Your Rhinoplasty Procedure

The operation usually takes one to three hours. Once you're sedated, small incisions will be made.Through these incisions, the doctor will separate the skin from the underlying bone and cartilage. External incisions, virtually invisible once healed, are hidden in the creases of the nose.

Depending on the structure of your nose and the desired result, your surgeon may use one or more of these techniques:

• Narrow or widen the bridge
  
• Maneuver bone and cartilage to sculpt the new shape
  
• File or chisel excess bone at the hump
  
• Remove small wedges of skin to narrow the base of the nose
  
• Suture to narrow flared nostrils
  
• Trim cartilage at the tip
  
• Add nasal cartilage, or bone or cartilage from another part of your body, to build up the nose.

Once the nose is reshaped, the doctor will then redrape the skin and soft tissues over the new structure. He or she will probably apply an external splint and may place soft rubber or plastic splints or absorbent material inside the nose. These protect the nose from bumps, maintain the new shape, and keep the nasal structures in place during the early part of healing. Finally, the surgeon will put a gauze drip pad under your nose to absorb blood and mucus.

It used to be common practice for doctors to pack the nose with long strips of Vaseline-coated gauze. This was done to support the nose and prevent bleeding. However, it is usually uncomfortable for patients when it's time to remove the packing from the tender, healing nose. As a result, today there is a trend toward doctors not packing the nose, but rather using special suturing to support the nose and prevent bleeding.

After Your Rhinoplasty

You'll probably go home the same day of your surgery. Most doctors will want to see you the next day. If your nose was packed with gauze, it will probably be removed the first or second day after your surgery.Your doctor will likely instruct you to sleep only on your back with your head elevated for the first week after your surgery.You will be able to return to work or school in as li tt le as three days.

You'll visit the doctor again within a week for another follow-up appointment. At that time, splints will be gently removed. Sutures, if not the absorbable kind, may be removed.Take your eyeglasses to the visit. Some doctors advise taping your glasses to your forehead for several weeks or supporting them another way until the nose is healed.

You'll see a change in your nose immediately after surgery; however, complete healing can take six months to a year. It often takes this long for all the swelling to subside. In some cases, your friends and family may say they can't see any difference. Improvement can be subtle and gradual, but if you've chosen a first-rate surgeon, there will be imp ro vement that you'll be aware of even if others are not.

Cleaning the Skin on Your Nose

Until the splint is removed, about a week after surgery, you won't be able to clean your nose, inside or out. After the doctor removes the splint, you can gently clean the skin on your nose with a mild, nonabrasive cleanser or soap. Use co tt on or a soft sponge, not a terry washcloth, and don't scrub. Your doctor may suggest carefully cleaning the incision area just inside the nose with petroleum jelly on a clean Q-tip (not on your fingers), and using hy d ro gen p e ro xide on a Q-tip to clean the external incision.

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