CURRENT
Facial Plastic Surgery
CURRENT
Facial Plastic Surgery
Rhinoplasty
Rhinoplasty is a surgical procedure to change the external structure of the nose. An asymmetric or large nose can distract from the rest of the face. The goal of rhinoplasty is to restore facial balance and harmony.
What is aWhat is a CURRENT Rhinoplasty?
Rhinoplasty is one of the most technically complex cosmetic procedures. Dr. Sarah Novis is an expert in rhinoplasty surgery, having trained with some of the most renowned rhinoplasty surgeons in the country. She has performed numerous surgeries and is known for her artistic eye and meticulous attention to detail.
Dr. Novis develops an individualized plan for each patient to complement the rest of the facial features. Book a consultation with Dr. Novis today to see how rhinoplasty can transform the way you look and feel about yourself.
Am I a candidate for Rhinoplasty?
Rhinoplasty surgery addresses multiple issues with the nose. Often patients complain of a nose that is “too large” or “too wide” or has a “bump.” Dr. Novis performs a full structural analysis on all consultations for rhinoplasty. She will discuss individual aesthetic goals and design digital renderings of pre-operative photos. Dr. Novis takes the time to listen to patients’ individual concerns and develop a surgical plan.
Procedure
Patients are expected to arrive on-time for their scheduled procedure. On the morning of the appointment, it is advised to abstain from consuming caffeinated beverages and ensure that breakfast is eaten. Having food in the stomach enhances comfort and helps prevent nausea. Prior to arrival, please cleanse the face thoroughly, ensuring no makeup or skincare products remain on the skin. Choose a top that is easy to remove, as it will need to fit over the head-dressing applied post-surgery. Avoid wearing any jewelry, including earrings, necklaces, bracelets, watches, etc., on the day of the procedure. Additionally, refrain from wearing contact lenses on the day of surgery.
Two weeks before surgery, it is advised to avoid drinking and/or smoking nicotine. One week before surgery, stop all aspirin and all aspirin-like products (ibuprofen, Advil, Motrin, Aleve, etc.). If you would like to use arnica supplements to reduce bruising, these may be started one week before surgery and continued for one week after.
On the day of your procedure, please come with someone who can drive you to and from your appointment. If your driver wishes to leave a cellular telephone number, we can text him or her with updates and a pick-up time.
Rhinoplasty Shopping List:
- Nasal saline spray
- Oxymetolazine (Afrin) nasal spray
- Tylenol (acetaminophen) 500mg tablets
- Gauze pads (2×2 or 4×4)
- Paper tape
- Hydrogen peroxide
- Cotton swabs
- Lip ointment to prevent chapped lips due to mouth breathing after surgery
- Ice-bags or frozen vegetable bags
- Foam wedge pillow or multiple pillows to keep head elevated. It is recommended that you keep your head elevated to at least 30 degrees while sleeping for 6 weeks postop
- Soft foods to eat for the first few days after surgery along with plenty of fluids (i.e. Ginger ale, Sprite, Gatorade) to avoid dehydration and constipation
Your Recovery
Recovery Guidelines
Nausea is rare, as several measures are taken before, during, and after the surgery to prevent it. Patients typically need only Tylenol alone right from the start, although prescription pain pills are used by some for 2-4 days after the procedure, and then switch to Tylenol – all other over-the-counter pain preparations are off-limits. Always take medications with food to reduce the risk of nausea and vomiting. Apply ice packs or frozen peas in a zip-loc bag with a thin washcloth or paper towel between the plastic and your as needed for pain and swelling. You may apply the ice over the compressive dressing on the face/neck for 15 minutes and the rest of the hour off while you are awake.
For the initial two weeks following your procedure, it’s important to avoid activities that involve wide mouth opening, vigorous exercise, heavy lifting, and prolonged periods of looking down. Additionally, during this period, it’s recommended to sleep with your head elevated at least 35° with extra pillows under your head/upper back for the first 1-2 weeks, to decrease swelling and bruising.
