Is your nose deformed? Wish you had a more attractive nose? Need to improve the function of your nose? Read the following facial procedure information below about our rhinoplasty or nose reconstruction procedures offered at Robinson Cosmetic Surgery:
First, why nose surgery? The nose is a very personal part of the face. Its shape must not only be acceptable to the individual but must also function well. Not all nasal surgery is cosmetic. Many patients elect to have nasal surgery because of: breathing difficulty and associated sinus problems, nasal drainage, sleep problems, and difficulty exercising.
These airway problems can be due to a deviated septum (the dividing structure between the right and left air passages on the inside). This deviation is usually from trauma but it can be congenital. The term septoplasty applies only to the surgery to correct a deviation. It will not change the shape of the nose.
If any of these situations apply to you, contact our office to schedule an appointment with Dr. Randy Robinson. During your consultation, he discusses your medical history and goals. Together, you arrive at an optimal patient care plan.
Who Needs Nose Surgery?
The size of the nose must relate to the overall face. The dorsum (outside shape) should be smooth and straight without a hump. But a slight convexity (hump) is better than a scooped-out appearance, or the ‘ski slope’ nose. The tip should be crisp and well-defined, not bulbous or asymmetric (uneven).
There should be a slight depression just above the tip on the dorsum to give a defining point to the tip. As the tip flows onto the columella (the structure below the nose that separates the nostrils), it is esthetic to have an open angle, between the lip and the tip. This area is called the infra-tip lobule.
The junction of the columella to the face forms an angle called the naso-labial angle. This angle should be about 100-110° for a woman and 90 to 100° for a man.
The patient’s overall height helps determine the degree of this angle, because it relates to how “turned up” the nose appears. On a tall person it is best to keep the angle less obtuse (or less than 100°).
The nares (nostrils) should be symmetrical and somewhat almond-shaped. They should not flare or be wider than the distance between the inside of the eyes.
All these descriptions and dimensions are ideals, and it is impossible and undesirable to give everyone the same nose. The goal is to make the nose fit the face attractively and function properly. With rhinoplasty, it’s possible to attain a comfortable, natural, and lasting ideal appearance of the nose.
In addition to this website, you can learn more about the rhinoplasty procedure at the American Board of Cosmetic Surgery website: ABCS Rhinoplasty Guide.
Rhinoplasty Procedure Details Video
For rhinoplasty, the surgery is performed under a general anesthetic or an IV sedation with local anesthesia. It takes one to three hours, depending on how extensive the changes are from the initial state of the nose.
The incisions are placed on the inside of the nose, except when it is best to ‘open’ the nose for more control over the tip, or when grafting bone or cartilage is indicated. If the incision is placed on the outside, it is located across the columella at the narrowest point. The scar is usually hardly visible. Functional corrections can be made through either approach.
Commonly, part of the turbinates are removed to help open the airway further. The turbinates hang down off the walls of the nose and help guide the air through the nose to humidify, warm, and filter it, but they may become enlarged, due in part to chronic allergies, blocking the flow of air. A turbinectomy removes part of the enlarged structure to open the air passages.
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After surgery, packs are placed in the nose to help control the oozing and increase the post-operative airway patency (openness). These packs are removed a day or two after rhinoplasty surgery.
A splint is applied to the outside of the nose to help protect it and maintain its shape. The splint is left on for one week. When it is removed, the nose is checked for straightness and proper width. At this stage the nose can be molded, if necessary, to help keep it narrowed and aligned.
Nausea is common after surgery. It can be caused by anesthetics and strong pain relief medicines. To help reduce nausea, eat a bit a food with your pain medications. Blander foods, like crackers, are best. Avoid dairy. Don’t force yourself to eat if you’re not hungry.
Take the pain pill with repeated sips of clear liquids that you can tolerate, e.g. ‘flat’ 7-Up, ginger ale, water, apple juice, etc. Call our office if you have you prolonged problems with vomiting.
If you have further questions about recovery for rhinoplasty procedures, be sure to discuss them with your board-certified cosmetic surgeon.
The amount of swelling will dramatically decrease after several days, but it will take six months to a year for the nose to be finalized in its appearance. Some bruising usually appears after the surgery around the eyes and cheeks and occasionally on the dorsum of the nose, too. The discoloration will fade after ten days.
Some sutures may need to be removed if there were incisions placed on the outside of the nose. The sutures on the inside of the nose will dissolve and do not need to be removed.
Sometimes it is necessary to inject steroids in the tip of the nose to help remove localized areas of swelling that may not resolve after surgery. This injection rarely has to be done more than twice.
Always discuss the risks of rhinoplasty surgery directly with your board-certified cosmetic surgeon.
Always discuss pre-operative instructions directly with your surgeon. However, as a general guide, follow the rhinoplasty pre-operative instructions below:
- Arrange for someone to take you home, stay with you – attentive to your needs for assistance in walking, eating, and bathing – after the operation for the first 48 hours if you are having any anesthesia.
- Do not eat or drink anything after midnight the night before the operation (or as instructed by your anesthesiologist). If you are likely to be nauseated, consult with your surgeon about medications you can take before surgery.
- Wash your face and shampoo your hair the morning of surgery, but do not applymakeup to your face.
- Wear comfortable clothes that are loose and easy to put on. Leave valuables at home.
- Take medications with only a sip of water as directed by your surgeon.
- Take no aspirin, ibuprofen, blood-thinning medications, or vitamin E two weeks before surgery, unless otherwise directed by your surgeon.
Always discuss post-operative instructions directly with your surgeon. However, as a general guide, follow the rhinoplasty post-operative instructions below:
- Keep head elevated on two pillows while sleeping for two weeks.
- Apply ice to the eyes and cheeks for the first 24 hours. Do not place the ice so as to cause pressure on the nose.
- No strenuous activity for four weeks. No lifting heavier than ten pounds for four weeks.
- Do not wear contacts for the first week after surgery. Glasses must be kept off the nose for four weeks. They may be taped to the forehead to avoid causing pressure on the nose.
- Eat a balanced diet as you desire, but you may want to eat only lightly the first day after surgery.
- Take one multiple vitamin with iron (on a full stomach) and 1,000 mg of vitamin C, in four 250 mg doses, daily for six weeks following surgery.
- Take anti-nausea medication as prescribed if nausea occurs.
- Keep incisions clean with hydrogen peroxide three times daily, then apply an antibiotic ointment to the incision after each cleaning.
- You may wash your hair and face the day after surgery, but do not allow the water to hit your face directly for one week.
- Avoid sneezing. Do not blow your nose for two weeks. If you must sneeze, keep your mouth and lips open.
- Avoid sun exposure for one month, as solar exposure will cause pigmentation changes.
- Call if:
- pain is not relieved with prescribed pain medications
- bleeding continues to saturate the cotton or gauze pads
- swelling is asymmetric (uneven) or sudden over one to two hours
- temperature is greater than 101.0°F by mouth
- nausea and vomiting persist, despite taking anti-nausea medication
- Take medications as directed.
Get the Best Rhinoplasty in Denver
If you’ve been searching for ‘rhinoplasty denver,’ we have the answer! There are few cosmetic facial surgeons in Denver, if any, with more training and experience than Randolph C. Robinson, MD, DDS, FAACS. Schedule your free cosmetic consultation today to discuss the details of your rhinoplasty procedure at Robinson Cosmetic Surgery.