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Nose Surgery


Nose Surgery

 

 

What Is Nose Surgery?

Whether the reason you are considering a nose job is aesthetic or the result of breathing problems, the available variations of this procedure are vast. By adding or removing bone and cartilage and adjusting the supporting structures inside the nose, a Rhinoplasty procedure, or Nose surgery can change the size and shape of your nose. Your nose can be shortened or lengthened by undergoing nose surgery where your surgeon can even remodel the tip of your nose, making it more uplifted, longer, shorter, or thinner.

 

 

The Procedure

Your surgeon will follow the surgical plan discussed with you before your operation. Based on the preoperative evaluation of factors such as your underlying facial muscle structure, bone structure; your surgeon will decide what he needs to do to achieve the best results for you.

General anesthesia is commonly used during a Rhinoplasty procedure, although local anesthesia or intravenous sedation may be desirable in some instances.

For your safety during the surgery, various monitors will be used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood. Your surgeon will follow the surgical plan discussed with you before surgery.

After numbing the area, your surgeon will make incisions to access the bones and cartilage that support the nose. There are two general techniques for making the incisions:

  • Open Rhinoplasty

During an Open Rhinoplasty, the incisions are made outside the nose with a small access incision on the underside of the nose between the nostrils that then connects with other incisions hidden inside the nose.

This approach may provide better visualization of the nasal structures and a more direct route for surgical manipulation; the small scar at the base of the nose is barely visible once it heals.

  • Endonasal Rhinoplasty

For an Endonasal Rhinoplasty, the incisions are made inside the nasal passages. Because these incisions are hidden, they are invisible after surgery.

This approach allows a limited dissection of nasal tissues, offers excellent visualization of nasal structures, and eliminates the visible scar at the base of the nose.

In addition to incision options, there are various methods for augmenting your nose or smoothing any surface deformities. Fillers or fat grafts may also be injected to smooth the nose, to camouflage deformities or indentations, or to add volume in desired areas. Your skin and other soft tissues will remodel to assume the shape of the underlying structure.

 

Your surgeon will then apply sutures and you will have a splint placed outside your nose to support its new shape as it heals. Nasal packing may also be used inside the nose to provide additional support.

The procedure normally takes between 120 - 180 minutes.

Am I a candidate for surgery?

You are a candidate for Nose Surgery if:

  • Your nose is too large, too small or not in proportion to the rest of your face
  • You have breathing problems resulting from irregularities inside your nose
  • If you have a nasal hump or a nasal tip that is drooping, too elevated or wide
  • Your nose is crooked, badly shaped, or out of alignment
  • You have a birth defect that you would like improved
  • You would like improvement, not perfection, in the appearance of your nose

If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.

Advantages of Nose Surgery:

  • Structural problems that restrict breathing and cause congestion can be corrected
  • Successful Rhinoplasty can have a significant impact on your self-image and self-confidence
  • The shape, angle and size of your nose will be improved

Disadvantages of Nose Surgery:

  • Depending on the type of surgery, you may develop scars at the base of your nose
  • It may take time to adjust to your new look
  • You may have skin problems or breakdown of skin tissue associated with the use of grafting materials

Preparation for Surgery

Prior To Your Arrival

Before traveling to Cyprus, as part of your surgery preparation you will complete a detailed specific questionnaire and will submit a recent Chest X-Ray and photographic images of the problem areas which you wish to have treated.

Initial Consultation: Once the images have been received by us, we will schedule a consultation with your chosen surgeon, via Skype or telephone. This will allow you to ask any questions regarding the procedure and will also allow your chosen surgeon to assess your condition and determine your eligibility for your chosen procedure. 

During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Your chosen surgeon will evaluate you as a candidate for surgery and clarify what Nose surgery can do for you. Understanding your goals and medical condition, both alternative and additional treatment options may be considered. You should be prepared to discuss your complete medical history. This will include information about:

  • Previous surgeries
  • Past and present medical conditions
  • Allergies and current medications
  • Medical treatments you have received
  • Medications you currently take

Your treatment plan

Based on your goals, physical characteristics, and the surgeon’s training and experience, your surgeon will share recommendations and information with you, at this point including:

  • An approach to your surgery, including the type of procedure or combination of procedures.
  • The outcomes that you can anticipate.
  • Associated risks and complications.
  • Options for anesthesia.
  • What is needed to prepare for the surgery.
  • What you can expect to experience after surgery.
  • Show before-and-after photos of cases that are similar to yours and answer any questions.

