Dallas Rhinoplasty Specialist, Dr. White - Information on Nose Reshaping

• Introduction
• Is rhinoplasty right for me?
• What should I expect from the consultation?
• How is rhinoplasty performed?
• How will I learn about the safety of nasal surgery?
• What can I do to prepare for my surgery?
• How will I be cared for on the day of surgery?
• How will I look and feel right after surgery?
• What should I know about my results?
• How long will I continue to see my plastic surgeon?
• Choosing a plastic surgeon
• It's advisable to consider the following points before scheduling a consultation
• Ask about the surgeon's hospital privileges

Introduction

What is an attractive nose? Quite simply, it is a nose that fits your face. It is a natural-looking nose that achieves a harmonious balance with your other facial features. If you feel that your nose is not a good fit, you may benefit from cosmetic surgery of the nose, also called rhinoplasty. Rhinoplasty can enhance the shape, size and general appearance of your nose.

You'll find basic information about rhinoplasty in this brochure. However, the best way to get complete answers to specific questions that relate to your individual needs is to have a personal consultation with a plastic surgeon certified by the American Board of Plastic Surgery.

Is rhinoplasty right for me?

Rhinoplasty can be performed on men and women of almost any age. However, it's usually recommended that young people wait until facial growth is complete—about age 13 or 14 for girls and 14 or 15 for boys. If you are a teenager, having the procedure should be your own idea.

You may be a good candidate for rhinoplasty if you have any of the following conditions:

• Your nose appears too large for your face
• There is a bump or depression on the nasal bridge when viewed in profile
• The nose seems too wide when viewed from the front
• The nasal tip droops or plunges
• The tip is thickened or enlarged
• The nostrils are excessively flared
• Your nose is off-center or crooked
• A previous injury has made your nose asymmetrical
• You have an airway obstruction that impairs breathing

What should I expect from the consultation?

A personal consultation is the first step for every patient considering rhinoplasty. During this meeting, your surgeon will assess your physical and emotional health and discuss your specific cosmetic goals for surgery.

You should arrive at the consultation prepared to provide complete information about:

• Previous surgeries
• Past and present medical conditions
• Medical treatments you have received
• Medications that you take, including nutritional supplements and herbal remedies
• Any allergies that cause congestion or conditions that cause breathing difficulties
• How often you use nasal sprays to relieve congestion

During your physical evaluation, your plastic surgeon will examine the structures inside your nose and the quality of your skin, as well as the size and shape of your nose and its relationship to your other facial features.

Your plastic surgeon may recommend other treatments that can be performed along with the rhinoplasty to better meet your appearance goals or to improve breathing.

To enhance your appearance:

• Chin surgery can help improve facial balance by making the chin more or less prominent.

To correct breathing difficulties:

• A turbinectomy can open the nasal air passages by reducing the turbinates, the internal projections that warm and moisturize the air that passes through the nose.
• A septoplasty can correct a deviated septum, a condition in which the dividing wall within the nose shifts from the middle to block the air passage.

How is rhinoplasty performed?

The technique used for your surgery depends not only on your surgeon's preferences, but also on your desired results. Alterations may be made to increase or decrease the nasal bridge, reduce the size or width of the nose, narrow the nostrils, reshape the tip, or change the angle between the nose and the upper lip.

Plastic surgeons may perform rhinoplasty from within the nose, making the incision inside the nostrils. This is called a "closed rhinoplasty." Other times, a surgeon prefers an "open" procedure, in which a small incision is made across the columella, the vertical strip of tissue separating the nostrils, as well as within the nose.

Working through these incisions, the nose's framework of bone and cartilage is sculpted to the desired shape. Your surgeon may reshape or reposition the bones in your nose, or build up certain areas, using either nasal cartilage or bones and cartilage from another body site, or other materials. The skin and soft tissues are then redraped over the reshaped framework. If the lower part of the nose is being narrowed or the nostrils are being reduced, small wedges of skin at the base of the nostrils may be removed through incisions that are hidden in the nose's natural creases.

How will I learn about the safety of nasal surgery?

Each year, thousands of people undergo cosmetic surgery of the nose and experience no major complications. However, it is important for you to be informed of the risks as well as the benefits. One of the most important parts of your consultation is the discussion that you and your surgeon will have about the possible complications of nasal surgery. In addition to listening carefully to what your surgeon tells you, be sure to raise any questions that you may have about the safety of the procedure.

By following your surgeon's advice and instructions carefully—both before and after surgery—you can do your part to minimize some of the risks.

What can I do to prepare for my surgery?

