Rhinoplasty (Nose Job)

RHINOPLASTY: MODERN TRENDS

Rhinoplasty : (Greek: Rhinos, "Nose" + Plassein, "to shape") or "nose job" is cosmetic surgery of the nose and one of the most common of all plastic surgery operations. In fact Rhinoplasty is amongst the first cosmetic plastic surgery operations ever performed way back in 1898.

The current Australian trend in Rhinoplasty is all about the "natural" look. However, if you wish for a “cute” or “Hollywood” nose, please discuss your desires clearly with Dr Tavakoli at the time of your consultation.

Rhinoplasty

• Remove humps over the bridge of the nose
• Modify and refine the nasal tip
• Improve the crooked nose by re-aligning the nasal bones
• Improve the angle between the nose and the upper lip
• Shorten or lengthen the length of the nose
• Increase or decrease nasal tip projection
• Narrow the nostrils

Septoplasty & Turbinoplasty

• Straighten the deviated septum hence improving breathing
• Reduce the bulk of airfilters (turbinates) hence improving breathing further

SUITABLE CANDIDATE FOR RHINOPLASTY

The best candidates for Rhinoplasty are those people who are looking for an improvement in the way they look, not those searching for absolute perfection. In fact patients completely obsessed with the appearance of their nose to the extent that it interferes with their daily living should perhaps seek counseling prior to consulting a plastic surgeon.

Well-meaning friends and family members are not a good source of information. Find out everything about your Rhinoplasty operation before proceeding with surgery - a well-informed patient is a happy patient.

Rhinoplasty surgery when performed on the right candidate by the right surgeon can produce profoundly positive transformation to ones face making the person more attractive and in most cases younger.

Rhinoplasty usually takes two hours, although more complicated procedures may take longer.

RHINOPLASTY SURGEON

Rhinoplasty is one of the most difficult operations in cosmetic surgery. In Australia Rhinoplasty is performed by five groups of doctors. Therefore your decision making process should heavily rely on word of mouth and personal research.

• Plastic Surgeons (usually for cosmetic reasons)
• Ear, Nose and Throat Surgeons (usually for functional reasons)

Others:

• Maxillofacial Surgeons
• General Surgeons
• General Practitioners

Please research your chosen surgeon thoroughly and specifically for Rhinoplasty.

TEST REQUIRED

In order to get the most from your consultation, please obtain a CT-scan (NOT X-ray) of your nose and sinuses. Your GP should be able to organise this for you if you suffer from any of these conditions:

• breathing problems
• previous injury to the nose
• previous surgery of the nose
• hayfever or sinusitis

PREOPERATIVE CONSULTATION

This is where you need to convey your aesthetic wishes and goals clearly to Dr Tavakoli. A great deal of time will be needed to establish a rapport so all aspects of Rhinoplasty surgery can be thoroughly discussed. A minimum two consultations are required prior to surgery and in some special cases three or four visits may be needed.

Dr Tavakoli’s practice has the latest digital imaging system available at your disposal. Marketwise Professional will enable you and Dr Tavakoli to communicate to each other the desired cosmetic goals on a large computer screen. Although useful, the imaging system should be used ONLY as a guide and not guarantee of outcome.

THE RHINOPLASTY OPERATION

Cosmetic and functional surgery (Rhino-septoplasty) of the nose usually takes approximately two hours and for your safety it is performed under a General Anaesthetic in a fully  accredited Day Surgery or Major Hospital.

Most incisions are placed  inside the nostrils (closed Rhinoplasty), but a small incision may be made  in the columella (open Rhinoplasty).  Columella is the skin dividing the nostrils. These incisions heal quickly and leave scars that are nearly invisible.

Rhinoplasty surgery starts with the skin of the nose being separated from its supporting framework of the bone and cartilage, which is then sculpted to the desired shape. The skin is then re-draped over the new framework.

Septoplasty is performed if needed to straighten any deviation in the septum and/or harvest cartilage graft for nasal re-shaping.

Turbinoplasty is performed if these air filtering structures are unusually enlarged.

At the end of the Rhinoplasty operation, an aluminium or thermoplastic cast will be placed on your nose. The external splint will stay on for 6-7 days. Usually a light dressing/packing may be placed inside the nostrils and removed the same day or the next day. If Septoplasty is also performed for airway correction, plastic tube may be inserted in the nostrils for up to 3 days.

RECOVERY FROM THE RHINOPLASTY PROCEDURE

During the first two to three days after Rhinoplasty surgery, the face will feel puffy, the nose may ache, and you may experience a dull headache. You should plan on resting with your head elevated for the first couple of days. There will be swelling and bruising around the eyes, reaching a peak after four days.

By the end of one week all nasal packing, dressings, internal and external splints and stitches should be removed. You will feel substantially better in your second week of recovery.

The most uncomfortable part of the recovery after the Rhinoplasty operations is the inability to breathe through the nose for several days due to swelling. This usually improves within four weeks. Expect some swelling around your eyes for several weeks. As the swelling subsides, you will start to see the improvements from your surgery.

A few special precautions are required during your recovery from the Rhinoplasty operation.

• Bending or lifting can prolong swelling, so this is not recommended for three  weeks after surgery.
• Running, cycling, or aerobics should not resume for four weeks.
• Contact sports (footy, rugby) should be avoided for eight weeks, as it takes that long for the bones to fully heal.
• You may drive when the swelling subsides enough not to interfere with vision, and you may fly two to three weeks after surgery.

Follow-up visits are needed for 12 months.

IMMEDIATE RISKS

• Nose Bleed: Mild bleeding is expected. Moderate bleeding is usually seen in septoplasty cases. Need to keep your head up and spray Drixine. Severe bleeding contact Dr Tavakoli’s Emergency Mobile Number or present to any Hospital Emergency Department.
• Mild Infection: This can occur despite oral antibiotics. More common in secondary Rhinoplasty cases. Please ensure the nostrils are impeccably kept clean and scab free. The prescribed antibiotic ointment must be used on a regular basis.
• Breathing Issues: This is a very common issue after Rhinoplasty. It usually a result of swelling and congestion of internal lining of the nose. Keep up the use of FESS (salt water) spray during the first month after the surgery and breathing will improve within 2 months.

LONGTERM ISSUES

• Prolonged Swelling of the Tip: 6-12 months post-surgery. This is not a complication but variable prolonged response to surgical inflammation and trauma. This is far more common in Men and Women with thick oily (sebaceous) skin.
• Nostril size discrepancy present prior to Rhinoplasty may become more evident once the nasal tip is lifted. Achieving perfect nostrils may not always be possible.
• Bent Nose: If you having a crooked (bent) nose corrected at the time of your Rhinoplasty please note that making such noses dead straight is impossible. Most of the population have some degree of bend in their noses which goes unnoticed.
• Secondary or Revisional surgery may need to be performed in order to finalise the outcome. This is far more common in Men and Women with thick oily (sebaceous) skin