Septorhinoplasty is a functional cosmetic operation designed to change the appearance of the nose and improve nasal breathing. It can reduce or increase the size of the nose, straighten the nose, change the shape of the tip, narrow the width of the nostrils, or change the angle between the nose and the upper lip. This operation can also sometimes help correct birth defects, old nasal injuries, and help relieve some nasal breathing problems.
Rhinoplasty surgery is customized for each patient, and will vary depending on the patient's wishes, goals, and existing nasal anatomy. The ideal nose should balance well with the entire face and lead people to focus primarily on the beauty of the eyes, not the nose.
The best candidates for this type of surgery are individuals who are looking for improvement, not perfection, in the appearance of their nose. In addition to realistic expectations, good health and psychological stability are important qualities for patients considering a septorhinoplasty.
Night Before Surgery:
No solid foods (that includes milk, cream etc.) for 8 hours prior to surgery. Typically this means no solid foods after midnight before the surgery. Small volumes of clear liquid like water may be drunk up to 4 hours prior to surgery.
Hospital Stay:
After surgery patient usually stays for 1-2 days in the hospital.
Lab Work:
Complete blood work up and CT scan may be done prior to surgery.
Surgical Steps:
- Septorhinoplasty is usually done under general anesthesia.
- The operation usually takes 1 to 2 hours.
- Incisions may be made within the nose (closed technique) or placed in inconspicuous locations of the nose (open technique) to expose the nasal framework.
- Deviated septum will be corrected
- The surgeon will refine the tip of your nose by removing some of the cartilage. If you have a hump (dorsum) on your nose, he will shave it down.
- The surgeon can also straighten and narrow the nasal bones by breaking and then setting them
- The surgeon may need to support or rebuild part of your nose using a cartilage graft, or bone graft.
- Incision may be closed by absorbable or non-absorbable sutures
- Insertion of pack inside of your nose to prevent bleeding, placement of splint and strapping on the outside of your nose for support.
Recovery:
- If nasal packs were inserted they are usually removed after 24 hours post operatively.
- Discharge medications will include pain killers, a course of antibiotics, decongesting drops and normal saline drops.
- You will be able to go home next morning and resume your light daily activity. Avoid activities that may injure your nose, Right after your surgery your nose is just starting to heal and can be damaged in many ways. Doing the following will help prevent your nose from getting injured:
- Donot allow anyone to accidently bump your nose.
- Donot blow your nose until you are told that it is safe to do so.
- Donot do any strenuous activities.
- Donot go swimming for one month after your surgery.
- Donot wear clothing that you have to pull on over your head.
- You can bathe next day but please follow these instructions:
- Avoid touching or getting your nose dressing wet when washing your face.
- Be gentle with brushing your teeth and use a soft toothbrush.
- Have someone else wash your hair during the first week after your surgery.
- Take tub baths only and do not shower. Keep your dressing dry when bathing.
- You can wear your contact lenses 2 to 3 days after your surgery. Donot wear your glasses or sunglasses.
- You will have a plaster cast or a splint on the outside of your nose, it will be left on your nose for about one week. Donot touch or disturb the cast or splint and Keep it dry.
- Swelling of your nose and face is common right after your surgery. It can slow healing and increase your pain. The swelling may not go away for weeks. Doing the following will help reduce your swelling:
- Avoid bending over.
- Rest and sleep with your head raised above your feet and body.
- You will be given a follow up appointment after one week for removal of suture and splint. Further follow up will be decided by the surgeon accordingly.
Complications:
- Pain after surgery is usually mild and well managed with painkillers.
- Allergic reactions - In rare cases, local allergies to tape, suture material, or topical preparations have been reported. Allergic reactions may require additional treatment.
- Numbness - Diminished (or loss) of skin sensation in the nasal region may occur. Permanent numbness is very rare, temporary numbness is normal and expected.
- Nasal bleeding can occur although not very common. Blood stained nasal discharge can occur during the first 1-2 weeks after surgery and should not be alarming.
- Septal hematoma which is collection of blood between the septum and the overlying tissue lining. It presents as soft fluctuant bulge on both sides of the nasal septum, this needs to be drained as soon as possible to prevent any damage to the cartilage.
- Infection at the site of incision can occur but is quite unusual.
- Scarring - Although good wound healing after a surgical procedure is expected, abnormal scarring may occur within the skin and/or in the deeper tissues. Scars may be unattractive and of different color than the surrounding skin. There is the possibility of visible marks from sutures.
- Asymmetry - The human face is normally asymmetrical. Your doctor may point out your facial asymmetries prior to the surgery so you have a better understanding of your anatomy. There can be a variation from one side to the other in the results obtained from a rhinoplasty procedure. If significant, then revision surgery may be necessary.
- Unsatisfactory result - There is the possibility of an unsatisfactory result from the rhinoplasty surgery. The surgery may result in visible asymmetries, unacceptable visible or tactile deformities, loss of function, or structural malposition after surgery. Additional surgery may be necessary should the result of rhinoplasty be unsatisfactory.
- Adhesions, where scar tissue forms deep inside your nose and can obstruct airflow.
- Nasal septal perforation - there is the possibility that surgery will cause a hole in the nasal septum, the occurrence of this is rare. However, if it occurs, additional surgical treatment may be necessary to repair the hole in the nasal septum. In some cases, it may be impossible to correct this complication.
- Long term effects - Subsequent alterations in nasal appearance may occur as the result of aging, sun exposure, or other circumstances not related to rhinoplasty surgery. Future surgery or other treatments may be necessary to maintain the results of a rhinoplasty operation.
