Article

Rhinoplasty 101 (Nose Job 101)

Topic: Aging and LongevityPublished December 30, 2009

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Rhinoplasty (commonly known as nose job) is the name of the opera¬tion designed to improve deformities of the nose with plastic and reconstructive surgical techniques … and to improve breathing and sinus function.rnThe operation consists of carefully removing any “excess” bone and/or carti¬lage while rearranging or reshaping the remainder.rnMost rhinoplasties are performed because the patient desires an improve¬ment in appearance and/or nasal func¬tion. (S)he may simply want a nose which is in harmony with the rest of the face rather than one which is out of pro¬portion with respect to the other facial features. On the other hand, it may be, as is often the case, that the nose is becoming progressively more disfigured the older the patient becomes until breathing diffi¬culty occurs.rnAt times patients have deformities of the inside of the nose which impair breathing, cause headaches, or contribute to sinus trouble. These problems cannot be satisfactorily treated medically with¬out simultaneously straightening the external nose. rnLike faces, every nose is different; some noses are too long, some too wide, some have large humps, some project away from the face, and so on.rnSince rhinoplasty surgery is as much artistic in nature as it is scientific, rarely are any two patients’ noses identi¬cal. A skilled rhinoplastic surgeon would strive to make each patient’s nose fit his or her face.rnThe alterations your doctor recommends will be determined by many factors, including one’s height, age, skin thickness, ethnic background and configuration of other features such as the forehead, eyes and chin. All in all, a rhinoplasty specialist strives to achieve a nat¬ural looking nose rather than one which appears to have been operated upon. No patient really wants an assembly line “nose job”; they want a nose individually tailored to their own features. The nose is reduced in size by removing excess bone and cartilage. The remaining struc¬tures are repositioned through a series of carefully planned internal nasal incisions. The skin then heals to the new framework. rnRhinoplasty: The Surgery ProtocolrnPrior to surgery, certain medications may be given to promote healing and help hold to a minimum the amount of swelling and discoloration, which may occur.rnThe surgery is usually done in a surgery center or hospital. Following surgery, the average patient can be discharged. rnAt the completion of surgery, a small protective adhesive dressing and splint are applied to the nose. The external protective splint and tape are to remain in place for about one (1) week.rnAlthough a drip dressing is applied which obstructs the nostrils, some surgeons like Dr. Simonido not ordinarily “pack” the nose after surgery. Patients, therefore, are more comfortable and generally less swollen. With the elimination of nasal packing, pain, swelling, bleeding, discoloration, etc., are dramatically reduced making the recovery period much more pleasant for the patient. In this technique, the surgeon suturs the internal nasal tissues back in place eliminates the neces¬sity of packing. This technique has been one of the greatest advances in nasal surgery, reducing much of the undesirable postoperative discomfort those patients whose noses are “packed” experience. Septoplasty: Nasal Breathing ProblemsrnOne of the common causes of breathing difficulties is a “deviated” or crooked nasal septum. The septum is a bony and cartilaginous partition that divides the inside of the nose into two chambers. If it is dislocated or leans to one side it can interfere with the flow of air through one or both sides of the nose.rnEven patients whose septum is not “deviated” frequently have a dominant nostril (airway passage). Most of us have a dominant eye, hand or foot; it is not unusual for one nasal airway to be better than the other. Your surgeon will evaluate the inside of the nose and attempt to improve the airway if (s)he feels it might be improved with corrective surgery.rnSurgery can often straighten or remove the offending portions of the crooked bones and cartilages and improve breath¬ing; however, the membranes lining the inside of the nose can become swollen from one or more of the fol¬lowing conditions:rna. Allergies (hay fever)rnb. Changes in temperature or environmental factorsrnc. Viral infections (colds)rnd. Bacterial infectionsrne. Emotional disturbancesrnf. Over-use of nasal spraysrng. Exposure to irritants in the air (hair spray, smoke, etc.)rnNone of these “membrane condi¬tions” are corrected by surgery but if the patient has a deviated septum plus one of these problems, correction of the septum frequently makes it easier for the patient to tolerate the membrane swelling. Rhinoplasty Specialist Most Rhinoplasty specialists are usually board certified by the American Board of Facial Plastic and Reconstructive Surgery(ABFPRS). "The ABFPRS certifies surgeons exclusively in facial plastic and reconstructive surgery. The ABFPRS is dedicated to improving the quality of facial plastic surgery available to the public by measuring the qualifications of candidate surgeons against certain rigorous standards." "To achieve certification by this Board (ABFPRS), a surgeon must: ? Complete an accredited residency training program after medical school that provides training in facial plastic surgery. ? Achieve previous certification by one or both of the basic boards in the field: The American Board of Plastic Surgery or the American Board of Otolaryngology. ? Successfully complete an additional two-day examination (written and oral) focused solely on facial plastic and reconstructive surgery. Present for peer review at least 100 surgical cases in facial plastic and reconstructive surgery for each of the previous two years." rnThe ABFPRS holds its member surgeons to a published code of ethical conduct.

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