Dr.K.O.Paulose FRCS DLO, Consultant ENT Surgeon, Jubilee Hospital, Trivandrum, Kerala, India; www.drpaulose.com www.snorefreesleep.com
Introduction
Rhinoplasty (Cosmetic Surgery of Nose) is done to improve the shape and or function of the nose and is one of the most popular cosmetic surgery procedures worldwide. Â It can be carried out to make the nose look smaller or bigger, improve the alignment of the nose or improve the shape or size of the nostrils. It is a surgical procedure to reshape your nose to improve its appearance and proportion in relation to your other facial features.
Ideally Rhinoplasty should not be done before 15-16 years of age as before this age the bones of the face and nose are still growing. By the mid-teens the facial bones have reached their full mature size and shape. After this age Rhinoplasty can be done at any age as long as the person is in good general health.
Rhinoplasty can be done by the Open (External) or closed (Internal) technique. This will depend on where the incisions are made. I prefer external approach in most cases as it gives better visualization of structures.
There is a small incision across the collumella which is hardly visible and need only 3-4 sutures.The resulting scars usually fade very well and ultimately should be barely noticeable.
The nose is reduced, or in some cases built up, by adjusting it’s supporting structures-either removing or adding bone and cartilage. The skin and soft tissues then redrape themselves over this new scaffolding.
Septoplasty with Rhinoplasty
In some instances, there may be an internal deformity of the nose that can affect the breathing. This may be due to an irregularity in the septum (the central structure of cartilage and bone that separates the two sides of the nose) or the turbinates (structures protruding internally from the lateral walls of the nose). Adjustment of these structures to improve the nasal airway may be made at the same time as alterations to the external appearance of the nose.
Post operative Post Op Instructions
There are really no hard and fast rules about Rhinoplasty recovery. Everyone heals differently, and in their own time. Your road to recovery begins almost immediately after your nose surgery.
Nasal Packing: I use Merocel –Compressed gel-for internal nasal pack. This will be removed after 24-48hrs. With packing in place, you will have to breathe through your mouth, and you will have somewhat more swelling than usual.
Internal Silastic Splint- A small splint will be placed inside the nose. This keeps the septum in place, and removed after 5-7 days time.
External Thermpolastic Splint. The splint put on your nose at the end of surgery is intended to provide protection, serving as a sort of small external skeleton. It will be removed in 7 days time.
Sleeping: Keeping your head (and nose) elevated tends to reduce swelling. If possible, sleep on two or three pillows.
Bleeding: After surgery, some oozing and bleeding usually occurs for a day or two, and crusting dried blood will collect in the nostrils.
Nasal blockage-You may also feel extremely stuffed-up after nose surgery. The challenge here is that you should not blow your nose for at least one week. Decongestants may help relieve your stuffiness.
Bruising-There will be some bruising and swelling in the days and weeks after your nose surgery. You may even develop two black eyes. Try applying cold compresses on the sore areas. I usually give Dexamethazone and Enractin the first day.
Be careful washing your face and make sure to apply sun screen if you go out in the sun. Your nose will be very sensitive for a while after your Rhinoplasty.
Post of the swelling resolves within two weeks and the rest tends to go away within a month, but it can take up to 3-6 months for all the residual swelling to abate. Be patient.
You can likely return to work within 10-14 days after having Rhinoplasty.
Outcome
After surgery it takes a considerable time for the tissue to heal and the swelling and edema to settle to reveal the new shape of the nose. For this reason do not make any judgment on the on the result of your surgery for several months, even a year after surgery, until the tissue healing is complete.
Outcome should aim to have a natural shape in harmony with the rest of the face, not a “surgical” nose. Remember-the intention of Rhinoplasty is for your new nose to blend in naturally with your face.
Whom to approach for Rhinoplasty
It is better to see an ENT Surgeon with Plastic Surgical experience in Cosmetic Surgery of the face. When there are problems with airway due to septal deformities, it is better an ENT surgeon can deal with the issues of functional aspects of the Nasal airway.
Unrealistic Expectation of Patient
Always counsel the patient before undertaking Rhinoplasty.There can be underlying psychological problems which need attention. Patients also should not have unrealistic expectation about the outcome. Pre operative and post operative photographs are to be done in every case.
Cost of Rhinoplasty in Jubilee Hospital:
The cost of Rhinoplasty depends on the procedures involved; say anywhere Rs 80-9000. (USD1500-2000).It is affordable to most patients.
For Consultation:
OR
Make Physical Consultation with-
Dr.K.O.Paulose FRCS, Consultant ENT Surgeon
Jubilee Hospital Trivandrum Kerala South India
Tel. 0471 3080300 , 0471 233 4561
OP Clinic Mon-Wed-Friday 9 AM -12 Noon
Operation Days Tues-Thu-Saturday 8 AM -2 PM
To Reach Jubilee Hospital: jubileehospitaltrivandrum
http://www.jubileehospital.org/
