Are you uncomfortable with the size of your nose? Do you feel like it doesn’t fit with your other facial features and is a far too noticeable trait? Do you feel like you would feel better in your own skin if you had a smaller nose? If this is the case, you might want to consider getting a rhinoplasty, the only way to effectively make your nose smaller. Mr. Salerno, at Real Cosmetic Plastic Surgery in Moonee Ponds, VIC can take care of all your nose goals.
Rhinoplasty: The Basics
The procedure is commonly referred to as a “nose job,” and it can be used to reduce medical symptoms caused by structural defects in the nose or to enhance facial harmony by changing the proportions of the nose.
Types of Nose Jobs
Nose jobs can be done for either functional or cosmetic reasons. Functional nose jobs are done when the client is having issues with breathing, sinuses, or other nasal functions help restoring their nose to proper functionality. Cosmetic surgeries, on the other hand, occur when the client simply wants to fix the size or shape of their nose for purely aesthetic reasons.
The type of nose job that is being done can have an impact on the approach and goals of the surgery. When you meet with Mr. Salerno, you can discuss with him the reasons you are looking for a nose job and what your goals are. With your nose job goals and his expertise, you can decide the best way to proceed.
Functional Nose Job
A functional nose job is done to treat physical symptoms that arise from structural issues in the nose. This may include nasal passages that are too narrow for air to easily pass through or a crooked or deviated septum. Deviated septums can happen as a result of being damaged in an accident. It’s also possible that the septum simply grew in a crooked manner throughout the individual’s development.
Functional problems can also arise from allergies, hormones, or sinus infections that cause turbinates to become enlarged. Turbinates are shell-shaped structures made of bone, blood vessels, and other tissues that warm and humidify the air as it moves through the nasal passages. Various issues can cause the lowest turbinates to become swollen and have a serious impact on an individual’s health. Nose jobs to treat this functional issue may involve removing tissue to provide more open space for air to pass through.
Cosmetic Nose Job
Perhaps even more common than functional nose jobs are cosmetic nose jobs. One of the most common reasons patients cite for wanting a nose job is nose size. Sometimes noses are large enough that they appear out-of-proportion to the other facial features. It can feel like the nose stands out, draws unwanted attention, and is the defining feature of the face. Getting a cosmetic nose job can help facial symmetry and harmony.
Another common reason for cosmetic nose jobs is asymmetry. The nose might tilt, lean, or point too far to one side or another, and a cosmetic nose job can help to straighten this out. It can be used to treat nose bridges or nostrils that are too wide. It’s commonly used to treat a nasal tip that is enlarged, drooping, upturned, or hooked.
Surgical Approaches to Nose Jobs
There are two surgical approaches when you get a nose job: external and endonasal approaches.
Endonasal Surgical Approach
The endonasal approach is also called the closed surgical approach. That’s because the nose remains closed during the surgery, and the surgery is performed by going through the nose. In an endonasal surgery, the incisions are hidden within the nose.
In the closed surgical approach, the doctor makes small incisions in each of the nostrils. They perform the entire surgery through narrow surgical openings. This gives them enough room to make minor refinements, augmentations, and other changes to the nose.
Good Candidates for the Endonasal Approach
The best candidates for the closed surgical approach require only mild to moderate shaping and structural changes to their nose. This is because the doctor can only have limited visibility with this method. If you are looking for major changes to your nose, you might want to consider the open, or external, approach.
Good candidates for this approach may be individuals who are concerned with scarring following the surgery, as this approach does not leave the patient with any lasting scars. Additionally, this surgery is good for candidates who want the quickest recovery time possible.
External Surgical Approach
Rather than only make incisions within the nasal cavities, the surgeon can make a trans-columellar cut that connects the two nasal incisions over the bridge of the nose. This allows the doctor to fold the nasal skin upward to reveal the entire nose. With unhindered access to the nasal skeleton, the doctor is able to make much larger changes to the nose’s structure.
This surgery tends to be the choice for any functional nose jobs. That’s because cosmetic nose jobs often only require small changes to the nose. The doctor can make small structural changes easily through the closed approach, but for major structural changes, the doctor wants to be able to see and make changes to the entire structure of the nose.