In advance of your procedure, your surgeon will ask you to:

  • Stop smoking at least six weeks before undergoing surgery to better promote healing.
  • Avoid taking aspirin and certain anti-inflammatory drugs that can increase bleeding.
  • Regardless of the type of surgery to be performed, hydration is very important before and after surgery for safe recovery.
  • Be asked detailed questions related to dry eyes, glaucoma, eye-related allergies, and other eye problems.

Ten days prior to your arrival in Cyprus, you will receive all the necessary pre operative instructions, to prepare yourself both physically and mentally for your chosen cosmetic procedure.

Before your departure to come to Cyprus your records will be reviewed thoroughly by our surgeon. This includes Chest X-ray and a complete medical and surgical history.

Getting your house ready before your surgery

It is also important to get your house ready for after you come home from the hospital. At first it will be harder for you to move around, so arrange your furniture and household items ahead of time to make it easier for you during your rehabilitation.

Remove all your throw rugs or anything on the floor that may cause you to trip.

Move phone and electrical cords close to the walls.

Move necessary personal items you need to reach to shelves and tables that are above your waist level.

Preparation for the hospital

Here are a few things to keep in mind as you pack and prepare for the hospital and recuperation:

  • Clothing

Getting dressed in the morning helps you feel better, so be sure to bring some comfortable clothing to the hospital:

  • Loose shorts or pants
  • Loose tops or T-shirts
  • Underwear and socks
  • Short robe or pajamas
  • Toiletries

Upon Arrival

After traveling to Cyprus, a new set of blood tests, E.C.G and chest X-ray will be taken as well as an in person physical examination.

The surgeon and anesthetist will meet with you and go through your medical and surgical plan.

During this consultation, your surgeon will discuss your surgical procedure and answer any further questions. Your plastic surgeon will proceed to examine measure and photograph your face for your medical record.

Day before surgery

Your doctor or nurse will give you more instructions based on the type of prep.

You should not eat or drink anything after midnight the evening before your surgery.

 

Morning of surgery

Bring all your medicines, if any in their original containers with you to the hospital.

You will meet with the anesthesiologist. This doctor will talk to you about general anesthesia. This is a controlled sleep while the surgery is being done so you will not feel any pain or remember the surgery. You will have an IV or intravenous line put in to give you fluid and medicine during your surgery.

Your plastic surgeon shall consult with you once again for the proposed procedure.

Recovery after surgery

When you wake up after your surgery, you will be in the recovery room, where you will continue to be closely monitored. You will stay there until you are awake and your pain is under control. Most patients return to their room after a couple of hours.

After surgery you may be asked to wear a nasal splint over your nose for support. The splint will protect your nose while you sleep and shield it from accidental bumps. You may also have a small triangular bandage beneath the tip of your nose.

Nasal packing will be placed inside your nose for additional support and acts as an internal splint to hold everything in place, keeping the airway clean and free of crusts.

Your face will be puffy, and the areas around your nose and eyes will be bruised and swollen after surgery.

Hospital discharge and home instructions

Your diet is slowly increased from ice chips to liquids to solid foods as your intestines start functioning.

Before leaving the hospital, our surgeon and staff will help you adjust to recovery in every way possible. You will receive specific instructions and precautions from your surgeon and nursing staff and they will show you safe techniques of simple activities like getting in and out of bed, bathing, going to the bathroom, managing steps at home and getting in and out of a car.

You will be able to leave the hospital when you are:

  • Able to eat a regular diet and drink fluids
  • Passing gas or you have had a bowel movement
  • Passing urine
  • Not having a fever or other signs of infection
  • Walk for short distances

Most people are able to go home the day after their surgery; however recovery time after the procedure and the length of your hospital stay depend on your overall health and the type of procedure performed.

Life After Surgery

These guidelines give you an overview of what you may expect as part of your care after you leave the hospital. Be sure to follow your doctor’s discharge instructions if they are different from what is listed here. This will include information about wearing compression garments, taking an antibiotic if prescribed and the level and type of activity that is safe. Your surgeon will also provide detailed instructions about the normal symptoms you will experience and any potential signs of complications. It is important to realize that the amount of time it takes for recovery varies greatly among individuals.

