A Rhinoplasty, (Nose Job), is a procedure designed to reshape or refine the nose. It can also help in selected nasal air flow problems. A Septoplasty is a procedure designed to correct problems with the nasal septum.
Dr. Roth will first listen to your concerns and goals. He will then gather a thorough medical history. Past medical events may impact your surgery, anesthesia, and recovery. Current issues such as; medications, herbal remedies, allergies, smoking, drug use, bleeding and scarring tendencies, will be reviewed. Chronic issues, (e.g. diabetes, high blood pressure, auto immune disease), are also important. Specifically, history of breathing problems, trauma, and previous operations to the nose will be discussed.
Dr. Roth will examine your nose. An exam of your remaining facial features will also be done so as to evaluate how your the appearance of your nose is related to the rest of your face. Dr. Roth will explain what he sees, and how it relates to your appearance or other issues. He will then explain what might be done to improve each area medically or surgically. You may not wish to take advantage of every treatment that is available, but at least you can know about available options and what each might offer.
Before Your Procedure
Many things can effect the success of the procedure, the subsequent healing process, and final result. Clearly, issues effecting your general health and ability to heal can impact the process, but more subtle issues and practices can also make a significant impact.. It is imperative that patients refrain from ingesting any medications or other substances that could potentially cause surgical complications. A list of medications should be reviewed and selected medications discontinued at least two weeks prior to the procedure.
Patients undergo a general physical examination prior to their surgery. This is to ensure that no underlying medical problems exist that may interfere with the safety of their surgery. The Anesthesiologist may have specific criteria to be met. Appropriate consultation, (Cardiology, Pulmonary, etc.) may be requested to address any issues. Any issues, however trivial they may seem, should be reported. For example, a seemingly innocent minor infection can result in a surgical wound infection, and so must be treated prior to surgery. Likewise, hypertension must be under control. Blood pressure medicines are typically taken right up to the time of your procedure. Cigarette smoking has a significant impact on wound healing and needs to be discontinued prior to the operation. Some procedures will not be performed in those who smoke. The extent of some procedures may be significantly curtailed. Serious wound healing complications can occur in patients who are exposed to smoke, even passively. The risk of wound healing problems decreases after one quits. Appropriate timing of surgery after cessation of tobacco exposure can be discussed.
Preoperative photographs are taken. They assist in the planning of the procedure and in reviewing the improvement afterwards. Postoperative photographs are generally taken at 3 and 6 months after your procedure as well.
You will be asked to sign a surgical consent, which enumerates the risks of the procedure in detail. Some of these risks have been reviewed here, but are also discussed at the consultation.
Appropriate prescriptions are written, (e.g. pain pills, so that you will be able to take them when you return home).
You will need to arrange for someone to drive you to and from the surgery center. Patients cannot drive after surgery, and for 10 days afterward. Recently sedated patients will not be placed into taxis for transport home. Medical transportation can be arranged in the event that you cannot find someone. It is also mandatory to have someone stay with you for at least 24 hours after surgery, for your comfort and safety.
After Your Procedure
After arrival at the surgicenter. The nursing staff will register you and have you change into the appropriate gown.
Incisions are usually marked prior to taking you to the operating room.
The choice of anesthetic will be made with input from the Patient, Surgeon and Anesthesiologist. Continuous monitoring of your vital signs is carried out throughout the operation.
The procedure usually takes about an hour, depending on the extent of your particular anatomy, tissues, and procedure. Appropriate arrangements will be made so that you'll be observed for the first night after the procedure.
Remember that any surgical procedure requires a certain period of recovery from the surgery and anesthetic. Individuals vary, but it is possible (and normal) to experience swelling and bruising. Depending on how you feel, you can still go out in public. Makeup can be worn to cover visible areas of bruising. We offer a complete line of concealment and everyday makeup, and can help select the correct modality for you.
You will need to have someone drive you home from the surgery center. You should also have someone stay with you the first couple of days after you go home. You will also need someone to drive you to your visits to the Doctor. Remember, no driving for 10 days after the procedure. You should maintain head elevation of at least 30 degrees from horizontal to keep the swelling down. Any discomfort following a Rhinoplasty, (Nose Job), and/or Septoplasty is usually controlled well with the prescribed pain medication. Ice packs will help both swelling and discomfort. It is more important to sleep than to have ice on your eyelids, so don't "stay up" in order to apply ice. Some minimal oozing and bleeding is normal and expected.
The splint applied to your nose is intended to provide protection. It is usually removed a week after surgery. If any packing was used, this usually is removed 2-7 days after surgery.
Although you will be up and around in a day or two, you should plan to rest as much as possible for the first week. If your work is secondary, you may return as you feel fit. If work is more strenuous, you should wait 7-10 days. Do not do anything that requires straining or heavy exercise for at least 10-14 days. Likewise, you should avoid vigorous activity, including sex, for two weeks after surgery, this will reduce the incidence of swelling or bleeding. Walking and stretching are encouraged. You should have someone walk with you for the first week, in case you get tired. You should avoid bending over for about three weeks, and avoid alcohol, steam baths, and saunas for four weeks after surgery. The eyelid areas may be numb for weeks to months, and so heating pads and sun lamps are to be absolutely avoided. Sun exposure is discouraged for at least the first few months.
Everyone responds differently to an operation. It may take a significant time for the healing process to let you accurately appreciate the operation. All of the swelling may not disappear for months. The incision site inside the nose may feel firm for months as well. With proper peri-operative care, you should be able to maximize the healing process and help to achieve your goals.