Rhinoplasty (Cosmetic Nose Surgery)
Rhinoplasty is a surgical procedure designed to improve function and esthetics of the nose. Appearance can be improved for those people who are dissatisfied with the shape and size of their nose by removing, rearranging or reshaping bone and cartilage. Nasal Surgery was one of the first cosmetic procedures ever developed and is among those most frequently performed today. Reasons for performing Rhinoplasty include reducing the size of the nose, and improving proportions of the nose. Conditions may be natural or due to trauma to the face. This operation can also help patients who have difficulty breathing through their nose, and can be performed on nearly all age groups, including teens and the elderly.
Dr. Spanganberg performs Rhinoplasty at our state-of-the-art surgical facility. Surgery is usually performed under general anesthesia but the decision on the depth of anesthesia will be determined during your pre-operative appointment. In most cases involving a change in shape or size of the nose, angle or removal of a hump, the skin of the nose is separated from the underlying skeleton of bone and cartilage. The bone and cartilage are then reshaped and the skin re-draped over the surface. Patients who have a deviated septum may benefit by correction of this problem at the same time. The incisions are placed inside the nose unless Dr. Spanganberg uses an open approach, in which case the incision is extended across the columella (the tissue between the nostrils). In cases where the nostrils flare, Dr. Spanganberg may make an incision at the junction between the nose and the skin of the upper lip to narrow the flared appearance. It is common to combine Rhinoplasty with chin augmentation to improve the facial profile.
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Reasons for Nose Surgery
Reasons include reducing the size of the nose, removal of bumps as well as improving the angle of a nose. Conditions may be natural or due to external trauma to the face. This operation will also help patients who have difficulty breathing.
A medical history will be obtained in order to evaluate your general health. We will discuss with you the way your nose can look in relation to other facial features. Digital photographs will be obtained to allow Dr. Spanganberg to evaluate and plan for your case.
Preoperative Instructions for Patients Undergoing Intravenous (IV) Anesthesia
- The patient may not have anything to eat or drink (including water) for six (6) hours prior to the appointment except enough fluids to take your normal medication or medication prescribed by our office.
- A responsible adult must accompany the patient to the office, remain in the office during the procedure, and drive the patient home after the procedure.
- The patient should not drive a vehicle for 24 hours following anesthesia or for 4 hours after taking narcotic pain medication.
Wear loose fitting clothing with short-sleeved shirts or sleeves, which can be rolled up past the elbow. Contact lenses, jewelry and dentures should be removed before the time of surgery.
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After Rhinoplasty Surgery
Recovery takes 1-to-2 weeks with most people resuming their normal activities within 2 weeks. Following surgery, a lightweight splint is applied over the nose to protect and maintain the new shape of the nose. The splint is usually removed within a week. Internal nasal splints may be inserted at the time of surgery to maintain the position of the septum. These are usually removed 2-3 days after surgery. There is always some stuffiness of the nose from swelling, especially when Septoplasty or Turbinoplasty have been performed.
Pain is mild and is controlled with medications. Bruising usually occurs around the eyes, but begins to fade within a few days and is gone in 10-14 days.
- Positioning: For the first several weeks, it is best to keep you head elevated. When you return home from surgery sit in a recliner, or with your head elevated on a sofa, place ice packs over your eyes on both sides of your nose (20 minutes on and 10 minutes off). Crushed ice in a “baggie” or frozen peas work well. Ice is helpful up to 24 hours. After this time, use ice only if it feels good to do so. When sleeping, keep your head elevated above the level of your heart (you do not need to sit upright). Extra pillows under your head, or a blanket or two under the mattress works well.
- Bleeding/Cleaning: Oozing from the nose is normal for the first few days after surgery. You will leave the office with a “mustache” dressing in place. Change the dressing as needed. When bleeding stops, you no longer need the dressing.You may notice that oozing recurs when you become active or bend over. If so, sit quietly with your head up, ice packs over your eyes, and with a new mustache dressing in place until the bleeding stops. Clean nostrils with a Q-tip soaked in 3% Hydrogen Peroxide. Place the Q-tip in nostril only so far as the cotton tip to remove dried blood. Then clean nostril with liquid soap and a Q-tip, followed by water on a Q-tip, and finally roll a small amount of antibiotic or A&D ointment into the nostril. This keeps the nose moist and minimizes crusting and clogging of the nose.
- Swelling/Bruising: Swelling and bruising are normal body responses to surgery. Swelling usually peaks the second or third day after surgery then begins to decrease. Most swelling is gone in 10 days, but the remainder takes months to resolve. “Black eyes” are expected with nasal surgery. This bruising can last 7-14 days. By taking the medications as prescribed and carefully following these instructions, you will be doing everything possible to minimize swelling and bruising.
- Nutrition: Good nutrition is very important in optimizing healing after surgery. Make sure you eat a balanced diet.
- Exercise: Light exercise, such as evening walks, can begin 2-3 days following surgery. Do not lift heavy objects, bend over, or return to strenuous activity until cleared by Dr. Spanganberg or staff. On average, moderate exercise begins in 10-14 days, and rigorous exercise 5-6 weeks after surgery.
- Medication: If you are able to take Ibuprofen, take over-the-counter Ibuprofen (Advil, Motrin) 200 mg tablets, 3 tablets 4 times per day, for 3 days after surgery. Take narcotic pain medication prescription as needed. Do not drive for 4 hours after taking narcotic pain medication.
Your insurance company may pay for part of the costs associated with your surgery if it is performed as a result of nasal obstruction or trauma. It is recommended that you check with your carrier to determine if there is coverage.