Septorhinoplasty Procedure

Septorhinoplasty is performed to improve both the external appearance and internal breathing capabilities of the nose. Functional septorhinoplasty is among the most common procedures performed within the realm of Facial Plastic and Reconstructive Surgery.

Improving nasal airflow remains the fundamental goal of the procedure. Whereas rhinoplasty surgery focuses exclusively on the shape of the nasal exterior, septorhinoplasty incorporates modification of the nasal septum (the midline partition dividing the nose into left and right breathing chambers) into the surgical plan.

Cartilage safely obtained from the septum is precisely sculpted into structural grafts; these grafts are then incorporated into the nasal exterior framework to improve airflow.

In the course of obtaining these grafts, an oftentimes “deviated septum” is simultaneously corrected.

Goals of Surgery

Form and function are inextricably linked during surgery, for the esthetically pleasing nose must also breathe well. Areas of functional concern that are successfully and commonly improved with functional septorhinoplasty include:

  • Correcting the “deviated septum”
  • Straightening the “crooked” nose
  • Augmenting the width of the nasal bridge
  • Augmenting the height of the nasal bridge
  • Supporting the “droopy” nasal tip
  • Supporting “floppy” nostril cartilages
  • Increasing nasal projection
  • Increasing the width of the nasal base
  • Improving nasal breathing

Pre-Surgical Consultation

During the pre-surgical consultation, a detailed examination and analysis of the nose is performed.

Digital photographs of the nose are reviewed on our advanced computerized imaging software to facilitate communication of the changes desired and to illustrate the expected post-surgical outcomes.

A comprehensive surgical plan customized to address each patient’s cosmetic and functional concerns is ultimately developed and carefully explained.

Is Septorhinoplasty for You?

As with all facial plastic surgery, good health and realistic expectations are prerequisites. Understanding nose surgery is also critical.

Since there is no ideal in septorhinoplasty, the goal is to improve the nose aesthetically, making it harmonize better with other facial features.

Skin type, ethnic background and age are important factors to be considered in discussions with your surgeon prior to surgery.

Before the nose is altered, a young patient must reach full growth, usually around age 15 or 16. Exceptions are cases in which breathing is severely impaired.

Before deciding on septorhinoplasty, ask your facial plastic surgeon if any additional surgery might be recommended to enhance the appearance of your face.

Many patients have chin augmentation in conjunction with septorhinoplasty to create a better balance of features.

Making the Decision for Septorhinoplasty

Whether the surgery is desired for functional or cosmetic reasons, your choice of a qualified facial plastic surgeon is of paramount importance.

Many facial plastic surgeons are trained in both ear, nose, throat and facial cosmetic surgery, which provides you, the patient, with the highest level of training and expertise.

Your surgeon will examine the structure of your nose, both externally and internally, to evaluate what you can expect from septorhinoplasty.

Your surgeon also will discuss factors that may influence the outcome of the surgery, such as skin type, ethnic background, age, degree of deformity, and degree of function of nasal structures.

You can expect a thorough explanation of the surgeon’s expectations and the risks involved in surgery.

Following a joint decision by you and your surgeon to proceed with septorhinoplasty, the surgeon will take photographs of you and discuss the options available.

Your surgeon will explain how the nasal structures, including bone and cartilage, can be sculpted to reshape the nose and indicate how reshaping the chin, for example, could enhance the desired results.

After conducting a thorough medical history, your surgeon will offer information regarding anesthesia, the surgical facility to be used, and the costs for the procedure.

Understanding the Septorhinoplasty Procedure

The definition of septorhinoplasty is, literally, shaping the nose. First, incisions are made and the skin of the nose is lifted from its underlying bone and cartilage support system.

The majority of incisions are made inside the nose, where they are invisible. In some cases, an incision is made in the area of skin separating the nostrils.

Next, certain amounts of underlying bone and cartilage are removed or rearranged to provide a newly shaped structure. For example, when the tip of the nose is too large, the surgeon can sculpt the cartilage in this area to reduce it in size.

The angle of the nose in relation to the upper lip can be altered for a more youthful look or to correct a distortion.

