Nose Surgery | American Academy of Otolaryngology-Head and Neck Surgery News media interested in covering the latest from AAO-HNS/F can find information on embargoes, Annual Meeting press registration and more below. Please direct any interview requests or policy questions to our media and public relations staff at newsroom@entnet.org . Improving Form And Function Of The Nose Each year thousands of people undergo surgery of the nose. Nasal surgery may be performed for cosmetic purposes, or a combination procedure to improve both form and function. It also may alleviate or cure nasal breathing problems, correct deformities from birth or injury, or support an aging, drooping nose. Patients who are considering nasal surgery for any reason should seek a doctor who is a specialist in nasal airway function, as well as plastic surgery. This will ensure that efficient breathing is as high a priority as appearance. Can Cosmetic Nasal Surgery Create A "Perfect" Nose? Aesthetic nasal surgery (rhinoplasty) refines the shape of the nose, bringing it into balance with the other features of the face. Because the nose is the most prominent facial feature, even a slight alteration can greatly improve appearance.

(Some patients elect chin augmentation in conjunction with rhinoplasty to better balance their features.) Rhinoplasty alone cannot give you a perfect profile, make you look like someone else, or improve your personal life. Before surgery, it is very important that the patient have a clear, realistic understanding of what change is possible as well as the limitations and risks of the procedure. Skin type, ethnic background, and age will be among the factors considered preoperatively by the surgeon. Except in cases of severe breathing impairment, young patients usually are not candidates until their noses are fully grown, at 15 or 16 years of age. The surgeon will also discuss risk factors, which are generally minor, as well as where the surgery will be performed-in a hospital, freestanding outpatient surgical center, or a certified office operating room. To reshape the nose, the skin is lifted, allowing the surgeon to remove or rearrange the bone and cartilage. The skin is then redraped and sutured over the new frame. A nasal splint on the outside of the nose helps retain the new shape during healing. If soft, absorbent material is placed inside the nose to stabilize the septum, it will normally be removed the morning after surgery.

External nasal dressings and splints are usually removed five to seven days after surgery. When Should Surgery Be Considered to Correct a Chronically Stuffy Nose? Millions of Americans perennially suffer the discomfort of nasal stuffiness. This may be indicative of chronic breathing problems that don't respond well to ordinary treatment. The blockage may be related to structural abnormalities inside the nose or to swelling caused by allergies or viruses. There are numerous causes of nasal obstruction. A deviated septum (the partition between the nostrils) can be crooked or bent as the result of abnormal growth or injury. This can partially or completely close one or both nasal passages. The deviated septum can be corrected with a surgical procedure called septoplasty. Cosmetic changes to the nose are often performed at the same time, in a combination procedure called septorhinoplasty. Overgrowth of the turbinates is yet another cause of stuffiness. (The turbinates are the tissues that line the inside of the nasal passages.) Sometimes the turbinates need treatment to make them smaller and expand the nasal passages. Treatments include injection, freezing, and partial removal. Allergies, too, can cause internal nasal swelling, and allergy evaluation and therapy may be necessary.

Can Surgery Correct a Stuffy, Aging Nose? Aging is a common cause of nasal obstruction. This occurs when cartilage in the nose and its tip are weakened by age and droop because of gravity, causing the sides of the nose to collapse inward, obstructing air flow. Mouth breathing or noisy and restricted breathing are common. Try lifting the tip of your nose to see if you breathe better. If so, the external adhesive nasal strips that athletes have popularized may help. Or talk to a facial plastic surgeon/otolaryngolgist about septoplasty, which will involve trimming, reshaping or repositioning portions of septal cartilage and bone. (This is an ideal time to make other cosmetic improvements as well.) Internal splints or soft packing may be placed in the nostrils to hold the septum in its new position. Usually, patients experience some swelling for a week or two. However, after the packing is removed, most people enjoy a dramatic improvement in breathing. What Treatment Is Needed for a Broken Nose? Bruises around the eyes and/or a slightly crooked nose following injury usually indicate a fractured nose. If the bones are pushed over or out to one side, immediate medical attention is ideal.

But once soft tissue swelling distorts the nose, waiting 48-72 hours for a doctor's appointment may actually help the doctor in evaluating your injury as the swelling recedes. (Apply ice while waiting to see the doctor.) What's most important is whether the nasal bones have been displaced, rather than just fractured or broken. For markedly displaced bones, surgeons often attempt to return the nasal bones to a straighter position under local or general anesthesia. This is usually done within seven to ten days after injury, so that the bones don't heal in a displaced position. Because so many fractures are irregular and won't "pop" back into place, the procedure is successful only half the time. Displacement due to injury often results in compromised breathing so corrective nasal surgery, typically septorhinoplasty, may then be elected. This procedure is typically done on an outpatient basis, and patients usually plan to avoid appearing in public for about a week due to swelling and bruising. Will Insurance Cover Nasal Surgery? Insurance usually does not cover cosmetic surgery. However, surgery to correct or improve breathing function, major deformity, or injury is frequently covered in whole or in part. Patients should obtain cost information from their surgeons and discuss with their insurance carrier prior to surgery.

