The size and shape of the nose is determined by the ethnicity and heredity, but its appearance may have been altered by disproportional growth of its septum, by an injury or by a prior surgery on nose. Rhinoplasty or nose surgery sometimes referred to as nose reshaping or a nose job improves the appearance and proportions of nose.

It also enhances facial harmony and self confidence. Surgery of the nose may also correct impaired breathing caused by structural abnormalities of the nose.
   
  Overview
  Rhinoplasty can change:
  • Nose size, in relation to other facial structures
  • Nose width, at the bridge
  • Nose profile by removing visible humps or depressions on the bridge
  • Tip of nose: Large or bulbous to small, drooping to straight, depressed to elevated or too upturned to normal
  • Nostrils that are thick, wide or flared
  • Nasal asymmetry and deviation
Cosmetic surgery on nose being a highly individualized procedure one should get it done only for oneself, not to fulfill someone elseís desire or to trying to fit into any sort of an ideal image.
   
  More Information
  Rhinoplasty procedure is a good option for you if:
  • Your facial growth is complete and you are 15 years of age or older
  • You are physically healthy
  • You have specific and realistic goals in mind for the improvement of your appearance


  Rhinoplasty improves form as well as function of the nose

Each year thousands of people undergo surgery on the nose. Nasal surgery may be performed purely for cosmetic purposes, or a combination of procedures to improve both form and function. It also may alleviate or cure nasal breathing problems, correct deformities from birth or injury, or support an aging, drooping nose. Patients who are considering nasal surgery for any reason should seek a doctor who is a specialist in nasal airway function as well as in plastic surgery, cosmetic surgeon being the best choice. This will ensure that efficient breathing is as high a priority as appearance.

   
  Risks and Limitations
  Is this surgery dangerous?

Serious complications are a rarity in nose surgery. This is due to the fact that each patient is carefully prepared for the surgical procedure, after analyzing their present health status. General anesthesia when required, carries its own risks. We will inform you in details about any special risks involved and obtain an informed consent from you.

What are the possible complications?

Possible problems should not be confused with intermediary cicatrization phases which the nose undergoes until it reaches the definite results.

What Are The Risks?

Amongst several different materials tried in human body over centuries, silicone is the most inert material as of today. Nasal Implants are prepared from highest medical grade silicon polymers. They are available as either straight or ‘L‘ shaped and in different sizes. They are pre-sterilized and come in dual ETO gas sterilized packs.
When a suitable type and size of nasal implant from a reputed manufacturer is used in a properly selected patient for a good indication and inserted following ‘Implant Protocol‘ gives excellent cosmetic result and patient satisfaction. Of course, post implantation precautions and care is mandatory and easy to learn and follow. Given due respect to above, the possibility of displacement, extrusion or infection becomes utmost rarity.
   
  Care & Aftercare
  Is Rhinoplasty considered as a small, medium or major surgery?

At our center, surgeries are listed as either small medium or major purely for the purpose of operating room preparations and other technical and administrative purposes. For the surgeon, there is only one classification and that is either a good or a bad surgery. With an ISO 9001:2008 credential to both the clinic and hospital, we look for results beyond very good to excellent and extra ordinary. ‘Our results are so natural, they can be seen, not noticed.‘

Any questions regarding possible post-surgery complications will be clarified by the surgeon who will provide you with all proper information.

Does nose bleed in the first few days?

After major nasal surgery, slight blood stained discharge may occur in the first 48 hours. This, however, should not be a concern since a protective dressing is placed there exactly to hold the bleeding. This additional bandage may be changed at home, whenever necessary.

How long does the surgery last?

It varies from case to case. Only implant surgery does not take more than half an hour. However, surgery duration should not be confused with the time in which a patient stays in the Operating Room, since that includes the period for anesthetic preparation and post-surgery recovery. We will inform you on the total duration of the surgery.

Are bandages necessary? How many?

After almost any of the cosmetic procedures on nose, a splint will be applied for nearly 7 days, to help your nose maintain its new shape and to give compression to reduce swelling. After this period splint can be removed. In some cases, nasal packs are used from 24 up to 72 hours. If septum is corrected simultaneously, this period may be extended and the packs changed.

   
  Faq
  Can Cosmetic Nasal Surgery Create A ‘Perfect‘ Nose?

There is nothing like a ‘Perfect‘ nose as it is a very individualized facial feature. Therefore, the so called ‘Perfect‘ nose for one face may not at all suit on another face. None the less, there are certain norms and proportions for an aesthetically pleasing nose, but they also need to be altered in view of ethnic background, sex and age of the patient and thickness and condition of the covering skin

Nose being the most prominent facial feature, even a slight deviation in size and shape of any of its elements becomes obvious. Unlike lips, mouth or chin, which also are single midline structures, nose though externally appears as a single, in reality is a fusion of two. Therefore, any deviation from midline and any difference between its two sides additionally become obviously noticeable.

