Understanding Rhinoplasty: Surgery of the Nose

Rhinoplasty, more than any other procedure, demands the extensive training of a Facial Plastic Surgeon. Facial Plastic Surgeons are uniquely qualified to address the aesthetic beauty of the nose and maintain the function that is so important. Half a million people annually seek consultation with Facial Plastic Surgeons about improving the appearance of their noses. Some are unhappy with the noses they were born with, and some with the way aging has changed their nose. For others, an injury may have distorted the nose, or the goal may be improved breathing. One thing is clear: nothing has a greater impact on how a person looks than the size and shape of the nose. Because the nose has distinct character, and can define one’s total look, a slight alteration can greatly alter and improve one's appearance.

Because successful facial plastic surgery is a result of good rapport between patient and surgeon, we recommend you visit Dr. Morgan for a consultation. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery. Dr. Morgan can answer specific questions about your individual needs. If you have wondered how rhinoplasty could improve your looks, self- confidence, or health, you need to know how rhinoplasty is performed and what you can expect. All of this will be discussed in the pre-operative evaluation.

Making the Decision for Rhinoplasty

Choosing a qualified Facial Plastic Surgeon is of paramount importance. Dr. Morgan is board certified in Facial Plastic and Reconstructive Surgery and Otoloaryngology Head and Neck Surgery which provides you with the

highest level of training and expertise. He will examine the structure of your nose, both externally and internally, to evaluate what you can expect from rhinoplasty. He will discuss factors that may influence the outcome of the surgery, including skin type, ethnic background, age, degree of deformity, and degree of function of nasal structures.
Your expectations, the risks involved in surgery, and the type of anesthesia will be discussed thoroughly. Additional procedures, most commonly chin augmentation, can enhance the desired results and will also be discussed. Preoperative photos will be taken and digital imaging will be discussed and viewed. Digital imaging will give you some idea of the expected outcomes of the surgery. This is not the actual outcome but a reasonable goal that is created with digital imaging software. This helps you see some of the changes Dr. Morgan will describe. Digital imaging is a nice tool to assist you in your decision to have rhinoplasty surgery.

Understanding the Surgery

Rhinopasty is performed with one of two techniques. In the “endonasal” approach, all incisions are hidden inside the nose. In the “open” approach, most incisions are hidden inside the nose, but another incision is made in the area of skin separating the nostrils. This incision is closed meticulously and rarely noticeable. Next, certain amounts of underlying bone and cartilage are removed or rearranged to provide a newly shaped structure. Humps and hooks can be corrected or reduced and nasal tips can be resculpted for more refined looks. The angle of the nose in relation to the upper lip can be altered for a more youthful look or to correct a distortion.

The skin is then redraped over the new frame and the incisions are closed. A splint is applied to the outside of the nose to help retain the new shape while the nose heals. Soft, absorbent material may be used inside the nose to maintain stability along the dividing wall of the air passages. Risk factors in rhinoplasty are generally minor, and Dr. Morgan will discuss these prior to surgery.

What to Expect After the Surgery

Immediately after surgery, a small splint will be placed on your nose to protect it and to keep the structure stable for at least a week. If packing is placed inside the nose during surgery, it is removed the morning following the surgery.

Your face will feel puffy, especially the first day after surgery. Pain medication may be required. Dr. Morgan will advise you to avoid blowing your nose for seven days after surgery. In the immediate days following surgery, you may experience bruising and minor swelling in the eye area. Cold compresses often reduce the bruising and discomfort. Absorbable sutures are usually used that do not have to be removed. The nasal dressing and splint areusually removed six or seven days after surgery and the final tape is generally removed two weeks after surgery.

Post-operative instructions will be given by Dr. Morgan and are crucial to ensure a good outcome, especially instructions to keep your head elevated for a certain period after surgery. Activities that are prohibited in the weeks after the procedure include sun exposure and exertion of any kind. General light activity is the norm, and risk of injury must be avoided. If you wear glasses, special arrangements must be made to ensure that the glasses do not rest on the bridge of the nose. Tape and other devices are sometimes used to permit wearing glasses without stressing the area where surgery was performed.

Although you may be up and about in a day or two following surgery, Dr. Morgan will advise you on the proper schedule for resuming your normal routine. To permit proper healing, activities which raise blood pressure, such as jogging, swimming, or even bending are restricted during the first few weeks. The decision to return to work depends on the individual's degree of swelling and discomfort. For those patients who play sports, contact sports are prohibited for a minimum of three months.