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Rhinoplasty (nose correction or reconstruction)

Rinoplastia

If you are considering rhinoplasty...

Rhinoplasty is one of the most common procedures in plastic surgery. This surgery can reduce or increase the size of the nose, change the shape of the tip or the nasal dorsum, narrowing the nostrils or change the angle between the nose and the upper lip. It may also correct a birth defect or injury or help relieve breathing problems.

It is important to consider that the nose is the central element in the face. For this reason, it will change the appearance of the entire face but on the other hand the nose must be in harmony with the other elements of the face. For this reason The surgeon should consider not only the nose, but its relation to the rest of the facial structure.

Rhinoplasty can enhance your appearance and self-esteem, but not necessarily make it the ideal nor change how you are treated by others.

Before surgery, think carefully about your expectations and discuss them with your surgeon.

The best candidates for rhinoplasty:

  • People who are looking for improvement, not perfection.
  • If you are physically healthy, psychologically stable and have realistic expectations you can be a good candidate.
  • Age may be a factor. Many surgeons prefer not to operate on teenagers until they complete their development. I.e. 14-15 years for women and a little later in men. Make sure that that the youth is emotionally and socially stable and it is not the desires only of the parents.

Rinoplastia

All surgery has some risk and unknowns.

When performed by a qualified plastic surgeon, complications are rare and usually minor. However there is always the possibility of complications, including infection, nosebleed, or a reaction to the anesthesia. The risks are reduced if you carefully follow the instructions of your surgeon.

After surgery small red spots may appear on the skin, which correspond to small vessels that have ruptured; they are usually small but can be permanent.

No scars should be visible when surgery is internal. With external incisions or when narrow nostrils, small scars in the nasal base that are not usually visible appear in approx. 10 % of patients and may require a second rhinoplasty, usually to correct a minor defect. Some cases are unpredictable and happen even in the most experienced surgeon’s hands. The corrective surgery is usually minor.

Planning surgery

Good communication between you and the surgeon is essential. In the initial consultation the face and nose will be assessed and the surgeon will explain the factors that can influence the procedure. These are: the structure of the nasal bones and cartilage , the shape of the face, skin thickness, age, and patient expectations . The surgeon will also explain the techniques, type of anesthesia, surgical risks and costs.

You should inform your doctor about previous accidents that involve the nose, allergy or respiratory problems, if you take medications, recreational drugs or smoke. Do not hesitate to ask your questions, it's time to do it.

Preparing for surgery

You will be given specific instructions for the day of surgery, you must follow exactly to speed your recovery and get better results. Make sure you have someone drive you home on the day of surgery. Usually surgery is ambulatory and does not require hospitalization unless it is a complex procedure.

The surgery is performed under local or general anesthesia, depending on the extent of the procedure and what you and your surgeon prefer.

Surgery

It usually takes one to two hours, complicated surgeries can last longer. During surgery the skin of the nose is separated from the nose, then sculpted into desired shape. The nature of the surgery depends on the problem and the technique preferred by the surgeon. Finally the skin is rearranged on the new nose.

Most surgeons prefer the closed technique with incisions inside the nostrils. Others prefer the open technique, especially in complicated cases. Once the surgery is completed is placed in a cast to help keep the shape of the nose. They can also be placed to stabilize the packing nasal septum, or dividing wall between both nostrils.

After Surgery

In the first 24 hours your face will feel congested, pain to nose and maybe head. This can be controlled with pain medication prescribed by your doctor. The first day stay in your bed with your head elevated, except to use the restroom.

Edema (swelling) around the eyes will increase in the first three days. To decrease swelling apply cold compresses to the area. In any case you will feel better than it looks. Most swelling subsides in the first two weeks. After that, a slight swelling that only you and your surgeon can detect and may remain for several months.

A little bleeding is normal during the first few days after surgery and you continue to feel stuffy for several weeks. You are advised not blow your nose for a week or more, until the tissues heal. If the surgeon packed the nose, this blockage will be removed in a couple of days and you will feel better. At the end of the second week you will withdraw all dressings and still have stitches.

Returning to normal

Most patients are up on the second day and return to school or normal life within a week. It will be several weeks before you can run. You may slowly restart normal activities by following these suggestions:

  • Avoid any heavy activity (jogging, swimming , sex, or any activity that increases your blood pressure ) for two to three weeks.
  • Avoid rubbing, bumping the nose or sun exposure for 8 weeks.
  • Be careful when washing your face or use cosmetics.
  • You can wear contact lenses when you want but not glasses.
  • You will schedule regular checks to assess progress. During these can exam all question can be asked.

Your new look

In the days following the operation and with facial swelling is hard to think that the face looks better. In fact, some patients become depressed at this time and this is normal and understandable. Rest helps overcome this phase. Day by day, your nose will look better and your spirits will improve. After a week or two you will not appear to have had a surgical procedure. The recovery process is slow and gradual, slight edema may persist for months, especially in the nasal tip.

Final results may not appear until a year later. At this time you may experience unexpected reactions by family and friends. They may say they do not see major difference in your new nose, or may seem resentful, especially if you changed something ethnic or familial mark.

If this happens, remember to keep in mind that you decided to have the procedure. If you achieved your desired surgical goals, then the surgery was a success.

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