When the date for your procedure has been set, your plastic surgeon will provide you with specific instructions for the days immediately before and after surgery. A number of points may be covered, including:

• Avoiding certain medications that may complicate surgery or recovery
• Stopping smoking for a period of time before and after surgery
• Arranging for help and care following surgery

How will I be cared for on the day of my surgery?

Rhinoplasty surgery may be performed in an outpatient surgery center, an office-based surgical suite or a hospital. If you are admitted to a hospital or surgery center, your stay will be a short one, perhaps just one night.

Mediations are administered to keep you comfortable during the surgical procedure. Local anesthesia and intravenous sedation may be used for patients undergoing rhinoplasty, although general anesthesia may be desirable in most instances. Your plastic surgeon will monitor your physical status throughout the operation and during your recovery.

How will I look and feel right after surgery?

When the surgery is completed, you'll be taken to a recovery area. Any discomfort that you feel will be controlled with medication prescribed by your surgeon. A splint may be applied to the bridge of your nose to protect the nose and hold the tissue in place until they have stabilized. You may also have a small bandage beneath the tip of your nose and splints inside the nostrils, especially if work has been done to improve your breathing.

Although everyone heals at a different rate, you can expect that your recovery will follow this general time line:

The first day:

• In this early stage of healing, you should rest with your head elevated to help minimize swelling
• Activity must be kept to a minimum
• You may experience a small amount of bleeding and stuffiness

Within 10 days:

• Swelling reaches its peak and then begins to subside
• Bruising will begin to diminish
• You can safely use makeup to conceal any discoloration
• Stitches and splints will be removed
• You may discontinue wearing the splint
• You may return to school or a non-strenuous job

After several weeks:

• You may resume exercise and most of your normal activities
• Most of the swelling will subside
• Numbness will diminish; however, some loss of sensation may persist for several months
• You may resume wearing eyeglasses normally. (In the early stages of healing, patients often use tape to keep their glasses from resting on their healing noses.)

In the months following surgery, it is important to keep your nose shielded from direct sunlight. Wearing sunblock lotion is essential for protecting your skin.

What should I know about my results?

It's normal to feel a bit anxious while you are adjusting to your new look and waiting to see the true results of your surgery. However, you are likely to begin enjoying your new look within weeks. As each month passes, you'll notice gradual improvement until healing is complete.

Most patients who have nasal surgery are very pleased with their results. You may find that you have a brighter outlook, or that you feel less self-conscious and more confident. The results of rhinoplasty are permanent, except for changes that may occur with the aging process. Occasionally, a touch-up procedure may be desired to further improve the results.

How long will I continue to see my plastic surgeon?

After the initial healing period, you will return to your plastic surgeon's office for a postoperative follow-up visit so that your healing and progress can be evaluated. In the following months, your surgeon may ask you to return for periodic checkups. It's important to keep these appointments so that your surgeon can assess your long-term results and address any questions or concerns you may have.

Choosing a plastic surgeon

No matter what type of plastic surgery you're considering, one of the most important factors in its success is the surgeon you choose. Although it may seem hard to believe, some of the physicians who are performing cosmetic surgery today have had no formal surgical training at all.

It's advisable to consider the following points before scheduling a consultation:

Find out if your doctor is certified by the American Board of Plastic Surgery. Surgeons with this certification have completed a minimum of five years of surgical training following medical school, including a plastic surgery residency program. During this intensive program, surgeons learn to perform surgical procedures for the entire body and face. At the same time, they develop their technical skill and aesthetic judgment. After training, a surgeon must pass comprehensive oral and written exams before being granted certification.

The two organizations that have prepared this brochure, the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery, require their members to be certified by the American Board of Plastic Surgery. Plastic surgeons with this certification have completed approved training and examinations in plastic surgery including both cosmetic and reconstructive procedures.

Ask about the surgeon's hospital privileges

Even if you are planning to have your surgery in your doctor's office or at a surgery center, it is important to find out if your surgeon has operating privileges in an accredited hospital for the same procedure that you would like to have performed. Before granting privileges, hospital review committees evaluate a surgeon's training and competency for specific procedures.

To find out more, click on Making Sense of Certification.

For more information about nasal surgery:

• Link to Frequently Asked Questions about Rhinoplasty
• Link to Rhinoplasty Before and After Photos
• Contact us for additional information or to schedule a consultation

       

STEVEN J WHITE, MD
PRESBYTERIAN HOSPITAL OF DALLAS
PROFESSIONAL BUILDING 3, SUITE 814
8230 WALNUT HILL, DALLAS, TEXAS 75231

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