Rhinoplasty

Rhinoplasty or nose job is a procedure designed to change the shape of the nose for the better while also trying to improve the function of breathing if required. Sometimes, the septum of the nose also requires surgery – either to harvest cartilage for graft material or to correct deviations in the septum that is causing obstruction to breathing.

Rhinoplasty is a high precision procedure where changes are made to the skeletal framework of bone and cartilage after elevating the skin of nose. The skin is then placed back to re-drape on the new framework. The new shape is mostly evident immediately at the end of surgery but when the patient gets to see it, there is swelling which obscures the real picture. One has to wait for swelling to settle and for the skin to complete its retraction process. Improvements continue for a year, so the final result is to be seen really at the end of 1 year. This is not to say that the change will not be seen before, in fact much of the new shape can be appreciated even at 1 week to 1 month depending on the skin type and previous problem.

A good rhinoplasty can have a remarkable effect on facial beauty. It requires an aesthetic eye, an analytic examination to identify the existing bony and cartilage ‘problems’ and precise hands to execute the required changes. The surgery has to be customized to each patient.

Unfortunately many surgeons do the old style of reductive rhinoplasty where bones and cartilages are reduced a lot to produce a small nose. The nostril rim is also often reduced. The reduced skeleton and excessive skin leads to a predictable ‘operated look’.
Nose surgery is performed entirely through internal incisions (closed rhinoplasty) or the internal cuts are connected across the divider in between the nostrils (open approach rhinoplasty) to lift the skin off the skeleton of the nose. Choice depends on the surgeon’s preferred technique or on the complexity of the case. At the end of surgery, taping and an external splint are applied, this splint stays on for 1 week.

Re-operative rhinoplasty or redo surgery is sometimes needed to correct minor issues after the first surgery or to set right major problems created by the above mentioned over-aggressive surgery.

The patient considering rhinoplasty must understand what kind of changes he/she wants and must be able to visualize the approximate end result with the help of the surgeon. Allowance must be given for post-operative swelling to settle. In cases of revision, it is recommended to wait for at least 1 year.

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