Aesthetic nasal surgery corrects and refines the size and shape of the nose and tries to bring it into balance and harmony with other facial features but alone it may not be able to give you a perfect facial profile. Therefore, patients are sometimes advised chin augmentation i.e. chinplasty (add hyperlink here) along with rhinoplasty to better balance their features. Please remember that rhinoplasty can not make you look like someone else, or improve your personal life. Before surgery, it is very important that the patients have a clear, realistic understanding of what changes are possible as well as the limitations and risks involved in the procedure.


Can I choose the shape of my, to be nose?

You may not be able to choose the exact shape of your future nose but certainly you can express your desire about it. With a mirror or even better, your close up photographs in front of you, you can tell the surgeon what you donít want and what you want in your present nose. You may bring other photographs or pictures from magazines to clarify your desire. But remember, there is an aesthetic balance between the nose and rest of the face. The nose which looks best and perfect on a friend, model, actor or actress may not suit your face at all. Therefore, the surgeon must be careful to preserve natural balance between the new shape of nose and rest of the face. Each case needs to be studied in detail, so that the nose will have the best possible form according to the requirements of that face. Surgeon and patient must agree with the possible result to be obtained after surgery. If your realistic desire coincides with the type of planned nose, obviously your wish will come true and you will be the happiest person.


Will I reach the definite result regarding shape and function immediately?

Your planned final result will be there at the end of the procedure, but it may not be visible in the immediate post op period. Immediately after removing the external splint, that is around 7th day, there will be still some swelling below the skin, which will decrease within next few weeks. Little amount of swelling of the skin itself may take longer time to resolve. Therefore, the final result should be judged not earlier than six months. It also depends on the type of nose job done. Recovery period is shortest in a plain implant surgery. It becomes longer as the work increases from tip work, septo-rhinoplasty, total rhinoplasty to various combined procedures. Even for a particular type of surgery, some patients may reach the definite result before and others later than expected. Those in whom the transitional swelling remains for a longer period than expected, should remember that usually it does not interfere with the final outcome.


Can my own tissues be used for augmentation of nose bridge?

Definitely they can be used and they are called as autologous implants. Bone, cartilage and fat are the three tissues most commonly used. There are certain advantages and disadvantages of their use. Advantages are they being part of your own body, body accepts it very well and no cost is involved. Disadvantages include: In bone and cartilage grafting, surgery and stitches at donor site with its accompanying pain and discomfort. Uncertainty of ‘take‘ of the graft and a highly variable rate of resorption even after the take. Autologous fat grafting is a useful option for small defects as it is harvested by needle prick and there is no donor morbidity.


What is ‘Open Rhinoplasty‘?

To reshape the nose, the skin is lifted up like a bonnet of a car, allowing the surgeon to work on the cartilage and bony framework. The skin is then re draped and sutured over the new frame. A nasal splint on the outside of the nose helps to retain the new shape during healing and reduce the swelling. If soft, absorbent material is placed inside the nose to stabilize the septum, it will normally be removed the morning after surgery. External nasal dressings and splints are usually removed five to seven days after surgery.


How long will the obtained results last?

Rhinoplasty results last for a long time. After many years, as in the face and other parts of the body, some structural changes are expected in the nose due to gravity and ageing process.


Does Rhinoplasty leave scars?

Some surgeries enable us to conceal the scars totally within the nasal cavity. In this case, there will be no visible scars. In other cases there will be an external scar but it will be barely visible as it will be on the columella, that is the lower end of the partition between the nostril openings. It can be either vertical about 5mm in implant surgery or transverse crossing from one nostril to the other. These external scars are barely visible as they are in the shadow area of the nose in frontal view.


What will happen to my breathing after surgery?

Rhinoplasty can also aim at improving the patient's breathing conditions when such conditions are precarious in the original nose. Although the patient may experience some stuffiness in the immediate weeks post-surgery, this is due to the fact that there is also a swelling inside your nose, and that the movement of the breathing valve is affected in this period in view of the change in elasticity of the nostrils. Over time, such problems tend to get corrected. Breathing problems may be related to the septum that, in some cases, may be corrected in the same operation.


When should surgery be considered for a constantly stuffy nose?

This may be indicative of chronic breathing problems that don't respond well to ordinary treatment. The blockage may be related to structural abnormalities inside the nose or to swelling caused by allergies or viruses.

There are numerous causes of nasal obstruction. A deviated septum (the partition between the nostrils) can be crooked or bent as the result of abnormal growth or injury. This can partially or completely block one or both nasal passages. The deviated septum can be corrected with a surgical procedure called septoplasty. Cosmetic changes to the nose are often performed at the same time, in a combination procedure called septorhinoplasty.

