Surgery of the nose is one of the most common of all plastic surgery procedures. There are individuals who have been unhappy with the appearance of their nose for their whole life, and there are individuals who have had their nose altered as a result of injury. Rhinoplasty offers a solution to these individuals. The best candidates for a rhinoplasty are those people who are looking for an improvement in the way they look, not those searching for perfection. There are many ways rhinoplasty can improve upon one’s nasal appearance. This surgery can reduce or increase the overall size of your nose, change the shape of the tip or bridge, narrow or widen the nostrils. Not only can rhinoplasty enhance appearance, it can also help improve one’s breathing. The consultation is an important part of the process because it allows the doctor to examine the current state of the nose and determine what can be done to enhance its appearance.
The rhinoplasty procedure usually takes an hour or two, though more complicated procedures may take longer. The surgery starts with the skin of the nose being separated from its supporting framework of the bone and cartilage, which is then sculpted to the desired shape. The skin is then redraped over the new framework. After the surgery is complete, a splint is then applied to help the nose maintain its new shape. Nasal packs or soft splints may be placed in the nostrils to stabilize the septum; this is the dividing wall between the air passages.
After surgery, during the first twenty-four hours, the face will feel puffy, the nose may ache, and the patient may experience a dull headache. The patient should plan on resting with their head elevated for the first day. There will be swelling and bruising around the eyes, reaching a peak after two to three days. By the end of one week all packing, dressings, splints and stitches should be removed and the patient is able to return to school or work. It will be a few weeks following surgery before patients can resume more strenuous activities. Healing times vary with patients.
Pre / Post Operative Instruction For Rhinoplasty
BUFFERED HYPERTONIC SALINE NASAL IRRIGATION
- When you irrigate, the hypertonic saline (salt water) acts as a solvent and washes out mucus crusts and other debris from your nose.
- The higher salt concentration pulls fluid out of the swollen membranes and shrinks them. This decongests them and improves airflow into your nose. This sinus passage begins to open.
- Studies have also shown that high concentration salt water and an alkaline irrigation (baking soda) improves nasal membrane cell function (Mucocilliary flow of mucus debris).
- Choose a one-quart glass Jar that is thoroughly cleansed- Fill with tap water. You do not need to boil the water or you may use bottled water.
- Add a heaping teaspoon of pickling/canning (rock) salt; do NOT use table salt as it contains a large number of additives. Add one teaspoon Arm & Hammer Baking Soda (Pure bicarbonate).
- Mix ingredients together and store at room temperature. Discard after one week. If you find this solution too strong, you may decrease the amount of salt added to 1 to 1 ½ teaspoons. With children it is often best to start with a milder solution and advance slowly.
You should plan to irrigate your nose with buffered hypertonic saline 2-3 times per day. You may use a bulb/ear syringe. Large medical syringe (30 cc) or water pick with irrigation tip. Always pour the amount of fluid you plan to Use into a clean bowl. Do not put your used syringe back into the quart jar because it contaminates your solution. Many people preheat to warm the solution slightly in microwave - But be sure that the solution is NOT HOT. Stand over the sink (some people do this In the shower) and Squirt the solution Into each side of your nose with the stream toward the back of your head. Do not aim towards the top of your head. This allows you to spit the saltwater out of your mouth. It will not harm you if you swallow a little.
For younger children you may want to place the solution into a pump spray container sort of as “ocean spray” or “nasal steroid” container and squirt several times into each side of the nose. Do NOT force your child to lay down. It is much easier to do in a sitting position.
If you have been told to use a nasal steroid such as Vancenase, Beconase, Flonase, or Nasacort, you should always use hypertonic saline solution first and then use your nasal steroid product. The nasal steroid is much more effective when sprayed onto clean nasal membranes and the steroid medicine will reach deeper Into the nose.
Most people experience a little burning sensation the first few times they use hypertonic nasal solution, but this usually goes away in a few days. Please call our office if you have any questions or problems.