Rhinoplasty is one of the most common operations performed by Cosmetic Surgeons today. This operation is designed to improve the general appearance of the nose by doing any one or more of the following procedures to the nose :

Reducing the forward projection of the nose.
Removal of hump
Correction of depressed nose
Correction of deviation of nose
Narrowing of the upper nose
Narrowing of the tip of the nose
Narrowing of the lower nose
Reducing the nostril size
Lifting the tip higher.

Many patients have a fear that the nasal change will be so great as to create a subject of discussion among their family or friends. In reality, neither the patient nor the patient's friends or relatives really remember the original shape of the nose, a few weeks after the surgery.

Surgical Procedure:

This operation is performed in the hospital. It takes about 11/2 hours to 31/2 hours for the surgery, depending upon what has to be done. Some corrections can be done as out patient surgery where as others require 1 to 2 days stay in the hospital. Rhinoplasty is done under local anesthesia. Sedation is also given just prior to surgery to help the patient be relaxed.

The incisions for reshaping or recontouring the external nose are usually made inside the nose. The nasal skin is lifted away from the cartilage and bone and reducing or adding or lifting is done. In reduction of the nose, the bone, the cartilage, and the excess tissues are removed. The nasal bones are usually narrowed. The excessive skin left by the reduction of the underlying bone and cartilages usually readapts itself to the new framework.

For depressed nose, after lifting the skin, enlargement or augmentation is done with cartilage from ear or with bone from rib or leg or with Silicone rubber.

To reduce the width of the lower part of the nose or to reduce the nostril size, skin is removed from the nose close to the cheek attachments ,lf the chin is smaller and disproportionate when compared to the nose and the rest of the face, chin enlargement could be done at the same time. Also, if the lips are too thick, they could be made thinner at the same time.

After Surgery
Immediately after the surgery, a restricting splint and/or dressings arc placed on the nose and will remain in position for approximately five days.

The operative procedure and the post operative period are not exceedingly painful. Since there will be packing in the nose for several days following the surgery, the patient will breathe through the mouth. This will give the feeling of having a minor cold and may cause drying of the membranes of the mouth. The nose may feel congested for several weeks following the surgery due to internal swelling.

Swelling & Discolouration:
After the nose surgery, there is moderate to marked swelling of the nose, eyelids, cheeks, upper lip and forehead. In most patients the swelling will increase gradually and reach to a maximum at the end of 48 hours after surgery. From the third day the swelling and the discoloration will start to decrease and most of the swelling would have subsided by the end of 10-14 day. However, it takes 3-6 months for all the swelling to disappear.

Occasionally the whites of the eyes will be blood shot and upper lip will feel 'Stiff' and unnatural for a varied period of time. Some numbness over the tip of the nose would persist for 2 - 3 months.

Results:
Some results of the nasal operation will be noted when the splint and/or dressings are removed. But, it takes about 8 to 10 weeks to know the result-of the surgery. Even after 10 weeks small changes occur over a period of 4 to 8 months.

Complications
One rare occasion, there could be complications like infections, healing problems, discolorations, absorption of the bones and cartilage grafts or rejection of the silicone rubber implant etc., In rare instances, a secondary 'Touch-Up' procedure may be required.

Pre Operation Instructions:

  • Wash hair and face with LIQUID BETADINE SURGICAL SCRUB SOAP (Not Betadine Solution) on the night before surgery and on the morning of the surgery.
  • After the above washes, do not use any hair oil, or Make-up.
  • Take any CEPHALOSPORIN ANTI BIOTICS (Eg: SPORIDEX 500 Mg or PHEXIN 500 Mg or RIPHEX 500 Mg) by mouth on the evening and the night before surgery.
  • Any jewellary or metal objects that are in contact with the body could be harmful during surgery. So, please do not wear any jewellary or metal objects when you come for surgery (including : nose rings, toe rings, etc ).
  • DIET: lf the surgery is to be done under heavy sedation-nothing by mouth (Not even water) for 8 hours prior to surgery. If under local anaesthesia, nothing by mouth for 4 hours prior to surgery.

Do not take ASPIRIN or Aspirin containing compounds or Birth control pills for 2 weeks before surgery

Post Operation Instructions:

  • DIET: Liquid Diet for 4 days after the surgery. Then soft diet for the next 4 days and restrict chewing for an additional four days(Liquids may be hot or cold and they can be with or without pepper, Ice cream, Milk Shake, Kheer, Soup, etc., are liquids.).
  • Do not get areas of the surgeries wet until further instructions.
  • Do not use Tooth brush for 12 days after surgery. May clean teeth gently with finger & tooth paste or Mouth wash like PIODIN.
  • Take any CEPHALOSPORIN ANTIBIOTICS (Eg. SPORIDEX 500 Mg, or PHEXIN 500 Mg or ORIPHEX 500 Mg) by mouth every 8 hours for 3 days after surgery. (If implant has been used in your nose, for 5 days after surgery).
  • Should there be pain take 2 tabs of PARACETAMOL 500 Mg with 2 tabs of CODEINE SULPHATE 15 Mg by mouth. If necessary, this can be repeated after every 6 hours.
  • Keep head elevated at all times (Use 2-3 pillows while lying down) for 3 weeks from the day of the surgery.
  • Strenuous exercises such as Gymnastics or Body Contact Sports or swimming should be avoided for 8 weeks.
  • Do not wear glasses for 8 weeks.
  • Do not take Aspirin or Aspirin containing compounds or Birth control Pills for 2weeks after surgery.
  • Make up may be used 3 weeks after the surgery.
  • Shampoo and hair coloring procedures can be carried out 10 days after the surgery.
  • Social activities should be limited for approximately 2 weeks following the surgery.

Travel:
Train or bus travel after 10 days. Plain travel after 4 weeks.

Back