Rhinoplasty generally consists of 2 types of nose surgery:
• Augmentation: building the bridge of
flat noses (predominant in most Asians)
• Reduction: reducing protruding bony and cartilaginous
structures (predominant in Europeans, Indians, and those of
Middle Eastern decent)
How is a Nose Lift (Augmentation Rhinoplasty) performed?
Surgical reshaping of the nose is initially performed
by making incisions inside the nostrils. Cartilaginous and bony
structures in the nose that comprise the so-called support system
may be altered in the process. Tunneling is then performed to
accommodate the implant for insertion. Pre-shaped implants made
of silicone, as well as grafts from the patient's own cartilage
may be used. These implants are individually sculpted at the time
of surgery therefore creating a natural and personalized look.
The skin incision is then closed and sometimes a splint is placed
to protect it. Occasionally Gortex or Med Por implants are used.
How is reduction Rhino done?
Depending on the structural deformity of the nose,
reducing it would entail cutting the bones (osteotomy) and trimming
the cartilages. The harvested cartilages may be implanted to areas
where height or bulk is needed. Swelling and bruising are more
severe with this particular procedure.
What other procedures can be done to enhance the appearance of
the nose?
Alar/plasty, better known as trimming of the nostril/alae,
is done to narrow the width of the nose. Hanging alae can be corrected
through an alar lift technique. The tip of the nose may be enhanced
through different methods of tip plasty.
What anesthetic is used for the operation?
The procedure is usually done under local anesthesia
unless the patient requests to be sedated, then twilight anesthesia
(conscious sedation) is used, administered by a certified anesthesiologist.
How long does the procedure take?
The operation itself usually takes about an hour.
More time is given to patients who prefer to be sedated for better
recovery.
What should I do after the surgery?
You will be provided with a list of do's and don'ts
after surgery. You are asked to keep your head elevated during
sleep and apply cold compress for the first two days. Post-operative
medicines will be prescribed. Engaging in strenuous activities
during the first week after surgery should be avoided. Scheduled
follow-up will be 5 – 7 days after surgery for removal of
sutures. The outcome of the surgery will be apparent gradually
in 6-8 weeks up to 6 months time. Patients are advised to wait.
Who are candidates?
Rhinoplasty may be performed on any adult. For minors,
parental consent is required. The minimum age to undergo this
procedure is about 16 years old (post-puberty).
What are the complications?
Recovery from surgery depends on the individual's
response to the procedure. Bruising and swelling around the nose
as well as the eyes may last from 4 days to a week. Surgical incisions
may leave a scar but are of minimal concern since they are placed
in natural skin creases; hence, they are hidden from view. Bleeding
and infection are very uncommon, however once identified, proper
medical management should be instituted. Implant extrusion may
occur however rare.
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