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Surgical Procedures

The painful symptoms associated with chronic sinusitis can be overwhelming. If symptoms are difficult to control with medications alone, your primary doctor may refer you to an Ear, Nose and Throat (ENT) specialist, who can determine the best course of treatment, including further medication therapy or surgery to open the sinus passage ways.

Now, there is an additional surgical option for treatment of blocked sinuses called Balloon Sinuplasty technology. If you have been diagnosed with chronic sinusitis and are not responding well to antibiotics you may be a candidate for surgery, you now have a less invasive option that is clinically proven to be safe, effective and improve the quality of your life.

Balloon Sinuplasty technology is an endoscopic, catheter-based system for patients suffering from sinusitis. The FDA-cleared technology uses a small, flexible, sinus balloon catheter to open up blocked sinus passageways, restoring normal sinus drainage. When the sinus balloon is inflated, it gently restructures and widens the walls of the passageway while maintaining the integrity of the sinus lining.

Rhinoplasty, also called plastic surgery of the nose or a “nose job,” is a very popular procedure that can make profound differences not only in the balance of facial features, but also in a person’s self-esteem. The aesthetic improvements that a rhinoplasty surgeon can make include decreasing or increasing the size of the nose, altering the tip or bridge of the nose, and narrowing or changing the shape of the nostrils. Learn more about the nose surgery procedure, its cost, the possible risks and benefits of nose surgery, and more.

Rhinoplasty, also called plastic surgery of the nose or a “nose job,” is a very popular procedure that can make profound differences not only in the balance of facial features, but also in a person’s self-esteem. The aesthetic improvements that a rhinoplasty surgeon can make include decreasing or increasing the size of the nose, altering the tip or bridge of the nose, and narrowing or changing the shape of the nostrils. Learn more about the nose surgery procedure, its cost, the possible risks and benefits of nose surgery, and more.

Nose reshaping candidates should be at least in their mid teens — 14 to 15 for girls, and slightly older for boys. At these ages, the nasal bone has matured and the shape of the nose has stabilized. All rhinoplasty patients should have realistic expectations for their surgery. It is helpful for the surgeon to know, prior to surgery, what the patient hopes to look like after rhinoplasty, but it is important that those expectations be aligned with what is surgically possible. Before the rhinoplasty surgery, you’ll have a chance to discuss your personal goals in detail with your rhinoplasty surgeon.

The cost of rhinoplasty surgery will vary greatly, depending on several factors. Each individual procedure is unique, depending on the patient’s physiology and goals. Furthermore, different regions of the country will have different pricing: most likely, a nose job performed in Manhattan or Beverly Hills will be more expensive than one performed in a smaller metropolitan area. Be sure to ask what services are covered in the stated rhinoplasty cost, as anesthesia, surgical costs, and other fees can add up very quickly if not covered in the quoted price.

Also, doctors realize that most patients are not able to pay for the costs of cosmetic surgery out-of-pocket, and as a result most will accept rhinoplasty financing. There are several different options, including short-term, no-interest plans, long-term plans with interest, and some physicians will even offer their own plans

Rhinoplasty carries the same risks as any other surgery. Bleeding, infection, and reactions to medications or anesthesia are possible side effects of rhinoplasty surgery. In addition, there are several risks that are unique to plastic surgery of the nose. These include burst blood vessels that can lead to red spots and small scars on the underside of the nose. You might also require a revisionary second procedure at some point in the future to remove or correct tissue. Explore this site to learn more about the risks and benefits of rhinoplasty surgery.

When preparing for your rhinoplasty procedure, it’s a good idea to make sure you have received and filled any pain medication prescription from your doctor, as you will want this after your anesthesia wears off and probably won’t feel like going out to pick up a prescription at that stage of your recovery. You should also have someone drive you to and from your procedure, because you will not be able to drive immediately after your surgery. Other than that, you will want to prepare yourself mentally for the physical change that you’ll be going through, as well as the recovery time that will be necessary.

Plastic surgery of the nose begins when the rhinoplasty surgeon makes an incision either inside the nose or across the skin that separates the nostrils (this skin is called the columella). The cartilage and bone that make up the framework of the nose are then exposed and sculpted to create the desired shape and profile. The plastic surgeon then stitches the skin back into place to complete the nose surgery. Rhinoplasty surgery generally lasts one to two hours and is usually an outpatient procedure.

Recovery after Rhinoplasty Surgery

Following your nose job procedure, you can expect to be somewhat sore. Beginning on the first day and continuing for several days after, you can expect swelling and bruising to increase — black eyes are not unusual during rhinoplasty recovery. Applying cold compresses around, but not directly to, the nose will help reduce swelling. Furthermore, most patients report that the pain is not as bad as the facial appearance may make it seem.

