NOSE SURGERY

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.

 

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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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