Nose Surgery (Rhinoplasty):

The eyes and mouth are communication centers of the face, intellect and personality. The nose must be in proportion and harmonize with the eyes and mouth. Therefore, reguardless of age, the nose is one of the most important cosmetic features of a person's face. Teenagers, men and women who are dissatisfied with the shape or size of their noses can improve their appearance through a procedure called rhinoplasty. Nasal reconstruction, and rhinoplasty, was one of the first cosmetic procedures ever developed and is among those most frequently performed today. Rhinoplasty is a surgical procedure in which deformities of the nose are corrected by removing, rearranging augmenting or reshaping bone or cartilage.

Typical reasons for this surgery are to improve the angle, reduce the width of the nose, or remove a hump. These conditions may be the result of natural causes or external trauma to the face. Both profile and frontal face views can be altered through rhinoplasty. The surgery can be performed in conjunction with procedures designed to relieve nasal obstructions. It is not usually performed, however, until a person has reached the mid-teenage years when growth is nearly complete. The exception would be correction of a cleft lip related nasal deformity.

BEFORE SURGERY
Prior to surgery, a medical history is taken in order to evaluate the general health of the patient. A careful examination is also conducted. Dr. Gordon and patient discuss together how the nose should look in relation to the patient's other facial features. It is important for the patient to understand that the goal of the surgery is not to achieve perfection, but rather, to improve the appearance. Digital photography and imaging of the nose allow Dr. Gordon and his patient to evaluate the appropriate procedure to achieve the desired results. The type of anesthesia to be used, the procedure and possible risks, and complications are also discussed. Pre-operative instructions may include the elimination of certain drugs that contain aspirin in order to minimize the possibility of excessive bleeding. Antibiotics will be prescribed before surgery to prevent infection.

THE PROCEDURE
Rhinoplasty can be performed at the accredited Complete Cosmetic Surgery Center or at Spring Valley Hospital, depending upon the patient and Dr. Gordon’s preference. It is done under general anesthesia with the patient asleep. Pre-medication may be administered to relax the patient.

The procedure is determined by the type of correction to be made. In most cases, incisions are made inside the nose. Working through these incisions, Dr. Gordon is able to cut bone and cartilage, the soft, movable tissue inside the nose, to reshape it. Many times septal cartilage is used to graft & improve appearance, or projection.

To remove a nasal hump, a special file or chisel is used. Bringing together the bones on either side of the face then forms a narrower nasal bridge. In a patient who has a nasal tip that is too large, cartilage is removed or reshaped through the inside incision. The angle between the nose and the upper lip can be improved by elevating or lowering the bottom part of the nose (columella).

In some cases, it is necessary to narrow the base of the nose. This procedure involves removal of skin from both sides of the nostrils at the center. In order to improve the contour of the noses of some patients, it is sometimes necessary to add tissue. These procedures can last from one and a half to two hours or more depending upon the extent and complexity of surgery.

FOLLOWING SURGERY
Following surgery, a lightweight splint is applied to maintain the new shape of the nose. The splint is usually removed in five to nine days. Sometimes a second splint is applied for several more days. Nasal packs are sometimes inserted at the time of surgery to protect the septum. This packing is removed within a day or two. There is frequently some stuffiness of the nose, particularly when work has been done on the nasal septum. Dr. Gordon will advise you when it is permissible to gently blow the nose.

Pain connected with the surgery is minimal to moderate and is controlled with oral medication. Bruising around the eyes occurs but begins to fade within a few days. Discoloration usually disappears in two to three weeks. Swelling around the treated areas slowly diminishes and can be reduced by keeping the head in a slightly elevated position when reclining. You will be given an assortment of homeopathic medications which will significantly reduce swelling and bruising. Cold compresses are helpful during the first 24 to 48 hours. Swelling will be present for at least two to four months. Your final result will take 12 to 18 months! Dr. Gordon will advise you.

During the healing process, great care must be taken to protect the nose from injury. Eyeglasses should be adjusted in order to minimize pressure on the nose. Dr. Gordon will advise you if contact lenses should be worn. Although patients are usually up and around a day or two after the procedure, strenuous exercises, particularly those which might elevate blood pressure, must be avoided for two weeks. Dr. Gordon determines when normal activities can be resumed.

HOW MUCH IMPROVMENT CAN BE EXPECTED?
The amount of improvement is individual and depends upon the starting point and extent of surgery. In some cases, as when a badly misshapen nose is reconstructed, dramatic results may be obtained. On the other hand, the removal of a slight bump may produce very subtle yet satisfying results. Final results may not be apparent for one year or more.

Each year thousands of rhinoplasties are successfully performed on people who want to change the size or shape of their noses. Complications connected with rhinoplasty are rare; however, there are some inherent risks connected with every surgical procedure. Possible risks and complications will be thoroughly discussed by Dr. Gordon. Patients can minimize complications by carefully following Dr. Gordon's directions, and calling the office promptly if a question or problem arises.