Nose forms the centre of the face and can make either a good or a bad statement. The surgery of the nose involves changes to all or some parts in the nose and reshaping. People who are unhappy with the shape of the nose and also have a difficulty in breathing can be improved simultaneously. Septum can be corrected at the same time resulting in being able to breathe better. This is the cosmetic surgical procedure most frequently performed all over the world. A good treatment plan and the understanding of your requirements is very important for a successful treatment outcome. The results achieved are permanent and very pleasing.
The common concerns of people with regards to the nose are reducing or enlarging certain areas, smoothing nose humps, narrowing the nose, correcting the deviation and making the nose sharper. The deformities of the nose may be present from birth or may have developed secondary to an injury. Surgery of the nose should ideally be done after the growth is complete.
An in depth discussion with the surgeon is the first step in the understanding your needs and preferences if any. A brief medical history and examination of the nose will be conducted. Photographs of the face will be taken and the relationship of different parts of the face will be assessed. Silhouette drawings of the nose will help you understand the possible outcome of the surgery. Smoking and use of drugs that contain aspirin will have to be stopped about 2 weeks prior to surgery. CT scan of the paranasal sinuses will be ordered and an otolaryngologist(ENT) opinion will be sought if there are functional problems or sinus pathology.
Surgery is usually performed under IV sedation or under general anaesthesia usually as a day care . These are extremely comfortable and results in minimal swelling and bruising. Most of the incisions are inside the nose with a very small segment seen outside which is barely visible after a few days. The skin of the nose is raised and necessary changes are made to the bones, cartilages and soft tissue. Implants are placed as and when required. Septal deviation if any is corrected at the same time. The flaring nose is also corrected with a cut at the base of nostril or through the inside of the mouth. Chin augmentation may be combined with nose surgery occasionally. Nose is packed for 48 hours with a sponge like dressing(Merocel) if septum is corrected at the same time.
The recovery takes a couple of weeks. Swelling of the nose may stay a few weeks longer. Most people resume their daily activities in a couple of days and resume office work in a week. There are small paper tapes over the nose to keep the changes in shape. Splint may be used if bony changes are made. There is always some stuffiness of the nose when work has been done on the nasal septum. Pain is minimal and is controlled with medications. Bruising occurs around the eyes if bones are rearranged but will fade within a few days. Discolouration usually disappears in 2 weeks.
Dressings
– A tape will be placed on the outside
of the nose and must be placed for 7 days. If
you had simultaneous septal surgery to correct
a deviation there will be a small dressing placed
inside each nostril that will be removed the
second day after surgery.
Sutures
– Most sutures will dissolve, few to
be removed in 5 to 7 days.
Activity
– Sleep with your head elevated 30
to 45 degrees to help decrease swelling. Apply
ice as much as possible for the first 2 days
which will decrease the amount of swelling and
bruising. No heavy exercise or lifting for two
weeks. Soft diet the first few days, Vigorous
chewing may provoke increased drainage form
the nose.
Special
Instructions – Protect the sensitive
skin on nose and face from sun exposure for
at least six weeks. Avoid pressure on the nose
i.e. tape glasses off of nose for up to 6 weeks.
Also avoid bending over with your head below
waist level. The nose may be stuffy the first
couple of weeks since this may distort the delicate
sutures and cartilage inside your nose.
Swelling
and bruising are normal as well as some bloody
drainage the first couple of days. Expect two
to three days of recovery before normal activities
can be performed. Consult the doctor before
attempting any athletic or precarious activities
that may affect the healing process.
