Nose Job (Rhinoplasty) Santa Barbara
What is a rhinoplasty?
A rhinoplasty is the surgical correction of the nose to enhance facial harmony and the proportions of the nose. It can also correct impaired breathing caused by structural defects in the nose. It addresses any or all of the structures within the nose including the bones, the cartilage and soft tissues such as skin and fatty layers.
A rhinoplasty may be performed exclusively for cosmetic purposes, functional purposes or both. Rhinoplasty surgery can:
- Reduce nose size in relation to facial balance
- Decrease excess height, width and length along the entire nose
- Provide better definition along the nasal tip by correcting a nasal tip that is enlarged or bulbous, drooping, upturned or hooked
- Decrease flaring of the nostrils
- Create a nose that is more proportional and in better harmony with other facial features
Restore the airway to allow improved breathing
How is a rhinoplasty done?
Rhinoplasty may be performed in two ways: open rhinoplasty and closed rhinoplasty.
The primary difference between the two is that the open rhinoplasty requires a very small incision along the vertical segment of tissue separating the two nostrils, the columella. In closed rhinoplasty, the incisions are placed inside the nose.
The more extensive the work that is required, the more likely the need for an open rhinoplasty.
In both types of surgeries, the skin and soft tissues are elevated from the underlying cartilage and bone so that these might be trimmed or in some cases augmented with grafts to the appropriate dimensions. Grafts are commonly harvested from the septum, but ear and rib cartilage can also be used in cases of revisional rhinoplasty or if large amounts of grafting are needed. Once the changes have been made to the cartilage and bone, the skin and soft tissues are allowed to re-drape over the new framework.
The quality of the nose skin affects the final aesthetic outcome. The thinner the skin, the more likely it will re-drape over the new framework and allow the changes of the new structure to manifest. However, in cases where the skin is excessively thin, any slight irregularities in the cartilage or bone may be visible externally.
Thick skin does not re-drape back as easily as the thin skin. This can pose limitations in the changes that may be achievable within the nose. This is especially true along the nasal tip where thick skin can significantly limit the extent of achieving tip definition.
What kind of anesthesia is recommended during a rhinoplasty?
Depending on the degree of surgical correction necessary, the procedure may be performed under local anesthesia with IV sedation (twilight anesthesia) or general anesthesia.
In extensive rhinoplasty cases or when patients are very apprehensive, general anesthesia is recommended.
What can I expect after rhinoplasty?
There will be swelling and bruising. Both will become worse over the first 48 hours after surgery.
The swelling occurs along the nasal tip, both eyes and the forehead. The only part of the nose that is not noticeably swollen is the part covered by the nasal splint as this provides pressure and minimizes swelling.
The bruising accumulates along the eyes.
Most patients will have an aching sensation in the nose for the first few days following surgery. Some may even report a mild headache. The prescribed pain medication should be sufficient to alleviate the pain. There may be temporary numbness along the tip of the nose.
The nasal splint and tape will be removed approximately one week following surgery. When the splint is removed patients may see the new shape of the nose. There will be a fair amount of swelling through the nasal tip as well as across the bridge. This subsides over the subsequent two to three months.
It will take approximately one year to see the final appearance of the nose.
When is it the right time for a rhinoplasty?
Once the face has completed growing, it is safe to consider a rhinoplasty. Usually, after completion of puberty the facial features have reached their adult relative proportions.