Cosmetic surgery of the nose, or rhinoplasty, is a procedure to improve the appearance of the nose. The nose is the most central, most prominent feature of the face and a major factor in defining balance and harmony among facial features. When the nose is out of proportion with other facial features, or the nose does not complement the face, it can affect self-image and confidence. If you are bothered by the size or shape of your nose, then cosmetic surgery of the nose may be right for you.
Specific features addressed by Dr. Waslen during your consultation include nose size, width, profile, nasal tip, nostrils, and nasal asymmetry. In some cosmetic cases, the characteristics of the nose are not the only factors contributing to facial imbalance. The facial structure – especially a small chin, weak cheeks and/or lower jaw – may also contribute to imbalanced facial proportions. In these cases, surgery of the nose may be performed in conjunction with placement of facial implants to achieve overall facial harmony.
Through the use of photography and specialized computer resources, our unique digital imaging tool allows you to actually preview achievable surgical results with Dr. Waslen during your consultation. For more information, please see our Digital Imaging page.
Preparing for Surgery
2 Weeks before surgery
- Avoid all aspirin containing products, all anti-inflammitory medications (ie: Ibuprophen such as Advil or Motrin), all products containing 400 IU's of vitamin E and all herbal products. These products can increase bleeding both during and after surgery and may lead to increased post-operative bruising, swelling and recovery time.
- Stop or at least cut down on smoking. Smoking constricts small blood vessels causing delayed healing, increased scarring and increased recovery time.
- Begin taking a multivitamin tablet daily, which can speed healing and shorten recovery time. It is recommended to continue your multivitamin for one month following surgery.
- Arrange for transportation to and from surgery. You must have someone responsible pick you up and remain with you for a minimum of 24 hours. You cannot take a taxi home on your own.
- It is recommended to restrict activity for approximately 2 weeks following surgery. It is advisable to make arrangements for assistance.
- Avoid dental appointments 2 weeks prior to your surgery as well as 2 weeks post operatively.
- Arnica capsules or pellets can be taken orally starting 2 days before surgery and can continue for 5 days post op. This homeopathic medication can assist in decreasing bruising and swelling due to surgery.
24 hours before surgery
- Avoid alcohol or smoking.
- Nothing to eat or drink after midnight the night before your surgery (no water, no gum). If surgery is booked after 12 noon, clear fluids may be allowed up to 6 hours before surgery (ie: black coffee/tea, clear juice, water). Our nurse will advise you on this when you are given your time for surgery.
Day of surgery
- Wear loose, comfortable button-up/zipper clothing (ie: jog suit, slip on shoes).
- Leave valuables at home (remove contact lenses, jewellery or piercing of any kind).
- Take any regular prescribed medications (ie: blood pressure medications) with a small amount of water.
Rhinoplasty is usually performed using a small incision made across the columella, the narrow strip of tissue that separates the nostrils. Through the incision, the soft tissues that cover the nose are gently raised, allowing access to reshape the structure of the nose.
Surgery of the nose can reduce or augment nasal structures with the use of a cartilage graft. Once the underlying structure of the nose is sculpted to the desired shape, nasal skin and tissue is redraped and incisions are closed. Additional incisions may be placed in the natural creases of the nostrils to alter their size.
- Some pain and nausea can be expected. This can be relieved with anti-pain and anti-nausea medications. Take them as directed. If you are coming from out of town, please have these medications with you.
- Begin taking antibiotic medication once home from surgery and continue until the prescription is finished.
- Any bandages worn post-operatively should be comfortable and not too tight. Adjust as necessary.
- Use cold compresses 20 min on and off during waking hours. Use a facecloth soaked in ice water and drape over face. Never place ice directly on skin.
- Maintain a regular fluid intake during the day. Gatorade is a good option. Restrict fluids after supper; increased fluid intake will increase swelling.
- Rest is important to minimize pain, nausea and swelling.
- Try to maintain an upright sitting position at all times (ie: 25-45 degree angle) for the first 2-7 days post-op. This will assist in the reduction of post-operative swelling and speed healing time.
- Begin a light nutritional regime and increase food intake as tolerated.
- Take anti-pain medications with food to avoid an upset stomach. Begin taking antibiotic medication once home from surgery and continue until prescription is finished. Eat yogurt while taking antibiotics. If diarrhea occurs, stop antibiotics and call our office for further direction.
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Post-operative Day 1
- You may remove the bandage and shower if you wish. Remove all gauze.
- Be aware of any unusual swelling or a sudden increase in pain. If either of these are noted, phone the office as soon as possible.
- Continue to maintain a regular fluid intake during the day, decrease after supper.
- Continue to maintain an upright position.
- Use cold compresses for 72 hours to decrease swelling (ie: ice cubes or ice chips in a bowl of cold water with facecloths).
- Be aware of decreased skin sensation. Do not apply excessive heat or cold to the operative areas.
- Do not smoke.
- Rest as much as possible.
- A nurse will call you by noon to assess how you are doing. At this time, you will be given further post-operative instructions as well as an appointment for your first post-operative visit.
Post-operative Days 2-7
- Continue to maintain an upright position.
- Gradually increase your activity level after 7 days post-operatively. As individuals, everyone's post-operative healing phases will differ. Generally speaking, gentle exercise may resume at 10 days with moderate exercise resuming after 3 weeks. It is advisable to abstain from a full exercise regime until 6 weeks post-operatively.
- Scar tissue (firmness or hardening of operative tissues) may increase up to 6 weeks with the resultant softening of the tissues.
- Approximately 75% of swelling will diminish within 3 - 4 weeks. Any remaining swelling can take from 6 months to 1 year to absorb.
- Best results are usually not seen until 3 months following surgery.
- The final stages of healing are usually not complete until 1 year post-operatively.
Complications from Rhinoplasty are infrequent though may include bleeding, infection, skin numbness, scars and reaction to anesthesia.
A cast or tapes are used to support the nose for 5-7 days as it begins to heal. After surgery, some bruising and swelling will occur, but this will generally disappear within 7-10 days. It is often possible to return to work within one to two weeks.
Every surgical procedure involves a certain amount of risk. It is important that you understand the risks involved with this procedure. An individual's choice to undergo a surgical procedure is based on the comparison of risk to potential benefit. Although the majority of patients do not experience these complications, you should understand the potential complications.