Rhinoplasty Before and After[/caption]When people think of rhinoplasty, also known as nose surgery, most of them think of it as a strictly cosmetic procedure. In reality, rhinoplasty can be a useful tool for fixing real functional issues. When done well by a double board certified surgeon, both in facial plastic surgery & Otolaryngology (ENT) with a sub specialization in nose & sinus surgery, it can offer the best of both worlds: Better aesthetics alongside noticeably improved breathing.
What Is Rhinoplasty?
Rhinoplasty is a plastic surgery procedure in which the appearance of the nose is improved by changing its shape or size. Common problems that are often addressed include nasal humps, bulbous or prominent tips, nose deformities, and bridges that are too broad or narrow.
In order to achieve good aesthetic results during a rhinoplasty, Dr. Rubinstein insists on a pre-surgery consultation with each patient to be sure of the specific goals for the surgery. The examination will include a thorough intra nasal exam including nasal endoscopy which is typically covered by insurance. During this meeting, he’ll use a Canfield VECTRA 3-D imaging system to produce a model of the patient’s face. This will allow digital modifications to be made to the nose so that the patient can form realistic expectations of their results. Dr. Rubinstein will frequently divide the consultation into two visits. The first part is to get an idea of what the aesthetic goal is and for a detailed nasal exam both inside and out. Photos are taken at this time and a second visit is set up for 3D computer imaging and treatment planning. Patients will meet with Dr. Rubinstein’s patient care coordinator to go over price, as well as payment options, and a tour of our surgical facility. Patients living far away or abroad will frequently begin with a Skype or Face Time consultation followed by the actual face to face assessment the day before their surgery. Patients are expected to stay one week before they can fly home.
Combining Rhinoplasty with Sinus Surgery
During a rhinoplasty procedure, functional aspects of the nose can also be addressed. In many cases this will involve clearing a blockage such as a deviated septum, but sinus issues like polyps or narrowed passages can also be corrected during the surgery. In most cases, this simply involves performing endoscopic sinus surgery once the patient is anesthetized before beginning the rhinoplasty itself. This makes the surgery longer, but has the benefit of not requiring additional anesthesia, which could be both dangerous and costly. In addition, crooked cartilage from a deviated septum which is usually discarded, will be used to reshape the nose during the rhinoplasty procedure. There is a financial benefit in performing functional work during a rhinoplasty as it makes it much more likely that the patient’s insurance company will agree to pay for part of the procedure including anesthesia and facility fees.
I had the balloon Sinuplasty and rhinoplasty with Dr. Rubinstein on July 30th. I have been going to him for a while, and I get allergy shots there, too. He is a very professional surgeon. So far, it has been eight weeks and I am breathing better. I didn’t have pain after surgery, but I did have an issue with being very stuffy, and not being able to breath through my nose. That was a little tough for 2 weeks. Once I could actually blow my nose, it was fine. I will recommend Dr. Rubinstein to other people.
Candidates for Rhinoplasty with Sinus Surgery
Ideal candidates for a rhinoplasty with sinus surgery include anyone who wishes to improve the appearance of their nose while correcting common sinus issues like polyps or blockages that can cause chronic congestion, difficulty breathing, or frequent nose bleeds. Rhinoplasty is a safe procedure and can be a good choice for patients of any age or gender who are in good health and do not smoke.
The Rhinoplasty Procedure
For most patients, the procedure will begin with general anesthesia in order to minimize the risk of aspirating blood during the procedure. Once the patient is anesthetized, Dr. Rubinstein will begin by using a thin, flexible tool called an endoscope to gain access to the sinuses. Using the endoscope, he’ll remove any blockages and excess tissue that might be obstructing breathing.
Once the sinus portion of the procedure is done, Dr. Rubinstein will carefully make incisions inside the nostrils to allow changes to be made to the internal structures of the nose. In some cases, an additional incision may be made on underside of the nose between the nostrils. Using these incisions for access, Dr. Rubinstein will be able to remove, rearrange, or augment the bone and cartilage beneath to achieve the desired shape and size. After the necessary adjustments have been made, he’ll close the incisions and apply dressings to the nose before sending the patient to the recovery room.
Recovery after Rhinoplasty Surgery
After the surgery, there will be some swelling and bruising around the nose and eyes. This normally peaks 12-36 hours after surgery and fades completely within 14 days. There may be some discomfort as well, but this is normally quite manageable with the prescribed medications. A nasal splint will be necessary for the first week and will be removed during a follow-up appointment, but nasal packing is normally not necessary in most cases. Patients should be sure to rest and keep the head elevated for the first few days, but normal activity including work can be resumed in 1-2 weeks. Strenuous activity like working out should be avoided for up to a month in order to avoid raising blood pressure and exacerbating swelling. Out of state patients can fly home after one week. Patients are scheduled for routine follow ups at 6 weeks, 3 months, 6 months and one year at no extra charge. Photos are taken at follow up and Dr. Rubinstein likes to give his patients a copy of the pre and post rhinoplasty photos after their final visit.