Rhinoplasty

Rhinoplasty is the cosmetic procedure to alter the shape and size of the nose.Rhinoplasty is also called nose-shaping or nose job The goal of rhinoplasty is to reshape the nose in correct balance and proportion to facial features.

Why Choose for Rhinoplasty ?

Nose is the central feature of your face.  It’s one of the first things people notice about your appearance since it sits right in the center of your face.The size or shape of your nose can make a huge difference to the way your face looks. If you are not happy with it, this can make a serious dent in self-confidence.

Thus rhinoplasty will

  • Change the size & shape of your nose to achieve the overall look and profile you desire of.
  • Increase your self-esteem and confidence
  • You feel more comfortable in having your photo taken
  • Correct breathing difficulties caused by structural defects in the nose

What Rhinoplasty Can Achieve?

  • Change size of the nose in balance with facial features
  • Lengthen or shorten the nose
  • Elevate depressed nasal bridge
  • Smoothen lumps and bumps along nasal bridge.
  • Reduce and sharpen enlarged, bulbous and bulky nasal tip or elevate the drooping one
  • Change nostrils that are large, wide, or upturned
  • Correct asymmetry of the nose
  • Correct deviated nasal septum
  • Correct any structural deformity giving rise to breathing problem
  • Can be combined with function endoscopic sinus surgery (FESS)

Am I A Candidate?

You are a good candidate for rhinoplasty if:

  • Your facial growth is complete & You are physically healthy.
  • If you are unhappy with the size & shape of your nose and you feel
    • Your nose is too large and not in proportion with rest of the facial features
    • Your nose is too wide when viewed from front
    • There is bump on your nasal bridge
    • Your nasal tip is bulbous and thick
    • Your nasal tip is drooping down
    • Your nostrils are excessively flared
    • Your nose is asymmetrical and crooked
    • If you suffer with breathing difficulties, such as sleep apnoea

Types Of Rhinoplasties

Open RhinoplastyInvolves two small incisions inside nose and a small incision over collumella

Advantages:

  • Good binocular visualization
  • Evaluation of complete deformity without distortion
  • Precise diagnosis and correction of deformities
  • More options for maneuvering of stuctures
  • More precise implant placement

Disadvantage:

  • Small collumellar incision. But this scar will slowly fade off after few days

Closed Rhinoplasty Involves two small incisions inside nose without any incision over collumella

Advantage:

  • Avoids external collumellar incision

What are different materials or implants used in Rhinoplasty?

  • AUTOLOGOUS MATERIALThese are tissues from patient’s own body like cartilage from nasal septum, ear or ribs.
  • ALLOPLASTIC IMPLANTSDifferent implant materials which are used are-
    • Silicone (Most common )
    • Medpore
    • Gortex

Autologous Materials

Advantage

Since they are from patient´s own body, their acceptance rate is better than implants

Disadvantages

  • Donor site pain & scar
  • In few cases there may be some absorption of cartilage over long term so final result may alter.

Alloplastic Material (Implants)

Advantage

  • No donor site pain or additional scar.
  • No resorption- Final result will not change over long term.

Disadvantages

  • Since it is not patient´s own tissue, there is a small chance that body may treat implant as a foreign material and try to remove it which may result in implant exposure
  • Since it has no blood supply, it is not protected from body’s immune system. So there is small chance of infection.

Steps Of Rhinoplasty

Anesthesia:- The rhinoplasty is done under general anaesthesia , local anaesthesia or intravenous sedation.

The incision:- Depending upon the type of rhinoplasty, incisions are taken & skin over nose is gently raised to make access to bones & cartilages.

Reshaping the nose structure:- Large noses are reduced by removal of part of bones and cartilages of nasal framework. This also incorporates correction of any lumps and humps along nasal bridge. Sometimes nose may require addition of tissues like cartilage grafts ( pieces). These are usually taken from nasal septum, ear or ribs. Sometimes autologous material [implants) are used for this.

Correcting a deviated septum:- If the septum is deviated, it can be straightened and the projections inside the nose reduced to improve breathing.

Correction of nasal tip:- If nasal tip is deviated, it is corrected. At the same time a bulbous tip is made narrow & more defining

Additional procedures for breathing difficulty:- Any additional procedure , if required for correction of breathing difficulty , is done.

Closing the incision:- The skin is redraped & incisions are closed.

Pre-operative preparations & planning of Rhinoplasty

Once you decide to go ahead with the procedure

  • You will undergo clinical check up, blood investigations and chest x-ray for evaluation of fitness for surgery.
  • Please inform us if you had any past illness, surgery or any allergy.
  • Once you are fit for the surgery, the date of procedure will be fixed.
  • You will be given instructions about necessary pre-operative precautions.

Preoperative Precautions

  • Stop smoking.
  • Stop Aspirin or other painkillers or nutritional support 7 days before the procedure
  • Discuss with us if you are currently taking any medications, vitamins, herbal supplements, alcohol or any recreational drug (including steroids). You may have to stop or switch to alternate drug.
  • Discuss any medical condition that you have and any medical treatment you are taking.
  • You are to have nothing to eat or drink for the 8 hours before your surgery
  • WEAR PRESSURE GARMENTS REGULARLY.

What happens on the day of surgery before the procedure?

  • Before the procedure Dr. Ashish Sangvikar will meet you
  • He will take few clinical photographs of your face.
  • You will sign a consent.
  • You can discuss any queries or last minute questions at this time.
  • If you have had any recent illness of infection, please inform us.
  • A minor test of xylocaine injection will be done on your forearm.
  • You will then proceed to operation theatre.
  • You will have an intravenous cannula inserted
  • You may be given a sedative through IV to help you remain calm and relaxed.
  • Rhinoplasty will take place under general anaesthesia , local anaesthesia or intravenous sedation

Immediate post surgery recovery period

  • After the procedure you will be shifted to recovery room where your conditioned will be closely monitored.
  • You may have a splint over your nose to support its new shape & protect  it from any accidental injury.
  • Nasal packing may also be used inside the nose to provide additional support.
  • After two hours you will be shifted to room.

Post Surgery instructions

  • You are advised to rest with your head elevated & breath through mouth after surgery & few early days.
  • You will have some discomfort or soreness for which you will be given painkillers.
  • You will have antibiotics to reduce the risk of infection.
  • You will be allowed to go home next day.
  • Avoid bending, lifting or sudden movements of the head
  • Your face will be puffy with some bruising & swelling around your nose & eyes. You can use cold compresses to reduce swelling & discomfort.
  • It will take few weeks for swelling & bruises to subside. There may be some minor swelling around your nose. This swelling is not easily noticeable to others & may take 6-12 months to completely disappear.
  • The nasal packing will be removed after 2-3 days. The splint & bandages will be removed after 7-10 days.
  • You can resume you work after 2 weeks. Though you can start light exercises after 3 weeks, it is advisable to avoid heavy & strenuous exercises for 6 weeks after surgery.

Result After Rhinoplasty Surgery

Though initial swelling subsides in few weeks , it could be a whole year before your new nasal shape & contours fully refine and you can appreciate end the result of surgery.

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