Rhinoplasty Q & A with Dr. Aston
What is a Closed Rhinoplasty?
A Closed Rhinoplasty is a procedure that’s performed with all of the incisions being placed on the inside of the nose. I always perform Closed Rhinoplasty, even in noses some surgeons feel are very difficult to correct. An Open Rhinoplasty means that an incision is made across the columella of the nose. These incisions have the potential to heal very well, however the incisions on the columella on the outside of the nose are frequently visible. It is my opinion that all primary rhinoplasties and the majority of secondary rhinoplasties can be corrected using a Closed Rhinoplasty technique
What is the appropriate age for teenage rhinoplasty?
In general, teenage rhinoplasty can be performed for females when they have reached a level of emotional maturity and are having regular menses. The nose is not going to grow following a rhinoplasty. Many teenage rhinoplasties are performed at fifteen, sixteen, seventeen years of age for females. For males, the maturity occurs a couple of years later and it is more common that males have rhinoplasty at sixteen, seventeen, and eighteen years of age. There are obviously variations with individuals on both ends of the age spectrum.
What kind of anesthesia is used for rhinoplasty, is it local anesthesia?
I do not recommend local anesthesia for rhinoplasty. Rhinoplasty should be done in a way that the airway is protected so that the patient can breathe property throughout the surgical procedure. Most teenage rhinoplasties are performed using a combination of short-acting medications and the airway is protected with a laryngeal mask (LMA), which maintains the airway open and prevents any blood from getting into the lungs during the surgical procedure. With this kind of protection of the airway, it is possible to do whatever is necessary to a deviated septum or a bone spurs in the nose that needs to be corrected in order to improve the breathing passages. The short-acting anesthetic medications make it possible for the patient to wake up immediately after surgery and the vast majority of our patients walk to the recovery room.
Is there pain following a rhinoplasty?
There is always some discomfort following a rhinoplasty but very few patients describe it as pain. We always give a prophylactic, mild analgesics to make the patient comfortable. The patient also has stronger pain medication available just in case they experience more discomfort than usual. Very few of our patients today take narcotics following a rhinoplasty.
When can one resume normal activities after a rhinoplasty?
I permit my patients to return to all physical exercise, except for contact sports, at twenty-one days following the surgical procedure. The bandages are removed on the fifth day following the surgery. Some patients have very little to no bruising but occasionally we will have a patient that has a great deal of bruising. Bruising, almost always, goes away within ten days following the surgical procedure. On the day immediately following the surgery patients are up, outside and walking around. They feel much better with this kind of activity. We do not recommend that one stay in bed following a surgical procedure.
Can a deviated septum be corrected at the time of a cosmetic rhinoplasty?
Many patients have a deviated septum that is corrected at the time of a cosmetic rhinoplasty. Often the nasal passage is compromised by the deviated septum and preoperatively the patient may not be able to breathe as well out of one side as the other. Occasionally, a patient will have S-shaped septum giving a blockage to the airway on both sides. For the vast majority of patients with a deviated septum, the airway can be corrected or improved at the time of the cosmetic rhinoplasty.
How long does it take for the swelling to go down after a rhinoplasty?
The swelling that concerns most patients is gone in the first two weeks. The nose will change for twelve months following the surgery, especially in the tip area. Large nasal tips look better immediately after the surgery, and they continue to improve with the passage of time. In patients who have extremely thick skin, it will take longer to get the final result in the nasal tip.