Rhinoplasty: What Happens During the Surgery?

Rhinoplasty, commonly known as a nose job, is a surgical procedure designed to reshape or repair the nose. It can be performed for aesthetic reasons (cosmetic rhinoplasty) to improve the appearance of the nose or for functional reasons (functional rhinoplasty) to address breathing problems, such as those caused by a deviated septum. Rhinoplasty surgery is a highly skilled procedure that requires careful planning, precise execution, and a period of recovery.

If you’re considering rhinoplasty, it’s important to understand to know about :

1. Pre-Surgery Consultation

Before undergoing rhinoplasty surgery, you will have a consultation with your surgeon to discuss your goals, concerns, and the potential outcomes of the surgery. During this consultation, your surgeon will:

• Examine your nose and face: The surgeon will assess the structure of your nose, your facial features, and your skin type. They will evaluate whether you’re a good candidate for surgery.
• Review medical history: You’ll need to provide information about your medical history, including any previous surgeries, allergies, or medications you’re currently taking.
• Set realistic expectations: Your surgeon will explain the limitations of the surgery and provide you with a realistic understanding of the results.

In some cases, the surgeon may take photographs of your nose from different angles for planning and to show you a potential outcome based on your desired changes.

2. Preparing for Surgery

On the day of the surgery, you’ll need to follow preoperative instructions, which may include:

• Medication management: Your surgeon may advise you to stop certain medications (e.g., blood thinners like aspirin or ibuprofen) a few days before surgery to reduce the risk of bleeding.
• Arriving early: You’ll need to arrive at the surgical facility or hospital ahead of time to complete any necessary paperwork and prepare for the procedure.

3. Anesthesia

Rhinoplasty is usually performed under general anesthesia, which means you’ll be asleep and pain-free during the procedure. In some cases, local anesthesia combined with sedation may be used, especially for less invasive procedures or if the surgery is only targeting the nasal tip or cartilage.

• General anesthesia: This will put you completely to sleep during the surgery.
• Local anesthesia with sedation: This option numbs the area around the nose while you remain relaxed or lightly sedated.

4. Incision and Accessing the Nose

There are two main types of rhinoplasty incisions: open and closed. The method chosen depends on the extent of the surgery and the changes needed.

• Closed Rhinoplasty: In this technique, all incisions are made inside the nostrils, which means there are no visible scars. 
• Open Rhinoplasty: In this technique, the surgeon makes a small incision across the columella (the strip of skin between the nostrils), in addition to internal incisions inside the nostrils.

5. Reshaping the Nose

Once the incisions are made, the surgeon will begin to reshape the bones, cartilage, and tissues of the nose to achieve the desired result. Depending on the goals of the surgery, this may involve:

• Reducing the size of the nose: The surgeon may remove or sculpt excess bone or cartilage to make the nose smaller.
• Augmenting the nose: In some cases, the surgeon may use cartilage from the septum, ear, or rib, or synthetic implants to build up areas of the nose that are too small or recessed, such as the nasal bridge.
• Straightening the septum: If the patient has a deviated septum. Which can cause breathing issues the surgeon may straighten or reposition the septum to improve airflow.
• Reshaping the nasal tip: The surgeon may refine the shape of the nasal tip. Making it more lifted, defined, or balanced with the rest of the nose.

During this process, the surgeon will work with the underlying cartilage and bone structures and may use fine instruments to reshape them precisely to achieve the desired outcome. For those seeking functional improvements (such as breathing issues). The surgeon may also focus on improving airflow by correcting any structural problems inside the nose.

6. Closing the Incisions

After reshaping the nose, the surgeon will close the incisions using fine sutures. For closed rhinoplasty, the incisions are entirely inside the nostrils, so no external sutures are required. For open rhinoplasty, the surgeon will carefully stitch up the small incision across the columella to ensure the skin heals smoothly.

7. Post-Surgery Care and Recovery

Once the surgery is complete, you’ll be moved to a recovery room where you’ll be monitored until the effects of the anesthesia wear off. Here’s what to expect in the first few days after rhinoplasty:

• Nasal splints and dressings: You will typically have a splint or cast placed over your nose to support the new shape and protect it as it heals. There may also be packing inside the nostrils to help reduce swelling and bleeding.
• Swelling and bruising: It’s normal to experience swelling and bruising around the nose and eyes, which may last for several days to a week. Ice packs and head elevation can help reduce swelling.
• Pain management: You will likely be given pain medications to manage any discomfort. 
• Avoiding strenuous activities: You’ll need to avoid strenuous physical activities. The heavy lifting, and blowing your nose for several weeks to ensure proper healing.
• Follow-up appointments: You’ll have follow-up appointments with your surgeon to monitor your healing progress and ensure everything is healing correctly. 

8. Long-Term Results

While you may notice an improvement in the shape of your nose right away. The final shape will continue to evolve over several months as swelling fully resolves. It may take up to a year for your nose to completely heal and for the final results to be visible.

Final Thoughts

Rhinoplasty is a highly individualized procedure that can deliver both functional and aesthetic benefits. If you’re considering rhinoplasty, it’s important to choose a skilled and experienced surgeon who can guide you through the process and help you achieve your desired outcome. Be sure to have realistic expectations, and remember that the healing process takes time, but the results can be life-changing.