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Also called rhinoplasty, nose
surgery is an operation that changes the external
shape of the nose. Dr. Chartchai has performed surgery
on many types of noses reflecting his multi-ethnic
base of clients in Bangkok.
Dr. Chartchai is experienced in
nose surgery including open rhinoplasty and closed
rhinoplasty, narrowing of nostrils, and reshaping
the profile of the nose.
Surgery for the nose should be
made only after careful consideration as this procedure
can radically change a person's appearance.
You are not a good candidate for
nose surgery if the skin on your nose, especially
the tip, is very thick and inflexible. Children
shouldn't have this surgery until their noses are
fully developed.
What do you want to change?
The nose is composed of 3 layers: an inner lining,
bone and cartilage, and outer tissue and skin. Surgery
is usually done on the bone and cartilage and on
the outermost tissue.
To make the bridge narrower, an
incision on the inside of each nostril will be made.
This enables the reshaping of the nose by altering
the cartilage and bone. A bridge can be built up
by fat injection or altering the cartilage.
A bump may be fixed by carving
out excess cartilage and bone. The bones may need
to be broken so that they can be repositioned.
A bulbous or droopy tip can be
reduced by removing some of the cartilage or by
suturing the cartilage to bend it into a more pleasing
shape. Nostrils that are too wide can be narrowed
by removing small wedges of skin at the base of
the nostrils, where they join the upper lip. The
tiny scars that result can be camouflaged by the
natural crease there.
Procedure
- Open (or full) rhinoplasty
During a full rhinoplasty, bone, cartilage or
synthetic material can be carved to create the
proper curves and angles to enhance the shape
of the bridge. It is then layered over the bone
or cartilage within the nose. The skin holds it
in place. If cartilage or bone is to be transplanted
from another part of the body, it is done during
the same procedure.
Each surgery takes about 1-2 hours. The procedure
can be performed using local or, more commonly,
general anesthesia.
- Revision rhinoplasty
Revision rhinoplasty corrects a previous surgery
and traumatic rhinoplasty corrects a damaged or
broken nose. During the recovery period after
surgery there will be some discomfort, headaches,
bleeding and congestion.
Occasionally there are complications of infection,
bleeding and breathing problems.
- Deviated septum
A deviated septum is a blockage in the nasal passages
that can cause difficulty with breathing or a
recurring sinus infection. To correct a deviated
septum, the surgeon will stretch the septum or
reduce the jagged folds of the septum, making
it smooth allowing for easier breathing.
Recovery time
During recovery you may have a small tube in each
nostril and a splint supporting the outside of the
nose for about 5 days. Dr. Chartchai will cleanse
the nose about one week post surgery and clear nasal
passages.
The bridge of the nose will be
black and blue, and swollen for a number of days.
A dressing and/or gauze packing in the nostrils
may need to remain in place for a few days. Don't
blow your nose for about a week and don't hit or
bump it for about 8 weeks. You will have a stuffy
nose for a few weeks. You must stay out of the sun
for about 8 weeks.
Possible complications
Scar tissue from the incisions can cause breathing
problems. Also, at the outset, you may experience
the sensation of having difficulty breathing as
you adjust to the smaller nose.
After repair for a deviated septum,
a perforation hole may occur in the septum and mucus
may build up within the perforation and cause a
blockage. Additional surgery will clear this.
For up to 3 weeks it is common
to experience nosebleeds. Avoid activities that
raise blood pressure and could bring on a serious
nosebleed.
It can take as long as 12-18 months
for all evidence of swelling to disappear.
Small blood vessels in the nose
could burst, causing small but permanent red spots.
Reductive rhinoplasty is permanent.
A minor imperfection such as a very small bump may
occur as the bones and tissue heal. This can occur
from the formation of scar tissue, calcium deposits,
or the shifting of bone or tissue over time. Another
procedure 6 months to a year later can correct this.
Additional surgery could be required to correct
distortion in the shape, which can occur over time.
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