How a Rhinoplasty Is Performed

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Depending upon the correction needed or alteration desired, surgery may take anywhere from 1 hour to 2 1/2 hours. After you are sedated and your face has been sterilized and scrubbed with an iodine solution such as Betadine, the surgeon will make the appropriate incisions for access to the inner structure of the nose. Deeper, if a full rhinoplasty isbeing performed. If your surgery is for thinning the tip of the nose, sometimes called a Tiplasty, you may or may not have visible incisions say at the base of the septum on the columella. For open rhinoplasties, an incision usually in the shape of a Z is placed on the columella (the skin that separates the nostrils).

If you are having your nostrils narrowed you may have two incisions one on each side where the nose meets the face and forms a crease. The surgeon will normally take care to make the scars as inconspicuous as possible. Sometimes only incisions on the floor of the nose are made to bring in the nostrils.

If the nasal bone structure needs thinning you will have incisions leading up through the cartilage into the bridge of the nose so that a chisel like tool, called an osteotome, can be inserted and tapped manually with a rubber mallet (rubber hammer). This may take a few (usually no more than 8 sets of two, but this is highly individual) taps to break the nasal/facial bones precisely. The surgeon does not just clumsily break your nose with a hammer -- it is precisely carried out. If a hump is present, an osteotomy (where bone is divided or removed) is performed; t he dorsal hump can be rasped (filed down).

After the bones are broken, they are moved together to form a narrower nasal area as well as a little more projection, if needed. After all the reduction or infracture/outfracture methods have been carried out, the incision lines are then sutured and you may or may not have packing inserted. Your nose is then taped and a cast made from plaster, metal or more commonly, plastic, is applied to the nose to protect it and help it retain its new shape during the healing phase. The bones fuse together quite rapidly but refrain from contact sports until you receive the 'okay' from your doctor.

Your recovery from anesthesia is highly dependent upon the type you received for the operation. Many things can go wrong during initial recovery so this is an important thing to inquire about prior to your scheduling a surgery. The shivering and feeling cold is the least of your worries. Please read the below information and discuss the regarding your surgeon's anesthesia protocol.

* "Patients must be monitored during recovery to ensure that any adverse events are rapidly recognized and treated.
* Vital signs should be recorded at regular intervals and pulse oximetry should be continued until the patient is no longer at risk of hypoxemia.
* Monitoring should include observation by a person trained in recognition of post-procedure/post-sedation complications.
* Appropriate discharge criteria should be met prior to discharge.

When I begin to regain consciousness I feel very cloudy like my peripheral vision is gone temporarily and everything is of a white, blanched hue. I get emotional sometimes and this is very normal. Some patient cry, some are immediately back to normal but most report a sluggish feeling in their limbs and this will pass. You may think that you didn't even have your surgery because it feels as if you just went to sleep 5 minutes beforehand.

Some patients begin shivering and may become nauseated so alert one of the nurses if this is so. he or she can give you a warm blanket and a few sips of cool water to help stave the nausea or at least provide you with a receptacle in which to vomit.