Copyright © 2014 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly prohibited without prior written permission. Copyright © 2015 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly prohibited without prior written permission. Understand Breathing and Sinus: Expert Sinus Surgeon NYC | Dr Garrett Bennett - NY Sinus & Rhinoplasty Surgeon Deviated Septum What is a nasal septum and what are the nasal turbinates? The nasal septum is the wall in the middle of your nose composed of bone and cartilage that splits the inside of your nose into the left and right. The inferior and middle turbinates are mucosal covered bony structures on either side of the nasal septum. The nasal septum and turbinates warm, humidify and filter the air we breathe to protect the lungs from contaminants such as dust, pollen and cat dander. What is a deviated nasal septum and what are enlarged turbinates? A deviated septum is when the cartilage or bone that makes up the nasal septum is off to one side or even to both sides.

Enlargement of the inferior turbinates (turbinate hypertrophy) is caused by physical trauma to the turbinates from inhaled irritants or from internal swelling from allergies. Conditions like these will restrict breathing, stimulate snoring, and may lead to sleep apnea or sinus infections. Nasal swelling can be treated with over-the-counter or prescription nasal sprays and oral medication. Was I born with a deviated septum? There are many theories on why the nasal septum is deviated. Trauma from traveling in the birthing canal may cause micro-fractures in the nose that can become larger as we grow. Any nasal or septal fractures can cause deviation to the outside and the inside of the nose. As the nose ages, the septal shape may change as cartilage matures and twists. We receive genetic traits from our families and a deviated septum or twisted nose may be a gift from your parents. When do you need surgery for a deviated septum? Straightening the deviated nasal septum is called a septoplasty . Shrinking the size of the inferior turbinates is called a turbinoplasty. These corrective procedures may be required when medication and other conservative treatments have not improved breathing.

Functional nasal surgery provides improved breathing, decreased snoring, and better sinus function. These procedures are performed with no external incisions, going through the nostrils to straighten the septum and reduce turbinate size. The surgery takes about an hour at an ambulatory surgery center and can be done with local or general anesthesia. Patients can go home about an hour after surgery. There is generally a noticeable improvement in breathing within one week of the procedure. Breathing can continue to improve over the next couple of years. Is packing the nose needed after surgery? Nasal packing involves placing long strips of vaseline gauze in each side of the nose after surgery. Doctor Bennett finds that placement of nasal packing is very rarely required for his patients. Surgical techniques have greatly advanced in the last 15 years. Today, doctors have a better understanding of how the nose heals . Packing placement and the subsequent removal can cause trauma to the nasal septum, sinuses and turbinates and may cause scarring. Packing does not prevent a nose-bleed and may block the topical decongestants or nasal irrigation from working. Sinusitis and Sinus Surgery What are sinuses?

The sinuses are hollow spaces in the skull that are lined with mucosal tissue. This specialized tissue moves mucus and impurities from the sinuses into the nose and throat. Tiny passages known as osteomeatal complexes, connect the sinuses with the inside of the nose. The sinuses are shown below: What is acute sinusitis? Allergies, a deviated septum, or common cold can prevent the sinuses from draining normally. When this happens, a sinus infection (sinusitis) can occur. Because the draining spaces inside the nose are millimeters or less in size, even minimal swelling can cause sinusitis. A head cold that lasts more than a few days may be an acute sinus infection. Multiple episodes are termed “recurrent acute sinusitis”. What is chronic sinusitis? If the sinus infection lasts greater than three months, you have a chronic sinus infection. The bacteria will be more complex than during acute sinusitis and antibiotics are used mainly for worsening episodes of the sinus infection. What are sinusitis signs and symptoms? Thickened nasal discharge– Infected mucus becomes increasingly thick, green or yellow in color, and may have a bad odor. The discharge can drain from the nose or be coughed up.

Headaches or sinus facial pain– Pressure from obstruction of the small sinus passageways can cause severe facial pain, headaches, toothaches, or worsened nasal congestion. Repeated sinus infections– Swollen and blocked tissue inside the sinuses can narrow the channels that lead from the sinuses, therefore causing repeated infections. The bacteria inside the nose may become resistant to antibiotics and not completely go away between infections. Fatigue– Spending energy to fight an infection will waste the body’s reserves and can interfere with sleep and mental energy. How is sinusitis treated? Successful treatment of an acute sinus infection is often possible using antibiotics directed toward the most likely causes of infection. The management of chronic sinusitis is more directed towards decreasing sinus inflammation. Failure of antibiotics may require further testing, including a sinus CAT scan. Other conservative treatment includes combinations of anti-allergy medication, decongestants, nasal sprays, and saline rinses. Environmental controls, such as removing your carpet, having the cat sleep in another room, or using an air purifier, can also decrease symptoms. If left untreated, a sinus infection can bring about severe complications. Do not hesitate to speak with a sinus specialist if you are suffering from breathing problems. When do you need sinus surgery?