Try to sleep on your back and with your head elevated at least 35 degrees for the first 1-2 weeks after surgery. You may notice your swelling is more noticeable in the morning and then will improve throughout the day due to lying down. After rhinoplasty surgery, a splint is placed over the nose. This will be removed at 6-7 days after surgery. After splint removal, there may still be some swelling over the nose and bruising around the eyes. Makeup may be worn after splint removal. Patients generally return to work 1-2 weeks after surgery. It is recommended that heavy lifting or straining be avoided for 2 weeks after surgery.
- No ibuprofen, aspirin, Advil, or Motrin for 2 weeks after surgery as these medications increase your risk of bleeding
- No heavy lifting or straining for 2 weeks postop. Gradually resume your normal routine
- No alcohol for 1 week after surgery and as long as you are requiring medication
- Eyeglasses and sunglasses may only be worn when the splint is in place. You should avoid having glasses directly on your nose for 6 weeks postoperatively as the nasal bones are still mobile during this time
Timeline
Days 1-2
You will have gauze taped under your nose to catch bloody drips. You may change this as needed and will likely need to change it a couple of times. When you change the gauze, apply 2 sprays of saline spray to each nostril, gently dab incisions with hydrogen peroxide on a cotton swab to remove bloody crusts, and generously apply mupirocin or bacitracin ointment over the incision at the base of your nasal septum and inside of each nostril. Apply an ice pack over the eye area for 15 minutes every hour while awake. Remember to keep the nasal dressing dry. Medication may be taken every 4-6 hours during this time. If your pain is mild, you may use 500 mg of Tylenol. Do not take prescription pain medication and Tylenol/acetaminophen at the same time, as this can result in a Tylenol overdose. If you are having persistent bleeding, use the Oxymetolazine (Afrin), 2 sprays in each nostril. Allow to set 10 mins, repeating as needed. If bleeding persists, please contact Dr. Novis. Nasal congestion is normal, but it is okay to use the Oxymetolazine (Afrin) 2 sprays in each nostril at bedtime as needed for congestion. You should not use this spray beyond the first week after surgery.
Days 3-5
You no longer need to wear the gauze taped under your nose, unless you are having persistent bloody drips Apply nasal saline spray to each nostril at least 3 times daily (more is better!), followed by mupirocin or bacitracin ointment to the nostrils and incision. Avoid rubbing the delicate sutures over the base of your nasal septum, but rather dab off any drips. Start decreasing the amount of medication that you are taking and spacing it to longer intervals.
Days 6-9
Your nasal splint will be removed during this time. It is normal for the swelling to increase over the nose after the splint is removed. You may wear makeup after the splint is removed. The only place you may not wear makeup is on the incision line at the base of your nasal septum, which you may start wearing makeup over at 10 days postop. If bruises under the eyes occur, a “complete coverage” concealer will work best for camouflaging. Continue nasal saline spray followed by mupirocin or bacitracin ointment at least 2 times daily.
Days 10-14
You may discontinue mupirocin/bacitracin ointment during this time. Continue nasal saline spray about 2-3 times daily and as often as needed additionally for dryness and crusting. During this time you may gradually resume cardiovascular exercise. Avoid heavy lifting or straining until after 14 days.
If you experience extreme pain or swelling, nausea, vomiting, or are uncertain about something, please call our office at 834-371-1610
Results
Rhinoplasty FAQ
Is rhinoplasty surgery painful?
Patients are often surprised that rhinoplasty surgery is not as painful as they would expect. Dr. Novis uses meticulous techniques to avoid placing packing inside of the nose, which greatly improves postoperative pain and speeds recovery. Having a dull headache, facial soreness, and a stuffy nose is expected the first week after surgery and resolves in 1-2 weeks. Patients rarely require pain medication for more than a couple of days.
