What is rhinoplasty?

Rhinoplasty is an operation that changes the external structure of your nose.

When is it used?

This operation can be used to improve the appearance, size, or projection of your nose. It can also be used to correct deformities and obstructions caused by injury, disease, or birth defects.

What steps should be taken to prepare for a rhinoplasty?

• Your doctor will take photographs of your face and nose to help plan the operation.

• Your doctor should discuss your motivations and expectations and the most appropriate rhinoplasty strategy for you. Your ideal nasal appearance should fit your facial appearance.

• Your doctor will give you a complete physical exam, including blood and sometimes urine tests. A recent cold, allergies, or sinus problems may cause your operation to be postponed.

• Plan how you will take care of yourself after the operation. Make sure a family member, friend, or relative can stay with you at least 24 hours after your operation, if you are having it done in an outpatient center.

• Follow all instructions your doctor gives you. Usually no special preparation is needed for local anesthesia.

• If you are to have general anesthesia, eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

Your doctor may prescribe a sedative and a narcotic before you are given either local or general anesthesia. The anesthesia will keep you from feeling pain during the operation. When you are asleep or your face is numb, your doctor will reshape the cartilage and bone inside your nose. Most of the incisions are made inside your nose to avoid any noticeable scars. Some rhinoplasties are done with a small cut on the bottom of the nose. This is not usually noticeable.

Sometimes bone or cartilage is removed from the nose, and sometimes bone and cartilage grafts are added. Grafts can be taken from another part of your body, or a synthetic material can be used.

Your operation will last 1 to 2 1/2 hours, depending on the amount of work that is needed.

After your nose is reshaped, your doctor will pack thin pieces of gauze into each nostril to control bleeding. Your doctor will also tape a small protective splint over your nose to hold the reshaped bones and cartilage in place. You will wear the splint for 5 to 10 days. A small drip pad will be taped under your nose to catch any drainage or blood that seeps through the packing.

What happens after the procedure?

You will rest in bed with your head raised the first day, to decrease swelling and bleeding. For 10 to 14 days after surgery your face, nose, and eyes will be bruised, swollen, and discolored. Ice packs will help reduce the swelling, bruising, and discomfort.

Your doctor may prescribe medication to reduce drainage and a mild pain reliever for pain.

If you have packing in your nose, your loss of smell will lessen your appetite. You may prefer a liquid or soft diet, but you can eat whatever you feel like eating.

You will want to brush your teeth and rinse your mouth with a mouthwash frequently because you will be breathing through your mouth until the packing is taken out. You also will want to drink lots of beverages because of your dry mouth.

The packing will remain in your nose for 1 to 7 days. After the packing is removed, do not blow your nose for 48 hours. Also try not to cough too hard. Blowing and coughing may start bleeding.

After the swelling and bruising improve, your doctor will take pictures of your nose and face for a before and after record of your operation. You may not be able to see the final improvement from your operation for weeks or months.

What are the benefits of this procedure?

• Because your nose is such a visible part of your face, a more satisfying shape will give you a better body image.

• If you had any deformity that obstructed your breathing, you will be able to breathe more freely.

What are the risks and complications associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.

• A local anesthesia may not numb the area enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. Local anesthesia is considered safer than general anesthesia.

• You may have excessive bleeding that you may not notice because it drains down the back of your throat.

• You may have recurring nosebleeds from the crusting of the cut in your nose.

• You may have difficulty breathing from the narrowing of the nasal passages, or a reduced sense of smell.

• You may have an infection.

• You may have a torn septum, the wall dividing the two nostrils.

You should ask your doctor how these risks apply to you.

When should I call the doctor?

Call your doctor if you:

• have a fever

• notice excessive nasal drainage or bleeding from your nose on your drip pad

• are spitting up or vomiting blood that has run back into the throat

• are swallowing frequently and then belching, which is a sign of blood draining down your throat and collecting in your stomach.