Rhinoplasty Or Nose Job

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• QWhat should I expect following my rhinoplasty surgery?

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  A Dr. Jeremy P. Warner, MD , Plastic Surgery, answered on behalf of NorthShore University HealthSystem

  While rhinoplasty surgery is often peformed on an outpatient basis, it is truly surgery. And like all surgery, there is recovery associated with it. Fortunately, patient universally tolerate rhinoplasty surgery very well. Surprisingly, there is not a lot of pain associated with the surgery. There is some pain -- remember, it is real surgery. But the pain is generally very well controlled with medications that you will take by mouth. Most patients have a sense of "stuffiness" after surgery, and this is perhaps what bothers patients the most.
  
  You will have swelling and likely some bruising (especially if incisions are made through the bones to narrow the nasal bridge). Sweeling generally peaks after about 3-4 days and patients begin feeling better after that point. By a week out from surgery, you will be feeling much better. 
  
  You will be "sociable" by 2 weeks. This means that about fifty percent of your swelling will be gone and most, if not all, of your bruising should be gone. So you will look in the realm of "normal" at that point (though you and your doctor will still notice swelling, people out in public will not). 
  
  Most patients take between 1-2 weeks off work or school, depending on what they do. It does take time for the nose to heal, and while most patients notice a significant improvement even after one week, it will take a few more weeks before your nose begins to take its final shape with the resolution of the swelling. 

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• QWhy is a nose job a difficult surgery?

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  A Dr. Stuart A. Linder, MD , Plastic Surgery, answered

  Rhinoplasty surgery is quite complicated because the anatomy doesn't allow for error in the operating room. Only board certified plastic surgeons and otolaryngologist should perform rhinoplasty surgery. The approach can be either open or closed (through small incision in the nostril). Making a perfect nose requires skill with manipulation of bone, cartilage, and skin. This makes it one of the most challenging surgeries we plastic surgeons perform.
• QWhat does a nose job involve?

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  A Dr. Stuart A. Linder, MD , Plastic Surgery, answered

  A nose job is also referred to as a rhinoplasty. The components of each individual patient's surgery depends on the corrections necessary. Common manipulations include narrowing of the dorsum ( infracture of the nasal bone), tip elevation (anterior cartilage trimming and repositioning), and correction of breathing (septoplasty, turbinectomy). Rhinoplasty surgery should be performed by board certified plastic surgeons and facial plastic surgeons (otolaryngologist). 
• QWhat should I know about ethnic rhinoplasty?

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  A Dr. Jeremy P. Warner, MD , Plastic Surgery, answered on behalf of NorthShore University HealthSystem

  The term "ethnic" rhinoplasty refers to modern techniques of tailoring a patient's nose to fit his or her face and not just routinely "westernizing" a nose. In other words, there is not one nose to fit everyone's face. A rhinoplasty should look natural and blend into the rest of the face. It should not look "done", what I like to refer to as the "red-carpet" look, as many celebrities have nose jobs that are obvious and overdone. While every nose is unique, there are some cultural similarities in the way noses look. With the trend being toward more natural surgical results, ethnic rhinoplasty can be performed which alters the shape of the nose without making it look out of place. This usually involves maintaining some degree of "strength" along the dorsum in order to avoid a "surgical" look. 
• QHow long does it take to recover from a rhinoplasty?

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  A Dr. Jeremy P. Warner, MD , Plastic Surgery, answered on behalf of NorthShore University HealthSystem

  While rhinoplasty is, indeed, surgery, most patient do very well in recovering from the procedure. Surprisingly, it is not a terribly painful operation -- many patients get by with over the counter pain medication. Having said that, there is some pain -- it is a surgical operation.
  
  The more uncomfortable feeling that most patients experience is a feeling of congestion and stuffiness for a couple of weeks. This feeling gets worse over the first few days following surgery, but by the end of the first week the swelling is coming down and most patients begin to feel significantly better. It takes about two weeks for the patient to become "sociable." What that means is that, by two weeks, much of the swelling and bruising has resolved and patients are feeling close to normal again. There is still swelling at that point, but strangers won't notice this when you are out in public.
  