Good Candidates for the External Approach
The best candidates for the external approach either require more dramatic adjustments to the nose or structural changes that require an extremely gentle and precise procedure. It’s also generally recommended for patients who have functional issues because the extra visibility provided from this approach allows them to better diagnose the issue and provide better reconstruction.
Although surgeons can do bone or cartilage grafting in a closed approach, the external approach provides a better option for these types of surgical techniques. Although this surgery does leave the patient with a scar, it’s only a small scar on the bottom of your nose, making it not noticeable. Candidates for this surgery also have to be agreeable with general anesthesia and with a longer adjustment period and recovery.
Preparing for a Nose Job
The first step to getting the nose you want is to meet with your surgeon. The consultation gives you an opportunity to talk with the surgeon about why you want the surgery, what your goals for the procedure are, and what your options are.
During the consultation, you have the opportunity to discuss your medical history with the doctor. It’s important to disclose any medical conditions you have, as well as any medications, supplements, or herbs that you take. The consultation also gives your doctor a chance to closely examine the skin inside and outside of your nose to help you decide which surgical approach, external or endonasal, is the right option for you.
If you are looking to have other facial surgeries, you can discuss these with your doctor and decide whether they may be done alongside the nose job. The consultation may include photographing your nose from various angles. The photographs may be used to assess the long-term results from your surgery and may be used for reference during the surgery.
How to Prepare
For two weeks before, as well as two weeks after surgery, it is best to avoid painkillers that contain ibuprofen or aspirin. That is because these medications can slow down the blood-clotting process, resulting in more bleeding. Your doctor can let you know which of your other medications and supplements to stop using prior to surgery.
If you smoke cigarettes, it is a good idea to stop smoking prior to having a nose job. Smokers usually have more difficulty healing from this surgery, or any surgery, because cigarettes slow the recovery process. This happens because nicotine constricts your blood vessels, which results in less oxygen and blood circulating and healing your tissues.
What to Expect From the Procedure
If it’s a simpler procedure, like an endonasal nose job, the doctor may opt to only give you local anesthesia to your nose so that your face is numb. Local anesthesia is generally paired with medication through an IV line so that the patient is groggy and in a twilight state but still awake. For external nose jobs, doctors opt to use general anesthesia so the patient is completely unconscious.
Once the medication has had its effect, the procedure can begin. If your new nose requires a small amount of additional cartilage, the doctor may remove some from your ear or deep inside your nose. If more than a small amount is desired, the doctor may get an implant or a bone graft. Nose jobs generally take between one and two hours; however, more complex procedures can take longer.
Recovery From a Nose Job
When you wake up from surgery, you may find that your doctor has placed a plastic or metal splint on your nose to help your nose retain its new shape as it goes through the healing process. Your doctor may also choose to place nasal packs or splints on the inside of your nostrils to help stabilize our septum.
You can recover for several hours after the surgery in the recovery room. If you are doing well, you may be able to leave later that day. It’s important that you have someone available to drive you home because the different drugs given to you during the surgical procedure make it unsafe for you to drive. It’s also always a good idea to have someone stay with you for the first 24 hours in case you want extra help and to ensure your comfort.
What Not to Do
There are some activities that are best to avoid for several weeks following surgery. It’s best to not run or engage in other strenuous physical activities. Swimming can cause damage after surgery, as can blowing your nose and excessive chewing.
You might want to avoid excessive laughing, smiling, or other facial expressions that require a lot of movement. Resting eyeglasses on your nose can cause some damage, as can vigorous tooth brushing and pulling clothing over your head.
Whether you are having trouble breathing or you dislike the size or shape of your nose, rhinoplasty is a great option for creating facial harmony, proportion, and symmetry. Don’t keep wishing you had a different nose: take the leap and make it happen! Nose jobs are the best way to get the nose that you want. For more information, or to schedule a consultation contact Real Cosmetic Plastic Surgery, in Moonee Ponds, VIC today.