Nose Reconstruction (Rhinoplasty)

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KEY POINTS

• Nose reconstruction or rhinoplasty is procedure that can be done to change the shape of your nose.
• Tell your healthcare provider about all medicines and supplements that you take. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
• Every procedure or treatment has risks. Ask your healthcare provider how the risks apply to you

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What is nose reconstruction?

Nose reconstruction is procedure that can be done to change the shape of your nose.

Another name for this surgery is rhinoplasty.

When is it used?

This procedure may be done to improve the appearance, size, or angle of your nose. For example, it may make your nose smaller or larger. After the surgery you may feel better about how your nose looks.

This procedure may also be done to correct deformities and blockages caused by injury, disease, or birth defects. Sometimes it may be done to make it easier for you to breathe.

Your provider will talk to you about why you want the surgery, its risks, and the results you can expect.

How do I prepare for this procedure?

• Your healthcare provider will take photographs of your face and nose to help plan the operation.
• Follow your provider's instructions about not smoking before and after the procedure. Smokers may have more breathing problems during the procedure and heal more slowly. It is best to quit 6 to 8 weeks before surgery.
• You may or may not need to take your regular medicines the day of the procedure. Tell your healthcare provider about all medicines and supplements that you take. Some products may increase your risk of side effects. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
• Tell your healthcare provider if you have any food, medicine, or other allergies such as latex.
• Your provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
• Follow any other instructions your healthcare provider gives you.
• Ask your healthcare provider about your choices for treatment and any other questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for tests or procedures.

What happens during the procedure?

This procedure is usually done at an outpatient surgery center or at the hospital.

You will be given a local or general anesthetic to keep you from feeling pain. Local anesthesia numbs the part of your body where you will have the surgery. If you have local anesthesia, you may also be given medicine to help you relax. General anesthesia relaxes your muscles and you will be asleep.

Your healthcare provider will reshape the tissue and bone inside your nose. Most of the cuts will be made inside your nose so you won’t have much scarring on the outside of your nose. Sometimes a small cut is made on the bottom of the nose, where it attaches to the upper lip. This cut is not usually noticeable after you heal.

Sometimes bone or the tough, but flexible tissue (cartilage) between the nasal passages is removed from the nose. Bone or cartilage from another part of your body, or synthetic material may be used as a graft to help reshape your nose.

After your nose is reshaped, your healthcare provider may pack thin pieces of gauze into each side of your nose to control bleeding. You will have a small splint taped over your nose to hold the reshaped bones and cartilage in place. A small drip pad will be taped under your nose to catch any drainage or blood that seeps through the gauze.

The operation lasts 1 to 2 hours.

What happens after the procedure?

You may go home the same day as your surgery, or you may stay overnight in the hospital.

Sleep with your head up on at least 2 pillows, and limit your physical activity for a few days after surgery. This helps decrease swelling and the chance of bleeding.

Don’t push on your nose or jar it while it is healing. Don’t blow your nose. It’s OK to draw a breath back into your nose and swallow.

If you have packing in your nose:

• Your loss of smell will lessen your appetite. You may prefer a liquid or soft diet, but you can eat whatever you feel like eating. It’s best to avoid hot and spicy foods because they may increase bleeding.
• You will be breathing through your mouth until the packing is taken out of your nose. This will make your mouth dry, so drink lots of fluids.
• The packing will be removed in 1 to 7 days. After the packing is removed, don’t blow your nose for 48 hours. Also try not to cough too hard. Blowing your nose or coughing may start bleeding.

If you have a nosebleed, lean your head forward (so the blood does not go down your throat) and put gauze over your nostrils. If the bleeding does not stop within 10 minutes, call your healthcare provider. You may need to go to the emergency room to have the bleeding stopped.

You will keep the splint on your nose for 5 to 10 days.

For 1 to 2 weeks after surgery your face, nose, and eyes will be bruised, swollen, and discolored. Ice packs will help reduce the swelling, bruising, and discomfort. Your healthcare provider may prescribe a mild pain reliever and medicine to reduce drainage.

For a short time after the surgery, you may have trouble breathing because of a narrowing of the nasal passages, or you may have a weaker sense of smell.

After some of the swelling and bruising is gone, your healthcare provider may take pictures of your nose and face so that you have a before-and-after record of your operation. It may be weeks or months before you see the final improvement.

Follow your healthcare provider's instructions. Ask your provider:

• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

• You may have problems with anesthesia.
• You may have infection or bleeding.
• You may develop a hole in the septum. The septum is the wall dividing the 2 nostrils. The hole may cause crusting or bleeding from the edge of the septum or a whistling sound when you breathe in.

Ask your healthcare provider how the risks apply to you. Be sure to discuss any other questions or concerns that you may have.