Rhinoplasty: What should I Expect from Consultation to Recovery

WHAT TO EXPECT FROM RHINOPLASTY

No other aesthetic surgical procedure today has achieved wider acceptance than rhinoplasty, the reshaping of the nose.  It is an especially satisfying procedure that can be performed at any time after the middle teenage years.  Desire and health, not age, are the determining factors.  

The degree of improvement possible is limited by the individual’s basic nasal skeleton and skin thickness, but wide noses can be narrowed, noses with a hump can be reduced, drooping noses lifted, bulbous tips reduced, and wide nostrils can be narrowed.  The objective is to create a nose which is in harmony with your other facial features and has a natural appearance.  

Rhinoplasty for cosmetic reasons, or to correct deformities from injuries, is frequently performed in combination with internal nasal surgical procedures to correct breathing problems.  

Nasal surgery can be performed at the same time as a facelift, eyelid surgery, chin augmentation, or other cosmetic surgery procedures. 

THE PREOPERATIVE VISIT

After the initial consultation, the preoperative visit will be scheduled approximately two weeks before surgery.  It will give you an opportunity to ask questions you might not have previously asked.  We will review your medical history, give you a preoperative examination, and discuss what to expect during surgery.  If you are over forty years of age or have a history of heart abnormalities, you will arrange for an electrocardiogram and blood work.  We will also take preoperative photographs, which become a permanent part of your medical record and remain strictly confidential.  Your operative consent will be read and signed, preoperative instructions reviewed, and prescriptions for the medications you will need will be given to you at this visit.  Your fee will be due at this time.  

WHAT TO EXPECT DURING SURGERY

Nasal surgery is performed at the Highland Park Plastic Surgery Center on an outpatient basis under general or twilight sleep sedation anesthesia.  A board-certified anesthesiologist or anesthetist will be present to make you comfortable and unaware throughout the procedure.  

Dr. Toledo will talk with you just prior to the surgery to be sure there are no last-minute changes. Before surgery begins, you will be asked to change into a surgical gown and will be taken into a private operating room.  An intravenous line will be inserted into a vein in your arm.  This will make it possible for the anesthesia provider to administer fluids and to deliver the necessary medications to make you comfortable.  Monitoring devices will be connected to you to assure your safety.  

Your face and neck will be washed with an antiseptic solution. The incisions are made inside the nose, and at the junction of the nose and upper lip.  This means that scars remain hidden.  Specialized instruments are used to reposition nasal bones, allowing them to be moved and narrowed, reshaping the nasal structure.  The tip of the nose can be shortened or raised, usually by rearranging or removing an appropriate amount of cartilage.  It can also be reduced in size.  In some instances, an implant or cartilage from another part of the body can be added to obtain the final shape of the nose.  

Patients with unusually large nostrils can have them reduced in size by making a small incision at the base of each nostril.  A small wedge of skin is removed, and the incision is closed with sutures.  These incisions are usually difficult to detect.  

Most patients have splints placed inside and outside the nose to provide support and protection. 

Rhinoplasty generally takes an hour and a half to two hours.  If performed in conjunction with other procedures, surgery will naturally take longer.  

WHAT HAPPENS AFTER SURGERY

You will be transferred to a recovery room adjacent to the surgical suite, where you will be continuously monitored as you recuperate from the effects of the surgery and anesthesia.  You will be allowed to go home after a short recovery period. You should feel fine, although it is not unusual to expect some minor discomfort. 

You will have a metal cast on your nose which you will wear for approximately five to seven days.  You may also have splints inside of your nose if we operated on your septum.     

You must arrange for a responsible person to spend the first night and the next day with you.  We will give them instructions for care before you leave.  Have them read this paper prior to your surgery.  This is necessary as you will not be able to care for yourself immediately following surgery.  

Because everyone is different, it is impossible to write postoperative instructions that apply equally to everyone.  For example, some patients can have sedation vs. general anesthesia or outpatient vs. inpatient surgery.  Some patients have only a single procedure and others may have multiple surgeries in a single setting.  Use these instructions as a general guideline, but don’t panic if we vary on some issues.

WHAT YOU WILL SEE IN THE MIRROR

Bruising around the eyes is to be expected after nasal surgery but begins to fade within a few days.  It disappears completely within a few weeks.  

When the external cast is removed, your nose will still be slightly swollen, although it usually looks good at two weeks.  Final settling, shaping, and improvement may take six months to a year.  

The results of a rhinoplasty are extremely satisfying.