Rhinoplasty, often called a nose job, is a surgical procedure performed to change the appearance of the nose. This procedure enhances facial harmony by improving the shape, size, and proportions of your nose. It can also correct impaired breathing caused by structural defects in the nose.
There are many reasons that patients decide to pursue surgical rhinoplasty. This procedure can improve:
Nose size in relation to facial balance
Nose width at the bridge or in the size and position of the nostrils
Nose profile with visible humps or depressions on the bridge
Nasal tip that is enlarged or bulbous, drooping, upturned or hooked
Nostrils that are large, wide or upturned
Rhinoplasty can also be performed to improve an obstructed airway. Correction of a deviated septum, one of the most common causes of breathing impairment, is achieved by adjusting the nasal structure to produce better alignment.
If you desire a more symmetrical nose, keep in mind that everyone's face is asymmetric to some degree. Results may not be completely symmetric, although the goal is to create facial balance and correct proportion.
WHO IS A CANDIDATE?
Like most cosmetic procedures, and especially those on the face - rhinoplasty is a highly individualized procedure. You should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.
You may be a good candidate for rhinoplasty if:
Your facial growth is complete
You are physically healthy
You don’t smoke
You have realistic expectations for the improvement of your appearance and a positive outlook
The purpose of your consultation with Dr. Majewski is to evaluate whether you are a candidate for a nose job (or a different procedure) and to develop a treatment plan that will help you achieve your goals.
Dr. Majewski will ask you questions about:
Your surgical goals
Medical conditions, drug allergies and medical treatments
Current medications, vitamins, herbal supplements, alcohol, tobacco and drug use
Previous surgeries, injections, or traumas in the facial area
Your surgeon will also:
Evaluate your general health status and any pre-existing health conditions or risk factors
Discuss your surgical and non-surgical options options
Examine and measure your face
Recommend a course of treatment
Discuss likely outcomes of a nose job and any risks or potential complications
Discuss the type of anesthesia that will be used
The consultation is the time to ask Dr. Majewski any questions you may have regarding the procedure, recovery, and expected results.
It's very important to understand all aspects of your rhinoplasty procedure. It's natural to feel some anxiety, whether it's excitement for your anticipated new look or a bit of preoperative stress - or both. Don't be shy about discussing these feelings with Dr. Majewski. You’ll feel most confident about your procedure, recovery, and results if you know exactly what to expect.
The cost of your rhinoplasty procedure will vary depending on the extent of your surgery, and will include anesthesia fees, surgical facility costs, medical tests, post-surgery garments, prescriptions for medications, and the surgeon’s fee.
You might also consider the cost of childcare or other assistance you might need during your recovery period - such as meal delivery, a cleaning service, etc. Although usually not necessary, some patients prefer to delegate some of their household responsibilities during the first few weeks of recovery so they can focus on healing fully.
In preparing for your nose job, you may be asked to:
Get lab testing or a medical evaluation
Take certain medications or adjust your current medications
Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
Most of Dr. Majewski’s rhinoplasty cases will take place at our state-of-the-art Surgery Center at the Reserve, located conveniently right next door to our clinic. You should arrange for someone to drive you to and from your procedure.
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Dr. Majewski will recommend the best choice for you.
Rhinoplasty is performed either using a closed procedure, where incisions are hidden inside the nose, or an open procedure, where an incision is made across the columella, the narrow strip of tissue that separates the nostrils.
Through these incisions, the skin that covers the nasal bones and cartilage is gently raised, allowing access to reshape the structure of the nose.
An overly large nose may be reduced by removing bone or cartilage. Sometimes surgery of the nose may require the addition of cartilage grafts.
Most commonly, cartilage from the septum, the partition in the middle of the nose, is used for this purpose. Occasionally cartilage from the ear or rarely a section of rib cartilage can be used.
If the septum is deviated, it can be straightened and the projections inside the nose might be reduced to improve breathing.
Once the underlying structure of the nose is sculpted to the desired shape, nasal skin and tissue is redraped and incisions are closed.
Additional incisions may be placed in the natural creases of the nostrils to alter their size.
For a few days, splints and gauze packing may support the nose as it begins to heal.
During your rhinoplasty recovery, a splint and/or packing may be placed inside your nose, and a splint or bandages placed on the outside to support and protect the new structures during initial healing. You’ll receive a prescription for pain medication to help with any initial pain or discomfort, although most patients find that they are able to manage pain with over-the-counter (non-prescription) pain medication after the first few days.
Dr. Majewski will give you specific instructions that may include:
How to care for the surgical site
Medications to apply or take orally to aid healing and reduce the potential for infection
Specific concerns to look for at the surgical site or in your general health
When to follow up with your plastic surgeon.
