Surgical procedure aimed to improve the aesthetic aspect of the nose, by increasing it, reducing it, modifying different nasal angles or removing or adding tissue to enhance the nasal contour.
Also in the same procedure, and if it’s the patients case, one can also work on the functional part of the nose when deviations of the nasal partition or growth of the nasal internal tissues prevent a good respiratory function.
Pre-Surgical Evaluation
The initial interview with the Aesthetic Surgeon is very important, most of the doubts and expectations should be clarified, clearly establishing all the surgical points to be treated before undergoing the procedure. The surgeon by means of different visual aids will be able to show the patient the changes proposed and the methods used to achieve them.
It is also important to know the patient’s medical records regarding illnesses suffered, medications taken lately, mainly those that affect blood clotting like: steroids, Vitamin E, aspirin, a history of hypertension, previous nasal traumas, etc.
Define during the physical exam possible alterations of the nasal passages that could be fixed in the same surgery.
Surgical Procedure
This surgery lasts approximately 2 to 3 hours, its ambulatory, with general anesthesia and in very selected cases with few structural changes, with local anesthesia plus sedation. Most of the times it’s performed through internal nasal incisions. In some difficult cases when the patient has already been operated by another professional or has sequelae from cleft lip and palate, the Surgeon makes external nasal incisions (Open Rhinoplasty) with an excellent result in the scar healing that is absolutely imperceptible after some months.
The structural changes are based on the modification of the nasal bone and cartilaginous structures. By cutting, increasing and fracturing the bone, the Surgeon can modify the nasal angles obtaining the desired result.
Post-Surgical Stage
In most cases the patient leaves the surgery room with a nasal mold that will be removed on the seventh day and occasionally corked. These plugs are used according to the complexity of the procedure and if the surgery had a functional aim, they can be removed in the recovery room or may remain with them on between one to three days. The patient will present swelling of the face and hematoma that will begin to disappear starting from the fifth Post-Surgical day. It is important to place ice or cold compresses in the nasal neighboring areas avoiding skin burn. It is important to take the analgesic medication and anti-inflammatory drugs formulated by the Doctor. It is also recommended to rest with the head at 45°, pillows can be used for this purpose. Do not to use glasses the first 4 weeks after surgery. Do not clean the nose internally with Q-tips. Do not expose to sunlight the first two months, use solar protector and avoid activities of physical contact during the first months.
Complications
Although few, the most important one is post-surgical bleeding that can be of moderate to severe proportions. Due to the tissue edema the patient can experience at first respiratory distress. Mainly in a functional surgery some irregularities may require a surgical retouch later on.