Nose Reshaping Surgery (Rhinoplasty) can be performed to meet aesthetic goals, for reconstructive purposes, and to improve breathing problems.
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Dr. Jerry Darm is the medical director of Aesthetic Medicine in Portland, Oregon. Aesthetic Medicine is federally-accredited facility by the Institute for Medical Qualityand BBB accredited business with A+ rating.
Nose Reshaping (Rhinoplasty)
THE BEST CANDIDATES FOR RHINOPLASTY
The best candidates for rhinoplasty are those who are looking for an improvement to features that are unbalanced in relation to the rest of the face. Rhinoplasty can be performed to meet aesthetic goals, for reconstructive purposes, and to improve breathing problems
PLANNING YOUR SURGERY
Dr. Ciano will ask you which features, of your nose, bother you. He will evaluate the structure of your nasal bones and cartilage; the shape of your face, and the thickness of your skin. He will ask if you’ve had previous nasal surgery, or injury to your nose, and any allergies or breathing difficulties.
Dr. Ciano uses the “open” technique: this technique allows for greater visibility and precision. An incision is made externally, at the base of the nose, where it can be well concealed; the skin of the nose is separated from its supporting framework of bone and cartilage. The bone and cartilage is then sculpted to the desired shape, and the skin is re-draped over the new framework.
When the surgery has been completed, a splint is applied (this helps the nose maintain its’ new shape), and a small piece of gauze is placed in the nostrils to stabilize the septum (the dividing wall between the nostrils). The gauze is removed after two days, and the splint is removed after five to seven days. Once the splint is removed, most patients appear “socially acceptable”.
In the vast majority of cases it is not necessary to use a general anesthesia. We use a conscious sedation ( a type of twilight sedation) whereby you are up and ready to go home after your procedure.
AFTER YOUR SURGERY
The pain is minimal; the discomfort is mostly a bruised, swollen feeling. Plan on staying in bed, with your head elevated, and cold compresses on your face, for forty-eight hours. The swelling and bruising around your eyes will reach its’ peak within two or three days. Most of the swelling and bruising should disappear within two weeks, but some subtle swelling, unnoticeable to anyone but you and Dr. Ciano, will remain for several months.
A little bleeding is common for the first few days following surgery, and there may be a feeling of stuffiness for several weeks. While the tissues are in the early stages of healing, you should not blow your nose.
ALL SURGERY CARRIES SOME UNCERTAINTY AND RISK
Bleeding and infection are extremely rare: less than 3% and less than 1%, respectively. But, unlike marble, the sculpting of the nose’s bone and cartilage, can be unpredictable over time. As a result, irregularities can occur in 10% of patients, and some of these may require revisions.
While improvements in breathing cannot be guaranteed, most patients do experience some improvement.
GETTING BACK TO NORMAL
Most patients are able to return to school, or sedentary work, a week after surgery. Walking and some progressive activity is allowed during the second week, but it will be several weeks, before you’re entirely up to speed. It is important to avoid excessve exposure to the sun, for a year after surgery.
YOUR NEW LOOK
In the days following surgery, your face will be bruised and swollen. But day by day, the bruises will fade, and the swelling will decrease, and your nose will begin to show its’ new appearance. Still, healing is a slow and gradual process; some subtle swelling may be present for months, especially in the tip, and the final result may not be apparent for a year, or more.