Cosmetic Nasal Surgery (Rhinoplasty)

Rhinoplasty is a surgery performed to correct external deformities of the nose and to improve the overall appearance. Septoplasty is the correction of the internal structures of the nose to correct nasal airway obstruction caused by deviation of the septum. Often, surgery of the nose will consist of a combination of these procedures. Essentially, nasal surgery is performed by removing any excess bone or cartilage and then reshaping the remaining structure. The changes may be subtle or dramatic depending on the patient.

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The first step is to come in for an initial consultation with Dr. Goodman. At that time you can discuss what your ultimate goals are and what it is realistic to expect. There are many different determining factors such as skin texture and thickness, previous injury and surgeries, individual variations in healing, and facial proportions and contouring. During the consultation your entire face will be evaluated and if there are procedures that may be used in conjunction with surgery, Dr. Goodman will discuss those options as well.

The surgery would be performed in a hospital setting on an outpatient basis. General anesthesia is used, so you will be asleep for the procedure and will need to arrange for transportation home after the procedure. In most patients, all incisions are placed internally and are well disguised. In more advanced surgeries, a small incision is made on the column (the skin between the nostrils on the underside of the nose). This incision typically heals very well and is not visible at conversational distances. If the base of the nose is too wide and needs to be narrowed, incisions are made in the crease on both sides where the nostrils and cheek join; those incision sites are hidden by the crease.

It will take approximately one week to recover from the surgery and go back to mild activities. After two weeks you can gradually increase your activity so that you are back to your regular routine at three weeks. You will need to sleep with your head elevated for a few days after surgery. You can expect swelling and bruising of the operated and surrounding area which will reach it’s peak at 2-3 days after the surgery and then begin to subside. Ice packs around the eyes and nose and keeping your head elevated will help to alleviate these symptoms. After 10-14 days, most of the visible swelling will have disappeared, but there may still be a feeling of numbness. Your front teeth might also feel odd. These feelings will gradually disappear.

It is surprising how little discomfort is associated with rhinoplasty procedures. Most discomfort is caused by not being able to breathe through your nose. Usually oral pain medication for the first couple of days after surgery is all that is required. You will need to come into the office 4-6 days after surgery for post-operative evaluation and suture removal.

It is advisable to avoid flying for at least 10 days to avoid changes in air pressure. Also, it is important to keep your follow up appointments with Dr. Goodman, especially right after surgery.

Cosmetic nasal surgery may be combined with other facial procedures such as a chin augmentation or facelift.

What to expect after your rhinoplasty surgery:

You will be allowed to leave the hospital a couple of hours after your surgery is completed. You must arrange to have someone pick you up as you will be unable to drive.
You should stay in bed for the first evening and have only a light meal. Take your medication as prescribed and have someone stay with you for the first 24-48 hours.
Elevate your head and upper body by resting at an inclined angle.
Apply antibiotic ointment to the external nasal incisions and slightly inside the nose to keep the nostrils moist. Apply liberally every two hours for the first week. The ointment will help reduce crusting and scabbing and help to keep the incisions clean.
After 10-14 days, most of the visible swelling will have disappeared, but there may still be a feeling of numbness.
Do not attempt to clean your nose beyond what you can see at the outer opening.
You will probably have some bloody discharge for 2-4 days. This is normal.
Do not blow your nose for two weeks. If you have to sneeze, try to do so through your mouth.
If you have any excessive or unrelenting bleeding, call the office immediately.
You may shower 24 hours after surgery, but try to keep any dressings as dry as possible and do not remove the dressings.
Frequent bed rest for the first week is advised. Avoid any strenuous activity. Do not lift anything heavy or do anything that will raise your blood pressure for two weeks after surgery.
Do not wear make-up over incision sites until they are completely healed.

The best way to find out if you are a good candidate for a rhinoplasty is to contact us and schedule a consultation with Dr. Goodman.