What Happens During Rhinoplasty Surgery?

Rhinoplasty, a procedure aimed at correcting functional or cosmetic problems of the nose, can be categorized into two main types: the traditional surgical approach and the non-invasive option. Traditional surgical rhinoplasty is effective for addressing a wide range of issues, such as adjusting the size, shape, and symmetry of the nose, correcting lumps, bumps, flared or pinched nostrils, and rectifying crooked or asymmetrical features. On the other hand, the non-invasive approach offers a less intensive alternative, using techniques that can enhance the appearance of the nose without the need for surgery. This option is particularly appealing for individuals seeking improvements with minimal downtime.

If you’re considering having a rhinoplasty surgery, you may be curious about what exactly happens during the procedure. The rhinoplasty surgery usually takes one or two hours, but more complex work will require a longer surgery time. With the time needed to prepare and recover after the procedure, you should expect to spend a whole day at the surgical facility. You can either have the surgery at a hospital or at an outpatient clinic. The procedure will be mostly the same at both locations.

There are two main types of rhinoplasty: open and closed. Open rhinoplasty is typically used for more complex or extensive procedures, but there are very few differences between the two types. You should expect the same surgical procedure for both open and closed rhinoplasty. The surgery can usually be divided into five steps.

Step 1: Preparing for Surgery

You’ll have to check in at the surgical facility a couple of hours before your procedure. Before the day of the surgery, you’ll be given instructions on what to wear and what papers or forms to bring. You should wear loose, comfortable clothing that doesn’t need to be pulled over your head.

Before the surgery, you’ll wash your face thoroughly with a cleanser to remove any makeup, dirt, or oil on your skin. You shouldn’t apply any moisturizer or other creams. Your doctor will instruct you not to take any medication the day of your surgery, and you may have to stop taking some medications a few days or weeks before the procedure.

In the pre-operative holding room, the nurse will probably start an IV line to prep you for surgery. They may also administer a relaxing medication before you go into the operating room.

Step 2: Anesthesia and Sedation

When you arrive in the operating room, your doctors will administer general or local anesthesia. General anesthesia is more common for a rhinoplasty and will make you sleep through the surgery. It’s often administered both as a gas and through your IV.

With local anesthesia, your nose will be numbed, and you’ll be given a sedative. You’ll be awake for the surgery, but you’ll be very relaxed and feel no pain. You and your doctor will discuss which form of anesthesia is best before you go into surgery.

Your surgical team will use a pulse oximeter and an EKG throughout the entire surgery to monitor your vitals. They’ll be equipped to quickly handle any emergencies.

Step 3: Opening Up the Nose

Once the anesthesia has taken effect, your surgeon will make some incisions in your nose to open it up. If you’re having an open rhinoplasty, the surgeon will make incisions on the inside of your nose and on the columella, which is the strip of skin that separates the nostrils. If you’re having a closed rhinoplasty, your surgeon will only make incisions on the inside of your nose.

After making the incisions, your surgeon will raise the skin and other tissue on your nose to expose the bone and cartilage. This will let them rearrange and alter the structure of your nose.

Step 4: Rearranging the Tissue

Your surgeon will remove or rearrange the bone, cartilage, and tissue in your nose to achieve the desired shape. To smooth out a bump or to make the nose smaller, your surgeon may shave off some of the bone or cartilage. In some cases, they may have to break your nose and reset it to make it straighter or more symmetrical.

Your surgeon may need to add tissue to your nose to achieve the right shape. In this case, they may use a synthetic tissue or take tissue or cartilage from somewhere else on your body. Usually, they’ll remove some tissue from your ear, but they may also take some from your rib cartilage.

Step 5: Closing the Nose

When your surgical team has finished reshaping your nose, your doctor will close the incisions and stitch them up. Then, they’ll apply a bandage and splint to help with bleeding, bruising, and swelling. Before closing the surgical area, your surgeon may have to place some tubes inside your nose to support the nasal structure while it heals.

Most people are able to go home the day of their surgery. However, you may have to stay overnight in the hospital if there’s a risk of bleeding or complications. Once you’re ready to leave, a responsible friend or family member will have to drive you home and stay with you for a few days to assist you while you recover.

Dr. Andrew Jacono of the New York Center for Facial, Plastic, and Laser Surgery is a dual certified plastic surgeon. He is one of only a few surgeons to become board certified in both facial plastic and reconstructive surgery and in head and neck surgery. His New York facility offers a wide variety of surgical and nonsurgical cosmetic procedures.

If you’re interested in rhinoplasty or another surgery, you can learn more at his website: http://www.newyorkfacialplasticsurgery.com

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