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Rhinoplasty

Cosmetic nose surgery

Rhinoplasty is surgery to repair or reshape the nose.

Description

Rhinoplasty can be performed under local or general anesthesia, depending on the exact procedure and the person's preference. It is performed in a surgeon's office, a hospital, or an outpatient surgery center. Complex procedures may require a short hospital stay. The procedure usually takes 1 to 2 hours. It may take longer.

With local anesthesia, the nose and the area around it is numbed. You will probably be lightly sedated, but awake during the surgery (relaxed and not feeling pain). General anesthesia allows you to sleep through the operation.

The surgery is usually done through a cut (incision) made inside the nostrils. In some cases, the cut is made from outside, around the base of the nose. This type of cut is used to perform work on the tip of the nose or if you need a cartilage graft.

A splint (metal or plastic) may be placed on the outside of the nose. This helps maintain the new shape of the bone when the surgery is finished. Soft plastic splints or nasal packs also may be placed in the nostrils. This helps keep the dividing wall between the air passages (septum) stable.

Why the Procedure Is Performed

Rhinoplasty is one of the most common plastic surgery procedures. It can be used to:

Reduce or increase the size of the nose
Change the shape of the tip or the nasal bridge
Narrow the opening of the nostrils
Change the angle between the nose and the upper lip
Correct a birth defect or injury
Help relieve some breathing problems

Nose surgery is considered elective when it is done for cosmetic reasons. In these cases, the purpose is to change the shape of the nose to one that the person finds more desirable. Many surgeons prefer to perform cosmetic nose surgery after the nasal bone has finished growing. This is around age 14 or 15 for girls and a bit later for boys.

Risks

Risks of anesthesia and surgery in general are:

Reactions to medications, problems breathing
Bleeding, infection, or bruising

After surgery, tiny blood vessels that have burst may appear as tiny red spots on the skin surface. These are usually minor, but are permanent. There are no visible scars if the rhinoplasty is performed from inside the nose. If the procedure narrows flared nostrils, there may be small scars at the base of the nose that are not usually visible.

In rare cases, a second procedure is needed to fix a minor deformity.

After the Procedure

You will usually go home on the same day as your surgery.

Right after surgery, your nose and face will be swollen and painful. Headaches are common.

The nasal packing is usually removed in 3 to 5 days, after which you will feel more comfortable.

Outlook (Prognosis)

Full recovery takes several weeks.

Healing is a slow and gradual process. The tip of the nose may have some swelling and numbness for months. You may not be able to see the final results for up to a year.

Open References

References

Menick FJ. Aesthetic nasal reconstruction. In: Neligan PC, ed. Plastic Surgery . 3rd ed. Philadelphia, PA: Elsevier; 2013:chap 6.

Tardy ME Jr, Thomas JR. Rhinoplasty, Sclagani AP. In: Flint PW, Haughey BH, Lund V, et al., eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. Philadelphia, PA: Elsevier Mosby; 2015:chap 34.

Septoplasty - series

Presentation

<strong>Normal anatomy</strong><p>The septum is the cartilage and bony partition that separates the two nasal chambers (nostrils). </p>

<strong>Indications</strong><p>The main indications for nasal surgery are: nasal airway obstruction septal spur headache uncontrollable nosebleeds nasal septal deformity in the presence of other intranasal surgery nasal airway obstruction septal spur headache uncontrollable nosebleeds nasal septal deformity in the presence of other intranasal surgery Nasal airway obstruction is usually the result of a septal deformity that causes breathing by mouth, sleep apnea, or recurrent nasal infections that are slow to respond to antibiotics. A septal spur headache is defined as a headache secondary to pressure from the nasal septum on the linings in side the nose (septal impaction) and relieved by topical (applied to a localized area of the skin) anesthesia on the septal impaction. Other intranasal surgery indicating septoplasty includes polypectomy (removal of a polyp), ethmoidectomy (operation on the ethmoid bone at the superior part of the nasal cavity), turbinate surgery (operation on the concha nasalis), and tumor removal. </p>

<strong>Procedure</strong><p>The goal of the surgery is to straighten out the nasal septum, to relieve obstructions, or other problems related to the deviation of the septum. An incision is made internally on one side of the nasal septum. After the mucous membrane is elevated away from the bone, obstructive parts of bone and cartilage are removed, and plastic surgery is performed as necessary. Then the mucous membrane is returned to its original position. </p>

<strong>Aftercare</strong><p>Other intranasal surgery indicating septoplasty includes polypectomy (removal of a polyp), ethmoidectomy (operation on the ethmoid bone at the superior part of the nasal cavity), turbinate surgery (operation on the concha nasalis), and tumor removal. </p>

Nose surgery - series

Presentation

<strong>Normal anatomy</strong><p>The nose is made up of bone and cartilage. The size and relationship of the bone and cartilage which make up the nose determine the size and shape of the nose. </p>

<strong>Indications</strong><p>Nose surgery (rhinoplasty) offers improvement in the appearance in cases in which the nose is cosmetically unappealing. Age may also be a consideration. Many surgeons prefer not to perform cosmetic (elective) rhinoplasties until the growth of the nasal bone is completed (around 14 or 15 for girls, a bit later for boys). </p>

<strong>Procedure</strong><p>With local anesthesia, the nose and the surrounding area is numbed. The patient will usually be lightly sedated but awake during the surgery, and relaxed and insensitive to pain. The surgery is usually done through the incision inside the nostrils. Instruments inserted through the nostril, are used to reshape the bones which make up the nose. </p>

<strong>Aftercare</strong><p>The results of surgery are variable, depending on the initial shape of the nose, but rhinoplasty offers significant improvement in appearance in many cases. </p>

Septoplasty - series

Presentation

Nose surgery - series

Presentation

Review Date: 2/10/2015

Reviewed By: Hebe Molmenti, MD, PhD, private practice specializing in plastic and reconstructive surgery, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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