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Plastic surgeons usually recommend that patients wait until
they are at least 14 or 15, and possibly older for boys, before
undergoing rhinoplasty. This is because the nose may not be
fully developed at a younger age. If you are a teen, your plastic
surgeon will want to be certain that you have thought carefully
about surgery and that the desire to change your appearance
is based on your own feelings rather than those of your parents
or friends.
Assuming you are in good health, there is no upper age limit
for having your nose reshaped. Rhinoplasty is sometimes performed
in conjunction with a facelift or other rejuvenate surgery
to correct aging changes of the nose such as a drooping tip.
Sometimes certain breathing problems related to the internal
nasal structures can be corrected at the same time as nose
reshaping is performed. Your plastic surgeon will be able to
help you determine whether these structures should be modified
along with reshaping your nose.
Am
I a good candidate for rhinoplasty?
During the initial consultation, you may be asked to look in
a mirror and point out exactly what you would like to see improved.
This will help your plastic surgeon to understand your expectations
and determine whether they can realistically be achieved.
| Some of the indications that you may be
a good candidate for rhinoplasty are: |
| • |
your nose appears too large for your face |
| • |
there is a bump on the nasal bridge when
viewed in profile |
| • |
your nose seems too wide when viewed from
the front |
| • |
the nasal tip droops or plunges |
| • |
the tip is thickened or enlarged |
| • |
your nostrils are excessively flared |
| • |
your nose is off-center or crooked |
| • |
previous injury has made your nose asymmetrical |
It is important that you have a clear idea of how you would
like your nose to look and, at the same time, realize that
there are limitations to the procedure. Patients with sufficient
physical and emotional maturity who undergo rhinoplasty because
they want to enhance their self-image are usually very satisfied
with their decision.
Your plastic surgeon can provide further information if you
have an interest in any of these additional procedures.
How
will my plastic surgeon evaluate me for rhinoplasty?
You should come to the consultation prepared to discuss your
medical history. This will include information about any medical
conditions you may have, medical treatments you have received,
previous surgeries including repair of nasal injuries, and
medications that you currently take. Your plastic surgeon may
also ask whether you have difficulty breathing through your
nose, suffer from allergies that may cause nasal stuffiness,
or are a chronic user of nasal spray. It is important for you
to provide complete information.
In evaluating you for rhinoplasty, your plastic surgeon will
conduct a routine and painless examination of your internal
nasal structures. Your skin quality as well as the size and
shape of your nose and its relationship to your other facial
features will be carefully studied. In some instances, your
plastic surgeon may recommend surgery of your chin, making it
either more or less prominent, to improve facial balance. This
procedure can be done at the same as your rhinoplasty.
When
will I learn about the cost of surgery?
Because of individual factors, not everyone will achieve the
same results from rhinoplasty. Your surgeon's goal is to obtain
the best possible results for you.
It is understandable that you would like to have information
about the cost of surgery as soon as possible. Your plastic
surgeon must first complete a thorough evaluation before your
individualized surgical plan can be developed. Following this,
the fees required for your surgery will be discussed with you.
While most insurance plans will not pay for aesthetic nose
reshaping, they frequently will cover surgery performed on
the internal structures of the nose to improve breathing problems.
Your plastic surgeon can discuss this with you at the same
time of consultation.
Where
are the rhinoplasty incisions placed?
Alterations may be made to increase or decrease the nasal bridge,
reduce the size or width of the nose, narrow the nostrils, change
the angle between the nose and upper lip, or reshape the tip.
 |
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| Small wedges of skin, as shown, are
removed to narrow the base of the nose or reduce the width
of the nostrils. |
Incisions are placed inside the nose
to provide access to the cartilage (blue shaded area)
and brown (light brown shaded area) that form the nasal
framework. |
The surgical techniques employed will depend primarily on the
goals established by you and your plastic surgeon. In many instances,
all of the incisions will be placed inside your nose, where
they will not be visible. If the base of the nose is narrowed
or the nostrils reduced, small wedges of skin at the base of
the nostrils will be removed. Incisions are hidden in the natural
crease where the nostril joins the cheek.
 |
Depending on the surgical technique used, a splint may
be placed on the bridge of the nose for the purpose of
holding the tissues in place until they have stabilized. |
Sometimes a very short incision is made across the vertical
strip of tissue that separates the nostrils, called the columella.
This technique is called an "open rhinoplasty." Whatever incisions
are used to reshape your nose, they will ultimately be very
inconspicuous.
How
is my plastic surgeon able to reshape my nose?
Fortunately, significant complications from rhinoplasty are
infrequent. Every year, many thousands of people have their
noses reshaped, experience no major problems and are pleased
with the results. Anyone considering surgery, however, should
be aware of both the benefits and risks.
Through the small incisions described previously, work is done
on the cartilage and bone that form the framework of your nose.
Sometimes, the position of certain bones may need to be altered
slightly in order to make your nose look narrower and straighter.