The skin is then redraped over the new frame and the incisions are closed. A splint is applied to the outside of the nose to help retain the new shape while the nose heals.

Soft, absorbent material may be used inside the nose to maintain stability along the dividing wall of the air passages called the septum.

Risk factors in septorhinoplasty are generally minor, and your facial plastic surgeon will discuss these prior to surgery.

Surgical Approaches

Dr. Dresner routinely performs Initial (primary) septorhinoplasty and revision procedures for patients who have had previous nasal surgery.

There are two basic approaches, or methods, to surgically access the nasal framework. “Endonasal” approaches use incisions placed exclusively inside the nose. “Open” approaches also employ a small “gull wing” incision shaped like an upside-down letter “V” on the strip of skin in between the nostrils. The specific approach is determined for each individual patient by the techniques required to achieve the surgical goals discussed during the pre-surgical consultation.

All Septorhinoplasty carries some uncertainty and risk

When septorhinoplasty surgery is performed by a qualified plastic surgeon, complications are infrequent and usually minor.

Nevertheless, there is always a possibility of complications, including infection, nosebleed, or a reaction to the anesthesia.

You can reduce your risks by closely following your surgeon’s instructions both before and after plastic surgery.

After septorhinoplasty plastic surgery, small burst blood vessels may appear as tiny red spots on the skin’s surface; these are usually minor but may be permanent.

As for scarring, when septorhinoplasty surgery is performed from inside the nose, there is no visible scarring at all; when an “open” technique is used, or when the procedure calls for the narrowing of flared nostrils, the small scars on the base of the nose are usually not visible.

Incisions are made inside the nostrils or at the base of the nose, providing access to the cartilage and bone, which can then be sculpted into shape.

In about one case out of ten, a second procedure may be required for example, to correct a minor deformity. Such cases are unpredictable and happen even to patients of the most skilled surgeons.

The corrective surgery is usually minor.

Planning your Septorhinoplasty

Good communication between you and your physician is essential. In your initial consultation, the surgeon will ask what you’d like your nose to look like, evaluate the structure of your nose and face, and discuss the possibilities with you.

He or she will also explain the factors that can influence the procedure and the results.

These factors include the structure of your nasal bones and cartilage, the shape of your face, the thickness of your skin, your age, and your expectations.

Your surgeon will also explain the techniques and anesthesia he or she will use, the type of facility where the septorhinoplasty surgery will be performed, the risks and costs involved, and any options you may have like trimming the septum improves the angle between the nose and upper lip.

Most insurance policies don’t cover purely cosmetic surgery; however, if the procedure is performed for reconstructive purposes, to correct a breathing problem or a marked deformity following injury, the procedure may be covered.

Check with your insurer, and obtain pre-authorization for your plastic surgery.

Be sure to tell your surgeon if you’ve had any previous nose surgery or an injury to your nose, even if it was many years ago.

You should also inform your surgeon if you have any allergies or breathing difficulties; if you’re taking any medications, vitamins, or recreational drugs; and if you smoke.

Don’t hesitate to ask your doctor any questions you may have, especially those regarding your expectations and concerns about the results.

Post-Surgical Course

Septorhinoplasty surgery is generally performed on an out-patient basis under either conscious sedation or general anesthesia.

Patients are discharged with a cast over the nasal bridge and internal splints placed along the nasal septum.

The nose is not formally “packed.” A physician on our care team is always available to answer any post-surgical questions that may arise.

The cast and splints are removed one week after surgery, along with any sutures placed during open approach surgery.

Most patients return to work one week after surgery. Any bruising around the eyes that may occur typically resolves within two weeks post-operative.

Swelling peaks two to three days after surgery and gradually subsides thereafter. An appreciable reduction in swelling is evident at one month, but the nose will continue to heal for a full year after surgery.

Routine post-operative office visits are periodically scheduled for the year following surgery to ensure optimal healing.

Getting back to normal after your septorhinoplasty or Nose Surgery

A splint made of tape and an overlay of plastic, metal, or plaster is applied to help the bone and cartilage of the nose maintain their new shape.