Am I a candidate for nonsurgical rhinoplasty or liquid rhinoplasty?
Nonsurgical rhinoplasty or liquid rhinoplasty is the use of fillers in the nose to address cosmetic nasal issues. As part of nonsurgical or liquid rhinoplasty, filler can be used to camouflage small bumps or create a better tip definition. Dr. Novis performs liquid rhinoplasty or nonsurgical rhinoplasty in the appropriate patient, which can be determined during consultation.
Will Rhinoplasty surgery improve my breathing?
Addressing the structure of the nose often also improves the function. Dr. Novis uses cartilage from the septum to strengthen and support deficient areas of the nose. Current Facial Plastic Surgery does not perform surgery for insurance or septoplasty alone, but often patients will notice a functional improvement in their breathing after structural issues are addressed during rhinoplasty.
Is there male rhinoplasty?
Current Facial Plastic Surgery is a destination for both female and male rhinoplasty patients. Dr. Novis commonly performs male rhinoplasty and is skilled at creating natural results. “My goals for male rhinoplasty are to create an aesthetically pleasing nose that is masculine and balanced with the other facial features. Classical rhinoplasty techniques can result in over-resection and feminization of the male nose. I take great care to address the issues that a patient has with their nose while also maintaining the structure and character of the nose,” says Dr. Novis.
Can it fix my bulbous tip?
The nasal tip is a complex framework of underlying cartilage with a soft tissue envelope. Structural and skin issues can lead to a wide-appearing nasal tip with poor definition. Dr. Novis addresses all structural components of the nasal tip to create a natural and aesthetically pleasing result.
Can it fix my wide nose?
The “wide nose” often has issues with both a poorly defined tip as well as a wide nasal base. Many surgeons will address the tip but will fail to correct a wide nasal base, as it is technically difficult and time-consuming. Dr. Novis frequently performs alar base reductions and nasal base excisions as part of rhinoplasty for the wide nose. Meticulous incision placement and suturing optimize scar healing to give a natural result.
Will it fix my hump (dorsal hump)?
A common complaint among patients seeking rhinoplasty is a “bump” or dorsal “hump”. This often occurs where the nasal bone and cartilage meet. This area is commonly mismanaged, as it would seem that the hump can simply be removed or cut off and the rest of the nose can be left as is. “A hump reduction is like cutting off the top of a mountain,” says Dr. Novis. “Simply removing the top will lead to a flat, wide area. No one wants a flat, wide nose. It requires a lot of skill and experience to deal with bony work to create a thin, straight nose with a desirable profile”. Dr. Novis is an expert at reconstructing the nose in a way that will compliment your features, leading to a natural look.
Why does food taste different/bland right after surgery?
The sense of taste is largely mediated by the sense of smell. After surgery, the inflammation and crusts in your nasal cavity prevent air movement through your nose that would usually carry smells to your olfactory bulb. As the inflammation decreases and there is better air flow through the nose, you will notice that the sense of taste starts to return, usually over the first week or two.
When will I be able to breathe through my nose?
Immediately after surgery you have swelling both inside and outside of your nose that prevents movement of air. This will improve significantly over the first few weeks.
Why are my upper teeth painful or numb?
The nerves to your upper teeth run through the nasal septum, and manipulation or fracturing of the nasal septum can cause pain in this area and temporary numbness. The pain will decrease over the first week and the sensation will return over a period of weeks to months, but you will notice it much less in the first week or two.
Why is my nose numb?
In order to access the structures of the nose, the skin envelope has to be elevated off the cartilage. This involves the division of some of the tiny nerves that supply sensation to the skin. These nerves will slowly re-grow over a period of weeks to months, and during this time it is normal to notice some strange sensations including tingling and itching.
Why do I feel worse 2 days after surgery than I did right afterward?
The body’s inflammatory response peaks at 24-48 hours after surgery, so you may notice that pain and bruising are worse during this time. After about 48 hours you will notice the pain will start to improve.