Surgery of the Nose
Patients who are considering nasal surgery should consult with a physician who is a specialist in nasal airway function, as well as plastic surgery. This will ensure that efficient breathing is as high a priority as appearance. [ top ] Bruising around the eyes or a deformity following a nasal injury usually indicate a fractured nose. If the bones are pushed over or out to one side, immediate medical attention is ideal. However, once soft tissue swelling distorts the nose, waiting 3-5 days for an appointment with a facial plastic surgeon / otolaryngologist may actually help the physician in evaluating the extent of the injury as the swelling recedes. Head elevation and ice application for 3 days following the injury help to reduce and minimize bruising and swelling. What's most important is whether the nasal bones have been displaced, rather than just fractured or broken. In rare instances, a hematoma (collection of blood) may accumulate around the cartilage, depriving it of its nutrient blood supply. This would require immediate drainage. For markedly displaced bones, surgeons often attempt to return the nasal bones to a straighter position under local or general anesthesia with a procedure called a closed reduction. This is usually done within 7-10 days after the injury, so that the bones do not heal in a malaligned position. Sometimes the fractures are irregular, and won't simply "pop" back into place. Displacement due to injury often results in compromised breathing so corrective nasal surgery, called a septorhinoplasty, may be performed 3 months later as needed.
This procedure is typically done on an outpatient basis, and patients may return to work in 7-10 days when the swelling and bruising have resolved. Can Cosmetic Nasal Surgery Create a "Perfect Nose"? Aesthetic nasal surgery (rhinoplasty) refines the shape of the nose, bringing it into balance with other facial features. Because the nose is the most prominent midline facial structure, even a slight alteration can greatly improve appearance.
Rhinoplasty alone cannot give you a perfect profile, make you look like someone else, or improve your personal life. Patients should have a clear realistic understanding of what changes are possible as well as the limitations and risks of the surgery. Skin type, ethnic background, and age are important factors considered during the consultation with the facial plastic surgeon / otolaryngologist. Except in cases of severe breathing impairment, young patients usually are not candidates until their noses are nearly fully grown, usually between the ages of 14 & 17. The surgeon will also discuss risk factors, which are generally minor, as well as where the surgery will be performed: in a hospital, freestanding outpatient surgical center, or a certified office operatory. To reshape the nose the skin and soft tissue envelope is lifted, allowing the surgeon to remove or rearrange the bone and cartilage. The skin is then redraped over the new nasal framework. A cast is placed over the bridge of the nose to help retain its new shape during the healing process. A nasal splint is placed inside the nose to stabilize the septum. Both are removed one week following surgery.
Millions of Americans suffer the discomfort of nasal stuffiness. This may be indicative of chronic breathing problems that have not responded to medical therapy such as decongestants, antihistamines, and nasal steroid sprays. The blockage may be related to structural abnormalities inside the nose or swelling caused by allergies or viral infections. There are numerous causes of nasal obstruction. A deviated septum (the midline wall of the nose made of bone and cartilage) can be crooked or bent as the result of abnormal growth or injury. This can partially or completely close one or both nasal passages.
Overgrowth of the turbinates is yet another cause of nasal stuffiness. (The turbinates are the "air conditioners" of the nose - they warm, filter & humidify the air we breathe.) Sometimes enlarged turbinates need treatment to make them smaller and expand the nasal passages. If medical therapy has failed, surgery to reduce their size may be performed. Allergies, too, can cause swelling of the intranasal membranes. Consequently, allergy evaluation and treatment may be necessary.
Can Surgery Correct a Stuffy, Aging Nose? Aging is a common cause of nasal obstruction. This occurs when cartilage in the nose and tip are weakened by age and droop because of gravity, causing the sides of the nose to collapse inward, obstructing air flow. Mouth breathing, snoring, or noisy and restricted breathing are common. If breathing is improved when you lift the tip of your nose, external adhesive nasal strips that athletes have popularized may be of benefit. Another option would be to seek consultation with a facial plastic surgeon / otolaryngologist about septoplasty, which will involve trimming, reshaping, or repositioning portions of septal cartilage and bone. This is an ideal time to make other cosmetic improvements as well. Internal splints or dissolvable dressings may be placed to maintain the septum in its new position. Patients experience some swelling for a week or two. However after the splints are removed, most people enjoy a dramatic improvement in breathing.
Will Insurance Cover Nasal Surgery? Insurance usually does not cover cosmetic surgery. However, surgery to correct or improve breathing function, major deformity, or injury is frequently covered in whole or in part. Patients should consult with their insurance carriers prior to surgery. Author: Todd A. Morrow, MD, FACS e-mail: info@tomorrowsface.com [ top ] |
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