Recurrent acute or chronic infections can negatively affect your quality of life. After medical treatment has failed, sinus surgery can dramatically improve nasal function and your sense of well-being. Functional endoscopic sinus surgery (FESS) removes blockages, allowing the sinuses to ventilate and drain through its natural opening. How is the recovery from sinus surgery? With Dr. Bennett’s advanced surgical techniques, packing placement in the nasal cavities and the associated discomfort is rarely needed. This improves the overall experience and contributes to a more rapid recovery. Patients typically return to normal activity in 7-10 days. What is a rhinoplasty? Rhinoplasty Before and After The nose is one of the most defining characteristics of the face. Whether you would like to improve the appearance of your nose or you are having difficulty breathing, a rhinoplasty may be a suitable option. A rhinoplasty, or nasal reshaping, is a surgical procedure designed to create harmony between the nose and other facial features by reshaping the size, width, or profile of the nose and it may also be used to improve breathing. A cosmetic rhinoplasty is never covered by insurance.

However, a rhinoplasty to repair a broken or fractured nose, to correct a severely deviated septum, or nose surgery to fix nasal obstruction from collapsing of the nostrils may be covered by insurance. Broken Nose (Nasal Fracture) What is a nasal fracture? The nasal bones are a pair of bones that extend about a third of the way from the forehead to the tip of the nose. Because they are very thin and in the center of the face, they are highly susceptible to injury. Nasal fractures account for 40 percent of all bone fractures. Trauma to the nose can change the shape and functionality of the bone and cartilage that make up the nose. How do I know if I have a broken nose? Breaking the nose is usually very painful. The nose will swell, and breathing can become difficult. The outside of the nose may be depressed, twisted, or C-shaped. The nasal bones may be mobile, and you may be able to feel or hear them moving. The eyes may be black and blue and the nose will frequently bleed profusely. Do I need to see a doctor? Yes. It is important to see a doctor as soon as possible after the injury occurs.

The doctor will look for signs of a septal hematoma, or blood collected against the cartilage of the middle nose that can cause infection and destruction of the cartilage. It is best to see an Ear, Nose and Throat doctor, as they will be able to diagnose and treat the problem at the same time. Diagnosis is usually made by physical examination and an X-ray is rarely necessary. How long do I have to fix my nose? The broken bones will be mobile for up to two weeks and can sometimes be moved back into a natural position during that time. This can be done in the office or in an ambulatory surgery center. If the injury remains untreated for more than two weeks, the patient must wait at least two months – allowing the bones to completely heal – before seeking reparative treatment. The patient must then undergo a more extensive treatment to repair the nose. What are the complications of a broken nose? The main complications of a broken nose include permanent difficulty breathing and physical deformity of the nose. A fractured or deviated septum may be the cause of this breathing difficulty. The shape of the nose tip may change if the tip of the septum is bent.

A hole in the septum (septal perforation) can cause the nose to collapse (saddle nose deformity). The cerebrospinal fluid (CSF) that cushions the brain may leak. The patient may lose their sense of smell. Infections of the nose or sinuses may occur. Other bones of the face may also be fractured, so you should check carefully for any addition head or neck injuries. Seek emergency medical attention if you suspect you may have a septal hematoma, CSF leakage, or an uncontrollable nosebleed (epistaxis). What can I do at home? Applying ice across the nose and keeping your head elevated will reduce swelling. Consistent pressure to the nose for 10-15 minutes without letting go will control most nosebleeds. Afrin drops inside the nose may also help the bleeding stop. Tylenol (acetaminophen) is the only over the counter pain medication that should be used. Other pain medicines like Motrin/Advil (ibuprofen), aspirin, and Aleve (naproxen) can promote or worsen bleeding. Will insurance pay to fix my broken nose?

Insurance will almost always cover the cost of broken nose and deviated septum repair, as these are considered functional issues. Insurance will never cover cosmetic surgery, although your nose may look better after it is repaired with functional surgery. We will check your benefits for you and let you know what they are. Nasal Polyposis (Nose polyps) What causes nasal polyps? Nasal polyposis (Nose polyps) occurs when tissue within the nose swells and grows outward, creating mucus-filled sacs. No conclusive cause for nasal polyposis has been established, but they are thought to be caused by allergy or sinus irritation, and can be associated with asthma in adults and cystic fibrosis in children. More recently, an allergy to fungal spores in the air has been identified as a major risk factor for nasal polyps. What are the symptoms of nasal polyps? -Nose is always blocked (nasal congestion) -Constant runny nose or postnasal drip -Decreased or loss of sense of smell (anosmia) -Headache or forehead and cheek pain -A bad head cold that does not go away How are nasal polyps diagnosed?

A doctor can often detect polyps simply by looking in the front of the nose with a headlight. For a more complete examination, the doctor can use a narrow lighted tube with a magnifying lens (nasal endoscope) to look deeper inside the nasal cavity. A CAT scan of the sinuses will show areas that cannot be seen by looking into the nose and can show the extent to which the polyps have spread in the sinuses. The doctor can use skin or blood allergy testing to determine if allergies are causing some of the inflammation. What are the potential complications of nasal polyposis? Patients may have recurrent sinus infections from obstructive nasal polyps. Large polyps can eventually compress the eyes or push on the brain. Nasal obstruction can cause sleep apnea, a condition that stops your breathing during sleep and can cause serious heart and lung damage. What medical treatments are available? Nasal or oral steroids can reduce inflammation and may shrink nasal polyps. Oral or nasal antihistamines can decrease symptoms of allergies. Sinus infections should be treated aggressively with antibiotics. For fungal sinusitis, an antifungal medication may be effective.

