Also known as "nose reshaping" or simply as a 'nose job', rhinoplasty is a surgical procedure in which the nasal bones and cartilage are adjusted in size, shape and/or position for any one of a number of reasons, including-
- Repairing a deviated septum and a crooked nose.
- Realigning the nose in size and character to be more in harmony with the other facial features, gender identity or gender preference
- and many more
The nose, due to its position at the center of the face, plays a large role in anyone's appearance and self esteem. A small change or refinement may bring out attractive facial features. To achieve this, Dr Conrad works diligently with his clients prior to the surgery, using medical photographs to design a shape that balances their hopes and expectations with what looks most natural and appealing for them.
There are two types of Rhinoplasty surgery, Primary and Revision
Those wishing to correct cosmetic or structural issues with their noses for the first time, meaning they have never had surgery on their nose, are looking for what is known as Primary Rhinoplasty. This involves either realignment, removal, or addition of cartilage and tissue for cosmetic reasons or for correction of deformities that have resulted from injury. Always special attention is given to preserve or improve nasal breathing function.
The operation is usually performed under general anesthesia, with the patient safely asleep.
“A rhinoplasty, out of all the cosmetic operations performed on the human body, is the most challenging scientifically, technically and artistically. It can provide a rewarding experience for the surgeon and most importantly, immense patient satisfaction.” - Dr Conrad
A significantly large portion of Dr. Conrad's surgical practice is revision rhinoplasty, demanding from the surgeon vast experience and talent with the ability to choose and apply techniques designed to correct specific problems to gain the most optimal result.
There are patients in Dr. Conrad’s practice who have previously had multiple Rhinoplasty operations by more than one surgeon.
Nasal reshaping performed on individuals of African or Asian descent is frequently referred to as ethnic Rhinoplasty. Aesthetic goals in “Ethnic Rhinoplasty” are no different from those in Caucasian Rhinoplasty. In all cases regardless of the color of the skin it is aimed to achieve well defined nasal tip and nasal bridge with desirable width, length and size suitable for the patient’s gender.
Technical challenge in all the Rhinoplasty depends mainly on the character, thickness and elasticity of the skin and underlying soft tissue. These are the factors and not patients ethnicity that will influence the choice of the surgical method.
Open or Closed Rhinoplasty
Depending upon the nature of the needed nasal correction, the procedure may either be performed from within the nose through small incisions inside the nostrils or through a small incision across the columella, the vertical strip of tissue separating the nostrils. The choice of the method in the hands of an experienced and skilled surgeon is dictated by the patient's anatomical needs and should never be limited by surgeon's ability.
In most instances, the rhinoplasty operation is carried out with the patient fully asleep. In some cases, when a minor correction only is required, the patient is not totally anesthetized and local freezing is applied. Please discuss during the pre-operative visit the kind of anesthesia you will receive. The post-operative course is painless in most cases. Only occasionally may a pain-killing drug be required.
There are considerable differences in the amount of post operative swelling and bruising. It is expected to see minor discharge and nasal congestion which can decrease the comfort in breathing for a period up to two weeks. Post operative complications are rare and Dr. Conrad will discuss such possibilities during your consultation.
Use an antibiotic ointment, applied with a cotton tipped applicator, around the margins of the nostrils twice daily for the first seven days. This will decrease unpleasant crusting.
While your hair can be washed on the third day after your rhinoplasty surgery, you will need help to keep the nasal cast dry. Do not use excessively warm water and use a moderate heat setting with the blow dryer.
Post-operative nasal bleeding is rare and generally not difficult to stop. It can be precipitated by trauma, alcohol, smoking, or prolonged hot baths or showers.
Keep in Mind
Patients should remember that there is a limit to the corrective procedures possible or recommended. As much as a skillful and experienced surgeon will always aim to achieve perfection, the goal of the operation is an improvement and natural appearance. Some of the influencing factors in rhinoplasty are the contour and shape of the face, the texture and thickness of the skin, the inclination of the chin, lip and forehead, the depth of the angle between the forehead and the nose, the height and gender preference of the individual, and the healing characteristics of the tissues.
Finally, noses that have been severely injured (eg. sports, previous operations) present additional surgical challenge. A correction is possible in one operation in the vast majority of cases but at times, a short additional procedure is required.
People who normally have dark circles under the eyes may experience worsening of this condition, but it returns to its original state within a few months. A modern rhinoplasty employs a great number of complex and difficult manoeuvres. It is not surprising that there may be slight contour irregularities apparent only to the patient and the surgeon, but not noticed by others; these frequently disappear gradually. Not only skills, dedication and talent of the surgeon, but also a realistic, sensible attitude on the part of the patient are needed to make a rhinoplasty a successful treatment and without significant emotional stress to the patient.
Dr. Conrad allows adequate time to be spent with patients during pre-operative consultations to dispel misconceptions and answer their questions.