SURGERY OF THE NOSE Rhinoplasty
(1) Rhinoplasty patient shown before surgery with large nose, nasal hump, enlarged tip and nose that hangs slightly where it meets the upper lip. (2) Incisions are made on either side of the nose inside the nostril to provide access to cartilage and bone which can be cut and reshaped to alter the external appearance of the nose. The bridge of the nose can be narrowed by moving the bone inward, as shown by the arrow. (3) Areas where cartilage and bone have been readjusted to improve the shape of the nose are shown. (4) The postoperative patient with smaller nose, a straight nasal bridge, better defined nasal tip and an improved angle between nose and upper lip. Rhinoplasty can reshape your nose in a number of ways to improve its appearance and proportion in relation to your other facial features. People most often elect surgery to alter the size and shape of the bridge and tip of the nose. Your plastic surgeon may make one or more adjustments as necessary. Although there is no age limit for rhinoplasty, the mid teens, a time when the nose is near full development, is the earliest recommended age. With older individuals, health is the primary consideration. Reshaping is generally done through incisions inside the nose, but there may also be an incision passing across the central portion of the nose between the nostrils. It is sometimes necessary to narrow the base of the nose or reduce the size of the nostrils. This entails removing small wedges of skin at the base of the nostrils. The resulting scars usually fade very well and ultimately, should be barely noticeable. The nose is reduced, or in some cases built up, by adjusting its supporting structures - either removing or adding bone and cartilage. The skin and soft tissues then redrape themselves over this new "scaffolding". In some instances, there may be an internal deformity of the nose that can affect breathing. This may be due to an irregularity in the septum (the central structure of cartilage and bone that separates the two sides of the nose) or the turbinates (structures protruding internally from the lateral walls of the nose). Adjustment of these structures to improve the nasal airway may be made at the same time as alterations to the external appearance of the nose. After surgery, some pain, swelling and bruising of the nose are to be expected, but they will subside gradually. You will wear a splint for approximately a week or longer and can wear cosmetics safely after it is removed. Your routine will be severely restricted for only a day or two, but you should curtail activities that raise your blood pressure - such as swimming, jogging or even bending - for a few weeks. Reserve judgment on your rhinoplasty for several months, even a year, until your nose has had an opportunity to fully heal and settle. Often, the best compliment you can receive from your family and friends is that your nose does not appear very different. Remember that the intention of rhinoplasty is for your "new nose" to blend in naturally with your face.