Most septorhinoplasty patients are up and about within two days, and able to return to school or sedentary work a week or so following surgery. It will be several weeks, however, before you’re entirely up to speed.

Dr. Sertich will give you more specific guidelines for gradually resuming your normal activities.

They’re likely to include these suggestions: Avoid strenuous activity (jogging, swimming, bending, sexual relations any activity that increases your blood pressure) for two to three weeks.

Avoid hitting or rubbing your nose, or getting it sunburned, for eight weeks. Be gentle when washing your face and hair or using cosmetics.

You can wear contact lenses as soon as you feel like it, but glasses are another story. Once the splint is off, they’ll have to be taped to your forehead or propped on your cheeks for another six to seven weeks, until your nose is completely healed.

Dr. Sertich will schedule frequent follow-up visits in the months after surgery to check on the progress of your healing.

If you have any unusual symptoms between visits, or any questions about what you can and can’t do, don’t hesitate to call your doctor.

Your new look

After surgery, the patient has a straighter bridge, a well defined nasal tip, and an improved angle between the nose and upper lip.

In the days following surgery, when your face is bruised and swollen, it’s easy to forget that you will be looking better.

In fact, many patients feel depressed for a while after plastic surgery it’s quite normal and understandable. Rest assured that this stage will pass.

Day by day, your nose will begin to look better and your spirits will improve. Within a week or two, you’ll no longer look as if you’ve just had surgery.

Still, healing is a slow and gradual process. Some subtle swelling may be present for months, especially in the tip. The final results of plastic surgery may not be apparent for a year or more.

Understanding the Septorhinoplasty

The definition of septorhinoplasty is, literally, shaping the nose. First, incisions are made and the skin of the nose is lifted from its underlying bone and cartilage support system.

The majority of incisions are made inside the nose, where they are invisible. In some cases, an incision is made in the area of skin separating the nostrils.

Next, certain amounts of underlying bone and cartilage are removed or rearranged to provide a newly shaped structure.

For example, when the tip of the nose is too large, the surgeon can sculpt the cartilage in this area to reduce it in size.

The angle of the nose in relation to the upper lip can be altered for a more youthful look or to correct a distortion.

The skin is then redraped over the new frame and the incisions are closed. A splint is applied to the outside of the nose to help retain the new shape while the nose heals.

Soft, absorbent material may be used inside the nose to maintain stability along the dividing wall of the air passages called the septum.

Risk factors in septorhinoplasty are generally minor, and your facial plastic surgeon will discuss these prior to surgery.

What To Expect After the Septorhinoplasty

Immediately after surgery, a small splint will be placed on your nose to protect it and to keep the structure stable for at least five to eight days.

If packing is placed inside the nose during surgery, it is removed the morning following the surgery. Your face will feel puffy, especially the first day after surgery.

Pain medication may be required. Your surgeon will advise you to avoid blowing your nose for seven days after surgery.

In the immediate days following surgery, you may experience bruising and minor swelling in the eye area. Cold compresses often reduce the bruising and discomfort.

Absorbable sutures are usually used that do not have to be removed. Nasal dressing and splints are usually removed six or seven days after surgery.

It is crucial that you follow your surgeon’s directions, especially instructions to keep your head elevated for a certain period after surgery.

Some activities will be prohibited in the weeks after the procedure. Sun exposure, exertion and risk of injury must be avoided.

If you wear glasses, special arrangements must be made to ensure that the glasses do not rest on the bridge of the nose.

Tape and other devices are sometimes used to permit wearing glasses without stressing the area where surgery was performed.

Follow-up care is vital for this procedure to monitor healing. Obviously, anything unusual should be reported to your surgeon immediately.

It is essential that you keep your follow-up appointments with your surgeon.

Insurance does not generally cover surgery that is purely for cosmetic reasons. Surgery to correct or improve nasal function or surgery for major deformity or injury may be reimbursable in whole or in part.

It is the patient’s responsibility to check with the insurance carrier for information on the degree of coverage.

Source & More Info: sarhinoplasty.com and dresnerfacialplasticsurgery.com

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