Introduction

While other plastic surgery techniques are more generally performed to simply improve the appearance of a particular body part, rhinoplasty, or a nose job, can actually improve the function of the nose and improve a person's ability to breathe. However, aesthetics is probably the most common reason why rhinoplasty is performed today, and with the advancements in nasal refinement techniques it is now possible to shape your nose similar to your favorite actor or actress' nose. While nose jobs are safer and more common then they were several decades ago, there are still risks involved and limitations to what rhinoplasty can accomplish.

Do You Really Need a Nose Job?

There are three basic reasons why people elect to have rhinoplasty. The first reason is that they have a structural defect that is preventing them from breathing properly. This defect could have been caused by a genetic malformation or because of a traumatic injury to the nose that broke, cracked, or shifted the internal cartilage of the nose and blocked the air passage. If you have a structural problem that is preventing you from breathing properly, then surgery may be a necessary health treatment. To determine if nasal surgery is right for your condition you will need to talk with your doctor to see if there are alternative ways to correct your problem or if your only option for improving your breathing is to have surgery.

The second reason for electing to have rhinoplasty is because of a deformation of the internal and/or external structures of the nose. These deformations can be caused by genetic mutations, severe trauma to the face, burning, cancer, or exposure to toxic substances. A deformation anywhere on the body will impact a person's self image, their self-esteem, and their ability to fit into society. To help improve the physical appearance of a person who has been deformed by some acting agent, a skilled plastic surgeon can be enlisted to help remove damaged tissue, or excessive tissue, and then sculpt a new, more normal appearing nose with stronger more attractive internal nasal structures. While rhinoplasty may not solve all emotional issues that a person who has lived with a deformity has, it will help to give them the opportunity to experience a more normal life by reducing or eliminating the physical barriers that had previous been the source of their emotional and/or physical pain.

The final reason why people elect to have rhinoplasty is simply to change the way their nose looks. Motivation for this type of surgery is often based on the person's desire to refine their nose to reflect current trends in beauty. For example, women may get a nose job so that they look more like a movie star, television star, or popular musician. The expectations of this category of rhinoplasty candidates really need to be evaluated and addressed before surgery is scheduled to ensure that they don't have unrealistic expectations of what the surgeon will be able to do, and to ensure that the candidate is psychologically stable enough to handle the surgery and their subsequent transformation. People with obsessions, body image disorders, and who are addicted to plastic surgery may in fact be turned down for a procedure because it will either reinforce the psychologically damaging behavior, or it will result in the physical harm of the patient by increasing the chance that the nasal structures will collapse, or because it will result in the deformation of the patient. It is critically important to remember when considering plastic surgery that individual safety, health, and emotional well being are all key issues that should be factored into any decision regarding elective surgery.

Who is a Good Candidate for Rhinoplasty?

Plastic surgeons consider many factors when they are deciding if a person is a good candidate for rhinoplasty or not. The first factor is of course the candidate's age. Most plastic surgeons will not perform cosmetic rhinoplasty on a person who is under the age of fourteen or fifteen for girls, or fifteen or sixteen for boys. This is because adolescents go through their final growth spurt around these ages and the size and shape of the person's nose is still changing before the completion of this growth spurt. If, however, the rhinoplasty is intended to correct a structural problem or to correct a deformity, it may be necessary to address the family's concerns early in order to reduce the amount of psychological and emotional damage the physical deformity will cause the child.

The next factor that the surgeon will consider is if the person is healthy enough to undergo surgery. A full physical including blood work may be required to determine if the person will be able to handle the stresses imposed by surgery and the effect of the anesthesia. If a candidate is a smoker, they may be required to give up smoking at least a month before the surgery to ensure that their lungs will be healthy enough to handle sedation. Other conditions that may reduce the chance that a person will be allowed to get rhinoplasty include HIV, chemotherapy, infections, heart disease, cancer, or any other condition that reduces the body's ability to heal or handle physical stress.

Emotional and psychological health of a surgery candidate are also taken into consideration. To be considered a good candidate for rhinoplasty you should have realistic expectations of what the surgery will be able to do for you, and ideally you should be having the surgery to simply improve your self-esteem instead of creating your self-esteem.

What is Involved in a Nose Job?

What is involved in a nose job will greatly depend on your individual needs and the complexity of the surgery that you have requested. For a less complicated cosmetic refinement of the nose the surgery may only last an hour or two, and you may only need to go under a local anesthetic. However, for more complicated surgeries such as reconstructive surgeries a general anesthetic will be used and the surgery may last over eight hours.

The surgery itself will include an incision either inside the nostril or on the underside of the nose, again depending on the type of surgery that is being performed. The skin covering the nose will then be separated from the internal supportive structures so that the surgeon will be able to identify structures and have access to structures that will be modified. Chisels, scissor-like instruments, and scalpels will then be used to shape and refine the internal structures so that the outer skin will have a more attractive base to drape over. If the nose is too thin then harvested cartilage maybe implanted inside the nose to help reinforce the bridge and provide a sturdier support structure for the nose and the person's airways.

After the internal structures have been repaired or refined, the external elements are then addressed including removing excess skin, anchoring skin strata, and finally closing the incision lines. After these processes have been completed the nose is then placed in a split to protect the internal structures from damage. The nostrils are also packed with nasal packs or plastic supports to help reinforce the septum and to help absorb blood seepage from the incision sights.

The Healing Process

The amount of time it takes for you to completely heal from rhinoplasty will depend on a number of factors. The first factor is how complicated and extensive your surgery was. For major reconstructive surgeries, several months may be needed before the person sees the final result or results of the surgery, while a simple refinement may only take 4-6 weeks before the final results are visible.

Your first 24 hours after surgery will be the most intense in regards to pain, bleeding, swelling, and bruising. Pain medication and anti-inflammatories will be prescribed to you to help control your discomfort levels. You will not want to move around during this time period, so plan on staying in bed with your head elevated for 24 hours after your surgery. If you have young children, you will need to arrange for someone to care for them during this period, as you will be incapacitated and you will not able to tend to their needs. You will also probably want to have someone take care of you during this period. You will need help moving around to use the toilet, and you will need someone to bring you fluids and your medication.

During the first two to three days you will experience swelling, pain, bleeding, and bruising. The unpleasant sensations that these things cause will seem to intensify over the first few days, however, they will be dramatically reduced at about day four, and they should subside completely within a couple of weeks. To help reduce the pain, swelling, and bruising you can also use cold compresses on your face. Many plastic surgeons will recommend a specific compress devise that is designed for this purpose, or you can use a bag of frozen peas or corn wrapped in a soft cloth to experience the same result.

To reduce the chance that you will damage the results of your rhinoplasty surgery you should be careful not to bump or put too much pressure on your nose during the first week or so. This time will allow the modified structures in your nose to stabilize the structures. You should also avoid blowing your nose during the first week as this too could impair your results or even re-break your nose.

After a week all the medical dressings will be removed from your nose including the split, stitches, and nasal packing. At this point your doctor will inspect your healing progress and give you more care instructions for the next several weeks of your recovery. Your doctor may limit your physical activity for the first two or three weeks after surgery so that heavy breathing won't damage your surgery results. However, you should be able to go back to work within a week of your surgery if you are healing well. At this consultation you will also schedule another appointment with your doctor for one month from your surgery date so that your doctor can examine your healing and identify any problems that may have developed. After the one-month mark you should be feeling as good as new, and your results from your surgery should be visible and your bruising and swelling should be invisible to onlookers. This will be the time to really evaluate the success of your surgery with your doctor and to show off your new nose with pride.