If your nasal polyps prove resistant to medications, then they can be removed in an ambulatory sinus surgery procedure (polypectomy). If you are experiencing sinus inflammation, endoscopic sinus surgery can ventilate and provide drainage to the sinuses. You will generally go home about an hour after surgery. You may feel congested following surgery, but your breathing may also be better immediately. Can I prevent nasal polyps from coming back? The patient must maintain constant vigilance after nasal polyp removal. Unfortunately, nasal polyps will return in approximately 2 out of every 3 people who experience them. Saline rinses may decrease irritation in some patients, although others may feel that they cause more irritation. Air purification is always a good idea, as the air inside the home can have 5 to 10 times as many impurities as outside air. Avoiding dust, pollution, and irritating chemicals can decrease nasal swelling. Humidifiers can keep the inside lining of the nose moist in the winter or in dry environments. Medical treatment of allergies and asthma will also decrease inflammation inside the nose.

Hand washing and covering your nose when you sneeze are some of the best ways to prevent the spread of viral and bacterial infections that may aggravate the polyposis. Nasal Valve Collapse and Treatment Introduction to Nasal Valve Collapses Collapse of the nasal valves – internal and external – is a commonly overlooked cause of breathing obstruction. Common causes include previous trauma to the nose or cosmetic rhinoplasty. Lifting the soft tissue of the cheek on the affected side of the nose or using BreatheRite nasal strips may relieve some symptoms, but surgery is the best option for permanent treatment of nasal valve collapse. Many ENT surgeons are not comfortable with these surgical techniques. It may be necessary to find a surgeon with Facial Plastic Surgery Board certification, as he/she will have the additional training required to perform this corrective surgery. Internal Valve Collapse Before and after: Correction of bilateral internal valve collapse due to a previous cosmetic rhinoplasty. Note the ‘inverted-V’ shape of the nasal bones on the left (actual patient). The intersection of the nasal septum and upper lateral cartilage forms an angle that is usually eight to 15 degrees. Less than this can cause collapse of the internal valve, where much of the sensation of breathing comes from.

Internal collapse may also cause narrowing of the middle third of the nose. Visually, the nose may have an ‘inverted-V’ where cartilage has pulled away from the nasal bones. This can be corrected by placing of strips of cartilage at the area of collapse to splint out the valve, or reattaching the cartilage to the nasal septum. External Valve Collapse Before and after: correction of right external valve collapse (actual patient). If the side of the nose collapses inward during inspiration (breathing in), you may have a collapsed external valved. The sidewalls of the nose may look pinched where the cartilage is weak or has collapsed inward. This can also make the nose tip appear larger when it in fact has a normal size. Placing a cartilage graft into the weakest area of the nose can prevent collapse in that area. A deviated nasal septum or enlarged inferior turbinates may further contribute to external valve collapse. Causes of Valve Collapse Aging weakens the nasal sidewalls and causes the tip of the nose to sag. These changes can obstruct airflow inside the nose. Weak cartilage or cartilage turned inward can also predispose patients to nasal valve obstruction.

The primary cause of nasal valve obstruction requiring surgery is previous nasal surgery. Taking down a large bump or decreasing a large tip can weaken support in the rest of the nose. Dividing the cartilage from the septum can cause scarring in the internal valve area that is very difficult to correct. Cosmetically, the nose may look great, but your breathing is still problematic. This can be avoided by choosing a surgeon trained to avoid and correct this deformity. Cottle Maneuver: If your breathing improves when holding the cheek outward (as pictured above), you may have a collapsed valve(s). A “Cottle maneuver” is an invaluable tool for diagnosing nasal valve collapse. The nose’s internal and external valves are elevated outward and the improvement in breathing is scored on a 10 point scale. The doctor should perform an intranasal exam should be performed before and after the nose is decongested. He/she can also perform a nasal endoscopic exam to evaluate structures deeper within the nose. In addition to valve collapse, a complete intranasal exam should look for indications of a deviated nasal septum, inferior turbinate swelling, sinus infection, or adenoid enlargement. A Sinus CT scan may be required for some patients.

Is this considered cosmetic surgery? No. The ability to breathe through the nose is recognized by insurance companies as important to health and has its own insurance code. The nose shape may be more pleasing aesthetically as a result of correction of the nasal valves. Insurance will cover the functional cost of the surgery. Plastic surgery | definition of plastic surgery by Medical dictionary Plastic surgery | definition of plastic surgery by Medical dictionary 1. tending to build up tissues or to restore a lost part. 2. capable of being molded. 3. a high-molecular-weight polymeric material, usually organic, capable of being molded, extruded, drawn, or otherwise shaped and then hardened into a form. 4. material that can be molded. plastic surgery surgery concerned with the restoration, reconstruction, correction, or improvement in the shape and appearance of body structures that are defective, damaged, or misshapen by injury, disease, or anomalous growth and development. This kind of surgery has been practiced for thousands of years. Artificial noses and ears have been found on Egyptian mummies.

