What is rhinoplasty?

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Rhinoplasty: Overview

Rhinoplasty is surgery to reshape your nose. It can be done to improve your appearance, fix a birth defect, or help you breathe better.

The doctor will make a cut inside your nostrils. This cut is called an incision. You might also get one across the skin between the nostrils. Then the doctor will pull back the skin. Parts of the bones and cartilage under the skin will be removed or reshaped. Then the doctor will put the skin back in place and close the incisions with stitches. You will have thin scars that will fade with time. You won't even see the scars inside the nostrils.

Sometimes a part of the outside of the nostrils is removed to make the nostrils smaller. This usually leaves a very thin scar along the side of the nostrils, where they attach to the cheek. You can hide the outside scars with makeup.

You will go home about 1 to 2 hours after surgery.

How can you care for yourself after rhinoplasty?

Activity

  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Keep your head raised for several days after surgery. Sleep with your head up by using 2 or 3 pillows.
  • Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk.
  • You will probably need to take about 1 week off from work. It depends on the type of work you do and how you feel.
  • Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, for 2 to 3 weeks or until your doctor says it is okay.
  • Ask your doctor when you can drive again.
  • Do not blow your nose for at least 1 week after surgery. Wipe your nose gently with a tissue. If you need to sneeze, do it with your mouth open.
  • Ask your doctor when it'll be okay for you to bend over.
  • Do not rub your nose for 8 weeks. Use sunblock on your nose and wear a hat with a brim to avoid getting a sunburn. Put on sunblock or makeup gently.
  • Do not swim for a week.

Diet

  • You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Be safe with medicines. Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your medicine after meals (unless your doctor has told you not to).
    • Ask your doctor for a different pain medicine.

Incision care

  • After the stitches or staples are out, you may wash the incision with soap and water and gently dry the area.
  • If you have strips of tape on the incision the doctor made, leave the tape on for a week or until it falls off. Or follow your doctor's instructions for removing the tape.

Other instructions

  • Put ice or a cold pack on your nose for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days (when you are awake) or until the swelling goes down. A bag of frozen peas or corn works well for this, because it molds to the shape of your face. Put a thin cloth between the ice and your skin.
  • Do not set glasses on your nose for 4 weeks. Instead, wrap a piece of tape around the bridge of the glasses and attach the tape to your forehead.
  • For 1 week, avoid wearing clothes that you pull over your head.

How well does rhinoplasty work?

If your expectations are realistic and your plastic surgeon shares them, the surgeon will probably be able to give you the results you want. That's why it's important that you and your plastic surgeon agree on the goals of the surgery.

The results of rhinoplasty may be minor or significant, depending on what kind of correction you want.

How do you prepare for rhinoplasty?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

What are the risks of rhinoplasty?

You can always expect temporary swelling and bruising around the eyes and nose after rhinoplasty. Other problems that may occur include:

  • Bleeding.
  • Injury or holes to your septum (the wall that separates your nostrils).
  • Skin problems, including breakdown of skin tissue (skin necrosis) and irritation from the tape and bandaging.
  • Infection. Preventive antibiotics may be given after surgery to reduce the risk of infection.
  • Serious nasal blockage caused by swelling inside the nose.
  • Complications of anesthesia.

It is also possible that the cosmetic results of the surgery will not be what you wanted.

After rhinoplasty: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have severe trouble breathing.
  • You have sudden chest pain and shortness of breath, or you cough up blood.

Call your doctor now or seek immediate medical care if:

  • You have pain that does not get better after you take pain medicine.
  • You have symptoms of a blood clot in your leg (called a deep vein thrombosis), such as:
    • Pain in the calf, back of the knee, thigh, or groin.
    • Redness and swelling in your leg or groin.
  • You are bleeding from the incision.
  • You have loose stitches, or your incision comes open.
  • You have symptoms of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.
  • You are sick to your stomach or cannot keep fluids down.

Watch closely for any changes in your health, and be sure to contact your doctor if:

  • You do not get better as expected.

What can you expect as you recover from rhinoplasty?

The splint and bandaging around your nose will be removed in about a week.

Your face will feel puffy and the area around your eyes and nose will be bruised and swollen for several days. Cold compresses can help minimize the swelling and reduce pain. Your doctor may also recommend pain medicine. It takes about 10 to 14 days before most of the swelling and bruising improves.

You may need to keep your head elevated and relatively still for the first few days after surgery. It may be several weeks before you can return to strenuous activities.

After rhinoplasty: Overview

Rhinoplasty is surgery to reshape your nose. It can be done to improve your appearance, fix a birth defect, or help you breathe better.

You may have stitches or staples in your cuts (incisions). Stitches inside your nose and mouth will usually dissolve on their own. If you have staples, your doctor will take these out in the first week. A bandage will cover your nose. You may have a plastic or plaster splint to protect and help keep the new shape of your nose. You may have a "nasal drip pad" under your nostrils to collect any blood that may drip from your nose. Your doctor will show you how to change the pad as needed. You may have packing material inside your nose to reduce bleeding and swelling. Packing and the nasal drip pad will be removed within 2 days after surgery. The splint will be removed in about a week.

Your nose will be bruised and swollen, and you may get dark bruises around your eyes. The swelling may get worse before it gets better. Most of the swelling should go away in 3 to 4 weeks. You will have some pain in your nose, and you may have a headache.

Your nose may be stuffy and you may have trouble breathing for a short time. The skin on the tip of your nose may be numb. You may have some itching or shooting pain as the feeling returns.

If bones were broken during your surgery, you will need to avoid injury to your nose for about 3 months. In 3 to 4 weeks, you should have a good idea as to what your nose will look like. It can take up to a year to see the final result.

Why is rhinoplasty done?

Rhinoplasty can change the size, shape, and angle of your nose and bring it into better proportion with the rest of your face. It may also correct structural problems with the nose that cause chronic congestion and breathing problems.

Cosmetic surgery should only be done on a fully developed nose. This has usually occurred by age 15 or 16 in females and by age 17 or 18 in males. If surgery is done sooner, continued growth of the nose can change the results of the surgery. And it could cause complications.

What happens on the day of your rhinoplasty?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
  • The surgery will take about 2 to 3 hours.
  • You will have a bandage under your nose. You will probably have a splint and may have packing in your nose.

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