Rhinoplasty - Corrective Nasal Surgery

Corrective nasal surgery is perhaps one of the most common types of cosmetic procedures performed today. The operation is employed for repair of injuries and for those conditions of developmental nature that are essentially familial in origin.

Technical refinements in performance of this operation provide uniformly better results than were possible 25 to 50 years ago. Before proceeding with any discussion of surgical details, it seems appropriate to answer a number of general questions, which are posed quite frequently. At what age is this operation best performed? The answer relates more to the degree of physical and emotional development than it does to chronological age. There are many youngsters of 15 or 16 years who are not quite fully grown physically, but who are emotionally compromised by lack of confidence in their personal appearance. These individuals can be considered good candidates for the operation (other factors being equal) even though there may be limited degree of physical growth to take place. Delay under these circumstances means sacrificing the essential objective in treatment by giving lesser importance to emotional needs than to the one or millimeters of physical change that might take place after the surgical procedure. A child of 15 or 16 years may, however, be at the same stage of physical development and not at all emotionally prepared for this procedure. In this case, the operation should be deferred until there is more evidence of maturity. Certainly there will be some youngsters whose entire growth and development are late so that even at the chronological age of 17, surgery would be best postponed. The guidelines are rather clear and are consistent with attitudes towards cosmetic surgery in general; the objectives extend beyond purely anatomical considerations.

There are few circumstances where being in middle to older age group disqualifies the patient as a candidate. As previously noted, modified rhinoplasty procedure have become more desirable in association with facelift surgery to supplement overall results in achieving a more youthful appearance. Quite frequently the operation may be performed in the late 50's and 60's age group.

Changes in the nasal contour are made by removing, shifting or altering the underlying bone and cartilage structure. The skin over the surface can then be molded or draped over a new foundation to achieve the desired result. This operation is performed from inside the nose, leaving no external scars except in special circumstances. One might consider this procedure similar to raising or lowering the central support of a tent, resulting in change of its outside appearance.

The surgeon attempts to achieve a delicate balance, leaving sufficient framework to permit normal breathing capacity, while removing excess or distorted anatomical parts. In addition, he cannot direct attention to the nose without considering the other facial features. An experienced cosmetic surgeon considers all of these variables before he makes any final decisions concerning the technical and aesthetic goals of the operation. Almost everyone contemplating nasal surgery has considered what type of nose he or she would like to have. All of these attitudes should be communicated to the surgeon, but they must be realistic and possible within the limits of the patient's normal anatomy. Functional aspects also require consideration.

Final decisions are best left to the surgeon for judgment. Drastic changes are not reasonable objectives and generally are not compatible with already existing bone and soft tissue contour. Nor are such corrections likely to harmonize with other facial features. The goal should be removal of major bone deviation or deformities and subtle refinements of cartilage and soft tissue contour. Total change, which eliminates all definition of ethnic character, is anatomically, aesthetically and physically undesirable.

Nasal surgery is usually performed through the inside of the nose without external incisions or noticeable residual scars. There are however, a few special circumstances that require external incisions, particularly at the base of the nose near the normal fold. These incisions heal well and are difficult to detect. The nasal procedure is often performed under general anesthesia. Discomfort is quite limited after the first 24 hours. At the end of the operation a small splint is used over the outside to maintain proper position and limit nasal swelling. This splint originally taped securely and affords some protection from injury during the healing process. Varying degrees of swelling and discoloration around the eyes will become evident within the first 24 hours and will gradual decrease with the first week. After that time most patients can return to their customary activities.

Some numbness and limited swelling in the nasal tip area will normally persist. It varies depending upon the exact nature of the surgical procedure. It is not conspicuous but can be detected by a feeling of tissue firmness for some time after surgery. Final settling and softening may take six to nine months, during which time all of the final contour changes take place. It is a rather gradual process that cannot be hurried. While may patients want to see the final result immediately upon removal of the dressing, presence of early swelling can be misleading and premature judgments should not be made.

The specific risks of nasal surgery (apart from those associated with every surgical procedure) are few in number. Postoperative nasal bleeding can occur but is not ordinarily difficult to manage. Bleeding may occur approximately one week after the surgical procedure or after removal of the nasal packing. Cautery of the bleeding point may be necessary along with temporary packing with surgical gauze. Post operative infection is only a remote possibility.

How long does it take?
The procedure itself takes about an hour, depending on it's complexity. You then would spend the remainder of the day in the clinic, then you are discharged later that day.

What will I look like immediately after the procedure?
When will I look good?
Nose packs will be removed before you leave the clinic and the plaster is removed about a week later. The swelling of the face will gradually subside over two weeks, by which time almost all the swelling will have disappeared.

When can I wear makeup?
Once the plaster has been removed you may wear makeup immediately.

For further information and an initial complimentary consultation with a counselor, please contact your nearest Australian Aesthetic Surgery Centre.