Rhinoplasty refers to any reshaping of the nose. Rhinoplasty can be performed for cosmetic reasons or as part of a reconstruction after trauma, cancer resection, or congenital malformation. In this article, we will cover some basics about rhinoplasty and some considerations if you are considering having a rhinoplasty surgery.

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Regardless of the reason for rhinoplasty, there are two approaches – the open approach and the closed approach. The closed approach is generally undertaken when minimal changes are desired.

The closed approach involves making incisions just on the inside of the nose around the edges on one or both sides. Through these incisions, the surgeon is able to elevate the skin off the deeper supporting structure of the nose, the cartilage and bone, and effect the change that is desired. In the open approach, the same incisions are made and an additional incision is made through the skin of the middle part of the nose known as the columella. This incision, when healed, is barely perceptible. With the addition of the skin incision, the surgeon is able to lift the skin off the nose and have better access to the underlying structural supports.

This is often required in cases where more work must be done to the structure of the nose or extensive work is required to the tip of the nose. It is always necessary to consult with an experienced rhinoplasty surgeon to discuss the risks and benefits of the procedure before any surgery is to be performed. The most important thing to remember when considering rhinoplasty is that the function of the nose must be preserved regardless of what is changed with the appearance of the nose – simply put – you must be able to breath through your nose after surgery.

Other things to consider with rhinoplasty surgery include how long before you can return to normal activity, expected bruising and swelling, and will additional support material be needed. Depending on the extent of surgery, the bones of the nose may need to be repositioned. If this is the case, your surgeon may suggest that you stay away from contact activities for at least 6 weeks. As with any surgery, bruising and swelling are expected and are variable between patients. With an open approach rhinoplasty surgery, some swelling can be expected for up to a year after surgery. When dealing with reconstruction of the nose, and some cosmetic nasal procedures, it may be necessary to obtain additional support material for the nose. At times, this material can be obtained from the nasal septum, the middle part on the inside of the nose.

If this material is not adequate for the reconstruction needed, it may be necessary to obtain additional cartilage from either the ear or the ribs. If additional cartilage is necessary, this may prolong healing time and additional risks will need to be discussed.

Generally, rhinoplasty surgery is performed on an outpatient basis. There may be  a dressing on the outside of the nose and a dressing on the inside of the nose. The dressing on the inside of the nose is usually not uncomfortable and does not involve completely packing off the nose as some older procedures involved. The dressings are generally removed in about a week after surgery.

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