The first step toward undergoing a rhinoplasty procedure is the initial consultation. During this meeting I will listen to your concerns and assess your nose and its proportion to your face. We will discuss your goals and expectations; whether you want to increase/decrease the size of your nose, correct a deviated septum, increase/decrease the size of your nostrils, or to change the shape of your nasal tip. Your overall physical and emotional health will also be discussed. After this assessment a surgical plan will be discussed with you including the procedure in detail, expected results, and the recovery period.
The technique used for your surgery depends upon the corrections desired for your nose. The procedure can be performed with intravenous sedation and a local injection or with a general anesthesia. I usually use an open technique, which entails an incision across the central base of your nose. Smaller corrections frequently can require only incisions inside your nose, which is called the closed technique. Once the incisions are made and the framework of your nose exposed, the cartilage in the tip is sculpted to the desired shape, the bony framework is modified to the desired size and grafts are added if enlargement is desired in certain areas. Small wedges of tissue can also be removed at the base of the nostrils if these are deemed to be too wide. The incisions are then closed. A splint is applied to the dorsum of the nose, and nasal packing is frequently necessary for a couple of days.
After the rhinoplasty surgery you will be taken to the recovery room for a couple of hours and then discharged home with prescriptions for pain medication and antibiotics. You need to keep your head elevated to help reduce the swelling. A small amount of bleeding may be noticed the first couple of days. Any sutures that need to be removed are usually taken out about three days after surgery. The dorsal splint is usually removed between the third and seventh day. After the first week the swelling has gone down considerably and the bruising if any is resolving. Any residual bruising at this time can usually easily be covered up with makeup. Many people return to work after this first week, with no strenuous activity. After three weeks most normal activities may be resumed and most swelling resolved. Swelling in the nasal tip can be persistent and can take several months to resolve.
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