Rhinoplasty (RIE-no-plas-tee) is surgery that changes the shape of the nose. The reason for rhinoplasty may be to change the appearance of the nose, improve breathing or both.
The upper part of the structure of the nose is bone. The lower part is cartilage. Rhinoplasty can change bone, cartilage, skin or all three. Talk with your surgeon about whether rhinoplasty is appropriate for you and what it can achieve.
Your other facial features, the skin on your nose and what you would like to change are considered when planning the procedure. If you're a candidate for rhinoplasty, the surgeon will develop a personal plan for you.
Why it's done
Rhinoplasty can change the size, shape or proportions of the nose. It may be done to fix issues from an injury, correct a birth defect or improve some breathing problems.
As with any major surgery, rhinoplasty carries risks such as:
A bad reaction to the anesthesia.
What you can expect
Each rhinoplasty is customized for the person's specific anatomy and goals.
During the procedure
You're given medicine to put you into a sleep-like state for the surgery. This is called anesthesia. The kind of anesthesia you get depends on how complex your surgery is and what the surgeon prefers. Ask your surgeon which type of medicine is most appropriate for you.
Local anesthesia with sedation. This type of anesthesia is usually used in an outpatient setting. It's limited to a specific area of your body. A pain-numbing medication is injected into the nasal tissues, then you are given medicine through an intravenous (IV) line, which is a small tube placed in a vein in the hand, neck or chest. This medicine makes you groggy but not fully asleep.
General anesthesia. You receive medicine, called anesthetic, by breathing it in or through an IV line. General anesthesia affects your entire body and causes you to be asleep during surgery. General anesthesia requires a breathing tube.
Rhinoplasty may be done inside the nose or through a small external cut, known as an incision, at the base of the nose, between the nostrils. The surgeon will likely readjust the bone and cartilage underneath the skin.
The shape of the bones or cartilage in your nose can be changed in several ways. It depends on how much needs to be taken out or added, the nose's structure and available materials. For small changes, cartilage may be taken from deeper inside the nose or from the ear.
For larger changes, cartilage from a rib, implants or bone from other parts of the body can be used. After these changes are made, the skin on the nose and tissue are put back, and the cuts are sewn together.
Sometimes, the wall between the two sides of the nose, known as the septum, is bent or crooked. This is called a deviated septum. It can be straightened during surgery to make breathing easier.
After the procedure
After the surgery, you need to rest in bed with your head raised higher than your chest. This reduces bleeding and swelling. Your nose may be stuffed up because of swelling. It could also be from the splints put inside your nose during surgery.
Most of the time, the internal bandages stay in place for 1 to 7 days after surgery. A splint may be taped to your nose for protection and support. It's usually in place for about one week.
You may have a little bleeding and drainage of mucus and old blood for a few days after the surgery or after removing the dressing. A drip pad — a small piece of gauze held in place with tape — may be put under your nose to absorb drainage. Change the gauze as directed by your health care provider. Don't put the drip pad tight against your nose.
Very small changes to your nose's structure — even just a few millimeters — can make a big difference in how your nose looks. Most of the time, an experienced surgeon can get results both of you are satisfied with. But in some cases, the slight changes aren't enough. You and your surgeon might decide to do a second surgery to make more changes. If this is the case, you must wait at least a year for the follow-up surgery because your nose can go through changes during this time.