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Nose Reshaping

Rhinoplasty also referred to as nose surgery or nose reshaping, is a surgery that changes the shape of the nose. The motivation for rhinoplasty may be to change the appearance of the nose, its function or both.

Why it's done
When planning rhinoplasty, your surgeon considers your features, the skin on your nose and what you would like to change. The upper portion of the structure of the nose is bone, and the lower portion is cartilage. Rhinoplasty can modify bone, cartilage, skin or all three. Talk with your surgeon about whether rhinoplasty is appropriate for you and what it can achieve.
Rhinoplasty can change the size, shape or proportions of your nose. It may be done to repair deformities from an injury, correct a birth defect or improve some breathing difficulties.

What you can expect:
Rhinoplasty is not a procedure with a set series of steps. Each operation is unique and is customised for the specific anatomy and goals of the person undergoing the procedure.

Rhinoplasty may be done inside the nose or through a small external incision at the base of the nose, between the nostrils. Your surgeon will likely readjust the bone and cartilage underneath your skin.

Your surgeon can augment your nasal bone or cartilage in several ways, depending on how much needs to be added, the structure of your nose and available materials. For small changes, the surgeon may use cartilage harvested from deeper inside your nose or from your ear. For larger requirements, the surgeon can use cartilage from the rib, implants or bone from other parts of the body.

During the surgery
Rhinoplasty requires local anaesthesia with sedation or general anaesthesia, depending on the complexity of the surgery and your surgeon's preferences. Discuss with your doctor beforehand which kind of anaesthesia is best in your case.

Local anaesthesia with sedation. This type of anaesthesia is usually used in an outpatient setting and is limited to a specific area of your body. Your doctor injects a pain-numbing medication into your nasal tissues and sedates you with medication injected through an intravenous (IV) line. This makes you groggy but not fully asleep.
General anaesthesia. You receive the drug (anaesthetic) by inhaling it or through an IV line — a small tube placed in a vein in your hand, neck or chest. General anaesthesia affects your entire body and induces a temporary state of unconsciousness. General anaesthesia requires a breathing tube.
After the surgery, you'll be in a recovery room, where the staff monitors your return to wakefulness. You might leave later that day or, if you have other health issues, you might stay overnight.

After the surgery
After the surgery, you need to rest in bed with your head raised higher than your chest, to reduce bleeding and swelling. Your nose may be congested because of swelling or from the splints placed inside your nose during surgery. In most cases, the internal dressings remain in place for one to seven days after surgery. Your doctor also tapes a splint to your nose for protection and support. It's usually in place for about one week.
 
  • Avoid strenuous activities such as aerobics and jogging.
  • Take baths instead of showers while you have bandages on your nose.
  • Don't blow your nose.
  • Eat high-fiber foods, such as fruits and vegetables, to avoid constipation
  • Constipation can cause you to strain, putting pressure on the surgery site.
  • Avoid extreme facial expressions, such as smiling or laughing.
  • Brush your teeth gently to limit movement of your upper lip.
  • Wear clothes that fasten in the front; don't pull clothing, such as shirts or sweaters, over your head.
 Risks

Risk

As with any major surgery, rhinoplasty carries risks such as bleeding, infection and an adverse reaction to the anaesthesia. Other possible risks specific to rhinoplasty include:
 1.Recurring nosebleeds
 2.Difficulty breathing through your nose
 3.Permanent numbness in and around your nose
 4.Possibility of an uneven-looking nose
 5.Pain, discoloration or swelling that may persist
 6.Scarring
 7.Hole in the septum (septal perforation)

 Talk to your doctor about how these risks apply to you.
 how-to-prepare

How to Prepare

Before scheduling rhinoplasty, you must meet with your surgeon to discuss important factors that determine whether the surgery is likely to work well for you. This meeting generally includes:

1.Your medical history. The most important question your doctor will ask you is about your motivation for surgery and your goals. Your doctor will also ask questions about your medical history — including a history of nasal obstruction, surgeries and any medications you take. If you have a bleeding disorder, such as haemophilia, you may not be a candidate for rhinoplasty.

2.A physical examination. Your doctor conducts a complete physical examination, including any laboratory tests, such as blood tests. He or she also inspects your skin and the inside and outside of your nose. The physical exam helps your doctor determine what changes need to be made and how your physical features — for example, the thickness of your skin or the strength of the cartilage at the end of your nose — may affect your results. The physical exam is also critical for determining the impact of rhinoplasty on your breathing. Sometimes your surgeon may speak with you about performing a surgery to augment your chin. This is because a small chin will create the illusion of a larger nose. It's not required to have chin surgery in those circumstances, but it may better balance the facial profile.

3.Photographs. Someone from your doctor's office may take photographs of your nose from different angles. Your surgeon may use computer software to manipulate the photos to show you what kind of result is possible. Your doctor uses these photos for before-and-after assessments, reference during surgery and long-term reviews. Most importantly, the photos permit a specific discussion about the goals of surgery.

