Unfortunately, nasal surgery (rhinoplasty), like facelifts, has acquired a bad reputation for producing unnatural results. The truth is that in many cases, rhinoplasty produces subtle changes that fit the patient's features, resulting in an improved, but not overly dramatic, change in aesthetic. When done right, many rhinoplasties go unnoticed. Advances in nasal surgery have made results more predictable and the post-operative recovery easier than ever. At Jefferson Plastic Surgery, our Philadelphia surgeons frequently perform rhinoplasty to adjust the bridge, tip, nostrils, or septum.
Rhinoplasty can be performed through the open or closed approach.
- Closed approach: This involves small incisions just inside the nostrils.
- Open approach: This technique uses an incision at the base of the nose to provide additional exposure and allow the surgeon to see a patient's bone and cartilage in an undistorted manner.
Based on the shape and size of the patient's nose and the patient's expectations for a post-operative result, our surgeons will discuss with which approach is best to achieve the patient’s goals and expectations. Pre-operative pictures will be reviewed with you in the office to help delineate your surgical plan and expected post-operative result. Improved appearance can be achieved without disrupting nasal airflow. It is now common practice to perform other procedures at the time of rhinoplasty to actually make breathing better post-operatively.
Today, general anesthesia is commonly used by our surgeons for nasal surgery with strong but short acting drugs; our Philadelphia rhinoplasty patients can be completely and safely asleep during surgery and yet be ready to go home an hour or two after the procedure.
Gauze packing in the nose following nasal surgery used to be standard and clearly prevented the patient from breathing through their nose after surgery. Currently, nasal packing is infrequently employed. If packing is felt to be necessary, then absorbable material can be used which dissolves in two to three days and makes removal unnecessary.
One thing that used to characterize rhinoplasty was over-resection removing too much bone and cartilage during the procedure resulting in an excessively small nose. Today's rhinoplasty is typified by finesse in achieving a unique result, which fits the individual patient. Plastic surgeons rely less on removal and more on sculpting of excess cartilage. The benefit of this approach is that rhinoplasty results are more predictable and natural.
Our plastic surgeons offer the following information and tips regarding the rhinoplasty recovery process:
- Your surgical dressing (nasal splint) will be removed at your first office visit.
- Do not blow the nose for one week.
- If you have a drip pad, you may need to change it frequently the first few days after surgery.
- Sneeze with the mouth open for one week.
- Sleep at a 30-degree angle (usually with two or three pillows propping your head up for the first week.
- There may be some bruising or discomfort that can be diminished by using ice compresses (30 min. on, 30 min. off) for the first few days.
- Avoid exertional activities involving bending and lifting for six weeks. You may begin walking and other low impact activities after the first 48 hours.
- Bathing and washing the hair is permitted but avoid getting the splint wet.
- A “stuffy” feeling for the first week is normal. A saline spray can be used three to four times a day and all other nasal sprays (Afrin, Neosinephrine, etc.) should be avoided.
- Glasses may be worn even with the splint, but they must be taped to the forehead to relieve the pressure off the splint.
- After the splint is removed, the nose will still be quite swollen and a little numb. Full recovery resolves all of this in nine to 12 months.
- Moderate exercise may resume in three weeks, but still no heavy lifting.
- Overexposure to the sun should be avoided for the first year and sunscreen of at least SPF15 should be worn at all times.
- Usually, patients return to work in seven to 10 days after surgery.
Nasal surgery remains a challenging and gratifying undertaking. In general results are predictable and natural. Working with an experienced, board certified plastic surgeon you should be able to achieve the changes in nasal appearance you are seeking.
Philadelphia Rhinoplasty Consultations
Contact our Philadelphia practice to schedule a rhinoplasty consultation with the plastic surgeons of Jefferson Plastic Surgery.