Reshaping a nose is referred to as a “nose job” or “nose reshaping” or “Rhinoplasty”, by the patients. A Rhinoplasty helps to enhance the facial harmony and the proportions of the nose. Rhinoplasty can correct certain conditions that may affect the breathing, that is caused by the structural defects in the nose.
Nose reshaping, or rhinoplasty, is one of the most common plastic surgery procedures performed today. Nose reshaping procedures can help to correct the disproportionate appearance of the nose by altering the size or shape of the nasal dorsum/tip, the span of the nostrils, or the angle between the nose and the upper lip. In addition, nose reshaping procedures may be performed to correct a nasal birth defect or injury as well as chronic breathing problems. It is important to realize that individuals considering a nose reshaping procedure should be at least 16 years of age, as this procedure should only be performed after the nose has finished developing completely.
A surgical Rhinoplasty can help to rectify-
- A nose size, that is not proportionate to the face
- A proper nose width at the bridge
- Appropriate size and position of the nostrils
- A nose profile with visible humps or depressions on the bridge
- A nasal tip, that is enlarged or bulbous, drooping, upturned or hooked
- Nasal asymmetry
Benefits of Rhinoplasty
1.The surgical nose reshaping procedures can not only enhance the appearance and functional ability of the nose, but it also plays a major role in improving the confidence and self-confidence, by changing the nasal appearance
2.Rhinoplasty can increase or decrease the size of the nose, nostrils and reshape it in proportion with your face.
3.A nose surgery can rectify a deviated septum, that is one of the most common causes of breathing impairments. Readjusting the nasal structures helps to produce a better alignment, that resolves any breathing issues.
Types of Rhinoplasty
1.Reduction Rhinoplasty- It is the most common type of nose reshaping surgery which can provide patients with a nose that is more proportionate to their facial features. It can also rectify issues, like nose bump near the bridge, an elongated nasal tip or excessively flared nostrils. To reduce the size of the nostrils, the surgeons may need to remove a small amount of cartilage or apply a technique called alar base reduction, where the surgeon removes small wedges of tissue from the area, where the nostrils meet.
2.Augmentation Rhinoplasty- Augmentation Rhinoplasty is another popular nose reshaping surgery, that surgeons perform on bones or tissue to build up a nasal tip or bridge. To serve the purpose, the surgeons may also use cartilages from other parts of the nose, usually the nasal septum. In case of absence of tissues in the area, the surgeon may use a rib bone or cartilage from other areas, synthetic material or other biological tissues.
3.Post-Traumatic Rhinoplasty- Patients, who have suffered an injury to the nose may benefit from post-traumatic rhinoplasty. This procedure can address both the appearance and functionality of the nose. Surgeons may use this procedure to straighten the nose and repair the nasal septum. Often the post-traumatic patients experience a broken nose, which the surgeons have to re-fracture and re-set it to achieve the desired result.
4.Reconstructive Rhinoplasty- Patients may necessitate reconstructive nose reshaping if they have lost a part or entire nose in some accidental incident or skin cancer or any other serious illness. During the treatment, a surgeon may use skin grafts, flap techniques, and other advanced methods.
5.Ethnic Rhinoplasty- Ethic Rhinoplasty uses the same methods as other forms of nose reshaping surgery. Normally, this Rhinoplasty procedure is performed on individuals belonging from African American, Afro-Caribbean, Asian and Middle Eastern descent.
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A Rhinoplasty is typically performed on an outpatient basis, where the candidates do not have to stay overnight. The candidates are then administered with local or general anaesthesia, which the surgeons would contemplate for the patient. During the surgery, the surgeon typically makes cuts within the nostrils. In complex cases, the surgeons may also create incisions across the base of the nose. The surgeon then reshapes the inner bone and cartilage to produce a more appealing appearance. Once the underlying structure of the nose is sculpted according to the desired shape, the nasal skin and tissue is redraped. The incisions are finally closed up. Some additional stitches may be placed on the natural creases of the nostrils to alter the size of the nose.
Be sure to tell us if you’ve had any previous nose surgery or an injury to your nose, even if it was many years ago, history of allergies, or breathing difficulties; if you’re taking any medications, vitamins, or recreational drugs; and if you smoke.
Open Rhinoplasty :
The surgeon makes small incisions across the columella and inside each nostril. These incisions allow the physician to lift the skin away from the bone and cartilage of the nose. The nasal framework can be clearly visualized to make precise adjustments.