  It takes six weeks for the bones to heal completely back together again, so exercise and vigorous activity should be limited during that time. By three months, the swelling is resolving more and the nose will look very similar to the final product. Having said that, it does take about one year for all of the swelling to resolve and for the nose to completely heal. It may take longer than this in cases of revision rhinoplasty.
  
  There is also a psychological component of healing that takes place following rhinoplasty, as your brain must integrate your new look into your self-image -- this usually takes a couple of months. With support from family and your surgeon, you should be able to navigate the healing process successfully.

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• QHow is a rhinoplasty done?

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  A Dr. Jeremy P. Warner, MD , Plastic Surgery, answered on behalf of NorthShore University HealthSystem

  There are a number of things that must be considered when creating your rhinoplasty experience. Rhinoplasty can be performed in a number of different ways. The surgery can be done using general or twilight anesthesia. It can also be done using an "open" approach (with a small external incision) or a "closed" approach (no external incision). "Non-surgical" office-based rhinoplasty can also be done in certain cases.
  
  Rhinoplasty surgery is generally performed as an outpatient procedure and, surprisingly, most patients don't have a lot of pain after surgery -- it's really more of a "congested" feeling. What needs to be done during rhinoplasty surgery depends on the patient's concerns, the deformities involved, and what can be accomplished from the surgeon's perspective. The best way to figure out what your specific surgery will involve is to have a consultation with a rhinoplasty surgeon and develop a plan that is right for you. 

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• QWho is a good candidate for a cosmetic rhinoplasty?

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  A Dr. Jeremy P. Warner, MD , Plastic Surgery, answered on behalf of NorthShore University HealthSystem

  Anyone who has ever looked at their nose and been concerned with the way it looks may be a good candidate for cosmetic rhinoplasty. If there is something that you don't like about the way your nose looks, it's a good idea to talk with a board certified plastic surgeon about what can be done to alter the shape of your nose. After a personalized consultation, you and your surgeon will decide if surgery (or even non-invasive treatment) is right for you. If your concern is very subtle, surgery may not be recommended. But in most cases, if something is there that consistantly bothers you, it is likely amenable to surgical (or non-surgical) correction.

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• QShould my teenager have a nose job?

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  A Dr. Stuart A. Linder, MD , Plastic Surgery, answered

  Normally rhinoplasty surgery or a nose job should not be performed before age 14-16. It is vital that the nasal cartilages and bony vault be fully developed prior to elective nasal surgery. Rhinoplasty, when performed by a board certified otolaryngologist or plastic surgeon can greatly enhance the patient's self esteem and breathing. Rhinoplasty surgery can be performed for several reasons on a teenager. Cosmetic reasons may include a large dorsal hump, tip droop, wide nasal base, or nasal shift. Functional reasons may include septal deviation, nasal bone fracture, turbinate hypertrophy. 
• QHow effective is a rhinoplasty?

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  A Dr. Stuart A. Linder, MD , Plastic Surgery, answered

  Rhinoplasty is very effective for correcting aesthetic and functional problems. First, aesthetic reconstruction can include: narrowing the dorsum by infracturing, raising of the tip, re-positioning of the nasal lobule, and bringing the mid-nasal vault down. Functional reconstruction includes straightening out the septum (septoplasty) and removing the obstructing turbinates (turbinectomy). 

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• QWhat is rhinoplasty?

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  A Dr. Jeremy P. Warner, MD , Plastic Surgery, answered on behalf of NorthShore University HealthSystem

  Rhinoplasty surgery is performed to change the appearance of the nose. Nasal breathing problems may also be addressed at the same time. Patients may seek rhinoplasty surgery to straigten the nose, decrease or increase the nasal profile, and change the appearance of the nasal tip. The goal of any rhinoplasty should be to achieve a natural and harmonious look that allows the nose to blend into the rest of the face.

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