If your nose needs to be built up in some areas, this can be
done using nasal cartilage, or perhaps bone or cartilage from
another site. The skin and soft tissues then redrape themselves
over this new "scaffolding."
I understand that every surgical procedure has risks, but how will I learn more so that I can make an informed decision?
The goal
of your plastic surgeon and the entire staff is to make your
surgical experience as easy and comfortable for you as possible.
The subject of risks and potential complications of surgery
is best discussed on a personal basis between you and your
surgeon, or with a staff member in your surgeon's office.
Some of the potential complications that may be discussed with
you include hematoma (an accumulation of blood under the skin
that may require removal), infection and reactions to anesthesia.
Numbness of the skin following rhinoplasty may occur but is
usually temporary. Occasionally, if the surgical outcome needs
further improvement, additional surgery may be necessary.
You can help minimize certain risks by following the advice
and instructions of your plastic surgeon, both before and after
your surgery.
How should
I prepare for surgery?
If you are a smoker, you will be asked to stop smoking well
in advance of surgery. Aspirin and certain anti-inflammatory
drugs can cause increased bleeding, so you should avoid taking
these medications for a period of time before surgery. Your
surgeon will provide you with additional preoperative instructions.
If your rhinoplasty will be performed on an outpatient basis,
be sure to arrange for someone to drive you home after surgery
and to stay with you at least the first night following surgery.
What will the day of surgery be like?
Your rhinoplasty may be performed in a hospital, free-standing
ambulatory facility or office-based surgical suite.
Medications are administered for your comfort during the surgical
procedure. Frequently, local anesthesia and intravenous sedation
are used for patients undergoing nose reshaping, although general
anesthesia may be desirable in some instances. For your safety
during the operation, various monitors are used to check your
heart, blood pressure, pulse and the amount of oxygen circulating
in your blood.
When surgery is completed, you will be taken into a recovery
area where you will continue to be closely monitored. There
may be some discomfort, but this can be controlled by medication
which you may continue taking at home. Depending on the surgical
technique used, a splint may have been placed on the bridge
of your nose for the purpose of holding the tissues in place
until they have stabilized. The splint will protect your nose
while you sleep and shield it from accidental bumps. Frequently,
you may also have a small triangular bandage beneath the tip
of your nose. Packing or soft internal splints are sometimes
used inside the nostrils, especially if work has been done
to improve your breathing.
You probably will be permitted to go home after a few hours,
although some patients may stay overnight in the hospital or
surgical facility.
How will I look initially?
It is important to realize that the amount of time it takes
for recovery varies greatly among individuals.
The first couple of days after surgery, you should restrict
your activities and sleep with your head elevated. This will
help to minimize swelling and reduce the possibility of minor
bleeding, which is not uncommon. Remember, you must not take
aspirin or certain anti-flammatory medications.
Generally, bruising around the eyes and cheeks is most apparent
during the first three days following surgery. Most discoloration
will disappear within a week. A few days after surgery, you
can begin to use makeup as a concealer, if desired. Noticeable
swelling may last for several weeks. Minor residual swelling,
most frequently affecting the nasal tip, may continue for many
months, but generally this should not be apparent to others.
If packing was used, it will either dissolve by itself or be
removed three to seven days after surgery. Stitches may also
be removed at that time. You may need to continue wearing the
nasal splint for up to a week, during which time you should
avoid getting it wet.
When can I resume my normal activities?
The goal of rhinoplasty is a nose that looks natural and blends
harmoniously with your other facial features.
Since the healing process is gradual, you should expect to
wait up to one year to see the final results of your rhinoplasty.
You are likely, however, to begin enjoying your new look within
weeks of your surgery.
Occasionally, a touchup may be desired to further improve the
results. If this is the case, the additional procedure is usually
less extensive than the original operation.
Straining, bending and lifting should be avoided during the
early postoperative period. In many instances, you may be able
to return to work within a week or ten days after surgery.
Most normal activities including exercise can usually be resumed
within three weeks.
It will be a few months before you can expose your reshaped
nose to direct sunlight. Your nose will be sensitive during
this time, and you must be conscientious about using a sunblock
to protect your skin. If the bones of your nose were altered,
it may be a number of weeks before you can wear glasses without
special support such as tape.
How will I look initially?
In most instances, the results of rhinoplasty are permanent, except for
possible
changes associated with the normal aging process.
Maintaining
a Relationship with Your Plastic Surgeon
You will return to your plastic surgeon's office for follow-up
care at prescribed intervals, at which time your progress will
be evaluated.
Please remember that the relationship with your plastic surgeon
does not end when you leave the operating room. If you have
questions or concerns during your recovery, or need additional
information at a later time, you should contact your surgeon. |
Content provided by The
American Society for Aesthetic Plastic Surgery (ASAPS).
For advertising info, please contact Terry McGovern terry.mcgovern@latimes.com at (213) 473-2599
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