NOSE JOB (RHINOPLASTY) SURGERY IN AFRICA
OVERVIEW:
Rhinoplasty (RIE-no-plas-tee) is surgery that changes the shape of the nose. The motivation for rhinoplasty may be to change the appearance of the nose, improve breathing or both. The upper portion of the structure of the nose is bone, and the lower portion is cartilage. Rhinoplasty can change bone, cartilage, skin or all three. Talk with your surgeon about whether rhinoplasty is appropriate for you and what it can achieve. When planning rhinoplasty, your surgeon will consider your other facial features, the skin on your nose and what you would like to change. If you’re a candidate for surgery, your surgeon will develop a customized plan for you.
Sometimes part or all of a rhinoplasty is covered by insurance.
CONSULTATION
Before scheduling rhinoplasty, you must meet with your
surgeon to discuss important factors that determine whether
the surgery is likely to work well for you. This meeting generally
includes:
- MEDICAL HISTORY AND EXAM
The most important question your doctor will ask you is about
your motivation for surgery and your goals. Your doctor will
also ask questions about your medical history — including a
history of nasal obstruction, surgeries and any medications you
take. If you have a bleeding disorder, such as hemophilia, you
may not be a candidate for rhinoplasty.
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A PHYSICAL EXAM
Your doctor will conduct a complete physical examination,
including any laboratory tests, such as blood tests. He or she
also will examine your facial features and the inside and outside
of your nose. The physical exam helps your doctor determine
what changes need to be made and how your physical features,
such as the thickness of your skin or the strength of the cartilage
at the end of your nose, may affect your results. The physical
exam is also critical for determining the impact of rhinoplasty on
your breathing.
PHOTOGRAPHS
Someone from your doctor’s office will take photographs of your
nose from different angles. Your surgeon may use computer
software to manipulate the photos to show you what kinds of
results are possible. Your doctor will use these photos for beforeand- after assessments, reference during surgery and long-term
reviews. Most importantly, the photos permit a specific discussion
about the goals of surgery.
A DISCUSSION ON YOUR EXPECTATIONS
You and your doctor should talk about your motivations and
expectations. He or she will explain what rhinoplasty can and
can’t do for you and what your results might be. It’s normal to
feel a little self-conscious discussing your appearance, but it’s
very important that you’re open with your surgeon about your
desires and goals for surgery.
If you have a small chin, your surgeon may speak with you
about performing a surgery to augment your chin. This is
because a small chin will create the illusion of a larger nose.
It’s not required to have chin surgery in those circumstances,
but it may better balance the facial profile.
Once the surgery is scheduled, you’ll need to arrange for
someone to drive you home if you’re having an outpatient
surgery. For the first few days after anesthesia, you may have
memory lapses, slowed reaction time and impaired judgment.
So arrange for a family member or friend to stay with you a
night or two to help with personal care tasks as you recover
from surgery
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HOW TO PREPARE FOR A RHINOPLASTY?
FOLLOW MEDICATION DIRECTIONS
FOOD AND MEDICATIONS
Avoid medications containing aspirin or ibuprofen for two
weeks before and after surgery. These medications may
increase bleeding. Take only those medications approved or
prescribed by your surgeon. Also avoid herbal remedies and
over-the-counter supplements.
If you smoke, stop smoking. Smoking slows the healing process
after surgery and may make you more likely to get an infection.
ARRANGE FOR HELP DURING RECOVERY
If your Rhinoplasty is done as an outpatient, make plans for
someone to drive you home after surgery and stay with you the
first night after surgery.
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DURING THE PROCEDURE
Rhinoplasty requires local anesthesia with sedation or general
anesthesia, depending on how complex your surgery is and
what your surgeon prefers. Discuss with your doctor before
surgery which type of anesthesia is most appropriate for you.
•Local anesthesia with sedation. This type of anesthesia
is usually used in an outpatient setting. It’s limited to a
specific area of your body. Your doctor injects a painnumbing medication into your nasal tissues and sedates
you with medication injected through an intravenous (IV)
line. This makes you groggy but not fully asleep.
• General anesthesia. You receive the drug (anesthetic) by
inhaling it or through a small tube (IV line) placed in a vein
in your hand, neck or chest. General anesthesia affects
your entire body and causes you to be unconscious during
surgery. General anesthesia requires a breathing tube.
• Rhinoplasty may be done inside your nose or through
a small external cut (incision) at the base of your nose,
between your nostrils. Your surgeon will likely re-adjust
the bone and cartilage underneath your skin.
• Your surgeon can change the shape of your nasal bones
or cartilage in several ways, depending on how much
needs to be removed or added, your nose’s structure, and
available materials. For small changes, the surgeon may
use cartilage taken from deeper inside your nose or from
your ear. For larger changes, the surgeon can use cartilage
from your rib, implants or bone from other parts of your
body. After these changes made, the surgeon places the
nose’s skin and tissue back and stitches the incisions in
your nose.
• If the wall between the two sides of the nose (septum) is
bent or crooked (deviated), the surgeon can also correct it
to improve breathing.
• After the surgery, you’ll be in a recovery room, where the
staff monitors your return to wakefulness. You might leave
later that day or, if you have other health issues, you might
stay overnight.
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AFTER THE PROCEDURE
After the surgery you need to rest in bed with your head raised
higher than your chest, to reduce bleeding and swelling. Your
nose may be congested because of swelling or from the splints
placed inside your nose during surgery.
In most cases, the internal dressings remain in place for one
to seven days after surgery. Your doctor also tapes a splint to
your nose for protection and support. It’s usually in place for
about one week.Slight bleeding and drainage of mucus and old blood are
common for a few days after the surgery or after removing the
dressing. Your doctor may place a “drip pad” — a small piece
of gauze held in place with tape — under your nose to absorb
drainage. Change the gauze as directed by your doctor. Don’t
place the drip pad tight against your nose.
To further lower the chances of bleeding and swelling, your
doctor may ask that you follow precautions for several weeks
after surgery. Your doctor may ask you to:
• Avoid strenuous activities such as aerobics and jogging.
• Take baths instead of showers while you have bandages on
your nose.
• Not blow your nose.
• Eat high-fiber foods, such as fruits and vegetables, to
avoid constipation. Constipation can cause you to strain,
putting pressure on the surgery site.
• Avoid extreme facial expressions, such as smiling or laughing.
• Brush your teeth gently to limit movement of your upper lip.
• Wear clothes that fasten in the front. Don’t pull clothing,
such as shirts or sweaters, over your head. to prevent
pressure on your nose. You can use cheek rests or tape the
glasses to your forehead until your nose has healed.
• Use SPF 30 sunscreen when you’re outside, especially on
your nose. Too much sun may cause permanent irregular
discoloration in your nose’s skin.
RESULTS
Very slight changes to the structure of your nose – often measured in millimeters – can make a large difference in how your nose looks. Most of the time, an experienced surgeon can get results both of you are satisfied with. But in some cases, the slight changes aren’t enough, and you and your surgeon might decide to do a second surgery for further changes. If this is the case, you must wait at least a year for the follow-up surgery, because your nose can go through changes during this time.
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