 |
|
 |
This is a surgical
procedure that is done to improve the appearance of
the nose and/or the ability to breathe through the nose.
This surgery, therefore, may be done to improve the
cosmetic appearance or the function or, for some patients,
both. Nasal deformities may be present at birth or may
develop with growth and aging. Traumatic injuries, such
as a broken nose, or changes from previous surgeries
may result in significant deformity that can be reconstructed.
Nasal aesthetics are central in how we appreciate the
attractiveness of the face. The balance of elements
of the nose from any point of view affects not only
the attractiveness of the nose, but also the overall
balance and aesthetics of the entire face. Understanding
nasal aesthetics and the interdependence with the rest
of the face is as important as the technical skill and
experience required to perform this elegant and complex
operation. Rhinoplasty is generally considered among
the most difficult and challenging procedures in plastic
surgery because small changes can have important consequences
in the appearance or airway function.
Dr.
Weeter begins with a thorough consultation to understand
the patient’s goals and carefully evaluates size
and shape of the various nasal elements, the overlying
skin, the internal airway, and the relationship to other
facial features. Planning and surgical precision are
of critical importance. Dr. Weeter’s goal is to
achieve as natural a result as possible, without an
overly operated appearance.
WHO IS A CANDIDATE
| •
|
A
patient with a nose that is cosmetically unattractive
or does not have a pleasing balance with other facial
features. |
| • |
A patient with
overly prominent features of the nose. |
| • |
A patient who
wants removal of a "hump" on the bridge
of the nose, refinement of a round nasal tip or
elevation of a drooping tip. |
| • |
Someone whose
nose is crooked, too wide, too long, excessively
projecting, or flat may be improved. |
| • |
A patient that
has a structural deformity affecting the air passages.
When the nasal septum (the cartilage separating
the right and left internal nasal passages) is deviated
and it causes nasal airway obstruction. Correction
of a deviated septum alone is called a septoplasty
or submucous resection of the septum (SMR). A crooked
nose may worsen this disorder and therefore, require
correction at the same time. Surgery to correct
this is called a rhinoseptoplasty. Turbinates are
parts of the nose that help to add moisture and
filter inspired air. These structures can be enlarged
for many reasons and contribute to airway obstruction.
When this occurs, Dr. Weeter will recommend their
removal as part of the nasal surgery. Other problems,
such as narrowed passages and airway "collapse",
may require placement of cartilage grafts for structural
support. Occasionally, scar tissue within the nose
from previous injury or surgery may block airflow
and require correction. |
INSURANCE COVERAGE
| • |
When
reconstructive nasal surgery is done to restore
normal airway function or appearance, insurance
benefits may cover some of the costs associated
with these surgical procedures. Dr. Weeter’s
office will assist in obtaining pre-authorization
from your insurance company.
 |
Before
and After
Nasal Surgery
(click on any
photo to enlarge) |
|
INTENDED
RESULT
| •
|
A
more attractive nasal shape with the nose in better
proportion to other facial features. |
| • |
Maintenance of
the patient’s individuality. |
| • |
Correction of
breathing difficulties caused by fixed anatomical
obstruction. |
| • |
Realistically,
there are limitations in achieving the final goal
and the ultimate outcome will vary from patient
to patient due to the characteristics of the individual’s
skin, cartilage, and bone. |
PROCEDURE
| •
|
Cosmetic
rhinoplasty may be done with local anesthesia and
intravenous sedation in the safety of an accredited
outpatient surgery facility. General anesthesia
may be used upon patient request or physician recommendation.
|
| • |
Cosmetic rhinoplasties
have incisions hidden within the nostrils, inside
the nose. More complex nasal operations often require
a small incision in the narrow strip of skin between
the nostrils. This tiny scar is barely visible,
yet it allows the surgeon to "lift" the
nasal skin and directly view all of the cartilage
and bone requiring correction. This is termed an
open rhinoplasty. To narrow flaring nostrils, small
incisions are placed in the groove where the nostril
meets the cheek. |
| • |
Septal cartilage
and bone or other obstructing tissues can be relocated
or removed, as required. |
| • |
Cartilage and
bone grafts, if required, are most often taken from
within the nose. Ear cartilage is another possible
source of graft material to rebuild the underlying
architecture. |
| • |
After the underlying
framework of cartilage and bone has been modified,
the skin is redraped. |
RECOVERY
| •
|
An
external cast or splint will be placed immediately
after surgery. The nose may be packed for 24 to
48 hours. The cast or splint is usually removed
in 7-10 days. |
| • |
Initial discomfort
is easily controlled with oral medications. |
| • |
The majority of
swelling and bruising subsides progressively over
2 to 4 weeks. |
| • |
External sutures
(if any) are removed in 4 to 6 days. The internal
sutures will dissolve. |
| • |
Return to work
may be possible in about 7 to 14 days, depending
on the nature of your responsibilities. |
| • |
While the visual
improvements and better breathing should be apparent
relatively soon after the swelling diminishes, a
realistic approximation of your final result is
evident in 3 months. The final result will continue
to evolve and refine for 12 to 14 months. |
| • |
Areas of sensitivity
or numbness will slowly resolve. Temporary conditions
that may occur, but will improve over the first
several months, are stiffness of the tip of the
nose, nasal drainage, lumps and irregularities. |
| • |
Dr. Weeter will
personally see you for post-operative care at prescribed
intervals to evaluate your progress and answer questions.
His follow up care will go on for the following
year or more as the healing tissues mature to the
ultimate improvement. |
OTHER OPTIONS
| •
|
Chin
augmentation with a small synthetic implant may
help create better facial harmony and an improved
profile for some patients |
| NOTE: The specific risks
and the suitability of this procedure for you may be determined only at
the time of consultation. All surgical procedures have some degree of risk. |
| |
|
rhinoplasty & deviated septum correction 
