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.