Rhinoplasty

1) What are open and closed approaches for Rhinoplasty?

Ans:- in closed approach, incision for modifying nasal framework, are entirely inside the nose, no visible mark outside. In open rhinoplasty , the same inner incisions are connected externally either in mid columella (middle pillar of nose between nostrils when seen from basal view) or at lip columella Junction. Over the time they heal well and practically there is no visible scar in long term.

2) which rhinoplasty or nose job approach is preferable, open or close?

Ans:- preferred approach depends upon amount of work needed in any particular nose. Both can be done in any nose, close is preferred for minor modifications. Open approach provides clear view of entire nasal framework so fine manipulations are always better with this. All the incisions are kept inside nose in both approaches and not visible outside except that a mid collumellar incision or lip columella junction incision joins incisions of both sides in open approach. No noticeable scar in both cases.

3) How long the rhinoplasty or nose job surgery takes?

Ans :- may take one and half to two and half hours , depending upon amount of work needed.

4) General or local anesthesia for rhinoplasty or nose job ?

Ans:- local and nerve block anesthesia is sufficient for most of cases. Short term general anesthesia is used for osteotomy (cutting and inward mobilization) of nasal bones.
          For a complete Septo-rhinoplasty general anesthesia is preferable to local as its safer, more controlled and more comfortable for patient, also it allows surgeon to work in a comfortable environment which is most important for fine cosmetic and functional manipulations.

5) What manipulations usually done in rhinoplasty / Septoplasty / Septorhinoplasty or nose job.

Ans:- A complete rhinoplasty usually involves correction of bony and cartilaginous dorsum ( the part of base of nose visible in front view), tip correction ( narrowing or elevation) , correction of nostrils and lip nose relationship. Overall all work needed in a nose are done simultaneously, depending upon individual requirement.
In , septorhinoplasty, septum is dealt along with rest of nose, straightening, debulking etc are done , again decided by need of individual nose. Besides this septum provides the best possible source of cartilage for dorsum augmentation or tip work. so septoplasty is often added to rhinoplasty as it corrects septum as well as provides autogenous material for use in rest of procedure.

6) What about breathing difficulty in Rhinoplasty or nose job ?

Ans:- Nose has two valve areas , internal and external. In an otherwise normal looking nose , it’s the internal valve collapse which causes breathing difficulty and needs to be widen with spreader graft. In a nose with drooping tip, external as well as internal valves are affected and need correction.

7) Rhinoplasty Recovery After Surgery : How much is recovery time after Rhinoplasty or nose job surgery?

Ans:- surgery takes around two and half hours . recovery from general anaesthesia is almost instant after Rhinoplasty surgery. You may feel little tiredness for a few hours (2-3). Mobile and may take normal diet after 5-6 hours. Nose will be packed for 48 Hours. Discharge from hospital after 6-8 hours or next morning. Dressing on nose 7 days.
Your nose will look normal to others but you will feel swelling at 2 weeks.
After three weeks , nose looks almost normal , in newer shape, but mild ( undetectable) swelling is still there. It takes around three months before nose looks almost normal with all evidences of surgery resolved except very little amount of edema ( Swelling ) which is unnoticeable.

8 ) Any difference in Female & Male Rhinoplasty.

Ans : Male Rhinoplasty is always believed to be a separate entity , as male noses are usually more deformed also expectations in male is always more than females, their thick skin makes result late to appear. In our practice we see every nose as a different and individual entity be it male or female Rhinoplasty and contrary to the common belief in plastic surgery society our male patients are equally happy. In females skin is usually thin and shape of nose appears well after rhinoplasty.

9) what are materials used for nose augmentation?

Ans:- materials used for augmentation can be autogenous ( from patients own body) or artificial materials.
Autogenous :-
1. Cartilage:
from nasal septum—most commonly used.
conchal cartilage ( from ear)
or rib cartilage.
2. Bone:- pelvic bone ( iliac creast)
Calvarial ( outer table of skull )
Artificial materials:-
Medpore
Silicone
Goretex .

10) Which material is better autogenous or artificial ?

Ans: use of autogenous material is always better whenever available and applicable. use of artificial material is second choice. in most of noses remodeling of nose bony and cartilaginous framework itself is sufficient to give desired result, if not cartilage harvested from septum , or ear cartilage or any other option is chosen for. Among Implants silicone is more acceptable for dorsum and Medpore for paranasal augmentation. We usually dont use implants, if needed we use it in a different way so that Implant becomes incorporated part of nose rather than separate
      many people think cosmetic surgery always needs use of artificial material, its a big confusion, cosmetic surgery is surgery which is intended to improve your look when function problem is not there, in fact almost every cosmetic surgery involves improvement of both look and function.

11 ) Any rest required ?

Ans: yes, Rest for six hours after surgery, its better to take leave from work for 2-3 days, avoid exertion and heavy work for a week at least. There will be dressing on your nose for Seven (7) days if osteotomy has been done , for 5 days if not.