Nose Surgery
 Nose Surgery (rhinoplasty), includes a number of procedures, which can change the appearance and/or improve the function of the nose. Cosmetic and functional procedures are often combined in a single operative session. Surgery of the nose has advanced in recent years, giving the plastic surgeon and the patient more options than ever before. Dr. Tehrani now has the ability to "customize" your procedure based upon your specific needs and anatomy. This current ability to "customize" nasal surgery has evolved over the past fifteen years. In the past, nasal surgery was taught and practiced using a "cookie cutter" approach. Plastic surgeons of the time performed the same operation on practically all their patients regardless of their preoperative appearance. Today, the emphasis is placed on looking at your nose individually. Dr. Tehrani will discuss with you which features of your nose need change as well as those features best left untouched. Now, each nasal surgery is "customized" based upon your unique anatomy. With the emphasis on diagnosis, and with the aid of cosmetic computerized imaging, Dr. Tehrani will create a plan to obtain the most satisfying result.
There are a variety of procedures to improve nasal function, i.e. improving air passage into the nasal airway. These include septoplasty, turbinectomy and alar valve cartilage grafts. You and Dr. Tehrani will decide on the most beneficial procedure based on your personal nasal anatomy.
When you have surgery on your nose, it is important to preserve or restore normal function as well as to achieve an attractive cosmetic result. If you are having trouble breathing through your nose, the functional advantage of the surgery can be as dramatic as the emotional change that accompanies an improvement in your appearance.
Nasal surgery can be performed to change consequence of genetics, birth defect or injury. It can be done to enhance your appearance and/or to improve your nasal breathing. Potential changes include:
- decreasing the overall size of the nose
- removing the bump on the bridge
- narrowing a wide bridge
- refining and narrowing the tip
- adding "projection" to the tip
- narrowing the nostrils shortening the nose
- improving the transition between the nose and the upper lip
- straightening the nose if it is crooked
- straightening a deviated septum (the dividing wall between the air passages) to improve nasal breathing
- restoring the height of the bridge following injury or previous surgery
Candidates include men and women who are looking for improvement, not perfection, in the way they look. Most surgeons prefer not to operate on teenagers until after they've completed their growth spurt. In younger patients, the surgery can be performed after the skeleton of the face is fully developed. This usually occurs in young men by the age of sixteen. Skeletal growth is usually complete in young women by the age of fifteen. In adulthood, the surgery can be performed at any age.
If you have had a previous operation on your nose and are unhappy with the outcome, you may be a candidate for secondary nasal surgery. If too little bone and cartilage have been removed at the original surgery, additional reduction of your nasal skeleton may be indicated. If, however, too much tissue has been removed or the remaining tissues are distorted, the procedure may involve grafting bone or cartilage from other areas of your body.
At your initial consultation, Dr. Tehrani will ask you to express your concerns about your appearance and to describe your symptoms. Your goal for the eventual appearance of your nose will be discussed. Your medical history will be reviewed and a physical examination will be conducted to determine if nasal surgery is best for you. If you are a good candidate for surgery, Dr. Tehrani will explain what can be done to assist you. Additionally, with the aid of computerized imaging, he will discuss the steps of the proposed surgery and the variables that may affect the procedure. Physical characteristics such as the size and shape of your nasal bones and cartilage as well as the thickness of your skin may affect the technical considerations.
Dr. Tehrani may request that you visit your private medical doctor for a check-up and for any necessary lab work and x-rays. Precise preoperative instructions are provided, and all necessary prescriptions are given to you in advance of the surgery. All aspirin, aspirin-containing products, and anti-inflammatory products must be stopped at least ten days before and for ten days after surgery. You will be provided with a complete list of which medications to avoid. Tylenol may be taken during this time. Also, you will be given a list of vitamins and homeopathic preparations to take prior to and after the surgery. This is done to promote healing and limit bruising.
Some insurance companies will pay for nasal surgery if it is medically necessary. Our office staff will help you determine if you are eligible for such benefits. Dr. Tehrani will write a "predetermination letter" if required by your insurance company.
In most nasal surgeries, general anesthesia is used. However, in some cases, local anesthesia with intravenous sedation may be used. Dr. Tehrani and our anesthesiologists will help you make the decision of which type of anesthesia is best for you.
 Nasal surgery is generally performed as an outpatient procedure. It may be combined with other procedures, such as facial surgery and/or body contouring.
After anesthesia is given, Incisions are made inside the nostrils in most cases, though a small, external incision under the nose may be involved to aid in visualization. The skin is lifted off the nasal skeleton and cartilages. Miniature instruments are used to separate the skin from the underlying supporting framework of bone and cartilage. Dr. Tehrani can then sculpt the nasal shape and size before the skin is re-draped on the new nasal framework. The nature and extent of the sculpting are dependent on your nasal anatomy and the desired contour.
Another technique commonly used is the "open approach" which involves making a small skin incision across the columella (the vertical strip of tissue separating the nostrils). This provides more exposure in complex cases and is often used in secondary rhinoplasties. This incision heals very well and is usually inconspicuous three weeks after surgery.
When the surgery is completed, a splint is applied to maintain the new shape of your nose and to limit the amount of postoperative swelling. If the surgery involves straightening your septum, soft nasal splints may be placed in your nostrils to stabilize the septum. You will then be awakened and taken to the recovery room. The operation takes one to two hours.
The first one to two hours after surgery is spent in the recovery room. When you are fully alert, you will be able to return home in the care of a friend or family member. A private nurse can be provided at your request.
You will be encouraged to keep your head elevated for several days, and to use cold compresses to reduce swelling and bruising. There is very little if any pain following nasal surgery. Pain medication is prescribed, although it is usually not necessary.
There may be mild bruising and swelling which lasts for one to two weeks. A subtle degree of swelling will remain for several months. If you have nasal packing, it will be removed after a few days, and you will feel more comfortable. By the end of one week the splint will be removed.
Most patients may drive a car and return to work or social activities after one week. Strenuous physical exercise is avoided for three weeks following nasal surgery. Contact sports are to be avoided for six weeks after surgery. You can wear contact lenses after a few days; however, if you wear glasses, you will be given special tape to suspend your glasses from your forehead. It is important not to allow the glasses to rest on the bridge of your nose for six weeks after surgery.
If your nasal airway is obstructed, you are more dependent on mouth breathing which is much less efficient. This condition leads to early fatigue when exercising and symptoms of dry mouth. Nasal obstruction may also lead to snoring and chronic sinus infections. Septoplasty and nasal airway surgery are performed to alleviate these problems.
Additionally, changes in the size and shape of the nose can lead to a dramatic improvement in your facial appearance. It is of great importance that your new nose is in proportion to your other facial features. It should be "balanced" and natural in appearance. It is of great importance to Dr. Tehrani that your results not appear to be "artificial" or "surgical".
» Click here to view before and after photos.
To Schedule a consultation with Dr. Tehrani or for additional information on nose surgery, please contact us.
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