Things to know when considering rhinoplasty

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Among all plastic surgery procedures of the face, nose surgery - or rhinoplasty - is one of the more frequently requested. Due to the nose's prominent position on the face, its size, shape and symmetry are sources of concern for many patients. Here are some things you should know if you are considering this procedure.

Q. What exactly is a rhinoplasty?

A. Surgery of the nose, either cosmetic or reconstructive, e.g., after an injury.

Q. What is a septorhinoplasty?

A. Surgery on the nose and the septum (the partition that separates one nostril from the other). Following a fracture often the septum and-or nose isn't straight, causing breathing and sinus problems as well as a crooked nose.

Q. Is a rhinoplasty a painful operation?

A. No, because general anesthesia is used along with long-acting local anesthesia. Postoperatively, the nose is often packed with gauze for two to five days, according to what must be done. This causes a stuffy nose and might be uncomfortable to some patients. Otherwise, the nose is mostly sore to the touch.

Q. How involved is a rhinoplasty?

A. This is according to what has to be done. Noses come in so many shapes, from turning down to large humps, bulbous tips, to crooked noses, and more. The procedure is different for correction of each type of problem. Some need cartilage grafts taken from the septum or even the ear for added support or to fill in certain depressions. The procedure must be individualized according to the defect and patient's goals.

Q. Are splints necessary postoperatively?

A. A splint for a week is usually necessary if the bones are narrowed.

Q. How long is the recovery time?

A. The splint comes off in a week and usual activities can be resumed with the exception of vigorous exercising.

Q. Is there bruising?

A. Generally, yes. Patients have bruising around the eyes with swelling. Ice soaks should be used for two or three days on the eyes to reduce the amount of swelling and bruising. Bruising lasts seven to 10 days in most cases.

Q. When is the final result seen?

A. The final result is at about a year due to swelling. However, one can usually see a significant improvement as soon as the splint comes off at seven days.

Q. How does aging affect the shape of a nose?

A. Unfortunately, the cartilage part of the nose (and ribs and ears) continues to grow with age. This results in a more bulbous tip and a longer nose. The boney part, which is the upper half of the nose does not continue to grow. Surgery for the aging nose is actually simpler to repair if the bones are OK, and a splint is usually not needed.

Q. Can patients bring in photos of noses they like before surgery?

A. Yes, photos can give the surgeon an idea of what appeals to the patient. Like most plastic surgery procedures, duplicating another nose is virtually impossible, but the surgeon can use the photos to discuss the possibilities of achieving the patient's goals.

E. Ronald Finger, MD, FACS is a board certified plastic surgeon with offices in Savannah and Bluffton. fingerandassociates .com

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