Medical records show that the ancient Hindus reconstructed noses by using skin flaps lifted from the cheek or forehead—a technique that was often practiced, since it was a custom to mutilate the noses of persons who broke the laws. Skin Grafting . This is the most common procedure of plastic surgery, consisting of the replacement of severely damaged skin in one area with healthy skin from another area of the patient's body or from the body of a skin donor. (See further discussion at grafting .) With the advent of microsurgery , much of the inconvenience and lengthy waiting necessary for successful grafting of skin flaps has been eliminated. The transplanting of tissues other than skin also is possible through microsurgery. Free-bone grafts can be used to provide rapid replacement of long bone defects, and free muscle transfers permit restoration of muscle function. Repairing Mouth and Other Defects. Among common defects that can be corrected by plastic surgery are cleft lip and cleft palate . Others are webbed fingers and toes, protruding or missing ears, receding chins, and injured noses. In addition, the shape of various types of noses can be altered for the sake of appearance.

rhytidectomy is another common type of plastic surgery, done on the face to improve the aging patient's appearance. It is popularly known as a face lift . Facial Reconstruction. In facial reconstruction, missing bone and muscle, and sometimes skin, are replaced by substitutes. Sometimes the reconstruction is made with bone or cartilage taken from another part of the body, or sometimes it is made by artificial means. Use of Prostheses. Often the substitute for missing tissue is a prosthesis , a replacement not made from living tissue. It may be inserted beneath the skin (such as to build out a receding chin) or attached to the skin surface (for example, to replace an ear). Prostheses attached to, not inserted beneath, the skin frequently are employed to fill out depressed or missing facial areas, the aftereffects of accidents, cancer, or war injuries. In building such a replacement, the surgeon first makes an impression of the face and a plaster cast of the impression. The substitute part is molded in wax or clay in the plaster cast, and from this model the actual replacement part is made.

Such parts, molded and painted to match the texture and color of the skin, have been used to replace many structures, including missing ears and noses. Use of Cartilage, Skin, and Bone. Noses and ears also have been reconstructed with rib cartilage and skin grafts. Eyebrows have been made by the use of skin grafts from the scalp, and chest deformities repaired by the use of bone chips from other parts of the body. Sometimes a nose is remodeled to correct a hump or hook, or a saddle nose (a depression on the ridge), or a twisted nose. Incisions are made inside to avoid causing outside scars, and the surgeon either removes excess cartilage or bone, or inserts it, according to the improvement wanted. Cartilage and bone may be obtained from other parts of the body, usually the ribs or hip. After the operation, the skin over the nose adapts to the new structure. Dermabrasion . Skin blemishes such as acne scars and pits can be “sandpapered” or planed. This technique, called dermabrasion , seeks to correct superficial blemishes and to remove superficial accumulations of pigment.

However, as dermabrasion can occasionally cause increased scarring or introduce variation in skin color and texture, such treatment is infrequently performed today. surgery [sur´jer-e] 1. the branch of health science that treats diseases, injuries, and deformities by manual or operative methods. 2. the place where operative procedures are performed. 3. in Great Britain, a room or office where a doctor sees and treats patients. 4. the work performed by a surgeon; see also operation and procedure . adj., adj sur´gical. ambulatory surgery any operative procedure not requiring an overnight stay in the hospital; it must be carefully planned to ensure that all necessary diagnostic tests are completed prior to admission. Discharge instructions must place a high priority on patient safety. Called also day surgery . bench surgery surgery performed on an organ that has been removed from the body, after which it is reimplanted. plastic surgery Etymology: Gk, plassein, to mold, cheirourgia, surgery surgery to heal, reconstruct, restore function, and correct disfigurement or scarring resulting from trauma or acquired or congenital lesions or defects.

In performing corrective plastic surgery, the surgeon may use tissue from the patient or from another person or an inert material that is nonirritating, has a consistency appropriate to the use, and is able to hold its shape and form indefinitely. Implants are commonly used in mammoplasty for breast augmentation. Skin grafting is the most common procedure in plastic surgery. Z-plasty and Y-plasty are simpler techniques often performed instead of grafting in areas of the body covered by skin that is loose and elastic, such as the neck, axilla, throat, and inner aspect of the elbow. Dermabrasion is used to remove pockmarks, acne scars, or signs of traumatic skin damage. Chemical peeling is another technique in corrective plastic surgery. It is used primarily for removing fine wrinkles on the face. Tattooing, in which a pigment is tattooed into the skin of a graft, is performed to change the color of the graft to resemble more closely the surrounding skin. Reconstructive plastic surgery is performed to correct birth defects, to repair structures destroyed by trauma, and to replace tissue removed in other surgical procedures.

Cleft lip and cleft palate repair and other maxillofacial surgical procedures, including rhinoplasty, otoplasty, and rhytidoplasty, are among these reconstructive procedures. Care of the patient before and after plastic surgery may require considerable sensitivity and tact. The patient may be exceedingly uncomfortable about the real or perceived appearance of the defect. An accepting, nonjudgmental attitude of all staff members is to the patient's benefit. Optimal nutritional status helps a graft to "take" and speeds healing. Each procedure and technique involves particular kinds of care in the preoperative and postoperative periods. Instructions and assistance in self-care activities are also specific to the procedure. Success of most of the procedures depends greatly on the patient's cooperation and on fastidious nursing care. The correction of a visible abnormality may be of inestimable benefit to the patient's assurance, self-esteem, and function in society. See also specific procedures. Also called cosmetic surgery , reconstructive surgery .

