose. It can be done for cosmetic reasons, medical reasons, or both.

Your nose is made of a hard bony part (the upper part) and a soft cartilaginous part (the lower part and tip). When you get a rhinoplasty, the surgeon might alter one or both parts along with the overlying skin to improve how your nose looks and how you breathe.

Rhinoplasty is performed by an ear, nose, and throat (ENT) specialist or a plastic surgeon. They will discuss the surgery with you and will choose the correct proportions based on your specific anatomy.

Indications

Rhinoplasty can be done for purely cosmetic reasons if you’re not satisfied with how your nose looks. Your doctor can alter the angle, shape, and size of your nose and nostrils to fit your desired look.

Medical reasons include repair after traumatic injury, birth defects, and difficulty breathing.

Risks

Rhinoplasty is overall a safe procedure, however, like any other surgical procedure, it might incur some risks, such as:

• Bleeding
• Surgical site infection
• Difficulty breathing
• Losing sensation around your nose permanently
• Pain and bruising
• Scarring
• Asymmetry
• Septal perforation

Your doctor will explain to you the risks associated with rhinoplasty and how likely they are to occur.

Preparing for rhinoplasty

Your doctor will assess your nose and plan a procedure that is specific to your needs during your first visit to the clinics. Your doctor will do the following during your first visit:

• Take a detailed medical history: Your doctor will ask you about your medical history, surgical history, chronic diseases, and family medical history. They will ask you about your breathing, previous trauma to your nose, and your home medications. They will ask why you want to perform a rhinoplasty, and what you expect out of it.
• Perform a physical examination: Your doctor will examine the overall appearance of your nose. They might close one nostril and ask you to breathe through the other one to assess if there’s any obstruction. They will also assess your skin and facial features, which is essential when planning rhinoplasty. Your doctor might also order some routine blood work to make sure you don’t have any bleeding disorders or other problems that should be addressed before performing surgery.
• Take pictures: Most surgeons will have someone take a photograph of your nose from different angles. These photographs can be digitally edited to show you how your nose should look after surgery. They will be important to compare before and after results when you recover and can be used as a reference.
• Plan your journey: After you’ve received a full assessment, your doctor will tell you what they can offer, and what can you expect out of rhinoplasty. It is important to have realistic expectations. You should express your thoughts fully to your surgeons and let them know what you think of the plan and whether you would like anything changed. Your doctor will instruct you on whether you need to stop any of your medications before surgery, and you will be asked to stop eating and drinking the night before the procedure.

Procedure

Rhinoplasty is either done under general anesthesia (you will be completely asleep) or under local anesthesia with sedation.

Depending on your specific condition, your doctor might perform an incision to your nose between the nostrils. Using surgical instruments, the surgeon will remove parts of the bone and cartilage and readjust other parts to achieve the desired appearance of the nose. The septum (the wall between your two nostrils) might also be readjusted if it’s deviated and out of place.

After the surgeon is done removing tissue and readjusting your nose, they will close the skin again, and apply a proper wound dressing.

After surgery

Patients who have rhinoplasty are usually discharged the same day, however, there’s a slight chance you might be kept overnight just to make sure you are recovering well. You will need some bed rest with head elevation for the first few days after surgery. You should expect to feel nasal congestion because of post-operative swelling. Your doctor will likely apply a splint to protect your nose and support it. Mucus and bloody discharge can be seen during the first week after surgery and is not worrisome. The gauze packing inside your nose might be left for a few days, and your doctor will remove it him/herself. Some of the things that you need to do/avoid after surgery:

• Avoid strenuous physical exercise
• Avoid blowing your nose
• Keep smiling and laughing to a minimum
• Protect your nose from any trauma
• Avoid getting your bandages wet while trying to bathe
• Avoid wearing glasses for the first few days

Results

It is important to have realistic expectations. If you’re having rhinoplasty by an experienced surgeon, you can expect minor changes to translate to a completely new look. A change in the size, angle, and projection of your nose can alter the way your face looks and improve your overall satisfaction with its appearance. The final result may not be apparent for some time and in case you are not satisfied with the outcome, your doctor will ask you to wait at least a year to allow your nose to take its final form before choosing to reoperate.

Sources:

• https://www.plasticsurgery.org/cosmetic-procedures/rhinoplasty
• https://www.enthealth.org/be_ent_smart/nasal-surgery-fixing-form-and-function/
• http://care.american-rhinologic.org/septoplasty_turbinates
• https://med.stanford.edu/drmost/aesthetic-services/procedures/rhinoplasty.html

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