Posts Tagged "Rhinoplasty"


How a septoplasty is performed depends on the anatomies and underlying problems. Nevertheless, its goal is to correct the misaligned or deviated septum or the wall separating the two nostrils, thus improving one’s breathing functions and even quality of life.

Dr. Karan Dhir, one of the leading Beverly Hills plastic surgeons, says septoplasty as a stand-alone procedure takes 30-90 minutes to complete, although it could be longer when combined with rhinoplasty in which the “outside” appearance of the nose is improved as well.

how a septoplasty is performed

Septoplasty and rhinoplasty (or nose job) are commonly performed together if there is also a desire for cosmetic improvement. Also, it gives the surgeon the opportunity to use the nasal cartilage (or “main structure” supporting the nose) instead of getting it from other donor sites such as the bowl of the ear or rib.

As a stand-alone procedure, septoplasty rarely changes the outside appearance of the nose unless there is a very visible deviation prior to surgery.

Most septoplasties use incisions in the nostrils so there is no risk of visible scar. During surgery, doctors will make a cut on one side of the nose to lift the mucous membrane around the deviated septum.

The deviated septum is then straightened and any barrier or protruding nasal bone or cartilage is removed, trimmed, or filed. Once the necessary adjustments are made, the mucous membrane is positioned back.

Most patients will need stitches to support the new contour or hold the septum and membrane in place, although others will only require cotton, soft plastic sheets, or splints to keep them in position.

The success of any type of nose surgery (both reconstructive and cosmetic procedures) is largely determined by the surgeon’s level of skills. Ideally, it is performed by someone who has double board certifications in facial plastic surgery and ENT (ear, nose, and throat).

In most cases, septoplasty results in a straightforward recovery, with pain easily managed by prescribed medications. However, aspirin and aspirin-like products must be avoided for about 1-2 weeks to prevent healing problems, persistent swelling, and bleeding.

Instead of the actual pain, patients often think that nasal stuffiness is the most bothersome symptom, which could take up to six weeks to dissipate. However, controlling the amount of swelling (through head elevation, ice packs, and low-sodium diet) is one way to improve breathing function.

Ice packs have also been shown to control pain, although the general rule of thumb is to use them not more than 20 minutes at a time to avoid cold burns and injuries.

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Septoplasty recovery differs from patient to patient, although statistics show that most people feel good 2-3 days postop. However, bruising and swelling can take about a week or two to dissipate, assuming that it is performed as a stand-alone procedure.

But when septoplasty is combined with rhinoplasty, which improves the outside appearance of the nose, a patient should expect more bruising and swelling and longer “social recovery,” as suggested by experts at the California Surgical Institute.

septoplasty-recovery

Because septoplasty as a stand-alone procedure uses internal incisions in the nostril (to correct the crooked septum or wall between the nostrils, leading to improved breathing), the pain is easily controlled with narcotic pain medications.

But since prolonged narcotic use can cause constipation and lethargy, two days postop most patients are instructed to switch to Tylenol.

Aside from painkillers, some plastic surgeons also recommend antibiotics for 5-7 days to minimize the risk of infection.

Due to postop swelling, it is not uncommon to experience congestion and difficulty breathing, forcing some patients to breath through their mouth. However, this will improve after about a week or sometimes sooner if they are able to control the amount of swelling.

In the first few days, head elevation can control swelling. The idea is to minimize edema or water retention in the tissues by keeping the surgical site above the heart.

Other ways to control postop swelling include low-sodium diet, cold therapy around the eyes and bridge of the nose (never put ice directly on bare skin to prevent burns and injuries), and low level physical activity to prevent increased heart rate and blood pressure.

Meanwhile, the real challenge for most patients is the social recovery, which is largely determined by how long the bruising and swelling will dissipate. According to statistics, most people will have to wait about a week two before they can go to work or return to their social activities.

While most patients are back on their feet in no time, it remains crucial to avoid strenuous activities and heavy lifting for 4-6 weeks to prevent bleeding, hematoma, and other variables that could jeopardize their healing and result.

But for contact sports, a longer waiting period—at least six months—is ideal to allow the cartilage and other tissue to heal without any interruption.

Aside from low-level physical activity, they should also maintain their blood pressure and heart rhythm in relaxed state to promote quick recovery.

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Surveys have shown that a good number of male patients cited stiff job competition as their main reason for getting a plastic surgery procedure. For the past several years, men accounted for 8-9 percent of all surgical enhancements performed in the US.

Los Angeles plastic surgeon Dr. Tarick Smaili explains the most commonly requested plastic surgery for men and the corresponding techniques to preserve their masculine appearance.
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  1. Male breast reduction. This corrects a condition called gynecomastia in which the excess skin, tissue, and fat lead to the appearance of woman-like breasts.

Aside from removing the excess soft tissue, typically the procedure also involves reducing the nipple size to further achieve a more masculine contour. Meanwhile, failure to address an overlarge areola can lead to a disproportionate or “effeminate” appearance.

  1. Rhinoplasty. More commonly referred to as nose job, it should be able to produce results that respect the patient’s ethnicity, the rest of the facial features, and most importantly, his gender.