Closed Rhinoplasty :
Two small incisions inside each nostril in order to gain access to the cartilage and bone. The skin is not lifted away from the framework of the nose. Using very small instruments,the nose is reshaped by removing or adding bone, cartilage, and tissue to achieve the desired appearance.
Reshaping the Tip :
In patients whose nasal tip is wide or bulbous, a portion of the alar cartilage is removed from the tip of the nose.
Depending on your anatomy, sutures may be taken to bend or pull the alar cartilages inward to create a narrower tip or adjust its position.
Reduce the Dorsal Hump :
The dorsal hump usually consists primarily of cartilage and some bone. Using the osteotome, areas of cartilage and bone are carved away. Your nose may have what is known as an open roof, which is an open space between the nasal bones. The nasal bones might need to be repositioned with an osteotomy to close the open roof.
An osteotomy involves breaking the nasal bones in order to reposition them. An osteotomy can be performed to correct a high nasal dorsum with a dorsal hump, close an open roof after the removal of a dorsal hump, or create a narrower base of the nose.
The incisions inside the nose will be closed with dissolvable stitches. Nasal airway splints inside your nostrils that provide support and stabilize the nose as it heals. Steri-strips will be applied to the outside of your nose. If the nasal bones were broken during the procedure, a nasal splint will be applied as well.
The bandages and splint help the tissues heal and conform to the new cartilage and bone structure.
Nasal Implant :
An incision is made inside one or both nostrils and a carefully sculpted pocket is created underneath the skin along the bridge to place the implant. The implant itself can also be sculpted for a perfect result.
PREPARING FOR THE PROCEDURE
The patients at first, meet with a board certified experienced surgeon, to discuss whether they are a good candidate for the procedure or not. The surgeon may verify the reasons to undergo a nose reshaping procedure. The surgeons may also examine the medical history of the patients and analyze the ongoing medical condition. Some physical exam may also be performed, where the surgeon will closely look at the skin type on the inside and outside of the nose to make sure about the changes to be made.
The surgeon would also suggest avoiding painkillers containing ibuprofen or aspirin for about two weeks before and after the surgery. These medications slow down the blood clotting process which results in excessive bleeding during the surgery.
Smokers face more difficulty in healing because cigarettes can slow down the recovery process. Nicotine constricts the blood vessels that results in less oxygen and blood in the body which naturally slows down the healing procedure. So patients are advised to quit smoking before and after the surgery.
During the recovery of, the incisions are covered with dressings or bandages and an elastic bandage or supporting garment to minimise the swelling and to provide support to the new chest contour, while it heals completely. Strenuous activities, heavy lifting, and stretching activities must be avoided for about six weeks. The patients can start driving when they feel comfortable.
It may take few weeks to fully heal and recover from the breast reduction surgery. The patients, who have undergone the procedure requires few days of leave from the work. The final results may take up to six months to be visible. Before leaving for home from the clinic or hospital the surgeons provides an elastic, garment that must be worn day and night for few weeks after undergoing the operation. The post-op instructions must not be missed because that would depend on how quickly the wounds heal.
POST OP RECOVERY
After surgery-particularly during the first 24 hours-your face will feel puffy, your nose may ache, and you may have a dull headache which can be controlled by medication.
You’ll notice that the swelling and bruising around your eyes will increase at first, reaching a peak after 2 – 3 days. Applying cold compresses will reduce this swelling and most of the swelling and bruising should disappear within two weeks or so.
Stitches,bandages, and the nasal splints may stay in place for approximately 3 – 7 days.
Q What is the minimum age of undergoing Rhinoplasty?
A Rhinoplasty can be performed at fourteen in female and fifteen in male teenagers.
Q How long does the procedure take?
A The procedure usually takes near about two hours for the completion of the procedure.
Q When can the candidate return back to their normal life?
A The patient can resume normal activities after a week and vigorous exercises and other strenuous activities after three weeks of undergoing the procedure.
QWhen can the stitches be removed?
A The surgeons normally remove the stitches on the fifth day of the postoperative day.
Sameer Karkhanis, MD
Board-Certified Mumbai Plastic Surgeon
Chief Plastic Surgeon & the Director at CCRS is a qualified Aesthetic Plastic and Reconstructive Surgeon. He is Board Certified, with the qualification of DNB Plastic Surgery (Diplomate of National Board). He is an active member of the International Society of Aesthetic Plastic Surgery.