You’ll be more confident and comfortable if you know exactly what to expect from recovery and can plan ahead. Be sure to ask your Dr. Majewski specific questions about what you can expect during your individual recovery period:
Where will I be taken after my surgery is complete?
What medication will I be given or prescribed after surgery?
Will I have dressings/bandages after surgery?
When will they be removed?
Are stitches removed? When?
When can I resume normal activity and exercise?
When do I return for follow-up care?
RECOVERY TIMELINE & TIPS
Most patients are surprised as to how quickly they are able to resume normal activities following a rhinoplasty. That said, since rhinoplasty is a facial procedure and can cause swelling and bruising, most patients prefer to stay out of the public eye for at least two weeks in order to avoid any unnecessary attention.
Although every patient recovers differently, here is a general recovery timeline of a typical rhinoplasty patient:
Week 1: You can expect to experience some pain right after your rhinoplasty, but it should fade relatively quickly. Most patients report that they only need to take narcotic pain relievers for a few days following surgery, and can move on to using milder pain relievers within a week of the procedure.
Your level of discomfort also depends on exactly which procedure — closed or open rhinoplasty — Dr. Majewski performs. In most cases, rhinoplasty causes discomfort to your nose and sinuses for about three weeks. The initial pain is more severe, but subsides after only a few days.
Many patients say that the most difficult part of the recovery process is the initial period during which the nasal splint and packing are in place. Your face will feel swollen and puffy, the area around your eyes may be bruised, and your nose will be painfully tender.
It’s recommended that you make use of cold packs to reduce swelling during this time, and take whatever pain relievers your doctor has prescribed. It will take about two weeks for the swelling and bruising to improve.
You might experience tiredness or fatigue during this time, but that is likely more due to the pain medication than the procedure itself. Listen to your body and take time to rest, as proper rest can expedite the recovery process.
One of the most common causes of discomfort after rhinoplasty is a dry throat. Since your sinuses will be packed with gauze during the first part of recovery, you’ll need to breathe through your mouth, causing throat dryness.
Here are some tips for soothing your dry throat:
Run a humidifier by your bedside while you sleep.
Avoid smoking cigarettes and drinking alcohol.
Drink a cup of hot tea with honey.
Take a hot, steamy shower.
Stay hydrated with cool water.
Use lozenges to increase saliva production and relieve any itchiness.
Weeks 2-3: By week 2, you should be able to discontinue use of prescription pain medication if you haven’t already. You will likely continue to experience swelling and bruising, although it should subside from week to week. You should continue to use cold packs to soothe any discomfort and reduce swelling.
By this point, you may feel comfortable resuming work or other daily activities, but ask Dr. Majewski for specific information regarding any strenuous physical activity. It’s important to be very careful with your nose during this time to avoid risk of injury - so he’ll likely recommend that you avoid strenuous activity for 3-6 weeks following surgery.
Injuring your nose during the recovery process can cause additional setbacks and complications. Much of your nasal tissue will be swollen and tender during your rhinoplasty recovery, so any injury will be painful as well as detrimental to your recovery.
Take care to avoid bumping your nose, and call our office immediately if you do injure yourself during the recovery process. You may need to schedule an appointment for a quick check up, or detailed imaging to determine the extent of the injury.
Weeks 4-5 and beyond: By this point, most bruising and initial swelling should be gone and you should feel comfortable stepping out into the world with your brand new nose!
It’s important to note that recovery from rhinoplasty has an emotional component as well. Any change to your body, and especially your face - can bring with it some anxiety, especially during the vulnerable first few weeks of recovery. As you step out into the world, your friends and family will likely notice the difference in your appearance - learn to accept their compliments, and embrace the changes to your face. Recovery from surgery can be a slow process, which is why it’s so important to go into surgery with a positive outlook, and to try to maintain that positivity throughout your recovery.
While initial swelling subsides within a few weeks, it may take up to a year for your new nasal contour to fully refine. Swelling may come and go and worsen in the morning during the first year following your rhinoplasty surgery. During this time, you may notice gradual changes in the appearance of your nose as it refines to a more permanent outcome.
Although the initial recovery period can leave you feeling quite vulnerable, most patients report a significant boost in confidence after rhinoplasty. A successful nose job can transform your facial profile and help you feel more confident and comfortable in your own skin.
ARE RESULTS PERMANENT?
As your body ages, it is natural to have some gradual changes to your face, including your nose. But most of your improvement should be relatively permanent. A healthy lifestyle and life-long sun protection will help extend the results of your new appearance.
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