Close up photo of lady with nice lips in operating room. Doctor in gloves holding medical instrument during rhinoplasty

P. Daniel Ward Gives an Overview of the Rhinoplasty Procedure

While many people get rhinoplasties for cosmetic reasons, sometimes they are necessary for a patient’s health. Rhinoplasty surgery, or a nose job, can be vital for people with certain medical conditions like breathing problems, traumatic illness, or injury. P. Daniel Ward MD explains the need for rhinoplasty, the surgery, and the recovery period, putting special emphasis on how a patient can help to ensure their own health and safety.

Reasons for Rhinoplasty
Patients may need to improve their breath flow and correct birth defects. Patients may also want to have a more symmetrical appearance. Whether the surgery is done for medical or cosmetic reasons, the procedure and pre-surgical requirements are the same.

Before a patient receives a rhinoplasty, they must meet with the surgeon and possibly a mental health counselor to determine whether they are in the right frame of mind to receive it. The physician will do a complete consultation with the patient, giving realistic examples of the kind of change that a patient can expect after rhinoplasty surgery. If a patient is looking for an unrealistic change, the plastic surgeon will adjust their expectations accordingly.

A plastic surgeon can change the bone, skin, cartilage, or all three of these during a rhinoplasty. The surgeon will consult with the patient beforehand to make sure that the changes are desired.

Patients must be screened to make sure that they are able to have elective surgery. Their blood pressure and other vital signs must be checked, including lists of any prescription or non-prescription medication that the patient is taking. Some medications can interfere with clotting and healing, making any surgery extremely dangerous.

Before surgery, patients need to avoid aspirin and any products which contain it as well as ibuprofen. Tobacco and alcohol need to be avoided, and routine medications must be made known to the doctor.

Rhinoplasty is Complex
Rhinoplasty is challenging because even the smallest changes can make a huge difference in the patient’s face. Rhinoplasty also does not have a specific procedure shared by all surgeons: the surgery must be planned individually for each patient. Experts in rhinoplasty are sought-after, and patients may need to interview several surgeons before they find the right one.

Risks of Rhinoplasty
The three major risks of rhinoplasty, as with any surgery, are bleeding, infection, and adverse reactions to anesthesia. Other specific risks that may happen after surgery are difficulty breathing through the nose, numbness, pain, scarring, and a hole in the septum or the tissue that divides the nostrils from each other. This may require further surgeries.

Procedure of Rhinoplasty
Patients may be sedated through general anesthesia or through local anesthesia with sedation. Rhinoplasty may be performed inside the nose or through an incision at the base, located between the nostrils. The surgeon will then be able to adjust the cartilage and bone beneath the skin. Surgeons can alter the shape of the bones and cartilage in several different ways, depending on the desired outcome of the surgery. If a surgeon wants to make small changes, they may use the cartilage from further inside your nose or ear.

If you need to have larger changes made, the cartilage can come from your rib. Implants and bones from other parts of the body can also be used. Surgeons can correct the tissue between the two nostrils (the septum) during this surgery. Having a deviated septum causes breathing problems. The physician then stitches the nose and any other areas back together.

Post-Surgical Care
After surgery, the patient will be watched carefully to make sure that they are recovering well from the anesthesia. Swelling is one of the main problems after surgery, and it can take up to three weeks for this swelling to subside. Patients with swelling should be especially careful to limit the sodium in their diets.

It is necessary to protect the area from getting wet, so take baths instead of showers. Eat high-fiber foods to promote digestion. Avoid smiling or laughing to keep from pulling any stitches. Do not wear eyeglasses unless you use cheek rests or tape the glasses to your forehead. No pressure whatsoever should be put on the nose or on the face surrounding it.

Even if a rhinoplasty is very small in nature, it can make a huge difference in how well a patient is able to breathe and in the physical appearance of the nose. Experienced surgeons can generally get a rhinoplasty right on the first try, though there may be patients who are not satisfied and will need follow-up surgeries after the area is completely healed. Patients must wait for a year after the first surgery to have a second one.

After Rhinoplasty
After rhinoplasty, the patient will be able to breathe much more freely through the nose. This can help to prevent snoring, wheezing, and other breathing problems including sleep issues. If a patient wants a cosmetic rhinoplasty, they will be pleased by the effect the surgeon has made.

Having elective surgery should not be looked down upon but should be respected as a medical decision. P. Daniel Ward MD recommends that all potential rhinoplasty patients see a respected surgeon and have a complete work-up before the surgery.