Plastic surgery: excision of excess lid tissue plas·tic sur·ge·ry (plas'tik sŭr'jĕr-ē) The surgical specialty or procedure concerned with the restoration, construction, reconstruction, or improvement in the shape and appearance of body structures that are missing, defective, damaged, or misshapen. plastic surgery Any surgical procedure designed to repair or reconstruct injured, diseased or malformed tissue so as to restore normal appearance and function. Compare COSMETIC SURGERY . Plastic surgery plas·tic sur·ge·ry (plas'tik sŭr'jĕr-ē) The surgical specialty or procedure concerned with the restoration, construction, reconstruction, or improvement in the shape and appearance of body structures. surgery 1. that branch of veterinary science which treats diseases, injuries and deformities by manual or operative methods. 2. the place in a hospital, or doctor's or dentist's office where surgery is performed. 3. in some countries a room or office where a veterinarian sees and treats patients. 4. the work performed by a surgeon. basic surgery kit the collection of instruments, wrapped, sterilized and ready for use in the majority of uncomplicated surgical procedures.

The choice of instruments may vary from one surgeon to another, but generally there are tissue forceps, thumb forceps, sponge forceps, hemostats, towel clamps, scalpel handle and needle holder. Scissors and needles may be added after cold sterilization. bench surgery surgery performed on an organ that has been removed from the body, after which it is reimplanted. cold steel surgery Cary, NC, Nose Surgery Nose Surgery Surgery for Congenital Defects of the Hand Nose Surgery Also known as rhinoplasty, nose surgery improves the appearance and proportion of your nose, enhancing facial harmony and self confidence. Surgery of the nose may also correct impaired breathing caused by structural abnormalities in the nose. Table of Contents Why Nose Surgery? Enhancing your appearance with nose surgery While the shape of your nose is usually the result of heredity, the appearance may have been altered in an injury or during prior surgery. Also known as rhinoplasty, surgery of the nose improves the appearance and proportion of your nose, enhancing facial harmony and self confidence. Surgery of the nose may also correct impaired breathing caused by structural abnormalities in the nose. What can surgery of the nose accomplish?

Rhinoplasty can change: Nose size, in relation to the other facial structures Nose width, at the bridge Nose profile, with visible humps or depressions on the bridge Nasal tip, that is large or bulbous, drooping, or too upturned Nostrils that are large, wide or upturned Nasal asymmetry and deviation Is it right for me? Nose surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else's desires or to try to fit any sort of ideal image. Surgery of the nose is a good option for you if: Your facial growth is complete and you are 13 years of age or older You are physically healthy What happens during nose surgery? Step 1 Anesthesia Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation or general anesthesia. Your doctor will recommend the best choice for you. Step 2 The incision Surgery of the nose is performed either using a closed procedure, where incisions are hidden inside the nose, or an open procedure, where an incision is made across the columella, the narrow strip of tissue that separates the nostrils.

Through these incisions, the soft tissues that cover the nose are gently raised, allowing access to reshape the structure of the nose. Step 3 Reshaping the nose structure Surgery of the nose can reduce or augment nasal structures with the use of cartilage grafted from other areas of your body. Most commonly, pieces of cartilage from the septum, the partition in the middle of the nose, is used for this purpose. Occasionally a piece of cartilage from the ear and rarely a section of rib cartilage can be used. Step 4 Correcting a deviated septum If the septum is deviated, it is now straightened and the projections inside the nose are reduced to improve breathing. Step 5 Closing the incision 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. Step 6 See the results Splints and internal tubes will likely support the nose as it begins to heal for approximately one week. While initial swelling subsides within a few weeks, it may take up to a year for your new nasal contour to fully refine.

During this time you may notice gradual changes in the appearance of your nose as it refines to a more permanent outcome. Swelling may come and go and worsen in the morning during the first year following your nose surgery. Nose surgery to improve an obstructed airway requires careful evaluation of the nasal structure as it relates to airflow and breathing. Correction of a deviated septum, one of the most common causes of breathing impairment, is achieved by adjusting the nasal structure to produce better alignment. Back to Top Important facts about the safety and risks of nose Surgery The decision to have nose surgery is extremely personal and you'll have to decide if the benefits will fulfill your goals and if the risks and potential complications are acceptable. Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

The risks include: Rupture of small surface vessels of the nose Infection Bleeding (hematoma) Nose asymmetry Cardiac and pulmonary complications can occur in longer surgical procedures and may be associated with the formation of, or increase in, blood clots in the venous system Change in skin sensation (numbness) Nasal airway alterations may occur after a rhinoplasty or septoplasty that may interfere with normal passage of air through the nose Nasal septal perforation (a hole in the nasal septum) may develop but is rare; additional surgical treatment may be necessary to repair the nasal septum but in some cases, it may be impossible to correct this complication Pain, which may persist Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal Possibility of revisional surgery Be sure to ask questions: It's very important to ask your plastic surgeon questions about your nose procedure. It's natural to feel some anxiety, whether it's excitement for your anticipated new look or a bit of preoperative stress. Don't be shy about discussing these feelings with your plastic surgeon. When you go home If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately.