According to studies, the ideal angle between the upper lip and nasal tip for men is around 90 degrees, thus creating a straighter profile. For this reason, male rhinoplasty must avoid any procedure that may cause the tip to become more upturned, leading to a feminine look.

Nevertheless, some male rhinoplastic patients can tolerate a minimal droop and still look attractive and “manly” with such feature.

  1. Facelift. Compared to women, most male patients require less contouring in their jaw line since they tend to ask for subtle improvements.

Male facelifts and forehead lifts also tend to be more conservative because it is crucial to preserve the “heavy” brow look and the strong jaw. An overly tight appearance, meanwhile, can lead to feminine-looking brow, flat cheeks, “distorted” smile, and other telltale signs of surgery.

  1. Liposuction. In general, men have more fibrous fats and have bigger body-frame than women, so their surgery is more time-consuming, more challenging, and more expensive.

Liposuction only removes the excess “superficial” fat beneath the skin, and not the deeper visceral types that lead to obesity-related health condition. For this reason, men who are complaining about their “beer belly” are rarely considered as good candidates for the procedure.

  1. Eyelid surgery. There are some subtle nuances involved in male eyelid surgery. For instance, men tend to have thicker and more vascularized skin (increasing the risk of bleeding and more postop bruising), and shorter upper lid platform than women.
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Facial plastic surgery such as facelift, rhinoplasty (nose job), fat grafting, brow lift, and eyelid lift involves postop bruising and swelling that may prevent anyone to join social activities for a couple of weeks.

Take note that healing from such procedures takes many forms—e.g., social recovery, physical recuperation, and return of normal sensation.

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For many patients, the hardest part of the recovery is not really the postop discomfort, which can be easily controlled by painkillers, but the interruption in their social activities.

The list below explains the length of social recovery after a specific type of facial plastic surgery and what kind of postop symptoms one should expect during the initial healing phase:

  • Facelift. Five to seven days after surgery, the swelling and bruising will rapidly improve that most patients can return to their social activities by eight day, although usually with the “assistance” of camouflage make-up and/or fashion accessories such as sunglasses and scarves.
  • Rhinoplasty. The postop bruises are the most apparent around the eyes and will take a week to subside to a significant degree. However, social recovery greatly varies from patient to patient, with some people able to look “more acceptable” within a week, while others have to wait for two to three weeks especially if they have a thick nasal skin.
  • Fat grafting. This involves injecting a small amount of fat into the area that needs more volume, leading to mild swelling and bruising that can last for seven days, although some patients may have to wait for another week to appear “socially presentable.”
  • Eyelid surgery. This involves a rather straightforward recovery with the use of very fine incisions made within the natural upper eyelid crease and close to the lower lash margin. For this reason, most patients can have “dinner with friends” after about five days, although big sunglasses remain helpful to hide any residual swelling and bruising, and to protect the scars from harsh elements.
  • Brow lift.   With endoscope or small camera probe, the procedure will only need several small incisions that can lead to about a week of social recovery; however, the initial healing phase could take longer with the standard technique in which one continuous incision from ear to ear, behind the hairline, is used.
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Facial plastic surgery such as rhinoplasty (nose surgery), facelift, eyelid lift, and brow lift require candidates to be at their optimal health. The idea is to avoid or at least minimize the risk of complications such as infection, poor wound healing, and bleeding.

Prior to facelift surgery, it is crucial that you are near your ideal weight and is not expecting significant weight changes in the future. This guiding principle will help you achieve predictably good results that can last an average of five-and-a-half years, as suggested by one study.
facial-plastic-surgery

Take note that facelift removes some of the hanging skin and reshapes the tissue, including the deeper structures of the face in an attempt to eliminate the sagging appearance and deep wrinkles—two problems that are not only tied to aging but also to significant weight fluctuations.

Failure to maintain a healthy weight after facelift could lead to recurrence of sagging skin and facial wrinkles. While revisions can correct these problems, Beverly Hills plastic surgery expert Dr. Tarick Smaili warns that another surgery may lead to a more extensive use of incisions and subsequent scarring, and higher risk of overly tight, unnatural appearance.

The same “guideline” also applies to other forms of “isolated” facelifts such as mid facelift, forehead lift, cheek lift, lower facelift, and neck lift.

Your weight also matters if you are having facial liposuction to eliminate the appearance of double chin, jowling, or rotund cheeks. This procedure, which removes a very small amount of excess fat to create a more chiseled countenance, could lead to unpredictable results if performed on someone who is overweight or obese.

Meanwhile, weight gain or loss in the future will not influence the result of your rhinoplasty or nose job since it is based on the underlying bony structure of the face, although it remains highly ideal that you are near your ideal weight prior to surgery.

The reason?

Obesity is linked to a significant risk of complications following any type of surgery. According to studies, obese patients are more likely to experience wound infection (1.7 times), heart attack (five times), UTI (1.5 times), and peripheral nerve injury (four times) than non-obese individuals.

In addition, studies have shown that obese patients have altered responses to some medications, making it extra difficult for anesthesiologists to come up with the right and safe dose.

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