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Rhinoplasty is the most commonly performed Cosmetic Surgery Procedure
in the United States. The procedure can be performed to reduce the
size of the nose, to narrow a "wide" nose, to accentuate aesthetic
features with or without changing the size, to straighten a "crooked"
nose or to correct deformities resulting from prior surgery.
Intrinsic to Rhinoplasty is a regard for breathing abilities. While
striving for the desired aesthetic result, an equal significance
is placed on maintaining adequate nasal airflow. Some older techniques
stressed only the aesthetic, resulting in breathing obstruction.
Fortunately, with a better understanding of nasal anatomy and function,
rhinoplasty procedures performed today yield a desirable appearance
while maintaining normal breathing. In fact, many procedures performed
today are aimed at correcting breathing difficulties or contour
irregularities resulting from prior "older style" rhinoplasty procedures.
Prior to any Rhinoplasty procedure, the nasal contour, anatomy
and function need to be meticulously examined. This includes examination
of the upper nose (nasal bones) and the middle and lower nose (nasal
cartilage). The thickness and quality of the nasal skin is similarly
important as this will dictate the type of procedure that will be
best suited for the patient. Exam of the inside of the nose is as
crucial as the internal structure may be contributing to the undesirable
external appearance. Internal exam also alerts the surgeon to any
allergic conditions and guides the surgeon with regard to maintaining
adequate nasal passages for breathing.
Rhinoplasty can be performed endonasally (from inside the nose)
or through a small incision under the tip of the nose. The approach
is dictated by the extent of modification to be made and, fortunately,
neither approach leaves any visible scars. The nasal septum (partition
between the left and right side of the nose) is treated at the same
time from inside the nose to further improve nasal breathing.
Rhinoplasty is an outpatient procedure that generally takes between
1-3 hours and can be performed under sedation anesthesia or general
anesthesia. Tape and a molded plastic dressing are applied for a
period of 5-7 days to limit swelling. Packing is very rarely used and,
according to patients, without packing, there is very little discomfort.
Moderate bruising may occur around the eyes, particularly if the
shape or position of the nasal bones has been modified.
The dressing and any sutures are removed 5-7 days after surgery.
At this point post operatively, the nose will still be somewhat
swollen although the proposed contour improvements will be visible.
Gradual improvement in swelling can be expected over the first 1-3
weeks following surgery.
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