Should any of these complications occur, you may require hospitalization and additional treatment. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another minor surgery may be necessary to reach the intended aesthetic goal. Be careful Following your physician's instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself. Back to Top My recovery After your procedure is completed, a splint, internal tubes or packing will likely be placed inside your nose and a splint or bandages placed on the outside to support and protect the new structures during initial healing. You will be given specific instructions that may include: How to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon.

Back to Top The results will be long-lasting It may take several months for swelling to fully dissipate and up to a year - and sometimes longer - for the outcome of the surgery to fully refine. Although the results of nose surgery are usually permanent, cartilage may continue to reshape and move tissue that may change the outcome over time. Back to Top How much will nose surgery cost? Cost is always a consideration in elective surgery. Prices for nose surgeries can vary widely. A surgeon's cost may vary based on his or her experience as well as geographic office location. Many plastic surgeons offer patient financing plans, so be sure to ask. Cost may include: Rhinoplasty (Functional) Rhinoplasty (Functional) Jay M. Dutton, MD FACS Introduction The term rhinoplasty in general refers to plastic surgery performed to make changes to the internal and external structures of the nose. While this may be performed for purely cosmetic reasons to improve appearance, often the primary or simultaneous goal is to restore the ability to breathe through the nose. In this case, the surgery is more specifically referred to as a functional rhinoplasty.

This is different from a septoplasty, which involves only repair of the internal wall that divides the nasal cavities, or from a cosmetic rhinoplasty, which is done to improve appearance. A functional rhinoplasty typically involves repair of the nasal valves, which is the medical term for the internal cartilage valves within the nostrils. These can be congenitally narrow(meaning you are born that way), collapse with age, or can be scarred from prior surgery. While surgery on the nasal valves is usually performed to restore breathing, it typically necessitates some type of change to the appearance of the nose. Indications The indications for a functional rhinoplasty include, but are not limited to: Obstructed nasal breathing (functional) Nasal injury (trauma) causing unsatisfactory breathing Nasal birth defect impairing function Acquired deformity due to trauma, tumor or infection Narrowing, collapse or stenosis of the nasal valves (nostrils) Procedure A functional rhinoplasty may be performed under different types of anesthesia depending on patient and physician preference, including local anesthesia (i.e. patient awake but with “numbing medications”), intravenous sedation (i.e.

“twilight”) or general anesthesia (i.e. completely asleep). Incisions are made to allow access to the underlying cartilage and bone. These incisions may be hidden completely inside the nostrils, or involve internal incisions combined with a tiny incision through the skin at the base of the nose. Often cartilage and/or bone may need to be obtained from another site to help gain support. These cartilage grafts are often taken from the nasal septum during the septoplasty portion of the procedure, although sometimes ear or even rib cartilage may need to be harvested. Further reshaping or grafting may need to be performed with sutures to the cartilage, or sutures to reshape or suspend the cartilage. Osteotomies – or deliberate fracturing of the nasal bones – may be performed to straighten the nasal bones if they are crooked or deformed. Although cartilage grafting remains the most common type of functional rhinoplasty, procedures to reshape the nostrils (ex: a “z-plasty”) or the use of sutures and screws to suspend the nasal tissues have grown in popularity.

At the conclusion of the procedure, the outside of the nose is often taped and some form of external cast may be applied. Plastic sheets and/or packing may also be temporarily placed inside the nose depending on the procedure and the surgeon’s preference. Risks Studies have shown that most functional rhinoplasties heal without serious problems or complications and the majority of patients are able to breathe better and enjoy an improved quality of life. However, there are potential complications that every surgical candidate should be aware of before proceeding with the procedure which include (but are not limited to): Complications of anesthesia Septal perforation (hole in internal wall of the nose) Unsatisfactory appearance Worsening (rather than improvement) in the nasal breathing. Benefits An improvement in nasal airflow is the primary benefit of a rhinoplasty performed for functional reasons. The procedure may also straighten the nose, repair post-traumatic or congenital deformities, and improve the appearance. Summary A functional rhinoplasty is a procedure to improve the function of the external nose, and the surgeon may use a great range of techniques depending on the patient’s goals, the anatomic problems, and the surgeon’s preferences.

The procedure may be done with the patient awake or under anesthesia and as a primary or revision surgery. It may involve cartilage grafting, and the recovery time may vary depending on the severity of the problem. Patients should be prepared to discuss their specific goals with their surgeon. After their consultation they should understand the procedure itself, as well as its risks and its benefits. They should understand that even if they undergo this type of surgery with the goal of improved nasal breathing, this may involve a modest alteration in the appearance of their nose. Revised 02/17/2015 {{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }} {{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }} Technically it is not possible to reduce the size of the nose with a "non-surgical" rhinoplasty. However, a non-surgical rhinoplasty can make some noses look smaller. Some examples of change the shape to create the appearance of a smaller nose: 1. A nose with a deep radix and a large bony hump. 2.

A nose with an deep angle between the upper lip and the bottom of the nose (acute naso-labial angle). Based on the one profile photograph, I would recommend an endo-nasal reduction rhinoplasty. However, in general it is best to consult a Board Certified Plastic Surgeon for more specific advice and photo-morphing to obtain the best results. {{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }} {{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }} Injecting fillers, such as Restylane, Juvederm, and Radiesse, in the nose can be helpful for certain patients who would benefit from additional volume in certain specific areas. Adding filler can cause certain noses to appear less deviated, improve symmetry, and fill indentations after prior rhinoplasty. Sometimes, adding filler above a hump can make it appear less prominent. However, there is no nonsurgical way to make a nose smaller. I would recommend that you seek consultation with a surgeon who performs both traditional (surgical) rhinoplasty as well as nasal fillers.

