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Rhinoplasty

Definition

Rhinoplasty is surgery to repair or reshape the nose.

See also: Septoplasty

Alternative Names

Cosmetic nose surgery

Description

Rhinoplasty can be performed under local or general anesthesia, depending on the exact procedure and the patient's preference. It may be performed in a surgeon's office, a hospital, or an outpatient surgery center. Complex procedures may require a short hospital stay. The procedure usually takes 1 -2 hours, but may take longer.

With local anesthesia, the nose and the area around it is numbed. You will probably be lightly sedated, but awake during the surgery (relaxed and not feeling pain). General anesthesia allows the patient to sleep through the operation, and is typically used in children.

The surgery is usually done through a cut made inside the nostrils. In some cases, the cut may be made from outside, around the base of the nose. This type of cut is used to perform work on the tip of the nose, or if you need a cartilage graft.

A splint (metal or plastic) may be placed on the outside of the nose. This helps maintain the new shape of the bone when the surgery is finished. Soft plastic splints or nasal packs also may be placed in the nostrils to keep the dividing wall between the air passages (septum) stable.

Why the Procedure Is Performed

Rhinoplasty is one of the most common plastic surgery procedures. It can be used to:

• Reduce or increase the size of the nose
• Change the shape of the tip or the nasal bridge
• Narrow the opening of the nostrils
• Change the angle between the nose and the upper lip
• Correct a birth defect or injury
• Help relieve some breathing problems

Nose surgery is considered "elective" when it is done for cosmetic reasons. In these cases, the purpose is to change the shape of the nose to one that the patient finds more desirable. Many surgeons do not like to perform cosmetic nose surgery until the nasal bone has finished growing (around age 14 or 15 for girls, a bit later for boys).

Risks

The risks of any anesthesia are:

• Reactions to medications
• Problems breathing

The risks of any surgery are:

• Bleeding
• Infection
• Bruising

After surgery, small burst blood vessels may occasionally appear as tiny red spots on the skin's surface. They are usually minor, but are permanent. There are no visible scars if the rhinoplasty is performed from inside the nose. If the procedure narrows flared nostrils, there may be small scars at the base of the nose that are not usually visible.

Rarely, a second procedure may be needed to fix a minor deformity.

After the Procedure

You will usually go home on the same day as your surgery.

Immediately after surgery, your nose and face will be swollen and painful. Headaches are common.

The nasal packing is usually removed after 3 to 5 days and you will feel much more comfortable.

Outlook (Prognosis)

Full recovery takes several weeks.

Healing is a slow and gradual process. The tip of the nose may have some swelling and numbness for months. You may not be able to see the final results for up to a year.

References

Tardy ME, Thomas JR. Rhinoplasty. In: Cummings CW, Flint PW, Haughey BH, et al. Otolaryngology: Head & Neck Surgery. 4th ed. St. Louis, Mo:Mosby;2005:chap45.