Turbinates are three shelves that hang from side walls into both the nasal passages. Overgrowth of these turbinates is yet another cause of stuffiness. Sometimes they need treatment to make them smaller and expand the nasal passages. Treatments include injection, freezing, and partial removal.


I have constantly ‘Running Nose‘. Will Plastic Surgery on nose correct it?

A sudden dribbling of watery discharge from nose and a sequences of sneezes most likely is due to allergic rhinitis, either seasonal or perennial which can cause internal nasal swelling and then the answer is a big ‘NO‘ as it has a totally different pathology and allergy evaluation and therapy may be necessary.


Can Surgery Correct a Stuffy, Aging Nose?

Aging is a common cause of nasal obstruction. This occurs when cartilages in the nose and its tip are weakened by ageing process and droop because of gravity, causing the sides of the nose to collapse inward, obstructing air flow. Mouth breathing or noisy and restricted breathing is common.

Try lifting the tip of your nose with a finger tip to see if you breathe better. If so, the external adhesive nasal strips that athletes have popularized may help. Rhinoplasty, involving trimming, reshaping and repositioning portions of septal cartilage will help. This is also an ideal time to make other cosmetic improvements as well.


During childhood I had undergone surgery for cleft lip but nose is still asymmetrical, can it be corrected?

Yes, if you are above 16 years of age it can be done . Cleft lip nose surgery is slightly different from cosmetic rhinoplasty because here distortion is combined with deficiency and in one sided cleft lips, it is mainly on the side of the cleft.


What treatment is needed for a broken nose?

Bruises around the eyes, bleeding from nostrils and/or a slightly crooked nose following injury usually indicate a fractured nose and immediate medical attention is ideal. But if unsuspected initially or time lost due to other reasons, then once soft tissue swelling distorts the nose, waiting 48-72 may actually help the doctor in evaluating your injury as the swelling recedes. You may apply ice while waiting to see the doctor. What's most important is whether the nasal bones have been displaced, rather than just fractured or broken which will be evaluated by your surgeon with the help of a digital X-ray.

For displaced bones, surgeons often attempt to return the nasal bones to a straighter position under local or general anesthesia. This is usually done within seven to ten days after injury, so that the bones don't heal in a displaced position. This procedure is typically done on an outpatient basis, and patients usually plan to avoid appearing in public for about a week due to swelling and bruising.


What type of anesthesia will I receive during Rhinoplasty surgery?

For implant surgery and tip work, local anesthesia is sufficient as well as preferred because it causes minimal bleeding and the surgeons prefer a dry field. If the patient is too apprehensive, we can put them to sleep. For more extensive surgeries either local or general anesthesia or their combination will be used. Finally, it is the surgeon who decides the type of anesthesia considering patient‘s wish as well as their mental status.


Is there any post-surgey pain?

Usually, rhinoplasty has a very comfortable post-surgery recovery. If any pain occurs, it can be easily controlled by painkillers.


How long will I need to stay in hospital?

Majority of the procedures on nose are day care surgeries but it will also depend on the type of anesthesia used and recovery of the patient in the immediate post-surgery period. We will determine the inpatient stay period for your safety and inform you in advance.


In what position should I sleep during immediate post-op period?

As such bed rest is neither needed or recommended. Upright and moving as well as sleeping in bed with its head end elevated or inclined with the help of pillows helps reduce swelling.


What will be the post-surgery evolution like?

You should bear in mind that until the final result is obtained the nose will go through different healing phases, which are typical of this type of surgery. Swelling, bruises, breathing difficulties in the first days are common to all patients; obviously, the intensity of such problems varies from patient to patient. But you should not get panicky. Within time, your body will be in charge of dissipating all small These intermediary problems invariably attract other people's attention, who will probably say: " Do you think, you are recovering well? Do you like to check that there is nothing wrong happening? " Any such concern should be communicated to us. We will provide you with all clarifications for your tranquility. Some patients get extremely anxious as soon as the splints are removed (7th day). In rare cases, slight anxiety occurs in view of the temporary aspect caused by swellings and bruises. All of this is transitory and normally it reflects the desire of reaching the final result as soon as possible. But remember that no nose surgery results should be analyzed before the 6th month after surgery.


Will Insurance Cover Nasal Surgery?

Insurance usually does not cover cosmetic nasal surgery. However, surgery to correct or improve breathing function, major deformity, or injury is frequently covered in whole or in part. Patients should obtain cost information from their surgeons and discuss with their insurance carrier prior to surgery.


Finally, is the result really worth of suffering and money spent?

Usually patients are very pleased with rhinoplasty. Remember what is written above: each case must be analyzed individually in the first few appointments, when all questions should be asked and clarified. Once the patient and doctor fully agree on the plan and opt to go ahead with the surgery, means that the results will be worthwhile.



   
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