That way, you would have access to all the different options out there for your nose. Computer imaging is a very valuable exercise during the consultation, for you to express your aesthetic goals and for the surgeon to express what she/he could do with fillers vs. rhinoplasty. Lastly, from your photo, it appears that you may benefit from a chin implant as well, as a more projecting chin will make your nose appear more balanced with the rest of your face. Regards, {{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }} {{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }} There are different kinds of rhinoplasty operations however we can divide them as the one that requires bone excision and the one that does not need bone excision. The main fact that we classify the rhinoplasty operations like that is that the results and postoperative period is associated closely with this fact. In the operations like “nasal tip correction”, “simple rhinoplasty” there is no need for a bone excision however these minor operations cannot be beneficial for everyone.

The operation type is need to be determined by the surgeon according to needs of the patient. In these minor operations the rhinoplasty is performed with closed method. The bone and the cartilage tissues are not involved in the surgery directly. Small nasal bumps can be removed in these operations. In the operation that needs the bone and cartilage tissues to be involved; open approach is used. In the procedures with open approach, the size, shape and functionality of the nose can be improved. The big nasal bumps can be removed and septal deviations can be corrected providing a better nasal airway. {{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }} {{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }} There are no nonsurgical ways to make the nose smaller. Fillers can be used to make the nose more shapely, but that makes that portion of the nose bigger. To reduce the nose size, cartilage and bone needs to be removed/repositioned, and that involves surgery. However, there is a nonsurgical option to make the nose "appear" smaller, and that's by making the chin bigger.

The chin can be made a bit more projected with fillers. This must be done with caution, as putting too much filler in the chin to harmonize with a big nose will make the chin too big and just look weird. I recommend consulting with several experienced rhinoplasty surgeons in your area to discuss the options. Best, {{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }} {{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }} Non-surgical, or "liquid", rhinoplasty involves the injection of temporary, hyaluronic acid fillers (like Juvederm or Restylane) into certain areas of the nose. This is performed to create balance between the different parts of the nose, creating an improved appearance. Strictly speaking, you cannot make the nose physically smaller by injecting it with filler. However, depending on your nose, certain injection techniques can create the illusion that the nose is smaller. It is important to note that sometimes a nose only appears large because it is out of balance with other aspects of the face - like the forehead or chin.

Occasionally you can make a nose look smaller by improving the appearance of these other facial features, with filler injections and/or surgery. Fillers in the nose can be riskier because of the unique blood-supply of the nose. When considering non-surgical rhinoplasty, it is important to consult an surgical expert who understands the delicate anatomy of the nose. {{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }} {{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }} Thank you for sharing your interest in a nonsurgical rhinoplasty, but current nonsurgical techniques involve fillers that INCREASE dimensions. Morphing to a smaller size requires removal of tissue , accomplished on computers non-surgically, but is not translated into reality without surgery. To simulate a reduced nasal appearance, one can increase the size of the other facial features. Most easily, a chin implant or chin injection with fillers such as Radiesse, as your photo suggests some lack of chin prominence, may add balance to a larger nose.

Occasionally enhancing one’s cheek bones with implants or fillers, and other features such as the lips , tends to proportionalize a larger nose. The most natural and easiest facial balance would be obtained from a reduction rhinoplasty and a slight chin augmentation. To help yourself obtain the clearer perspective, you may wish to consult with a Board Certified Plastic Surgeon or other specialist experienced in nasal and facial profile aesthetic enhancement, both surgical and non-surgical, so you will get an informed idea of the limits and applications of both approaches. Facial Cosmetic Surgery | Sierra Nevada ENT Facial Cosmetic Surgery Locations Facial Cosmetic Surgery Many people are self-conscious about how they look and may want to alter certain aspects of their face in order to feel more confident. Others are born with facial abnormalities such as a cleft lip, a birthmark, or other birth defects and desire correction. Many of us notice the effects of aging, sun damage, or previous facial trauma on the face. Fortunately, many of these conditions can be corrected through procedures performed by an SNENT surgeon. Our surgeons perform cosmetic, functional, and reconstructive surgical treatment of abnormalities of the face and neck and ear.

Some procedures include deviated septum, rhinoplasty, face lift, cleft palate, drooping eyelids and ear deformities. Rhinoplasty Facial Plastic Surgery & ENT | East Lansing, MI – Dr. Sufyan, MD, FACS Learn More Blepharoplasty Eyelid surgery, or blepharoplasty, is a surgical procedure to improve the appearance of the eyelids. Eyelid surgery can rejuvenate the area surrounding your eyes to improve the appearance. Learn More Rhinoplasty Rhinoplasty is a surgery on the nose done to change its shape or improve its function. Dr. Sufyan also utilizes Vectra 3D imaging for nasal reconstruction.

Question: What is a surgical procedure to improve the function or the appearance of a human nose?
Answer: Rhinoplasty