Rhinoplasty is nasal surgery which is designed to improve
the appearance of the nose, and/or the function of the
nose in regards to breathing.
Rhinoplasty is often considered the most challenging
type of plastic surgery, and choosing the exact procedure
involves studying the relationship of the nose to the
rest of the face, and reshaping the nose to enhance
facial balance. No other plastic surgery is individualized
to the degree that rhinoplasty must be. A thorough examination,
careful discussion of the patient’s goals, and
a review of photographic imaging are important in establishing
the surgical plan. I usually recommend at least two
separate preoperative consultations, to ensure clear
communicationbetween patient and surgeon, and to allow
an accurate and complete analysis of the patient’s
goals and nasal anatomy.
Either ‘closed’
or ‘open’ techniques of rhinoplasty may
be performed. The closed technique uses only incisions
inside the nostrils, and may suffice for more straight-forward
rhinoplasties, for instance a first-time or ‘primary’
rhinoplasty that involves the reduction of a dorsal
nasal prominence or ‘hump.’ In most cases,
rhinoplasties will involve precise modification of the
nasal tip, which is best performed using the ‘open’
technique. This procedure uses the same incisions as
the closed technique, and adds a small incision across
the columella (the column of tissue between the nostrils).
A small external scar results, but this typically heals
very well and can be nearly imperceptible. The advantage
of the open technique is that is allows the surgeon
to better visualize the framework of bone and cartilage
that gives the nose its shape. The framework can be
precisely altered with the open technique, so as to
achieve the desired result with enhanced reliability
and predictability.
Depending on the needs
of the patient, rhinoplasty may involve the removal
or repositioning of cartilage and bone, or the addition
of cartilage from the nasal septum or ear. Other tissues,
or even synthetic materials, are sometimes used.
When nasal surgery
is performed to enhance breathing, procedures may include:
septoplasty (modification of the nasal septum, which
is the plate of cartilage between the right and left
nasal passages), turbinate surgery (modification of
tissues deep within the nasal cavity) , or alteration
of the nasal framework-- most often in an area of the
upper nasal passages termed the ‘internal valve.’
Rhinoplasty is performed
as an outpatient procedure, and under a general anesthetic
in most cases. After the surgery, a splint is usually
placed over the nose for protection and stabilization,
and packing may be used in the nostrils if the nasal
passages or nasal bones are altered. Pain and discomfort
following the surgery are controlled with oral pain
medication, and the stitches and splint are removed
within one week after surgery. Nasal packing, when used,
is removed within one to three days. Most patients feel
comfortable returning to work within one to two weeks.
Most bruising resolves within two weeks, though more
subtle swelling may persist for longer periods.
For rhinoplasty in Beverly Hills contact board certified plastic surgeon Dr. George Rudkin at 310.410.4599
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