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Rhinoplasty or nasal surgery is carried out to either improve the external appearance of the nose or to set right structural deformities internally that cause, primarily, breathing problems. In aesthetic applications, rhinoplasty succeeds in giving you a perfectly proportionate nose that contributes to enhancing your entire facial appearance. An attractive nose also increases self confidence.
Rhinoplasty can alter the overall size of the nose in relation to the rest of face, change the width of the nose at the bridge, improve the nose profile by eliminating humps or depressions on the bridge, shape the nasal tip, change the size of nostrils, and alter other irregularities. The surgery involves not only removing portions of bone and cartilage but also grafting cartilage. In certain conditions the cartilage underlying the nasal tip is reshaped with the help of permanent sutures. The material for grafting cartilage generally comes from the nasal septum and the back of the ear. Nasal surgery can be performed only on individuals 13 years of age or older, for whom facial growth has stopped. They also need to be healthy and stop smoking well before the surgery.
Nasal surgery can be carried out through two methods. Conventional techniques of rhinoplasty create incisions inside the nostrils to access the cartilage and bone. This technique is now employed for patients requiring simple modifications such as removing a bump inside the nose or modifying the tip of the nose. This technique can also correct breathing disorders.
The modern method, called the "open" method, offers an infinitely better view of the internal structures of the nose for the surgeon, enabling him to work better in internal alterations. This technique involves separating the nostrils by creating a small incision across the skin. The skin at the tip of the nose can be lifted exposing the interior to the surgeon who can carry out the surgery with greater perfection. Delicate alterations such as tip shaping, tip reconstructing to cure deformity caused by previous surgery, and cartilage drafting, require this modern approach. The only disadvantage is that the swelling occurring at the tip of the nose after the surgery takes longer to subside, while in the traditional method there is less post-operative swelling.
Nasal surgery is mainly performed to heal breathing disorders. The internal structure of the nasal septum contributes to the effortless breathing process. Structural deformities in the septum, blocked airways, or other non-surgical causes could cause breathing difficulties. Nasal surgery could set right the structural deformity, though significant improvement in breathing or total alleviation of the symptoms can't be always guaranteed.
Rhinoplasty can also correct the effects of previous flawed nasal surgeries. This is used on occasions where the desired appearance of the nose or tip is not achieved. Reconstructive or secondary nasal surgery requires more care and precision on the part of the surgeon, and the modern open method is preferred for this as it offers greater chances for perfection. Reconstructive surgery involves frequent cartilage grafts in the case of rebuilding areas of the nose where excess cartilage has been removed during a previous surgery. The cartilage grafts could help in reshaping the nose tip which has been pinched too much, or add mass to a nose that's been made too narrow to be proportionate to the rest of the face. Internal grafts can straighten a deviating nose or clear up the airway that became narrow after the earlier surgery.
What ultimately determines the success of any kind of rhinoplasty is the skill and experience of the surgeon, though factors such as thickness of the nasal skin, and flimsy tip cartilage can also influence the outcome. Dr Spero J Theodorou carries out rhinoplasty at Manhattan Eye, Ear and Throat Hospital.
While meeting the surgeon for consultation prior to the surgery, factors such as the patient's physical condition, current medication, and lifestyle would be thoroughly examined. The surgeon would also seek to know the psychological and other reasons for the patient to desire a nose job. It's important for the patient to be frank and candid in answering the questions, and also in asking questions to know more about the surgery and the risks involved. One should go ahead with the surgery only after analyzing all the factors and out of one's own desire, not due to pressure from others or the demands of lifestyle.
The basic steps of the surgery include anesthesia, followed by the incision (closed or open depending on the requirements), and then carrying out the main purpose of the surgery which could be either clearing obstructions in the airway, reshaping the interior of the nose or the exterior, through cartilage grafts from the nasal septum or from the back of the ear or rib. Reshaping the external nose could include either broadening an extremely narrow nose or vice versa, reshaping a rounded tip to make it more aesthetically pleasing and pointy, or removing a hump. The septum, if deviated, is corrected, and other obstructions in the airway removed. This is followed by closing the incision.
It would take approximately a week for the nose to heal during which splints and internal tubes hold the nose in place. Post-operative swelling may be there for a few weeks depending on the kind of incision made. For up to a year the nose would gradually shape itself to its new appearance. Temporary swelling may appear from time to time during this period.
Normal activities and exercises (with the exception of ball sports) can be resumed six to ten days following the surgery. If asymmetry and minor irregularities appear as the nose begins to shape itself, a touch-up process can be carried out a year after the surgery when complete healing and softening of tissues has taken place.