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Rhinoplasty - (Surgery of the Nose) |
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Rhinoplasty - (Surgery of the Nose) |
If your considering a Rhinoplasty . . .
Rhinoplasty, or surgery to reshape the nose, is one of the most common of all plastic surgery procedures. Rhinoplasty can reduce or increase the size of your nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip. It may also correct a birth defect or injury, or help relieve some breathing problems. The Best Candidates for Rhinoplasty
Rhinoplasty can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Beforeyou decide to have surgery, think carefully about your expectations and discuss them with Dr. Washak.
The best candidates for rhinoplasty are people who are looking for improvement, not perfection, in the way they look. If you're physically healthy, psychologically stable, and realistic in your expectations, you may be a good candidate.
Age may also be a consideration. Many surgeons prefer not to operate on teenagers until after they've completed their growth spurt - around 14 or 15 for girls, a bit later for boys. It's important to consider a teenager's social and emotional adjustment, too, and to make sure it's what they, and not their parents, really want. Good communication between you and Dr. Washak is essential. In your initial consultation, he will ask you what you'd loke your nose to look like, evaluate the structure of your nose and face, and discuss the possibilities with you. He will also explain the factors that can influence the procedures and the results. These factors include the structure of your nasal bones and cartilage, the shape of your face, the thickness of your skin, your age, and your expectations.
Dr. Washak will also explain the techniques and anesthesia he will use, the type of facility where the surgery will be performed, the risks and costs involved, and any options you may have. Most insurance policies don't cover purely cosmetic surgery; however, if the procedure is performed for reconstructive purposes, to correct a breathing problem or a marked deformity following injury, the procedure may be covered. Check with your insurer, and obtain pre-authorization ffor your surgery.
Be sure to tell Dr. Washak if you've had any previous nose surgery or an injury to your nose, even if it was may years ago. You should also inform Dr. Washak if you have any allergies or breathing difficulties; if you're taking any medications, vitamins, or recreational drugs; and if you smoke.
Don't hesitate to ask Dr. Washak any questions you may have, especially those regarding your expectations and concerns about the results.
Dr. Washak will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications, and washing your face. Carefully following these instructions will help your surgery go more smoothly.
While your making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days, if needed.
Where Your Surgery Will be Performed
Rhinoplasty may be performed in a surgeon's office-based facility, an outpatient surgery center, or a hospital. It's usually done on an outpatient basis, for cost containment and convenience. Complex procedures may require a short inpatient stay.
Rhinoplasty can be performed under local or general anesthesia, depending on the extent of the procedure and on what you and Dr. Washak prefer.
With local anesthesia, you'll usually be lightly sedated, and your nose and the surrounding area will be numbed; you'll be awake during the surgery, but relaxed and insensitive to pain. With general anesthesia, you'll sleep through the operation.
Rhinoplasty usually takes an hour or two, through complicated procedures may take longer. During surgery the skin of the nose is separated from its supporting framework of bone and cartilage, which is then sculpted to the desired shape . The nature of the sculpting will depend on your problem and Dr. Washak's preferred technique. Finally, the skin is redraped over the new framework.
Dr. Washak removes a hump using a chisel or a rasp, then brings the nasal bones together to form a narrower bridge. Cartilage is trimmed to reshape the tip of the nose
Trimming the septum improves the angle betwenn the nose and upper lip.
If the nostrils are too wide, Dr. Washak can remove small wedges of skin from their base, bringing them closer together.
To improve the nasal airway, the shape or position of the septum may be altered. Or, the deviated portion of the septum may be partially removed.
A splint made of tape and an overlay of plastic, metal, or plaster is applied to help the bone and cartilage of the nose maintain their new shape.
After surgery, the patient has a straighter bridge, a well defined nasal tip, and an improved angle between the nose and upper lip.
After surgery - particularly during the first twenty-four hours - your face will feel puffy, your nose may ache, and you may have a dull headache. You can controll any discomfort with the pain medication prescribed by Dr. Washak. Plan on staying in bed with your head elevated (except for going to the bathroom) for the first day. You'll notice that the swelling and bruising around your eyes will increase at first, reaching a peak after two or three days. Applying cold compresses will reduce this swelling and make you feel a bit better. In any case, you'll feel a lot better than you look. Most of the swelling and bruising should disappear within two weeks or so. (Some subtle swelling - unnoticeable to anyone but you and Dr. Washak - will remain for several months.)
A little bleeding is common during the first few days following surgery, and you may continue to feel some stuffiness for several weeks. Dr. Washak will probably ask you not to blow your nose for a week or so, while the tissues heal.
If you have nasal packing, it will be removed after a few days and you'll feel much more comfortable. By the end of one or, occasionally, two weeks, all dressings, splints, and stitches should be removed.
Most rhinoplasty patients are up and about within two days, and able to return to school, or sedentary work a week or so following surgery. It will be several weeks, however, before you're entirely up to speed. Dr Washak will give you more specific guidelines for gradually resuming your normal activities. They're likely to include these suggestions: Avoid strenuous activity (jogging, swimming, bending, sexual relations - any activity that increases your blood pressure) for two to three weeks. Be gentle when washing your face and hair or using cosmetics.
You can wear contact lenses as soon as you feel like it, but glasses are another story. Once the splint is off, they'll have to be taped to your forehead or propped on your cheeks for another six to seven weeks, until your nose is completely healed.
Dr. Washak will schedule frequent follow-up visits in the months after surgery to check on the progress of your healing. If you have any unusual symptoms between visits, or any questions about what you can or can't do, don't hesitate to call Dr. Washak.
In the days following surgery, when your face is bruised and swollen, it's easy to forget that you will be lookin better. In fact, many patients feel depressed for a while after plastic surgery - it's quite normal and understandable. Rest assured that this stage will pass. Day by day, your nose will begin to look better and your spirits will improve. Within a week or two, you'll no longer look as if you've just had surgery.
Still, healing is a slow and gradual process. Some subtle swelling may be present for months, especially in the tip. The final results of rhinoplasty may not be apparent for a year or more.
In the meantime, you might experience some unexpected reactions from family and friends. They may say they don't see a major difference in your nose. Or they may act resentful, especially if you've changed something they view as a family or ethnic trait. If that happens, try to keep in mind why you decided to have this surgery in the first place. If you've met your goals, then your surgery is a success.
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