DESCRIPTION
Many men and women desire correction
of the shape of their nose. This procedure is commonly
termed a rhinoplasty. This procedure is a very common
cosmetic procedure and may be used to reduce and change
the shape of the nose, whether it is the bridge or
the tip. Suffice it to say that the end point should
be a more natural and improved look. A rhinoplasty
can improve your self-esteem and looks but it may
not necessarily change your looks to what you perceive
is the ideal. Dr. Perez-Gurri is attuned to your specific
needs and the “ideal, beautiful normal”.
Most candidates for cosmetic rhinoplasty are young
men and women in their teens and twenties. There are
exceptions; and those patients that present themselves
following an accident and injury to their nose may
require nasal correction. Age is a factor when considering
a rhinoplasty. It is preferable to wait until the
age of 14-15 to allow the nasal septum to fully developed.
Each case must be considered individually with all
social & family factors taken into consideration.
PROCEDURE
 |
|
|
|
A
rhinoplasty can be performed under local anesthesia
with intravenous sedation or general anesthesia. The
procedure is performed as an outpatient allowing you
to go home afterwards. We have found that most of
our patients prefer general anesthesia. Various techniques
exist for performing a rhinoplasty. The two main techniques
are the endonasal and the external approach. In the
former case, the incisions are all within the inside
of the nares (nostril) whereas the external approach
requires external incisions. In any case, the skin
of the nose is “skeletonized” or separated
from the underlying bony and cartilaginous structure.
The bones and the cartilage are then sculpted to the
desired shape and the skin is allowed to drape over
the new shape. Each case will be different requiring
specific approaches to the underlying problem. Nasal
packing will be inserted followed by a nasal splint
that will help maintain the shape of your nose during
the first 7-10 days.
POST-OP RECOVERY
You will be allowed to go home
after your surgery. At home, you should lie in bed with
your head upright. Because of the nasal packing, you
will be required to breath through your mouth for the
first 24-48 hours. You will experience a feeling of
tightness and discomfort in the first 24-48 hours. Bruising
and swelling is sure to follow reaching its peak at
48-72 hours postoperatively. This is normal.
We urge you to apply ice compresses to help reduce the
amount of swelling and bruising. You may experience
some bleeding from the nostrils during the first few
days. It is normal. The mucosa (or lining of the nose)
will swell and blood and mucous will dry up and form
a crust thereby not allowing you to breath properly
even after the packing has been removed. As time goes
on, all of this will resolve. Pain is infrequent following
a rhinoplasty. Patients will sometimes complain of a
mild, dull headache. However, pain medication will be
provided for you and we suggest that all your post-operative
medications be purchased prior to surgery. You should
not be the person controlling the meds to avoid self-medication.
At home, it is suggested that you rest. You will be
asked to come to the office the next day. At this point
the nasal packing may be removed.
We will need to see you within the week to change dressings.
Most patients require 7-14 days recovery before returning
to school, work and/or driving their car unless your
work requires strenuous activity in which case you may
need 3 weeks. Exercise may be continued after 6 weeks.
Always check with us. Household chores may be started
within the second post-operative week. Every patient
is unique and will recuperate differently. If you feel
great, don't over do it.
COMPLICATIONS OF RHINOPLASTY
Although complications are not frequent and percentages
will vary, you need to be aware that the following complications
may occur:
CONTOUR DEFORMITIES/IRREGULARITIES, KELOID/HYPERTROPHIC
SCARS, ASSYMETRIES, NASAL CONGESTION/DIFFICULTY BREATHING,
HEMATOMA, PERSISTENT SWELLING and/or PIGMENTARY CHANGES
OF SKIN, LOSS OF TISSUE, DISTORTION, REMOTE POSSIBILITY
OF ANOSMIA (Inability to differentiate smells)
Some of these complications if severe enough, may delay
recovery time, require further surgery for correction
at additional costs and may involve other specialists
within the medical field. Please be aware that smokers,
diabetics and overweight individuals have a higher incidence
of complications when compared to those who don’t
smoke, have diabetes and/or are overweight. You should
also note that patients undergoing combined procedures
(i.e. Rhinoplasty and Chin implant) also have a higher
complication rate than those undergoing a single procedure.
WHAT & WHAT NOT TO EXPECT
These procedures are considered
enhancing in nature. They are not meant to totally change
someone's looks.
We have found that one of the key factors in achieving
patient satisfaction is patient expectation. No guarantee
implied or in writing is given regarding how you will
look postoperatively. All attempts will be made by Dr.
Perez-Gurri to satisfy your requests, within reason.
The end point of this surgical procedure is to make
your nose look better and enhanced. Please note that
all individuals are unique and will require a different
surgical approach. A suggestion is made by Dr. Perez-Gurri
based on his professional experience as to the procedure(s)
best suited to achieve your aesthetic goals. Remember
that many things are taken into consideration but the
one limiting factor is the skin elasticity, bony and
cartilaginous structure and availability of good tissue.
Genetics plays a crucial role in the appearance of your
nose.
There seems to be an inverse relationship with expectation
and satisfaction. That is, the higher the expectation,
the lower the satisfaction. Body image is unique and
what the patient frequently sees may not be what is
seen by the surgeon. Therefore, it is important that
you become keenly aware of your expectations for the
procedure, know its limitations and fully discuss any
concerns that you may have regarding the procedure with
Dr. Perez-Gurri. We encourage questions and have allowed
ample time to answer them personally or with our literature
and videotapes. Please realize that the results obtained
through a rhinoplasty may not permanent. Gravity continues
to have an effect on the tissues and the aging process
and laxity of tissues continue at the same rate as before.
The nasal tip tends to get wider and fall with increasing
age. Every patient is different and will have a unique
experience.
OTHER QUESTIONS
Does smoking affect my results?
Yes. Multiple studies have been done that show that
smoking has an adverse effect on tissues and often times
will delay healing. We ask that you stop smoking for
2-3 weeks prior to your surgery. Although this will
not prevent all complications of healing, it will more
probably than not improve pulmonary function.
How long does the procedure take to perform?
It will vary from 1-3 hours depending on how many procedures
are performed in conjunction with the rhinoplasty.
Are my results permanent?
Very possibly. The normal processes of aging & gravity
that cause continued laxity of the tissues eventually
lead the tissues to sag again. This in turn may affect
the tip of the nose as you age.
Will I be very swollen and bruised?
Probably. Every patient will be different. However,
most patients will experience significant swelling and
moderate bruising following their rhinoplasty. Do not
be frightened. Swelling usually reaches its peak during
the first 48-72 hours following your surgery.
The above information has been compiled
as a benefit to you. We hope that this document has
served to better inform you on the proposed procedure.
We encourage dialogue. Dr. Perez-Gurri and his staff
at Imagos Institute of Plastic Surgery, Inc welcome
your questions.
It is our sincerest wish that your surgical experience
at IMAGOS INSTITUTE OF PLASTIC SURGERY, INC. be a
pleasant and informative one. We recognize that all
patients will experience pre-operative anxiety and
fear of elective surgical procedures is normal. Our
trained professional staff and doctors are here to
serve your needs and answer your questions.
|
