Rhinoplasty (Nasal Surgery)

Also known as rhinoplasty, nasal surgery is a cosmetic surgical procedure done to correct a nose imperfection caused by internal structural deformities, or to enhance the appearance of the nose. Nowadays, this procedure has become popular among both men and women.

Nasal surgery gives you a perfectly proportionate nose that contributes towards greatly improving your facial appearance and self confidence. Rhinoplasty is the best treatment choice, whether to straighten or reshape the tip of the nose, reduce or add to the overall size of the nose, change the size of nostrils, correct bumps, indentations, and alter other irregularities. The nose surgery was initially performed by removing portions of bone and cartilage. Sometimes, cartilage grafts were used in the nasal surgery to achieve the best aesthetic results. The modern practice in rhinoplasty therefore uses a combination of techniques including tissue removal, cartilage reshaping with sutures, and adding cartilage grafts so as to produce excellent cosmetic and functional results.

For performing the nasal surgery, cartilage grafts are acquired from different parts of the body. Cartilage is ideally grafted from the nasal septum or the back of the ear. To be a potential candidate for cosmetic nose surgery, you need to be at least 14 years old. It is better to wait until the ear has reached full development.

Various techniques have been proposed for rhinoplasty. For those who require simple internal changes such as tip modification and removal of a bump, it is ideal to choose the ‘traditional rhinoplasty technique’. This technique can also be used to correct a breathing disorder. In traditional techniques, the incisions are placed inside the nostrils to access the cartilage and bone, and are therefore not visible.

The ‘open’ technique enables the plastic surgeon to have easier access to the nose while performing the surgery, which could not be successfully effected by the earlier method. Here, the incisions are placed across the skin that separates the nostrils, which allows the nasal skin to be lifted off the tip of the nose exposing the interior structure to the surgeon. This helps the surgeon to carry out the surgery with great perfection.  The open technique is meant for adding cartilage grafts, performing delicate tip shaping maneuvers, and for reconstructing the nostril tip deformed by previous surgery. In the open method, the swelling on the tip of the nose takes longer to subside, while the traditional method has the advantage of less post-operative swelling.

Occasionally a second procedure may be required for correcting deformities resulting from previous surgery. In most cases, open technique is utilized. In the case of rebuilding areas, cartilage grafts are frequently required. Cartilage grafts are meant to build up a scooped out profile, straighten a nose deviated over to one side, narrow a wide nose, add volume and improve the shape of a pinched tip, or to open up a narrow airway. Thus, by using any of these techniques, you can achieve dramatic improvements in the appearance and function of a deformed nose. Difficulty in breathing is usually the result of structural deformities in the septum, blocked airways, or other non-surgical causes. Rhinoplasty can correct these structural deformities to some extent.

In combination with nasal surgery, chin implants and liposuction are performed for better results. In case the chin is recessive or weak in relation to the cheekbones, then chin implants may be required.

Factors such as thickness of the nasal skin, and weak and flimsy cartilage can impose limitations on what can be achieved surgically. Another factor with significant impact on the final outcome is the skill of the surgeon you choose. Before undergoing the surgery, it is important to ask about the surgery and the risks involved.

Surgery is performed on an outpatient basis at our facility by a board certified plastic surgeon - Dr. Christopher T. Chia. General anesthesia with a breathing tube is usually recommended to adequately protect the airway. Lighter forms of anesthesia are not considered safe for nasal surgery. Depending on your medical history and the type of surgical procedure, the type of anesthesia required also varies. You will be given the opportunity to discuss your concerns regarding anesthesia options with our anesthesiologist prior to surgery.

The surgery would take about two hours to complete. In order to correct multiple deformities resulting from a previous rhinoplasty, the procedure might require three hours. A plastic splint is usually applied to the nose after surgery. It is removed after five to six days. Nose swelling and bruising around the eyes is typical, which will begin to subside after 48 hours. The stitches are dissolvable and do not need to be removed.  In case the skin stitches are between the nostrils, these are removed after five or six days.

Rhinoplasty may involve some mild pain and discomfort. You can begin most types of exercise after three weeks. But it is better to avoid vigorous activity and ball sports for six weeks to minimize any risk of further complications. You can return to work and other activities after a week. Bleeding is the most common problem seen, and it will stop spontaneously. Another rare complication is infection.