Nose Surgery (Rhinoplasty)
Some of us are unhappy with our nose, either because of its size or shape or because of breathing problems. Rhinoplasty reshapes the skin as well as the bone and cartilage inside to alter the size and shape of the nose. Work on the cartilage that separates the two nasal air passages can help with breathing problems. This so-called “septoplasty” is often done as part of rhinoplasty or as the sole procedure. Sometimes this same cartilage is also used as a graft to help in the nose reshaping.
During your consultation at Northwest Valley Oral & Facial Cosmetic Surgery, Dr. Hammond will examine you and discuss recommendations for the best type of procedure to yield the best results. The procedure is usually done as an outpatient, under general anesthesia or local anesthesia. Most patients have very little pain following the surgery as well because long-acting local anesthetic is administered as part of the procedure. Following the procedure, the nose may be packed with gauze for several days to help mold it into the new shape sculpted during surgery. Most patients return to work about a week after surgery. There may be some bruising for a week or so and some swelling for a few weeks following surgery.
Rhinoplasty will improve the appearance and proportion of the nose. It will also enhance the facial harmony and usually will enhance the patient’s self confidence. For younger patients, surgery is considered when they have completed their growth after 18 years of age.
On your first consultation, Dr. Hammond will evaluate the nasal structures. These important structures include the quality of your skin, location and shape of the cartilages, and prominence or deficiency of the nasal bones. The anatomical reasons for your difficulty in taking air easily through the nostrils will be thoroughly discussed and may involve a significantly deviated septum, large turbinates, or polyp growths.
Dr. Hammond will also examine other facial features such as the shape of your face, your chin, and eyes in order to achieve harmony of your nose with these other facial features. Rhinoplasty may be performed in our office surgical suite, an outpatient surgical center, or the hospital. The selection of the facility depends on many factors, including the complexity of your case, comfort, and safety.
A sculpting rhinoplasty is one that selectively removes and repositions portions of the supportive framework, such as the nasal bones or cartilages, to obtain the desired appearance. The nature of the sculpting depends on your problem (shape, breathing). The surgical procedures are tailored to the areas of concern that may involve the bulbous tip, malposition tip, angle of the nose to the upper lip, shape of the bridge, and width of the nose and nostrils. At times, a deviated septum needs to be set in its midline position, enlarged lower turbinates need to be reduced, and space-occupying nasal polyps need to be removed to improve the flow of air through the nose.
When the surgery is completed there may be an external splint as well as internal packings to maintain its new shape. These dressings are usually removed within a few days or up to a week. Most patients are up and about within a few days. Dr. Hammond and his staff will carefully explained your procedure and answer any questions and concerns. At your preoperative visit, your pain and antibiotic medication will be prescribed. Dr. Hammond will assist you with more specific guidelines for return to normal activities.
When the external splint comes off at 1 week you will see an immediate difference but the nose will still be quite swollen. You should see more of a change within 6-8 weeks following surgery, with continued refinement for 6-12 months.
Rhiniophyma is a skin condition that causes disfiguring growth and thickening of the nose. If left untreated, rhinophyma can grow very large. Treatment involves reducing the abnormal tissue with radiowave surgery and/or CO2 laser. The procedure is performed with IV sedation and the nose will be pink for several weeks.