Rhinoplasty is the medical term for surgery to reshape the nose. Rhinoplasty is one of the most technically challenging procedures in cosmetic plastic surgery. The reason for this is that Rhinoplasty must take into account not only a change in form but also the preservation of function. It is essential that patients are able to breathe freely following cosmetic changes of the nose. Understanding this form and function requires not only excellent training but significant amount of experience to be able to provide reproducible high quality results.*
In regard to training, it is essential to understand the functional aspects of the nose. A surgical residency in ENT, head and neck surgery provides strong background in understanding the functional aspects of nasal surgery. It is for this reason that I chose to complete an ENT residency prior to completing a facial plastic surgery fellowship. With a thorough understanding of the functional component of Rhinoplasty, a fellowship in facial plastic surgery gave me the training to develop the skills necessary to shape the external nose.*
When evaluating a patient for Rhinoplasty there are multiple factors that must be taken into account to create a successful treatment plan. This includes the thickness of the skin, the underlying bony and cartilaginous structure, and the expectations of the changes to be made. Indian and Hispanic skin types often have very thick skin and require exaggerated changes of the underlying cartilage framework to achieve the desired definition of the nose. Thin skin requires different techniques when shaping the underlying cartilage framework to avoid visibility of any irregularities through the thin skin. Experience is essential to be able to understand and create a treatment plan that accounts for all of the variables that are present between different patients.*
I’ve also found that computer imaging is an essential tool to help communicate the possible improvement with Rhinoplasty. A digital photo is taken and the proposed contour changes can be visualized prior to any surgical procedure. I find this incredibly beneficial to ensure that the surgical changes that I am visualizing as the surgeon coincide with the expectations of the patient.*
What does a Rhinoplasty procedure involve?
Answer: Rhinoplasty involves an outpatient surgical procedure. The surgery typically lasts from one to two hours. Following surgery there is a splint on the outside of the nose and two thin splints inside the nose. I do not place nasal packing as this can cause significant discomfort. There is typically minimal pain for my Rhinoplasty patients. Patients follow up one week after surgery to have the splints and any sutures removed. Aerobic physical exercise should be avoided for three weeks following surgery.
Is Rhinoplasty surgery painful?
Answer: My patients typically do not experience much postsurgical pain. There are many reasons for this but at the top of the list is that I do not place nasal packing. This creates significant discomfort. Postoperative pain medications are given but are often not needed.
How soon after surgery can I expect to see the results?
Answer: Very often the results are noticeable immediately after the splints are removed one week after surgery. Typically acute swelling and bruising take up to three weeks to resolve. An additional 6 to 12 months is needed for the final refinement to occur.
How do I make a decision on which surgeon should do my surgery?
Answer: Rhinoplasty is a complex and difficult procedure and requires excellent training as well as a significant amount of experience. It takes years of experience and a significant number of surgeries for a surgeon to understand the complexity of Rhinoplasty surgery and understand how to manage all of the variables that occur with different types of noses. This complexity stems from the tremendous variation of the nasal structure between different patients. Along with this is the complex the of changing the nasal structure but maintaining normal breathing.
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