Rhinoplasty (Nose Surgery) in Fort Myers
The nose is the central feature of the face and determines to a large extent the overall visual perception and balance of your face. Ideally, the size, shape, and proportions of the nose should be in
harmony with the other facial features such as the eyes, cheeks, lips, and chin. Many people wish to change what they feel as a nose is too big, too long, too wide, has a large or bulbous tip or has
an excessive hump over the bridge. Some patients simply want more refinement and better definition of the form of their nose. Other patients may have nasal deformities resulting from injuries or simply
inherited features of the nose they wish to change.
A Highly Technical Procedure
Rhinoplasty is one of the most challenging procedures in aesthetic plastic surgery. It requires a high degree of technical precision and understanding of what it takes to make a nose change so as to enhance the size, shape, aesthetic proportion and form to meet a patient's realistic goals. The operation involves modifying the bone and cartilage skeleton framework, and soft tissues below the nose skin to sculpture and refine it. The actual technical steps of the rhinoplasty procedure performed on a given patient should be specifically tailored or "customized" to the other anatomical features of the face and the particular parts of the nose requiring modification. It should not be performed as a "one operation fits all" procedure. Rhinoplasty demands perhaps the highest degree of surgical customizing of any cosmetic surgery.
Rhinoplasty - The Procedure
The operation involves reduction, augmentation, and/or changing the shape and proportion of the nasal bones and the two sets of cartilages (upper and lower lateral cartilages) to refine the nose to the desired
appearance. The surgery can be performed under general anesthesia (asleep) or IV sedation and local anesthetic as an outpatient ambulatory procedure. The operation takes from one and one half to three hours to
perform depending on the extent and number of steps necessary to achieve the desired changes.
Open Rhinoplasty
Rhinoplasty is done most often as an "open procedure" or the skin is elevated to expose the underlying bone and cartilage framework to permit direct visualization and access by the surgeon to perform the surgical maneuvers needed. The incisions are almost all inside the nose except for a small incision across the underside middle part of the nose skin (columella). The internal stitches dissolve and the external skin stitches may dissolve or be removed in 6 to 7 days.
Closed Rhinoplasty
The "closed" or endonasal technique is less often performed than in the past and does not require any external stitches. It involves less extensive surgical dissection than the open approach. Most plastic surgeons feel that the open approach affords them more ability to perform the technical changes required to the bone and cartilages by the greater anatomical exposure.
Recovering From Surgery
Swelling and bruising will occur immediately following the surgery. The majority of swelling is cleared at three to four weeks and the bruising at two weeks. As in most cosmetic surgical procedures, the final end result appearance may take 5 to 6 months. The nose is somewhat different in that it continues to improve in the year following the operation and even sometimes longer. The discomfort level associated with rhinoplasty is typically moderate at worst and usually much less than most patients expect. Head elevation for the initial 7 to 10 postoperative days and ice packs during the initial 48 to 72 hours are used to control swelling, bruising and discomfort. Oral pain medication is also given. We see patients the first day after surgery and at one week postoperatively. An external splint is worn over the bridge of the nose the first week and taped for the second week. Some patients who also have breathing problems will have a septoplasty and/or turbinectomy done at the same time. These procedures open blocked nasal passages to permit easier nasal airway function. This may require internal splints during the first week, which are easily removed in the office.
The Result
It is very often remarkable how much the refinement in change of the nose can markedly improve the whole appearance of the face. Often patients will say that people will comment on their improved change in appearance, but be unsure of what exactly was changed. This is the case more often than not. Rhinoplasty is a procedure possibly more than any other facial surgery that can make such a profound difference in your facial presentation.
