Many of us are unhappy with shape of our nose. The nose many have an unattractive hump be too long or too wide. IN addition, there many also are problems that contribute to breathing difficulties and headaches. Any or all of these conditions may be improved with a surgical procedure called rhinoplasty, or cosmetic nasal surgery.
During your consultation, your cosmetic surgeon will try to determine the changes that you wish to make in your appearance. The surgeon stand the modifications that may be made and discuss problems of which you may be unaware. Fro examples, many patients who seek rhinoplasty also have a very weak chin or flat cheekbones. In a case like this, chin or cheekbone implants might be considered as a part of the operative plan.
HOW IS IT DONE?
Incisions are made inside the rim of the nostrils. Sometimes, tiny, inconspicuous incisions are made on the rim of the nose. Soft tissues of the nose are then speared from the underlying structures. The cartilage and bone that are causing the external deformity are altered and reshaped. At the same time, internal problems can be improved by removing the obstruction. This is part of the procedure is called septoplasty.
Rhinoplasty and septoplasty usually take one to two hours depending on the amount of work that must be done. The procedure can be performed in the hospital or outpatient surgical suite. The surgery is commonly done under either local or general anesthesia, depending on patient and doctor preferences.
A small cast or splint is placed on the nose for several days and a light internal dressing may be applied. There will be some swelling and stuffiness for several weeks, but patients usually resume normal light activity after a few days. It will take several weeks before the nose is completely healed to allow full physical activity. Surprisingly, there is very little pain after rhinoplasty and most patients require only mild analgesics. During the first few days, the splint will protect the nose.
WHAT ARE THE RISKS?
Free vary from lone geographic are to another. Your cosmetic surgeon and staff will discuss financial arrangements with to your surgery. In cases where there is the need for functional improvement, insurance may cover part or all of the cost of surgery.
This brochure is only intended as an introduction to this procedure. It should not be used to determine whether you will have the procedure performed and should not be construed to guarantee the result.
I. Pre-operative Preparation – Secure written consent
– Take pre-op standard photograph
– Antibiotics- prophylactic antibiotic is given at least 1 hour prior to surgery; antibiotic active against G (+) bacteria are recommended.
– Trim the nasal hair/vibrissae mainly at the alarm cartilage
– Wash face with soap and clean nostril with cotton pledgets dipped in soapy suds and water
– Position the patient on the operating table (semi-recumbent position)
– Placement of operative markings
II. Operating Techniques
– Asepsis and Antisepsis
– Application of sterile drapes
– Infiltration of local anesthesia
– Marginal incision done on right side
– Nasal packing on the side where the marginal incision is made (to prevent blood from dipping into the nasal cavity)
– A marginal incision fir pocket dissection measuring 15mm long is Made, starting from the upper half and just inside the alar margin. Incision is carried straight deep into the area just anterior to or above the outer surface of the medial crura, stopping short of penetrating the columella on tne opposite side.
– Dissection is further carried out using a fine blunt tipped scissors aiming to create a midline symmetrical pocket and staying within the limits of dissection maked before.
– The plane of dissection is between the alar and the lateral cartilage below and the subcutaneous layer above.
– Along the caudal part up the nasal bone, spreading type of blunt Dissection is instituted; the cornial extent of the pocket should stop 1-1.5mm short of the projected position of the cranial and of the implant.
– Creation of subperiostal pocket dissection area the proximal third of nose.
– Digital pressure is applied for 5 minutes to stop bleeding
– Sculpting of the silicon implant
– Insertion of implant into the pocket
– External nasal compression is applied immediately after implant insertion for 5-10 min.
– Final checking of implant position
– Closure of marginal incision (simple interrupted sutures)
– Application of external nasal tape splint
III Post-operative care Advised patient to …
1) Apply cold compress over forehead area every 15 minutes interval for 15 minutes duration for the first 24 hours post-op followed by warm compress and the same area for the 24 hour.
2) Avoid external nasal manipulation
3) Take home medications
· Continue prescribed oral antibiotic for 7 days
· Analgesic for PRN basis
4) To come back after 3 days for follow-up