Dr Jagdish M jyoti - Cosmetic Surgeon,Apollo Hospitals, Hyderabad, India.

Rhinoplasty (Nose Reshaping)

Q. What is Rhinoplasty?

Ans : Rhinoplasty is one of the most technically demanding cosmetic surgeries. It requires _ anatomical knowledge to fix functional deformities and produce the best-looking nose possible. 'Perfect' noses are acquired, not born with.

The goal of nasal surgery is a nose that looks natural and blends harmoniously with the rest of your facial structure. Reshaping of the nose (Rhinoplasty) is one of the most common among cosmetic plastic surgery procedures.

Rhinoplasty can change the size of the nose, the angle between the nose and upper lip, the shape of the tip or the bridge, or narrow the width of the nostrils. The size of the nose may be increased using bone graft or silicone implants or it may also be reduced. It may also correct bifid defects or breathing problems.

Though Rhinoplasty can be done at any age teenagers are best treated after their growth spurt, around the age of 16-18 years for girls and 18-20 years for boys.

Q. Do I Require Rhinoplasty?

Ans : You may require Rhinoplasty if :

Your nose appears too large for your face
There is a bump on the nasal bridge when viewed in profile
Your nose seems too wide when viewed from the front
The nasal tip droops or plunges
The tip is thickened or enlarged
Your nostrils are excessively flared
Your nose is off-centre or crooked / depressed (Saddle Nose)
Previous injury has made your nose asymmetrical
Occasionally your surgeon may suggest other surgical correction to improve facial balance, for example, chin reshaping.

Breathing problems if any can be corrected at the time of Rhinoplasty. You will be asked to explain exactly what you wish to improve. The surgeon will then evaluate what can be realistically achieved.

Q. Where will the incisions for Rhinoplasty be made?

Ans : In most cases, all the incisions will be placed inside your nose, where they will not be visible. If the base of the nose is narrowed or the nasal tip is reduced, small wedges at the base of the nostrils will be removed. Incisions are hidden in the natural crease where the nostril joins the cheeks. Sometimes an incision is made across the columella which is hardly noticeable.

Q. How will my surgeon reshape my nose?

Ans : Through the incisions your surgeon will work on the cartilage and bone that form the framework of the nose. Sometimes, the underlying bones may be altered slightly to give a narrow shape. If the nose needs to be built up in certain areas, a nasal cartilage or bone or cartilage from another site or quite commonly an artificial implant (Anatomical Implant) may be used. The skin and soft tissues redrape themselves.

Q. What are the risks associated with rhinoplasty?

Ans : significant complications from rhinoplasty are less common. Some of the important complications noted are swelling (swelling over the nose around the eyes), hematoma (accumulation of blood under the skin), infection and very rarely breathing problems.

Q. Is silicone implant safe for elevating the nose?

Ans : Yes, silicon implants are safe and time tested.

Q. What is the difference between implants and grafts from one’s own body? Which is better?

Ans : There are Three choices for elevating the nasal bridge: Implants (silicone/medpor), bone from ones own body (hip/elbow) or cartilage (nose/ear/rib). There are advantages and limitations of each option. Generally nose cartilage is preferred in USA and Europe. Among Oriental (China, Japan), African and Indian surgeons implants are very popular because thick skin of nose permits safe placement of implants.

Q. How will I look and feel initially?

Ans : The amount of time it takes for recovery varies patient. There may be minor bruising around the eyes and cheeks, which will subside within a few days. It is imperative to keep the head elevated while sleeping and restrict active movements.

Q. When can I resume my normal activities?

Ans : You may be able to return to work within a week to ten days. Most normal activities including exercise may be resumed after three weeks or when your surgeon advises.