All surgical packing within your nose will be removed within four to seven days after surgery.

The splint and bandages on your nose will be removed in a week to ten days.

Swelling and bruising, similar to having "black eyes," will likely last ten to fourteen days. Your surgeon will probably instruct you to apply ice packs or cold compresses to your eyes to help reduce swelling.

Sleep with your head raised higher than your chest. Use regular pillows, wedge pillows, or sleep on a recliner and help minimize swelling and bruising by keeping your head elevated as much as possible during the first few days of recovery.

You may wash your hair gently twenty-four hours after your surgery. Do not use the usual heat-type hair dryer; use the cap type or use the cool setting on the blow dryer. You may shower or bathe the day after surgery, but do not let the spray directly strike your face. It is permissible to get your suture lines wet, however.

You may be able to return to work within 2 weeks and to full activity within a few weeks, but you must avoid heavy lifting or straining during this time.

Your Activity                                                                                                                                                         

It is fairly common to feel weak and tired immediately after discharge from the hospital. The body needs time to recover from the stress of surgery.

Walking is permitted and encouraged beginning the same day of surgery. At home, start short, daily walks and gradually increase the distance you walk.

Going up and down stairs is permitted. Initially, have someone assist you.

You may lift light objects (less than 10lbs.) after your discharge. This may be increased gradually after 2 weeks. If lifting an object causes discomfort, you should discontinue the activity. This restriction helps prevent hernias at the sites of your incisions.

Driving is not permitted for 2 weeks after surgery or your first follow-up visit with your surgeon. If you are taking prescription pain medications or narcotics, DO NOT DRIVE.

Sexual intercourse may be resumed as your comfort level permits.

People with sedentary jobs have returned to work as early as 2 weeks postoperatively. A physically demanding job may require 4 weeks before returning to work. This may be determined by you and your employer. Some people have residual fatigue several weeks after surgery.

Do not go swimming, diving, water skiing, or participate in strenuous athletic activity for at least one month after surgery.

Your bowel habits

You may have different bowel habits after your surgery. Loose stools are common for the first week or two after surgery. If you have watery diarrhea, call your surgeon. This may be a sign of a bowel infection. Severe constipation should be avoided. See the section below on medicines for constipation.

Your diet

There are generally no dietary restrictions following cosmetic surgery. Avoid foods that cause diarrhea or digestive discomfort. You will eventually be able to resume your regular diet. A dietary supplement or drink can be used.

Medications

Your medicines: Take the medicines you were taking before surgery, unless your surgeon has made a change.

  • For pain

Your surgeon will order a prescription pain medicine for you after surgery. As your pain lessens, over the counter pain medicines such as acetaminophen or ibuprofen can be used. They can also be used instead of your prescription for mild pain.

  • For constipation

Prescription pain medicines can cause constipation. Your doctor may order a stool softener to prevent this. You should be back to your normal bowel routine in about 2 weeks. If the stool softener does not work, take Milk of Magnesia. If you still are not getting relief, call your surgeon.

Call your surgeon right away if you have:

  • Diarrhea that lasts more than three days
  • Nausea and vomiting that will not go away
  • Pain in your abdomen that gets worse or isn’t eased by the pain medicine
  • Pus drainage or redness around your incision
  • Fever with a temperature of 100.5 or higher

Long-term

It will be a few months before you can expose your reshaped nose to direct sunlight, and it may be a number of weeks before you can wear glasses without special support, such as tape, if the bones in your nose were altered.

Minor swelling of your nose may persist for up to a year but most likely will not be noticeable to others.

 

How Long Will the Results Last?

When performed on a nose that has finished growing, the results of Rhinoplasty surgery are permanent. If Rhinoplasty is performed before development is complete, continued growth can change the outcome of the surgery and cause potential problems and complications.

Follow-Up

Follow-up after surgery is extremely important and our surgeons at Salus are committed to providing all the post surgical care you need. For safety, as well as the most beautiful and healthy outcome, whenever you notice any unexpected changes do not hesitate to contact your surgeon. In order to identify and treat any complications as they may arise, close, lifetime follow-up is essential.