Rhinoplasty Information

Rhinoplasty (Nasal Surgery)

The goal of anesthetic nasal surgery is to change the external features of your nose to harmonize with the rest of your face. Every nose is somewhat different in its anatomical structure with variations in thickness and size of the cartilages and bones, thickness of the skin, age of the patient, shape of the face, heredity and other factors. For these reasons, the surgical result is never the same in any two noses, however, the result is usually highly predictable when all factors are considered. Features relative to your nose will be discussed at the time of your consultation. Should Dr. Lomax, our plastic surgeon, feel that at other alterations of the face, such as augmentation of a recessed chin, would enhance your overall aesthetic appearance, he will advise you at the time of your consultation.

Duration of the Surgical Results

The effects of nasal surgery are permanent. If cartilage or bone are used to improve the appearance of your nose, some minor changes may occur within the first year of surgery.

Complications

Complications can occur from any type of surgery. Those that occur in nasal surgery are most often minor in nature. The most common complication after nasal surgery is a nosebleed. Fortunately, this is very rare and when it occurs it is troublesome, but usually not serious. Infection is extremely rare, but if it occurs it is treated with antibiotics. In up to 10% of patients a secondary operation may be necessary to improve the appearance of the nose further, particularly in the nasal tip area. Other complications include hematoma, adverse scar formation, bone or cartilage irregularities, malunited (crooked) nasal bones, cartilage warpage, incomplete correction and worsening of breathing ability. You will also likely have altered feeling on the tip of the nose (temporary or permanent).

Preoperative Photographs

Preoperative medical photographs show your face in detail. This allows Dr. Lomax to evaluate your nose and its relationship to your face. He studies these pictures carefully before your surgery.

Anesthesia

Either local or general anesthesia can be used. A sedative is always given when local anesthesia is used. The combination of light general anesthesia and local anesthesia is also excellent. Dr. Lomax will select the anesthetic method that he feels is best for your specific situation.

The Operation

Most aesthetic nasal operations require about 60 minutes. The operating time will vary according to the amount of surgery required in your case, and whether cartilage or bone grafts are required to improve the appearance of your nose.

Hospital Stay

In most cases surgery is done on an outpatient basis in our ambulatory surgery facility, which means you will be discharged on the same day as your surgery. If bone grafts are used or cartilage grafts are taken from your ribs, you will be hospitalized, typically for one day.

Scars

Nasal plastic surgery is performed through incisions inside the nose which are not visible. Occasionally small external incisions are made at the base of the nostrils to reduce the size of them, or in the vertical column of skin between your nostrils (columella). If these are necessary to your case, they will be explained to you.

Bandages

A splint is applied over your nose and remains for approximately one week. This protects your nose and helps keep down the swelling. Small packs may or may not be inserted into your nostrils. If they are used in your case, they will be removed in one week after the operation. This takes only seconds and is not painful. The splint is removed in the office approximately one week after surgery.

Pain

Most patients do not have pain after anesthetic nasal surgery, but there is some discomfort, as can be expected. This will be relived with the use of some analgesics and we will make sure that you are taken care of in this regard.

Stitch Removal

The sutures employed will all absorb on their own and do not require removal. It is important that you remain in Illinois for two weeks after surgery, so that Dr. Lomax can be sure you are healing as expected.

The Postoperative Period

Beginning as early as two to three hours after surgery, your nose, cheeks and eyes will begin to swell and bruise a bit. The extent of this varies from patient to patient, and there is no way to tell preoperatively who will swell or bruise a great deal and who will swell or bruise only a minimal amount. Most patients have their maximum swelling on the second morning after surgery. Do not scrutinize your nose under the splint too closely as it is swollen and taped under the splint and it may appear too short or altered in some fashion. When the splint comes off one week after surgery, there is usually some swelling or bruising. By 7-10 days after surgery, most patients are quite presentable to resume work or school. When the splint is removed, you can see your new nose, however, many months are required for the final subtle changes to appear. This period varies from 6-18 months, depending on the nature of the nose and the anatomical features mentioned earlier.

It is not uncommon for patients undergoing most aesthetic surgical procedures to have a day or so of mental depression at some time during the first few days following surgery. Do not let this trouble you as it is normal and will pass.

Vigorous athletic activities must be limited within reason for several months. The nose has "healed" in four to six weeks. At that time, swimming, tennis, golf, horseback riding and other sports are permitted that do not require direct body contact. Body contact sports, such as volleyball, football, wrestling, etc., are prohibited for three months. If your new nose is accidentally broken, it is easier to set the bones than before the operation.

Your nose may seem stuffy or congested from time to time for several weeks after surgery. This reaction is normal. Do not use nose drops unless instructed to do so by our office. Do not blow your nose for two weeks after surgery as this may cause bleeding.

Do not take aspirin or any aspirin containing compound for two weeks before or after surgery as this may increase bleeding. Tylenol may be taken.

Exposure to the sun is permitted in moderation immediately after surgery, but avoid sunburn to the skin of the nose.