4.A discussion of your expectations. You and your doctor should talk about your motivations and expectations. He or she explains what rhinoplasty can and can't do for you and what your results might be. It's normal for people to feel a little self-conscious discussing their appearance, but it's very important that you're open with your surgeon about your desires and goals for surgery.

Septoplasty

Septoplasty (SEP-toe-plas-tee) is a surgical procedure to correct a deviated nasal septum — a displacement of the bone and cartilage that divides your two nostrils. During septoplasty, your nasal septum is straightened and repositioned in the middle of your nose. This may require your surgeon to cut and remove parts of your septum before reinserting them in the proper position.

When planning septoplasty, your surgeon considers your symptoms — such as breathing difficulties — and the physical structure and features of your nose. Talk with your surgeon about what septoplasty can achieve for you.
Why it's done
Having some deviation of the septum is common. When a deviated septum is severe, it can block one side of your nose and reduce airflow, causing difficulty breathing through one or both sides of your nose.

The additional exposure of a deviated septum to the drying effect of airflow through the nose may sometimes contribute to crusting or bleeding in certain individuals. Septoplasty straightens the nasal septum by trimming, repositioning and replacing cartilage, bone or both.

If you experience symptoms — such as difficulty breathing through your nose — that significantly affect your quality of life, you may consider surgery to correct a deviated septum.
 
What you can expect
Septoplasty straightens the nasal septum by trimming, repositioning and replacing cartilage or bone. The surgeon works through incisions inside the nose.

During the procedure
Local anaesthesia. Usually used in an outpatient setting, this type of anaesthesia is limited to your nose. Your doctor injects the pain-numbing medication into your nasal tissues. If you will also have sedation, this is given with medication injected through a catheter placed in a vein — an intravenous (IV) line. This makes you groggy but not fully unconscious.
General anaesthesia. With general anaesthesia, you inhale an anaesthetic agent or receive an anaesthetic through an IV line. This type of anaesthesia affects your entire body and induces a temporary state of unconsciousness.
Discuss with your doctor beforehand which kind of anaesthesia is best in your case.

During surgery, the incision is closed with absorbable thread. Soft silicone splints may be inserted into each nostril to support the septum. To prevent postoperative bleeding, your doctor may place bandage-like material in your nose.

After the surgery, you're moved to a recovery room, where the staff monitors you and watches for any complications. You might leave later that day or, if the procedure is done in a hospital and you aren't ready for discharge, you might stay overnight.

After the procedure
To further decrease the chances of bleeding and swelling, your doctor may ask that you follow these precautions for several weeks after surgery. Depending on the extent of your surgery, you may not be asked to comply with all of them:

Avoid strenuous activities, such as aerobics and jogging. This is to decrease the chance of a blood pressure elevation that could cause a nosebleed.
Don't blow your nose.
Elevate your head when you're sleeping.
Wear clothes that fasten in the front; don't pull clothing, such as shirts or sweaters, over your head.
 
 Risks

Risk

As with any major surgery, septoplasty carries risks, such as bleeding, infection and an adverse reaction to the anaesthesia. Other possible risks specific to septoplasty include:

1.Persistence in previous symptoms, such as nasal obstruction, despite surgery
2.Excessive bleeding
3.A change in the shape of your nose
4.An opening in the septum (septal perforation)
5.A decrease in the sense of smell
6.A collection of blood in the nasal space that would need to be drained (septal hematoma)
7.A temporary numb sensation by the upper gum or teeth

Additional surgery may be required to treat some of these complications or if the outcome of the surgery doesn't match your expectations. Talk to your doctor about your specific risks before surgery.  
 how-to-prepare

How to Prepare

Before scheduling septoplasty, you must meet with your surgeon to discuss benefits and risks of the surgery. This meeting generally includes:
1.Your medical history. Your doctor asks questions about conditions you have or have had, as well as any current medications.

2.A physical examination. Your doctor conducts a physical examination, including any relevant testing. He or she also inspects your skin and the inside and outside of your nose.

3.Photographs. Someone from your doctor's office may take photographs of your nose from different angles. Your doctor may use these photos for discussion before septoplasty, or for reference during and after surgery.

4.A discussion of your expectations. You and your doctor should talk about your expectations. He or she explains what septoplasty can and can't do for you and what your results might be.
Before septoplasty, you may also need to:

1.Avoid certain medications. Avoid medications containing aspirin or ibuprofen (Advil, Motrin, others) for two weeks before surgery and two weeks after surgery. These medications may increase bleeding. Take only those medications approved or prescribed by your surgeon.

2.If you smoke, stop smoking. Smoking slows the healing process after surgery.

3.Make arrangements for the day of the surgery. For the first 24 hours after sedation, you may have lapses of memory, slowed reaction time and impaired judgment. Therefore, arrange for someone to drive you home if you're having an outpatient procedure. Also, arrange for a family member or friend to stay with you for a night or two to help with personal care tasks as you recover from surgery.