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Rhinoplasty
Rhinoplasty should generally be delayed until after age 13 for girls, and 15 for boys (since boys have their growth spurt later than girls). By this time, the nose is 90% of its adult size. However, not every teenager who dislikes his or her appearance is a good candidate for rhinoplasty; many of them will outgrow their dissatisfaction their nose. About 10% of all rhinoplasties are performed in people younger than nineteen. In adults, the aging process frequently results in your nose becoming longer and droops more as the skin loses its elasticity. Elevation of the nasal tip may give the patient a younger look.
What can I expect after a rhinoplasty?
If the nose is being reduced in size, a splint will have been applied and the nose will be packed lightly with a medicated gauze. Sometimes, only tape supports the nose while it is healing. The stitches are self-absorbing and do not require removal.
If an incision is made across the columnella, or vertical strip of tissue separating the nostrils, skin stitches are placed which require removal in 3-5 days. The need to do this is usually identified and discussed fully prior to the procedure, and is usually necessary in only about 5-10% of people.
There will be some swelling and stuffiness for several weeks, but patients usually resume normal light activity after a few days. It will take several weeks before the nose is completely healed to allow full physical activity.
What is the recovery period like?
You should be able to return to sedentary work after a couple of days. Although there is some pain in the first 24 hours, after this there is usually just a feeling of pressure and stuffiness. You will still look puffy and swollen. You should keep your head elevated above the level of your heart for the first few days to reduce swelling. Bruising around the eyes is to be expected, usually peaking around 72 hours and subsiding in 7 - 10 days.
Cold compresses will help to reduce the swelling around the eyes. You may have a little bleeding too, so you will probably want to change your gauze bandages a few times a day for the first several days.
After 3-5 days, the splint and any packing will be removed. By the end of the first or second week, all splints, bandaging and stitches will have been removed. You will still need to be careful to not blow your nose for about two weeks, and avoid bumps to the nose for about six weeks. Eyeglasses should be taped to the forehead, off the bridge of the nose, for the first month.
You may not be completely back to normal for several weeks. Your nose might be numb, especially if there have been considerable changes made to the tip. You should use extra sunscreen, be gentle when washing your face, and avoid strenuous activity for about 4 weeks.
What is the long-term outcome like for most people?
It is common to feel dissatisfied with the appearance of the nose in the immediate post-operative period. At this point, the nose is still quite swollen, and much of the detail is still not visible enough to appreciate. It is wise to take a wait-and-see approach since the elasticity of the tissues, the blood flow, the thickness of the skin and the appearance of the nose will change significantly during the first three months – even up to the first year or two. It is important to be patient during this period of time. Rushing to perform a second operation during the first nine to twelve months is almost always a mistake.
Many people seem to blossom with positive personality changes after this procedure. A new sense of confidence is the most frequently observed change. Temporary blues after the procedure have also been reported and is generally attributable to two causes: (1) it takes up to six months after the operation to see the complete results of the procedure and (2) rhinoplasty changes the appearance that you’ve grown accustomed to.
Rhinoplasty will provide significant improvements in the appearance of the nose for the vast majority of patients although, in occasional cases, a secondary correction may be required. There are risks with all surgical procedures. You should discuss all benefits and risks with your cosmetic surgeon.