Rhinoplasty Results

The vast majority of rhinoplasty patients who choose qualified surgeons to perform their surgery are satisfied with their results. In many cases, very slight changes to the structure of the nose — sometimes as little as a few millimeters — can produce drastic and pleasing results. To ensure the greatest chance of satisfactory healing following your procedure, there are several steps you should take following your surgery. Your doctor will go over all of them with you, and you can visit our rhinoplasty results information page to learn more in the meantime.

Revision Rhinoplasty

When mistakes are made during a rhinoplasty procedure, or when patients are simply so dissatisfied with the results of their procedure that they cannot accept them, revision rhinoplasty is the answer. Though following the initial nose surgery, the tissue usually must be allowed to heal for some time before a revision procedure may be undertaken, nevertheless significant improvements may be seen through revision rhinoplasty.

Several doctors have begun to offer non surgical nose jobs, or nose jobs which do not actually alter the structure of the nose itself. This is done through the injection of a facial filler. The type of filler that is used will be determined by you and your doctor after a discussion of your goals and medical history. Just as fillers are used to plump out wrinkles, they can fill out areas of the nose to correct minor deformities. While this procedure certainly has limitations, it can be much more affordable than full plastic surgery of the nose, and can be done much quicker with little or no downtime.

Ethnic rhinoplasty is a nose surgery designed to improve aesthetics while still maintaining ethnic characteristics. People with the same ethnic backgrounds tend to have similarities in their nasal features; some have particularly wide bases, while others might be more pronounced. Ethnic rhinoplasty can preserve or enhance these characteristics, depending on your taste. Visit our ethnic rhinoplasty page for more information.

Rhinoplasty surgery, as far as the procedure is concerned, is essentially the same for men as it is for women. But there are differences in the aesthetics of the male nose versus the female nose that must be taken into consideration. While every case must be addressed individually, based on your physical condition and goals, there are certain aesthetic commonalities in male noses. Learn more about male rhinoplasty procedures and how surgeons tailor the surgery to enhance the male vs. female nose.

There are numerous causes of nasal obstruction. A deviated septum (the partition between the nostrils) can be crooked or bent as the result of abnormal growth or injury. This can partially or completely close one or both nasal passages. The deviated septum can be corrected with a surgical procedure called septoplasty. Cosmetic changes to the nose are often performed at the same time, in a combination procedure called septorhinoplasty.

The nasal septum is the partition that separates the right and left nasal cavities. The front part of this wall is made of cartilage. A thin, bony plate forms the back part. It is covered with a mucous membrane. This area can sometimes be malformed or become injured. When either of these problems is present, a deviated septum (one part of the nasal cavity is smaller than the other) may result. If the septum deviates into one or both nasal cavities it can cause breathing difficulty, block the normal flow of mucous from the sinuses when a person has a cold, and prevent proper drainage during a sinus infection. Deviated septum is relatively common but rarely causes complications. A septoplasty is a form of plastic surgery used to straighten the nasal septum.

A septoplasty can be performed under general anesthesia, in which the person is put to sleep for the procedure. It may also be done under local anesthesia, with numbing only of the area involved in the surgery. An incision is made in the front of the septum. The cartilage and bony structures beneath are exposed. Crooked portions of the septal bone and cartilage are then removed. To hold the straightened septum in place, small plastic sheets, splints, or packing may be used.

After surgery, the person is taken to the surgery recovery room until the anesthesia wears off. The nose may have packing in place. The person may be anxious at first, and feel he or she is not getting enough air. The individual will be instructed to breathe through his or her mouth. Medication will be available to decrease the discomfort and nausea. The person will be taken to the recovery room once the anesthesia has worn off. Often, the individual may go home the same day. An antibiotic may be given to prevent infections.

Following a septoplasty, to minimize the risk of bleeding, you should avoid strenuous exercise, nose blowing, and products containing aspirin/ibuprofen for 2 weeks after surgery. The use of nasal saline spray will decrease crusting and clotting while keeping the mucous membranes in the nose moist. Bend at the knees not the waist if needing something off the floor. (The head must be kept above the heart to keep the pressure in the head down.) For 2-3 nights sleep with a few extra pillows or in a recliner. If there is packing in the nose, it will usually be removed the next day. Splints will be removed 7 days postoperative by the doctor in the office. Most patients will return to work 1 week postoperative. If heavy physical labor is expected at work, a 2 week recovery is recommended.

Apply ice gently to the nose. Sit at a 90 degree angle with your feet on the floor. Do not blow your nose. Give 2 sprays of Afrin up the side that is bleeding. If bleeding continues over 15 minutes, respray 2 puffs of Afrin up both sides of the nose. If bleeding continues beyond 15 more minutes, call the office immediately or contact the physician on call.

Rarely, a hole may appear in the septum as a result of septoplasty. A septal hematoma, which is a collection of blood, can also develop. This may cause pain, pressure, nasal blockage, and infection. If infection occurs and spreads into the sinuses, it can be life threatening. Any new or worsening symptoms, such as high fever or severe persistent pain, should be reported to the healthcare provider.

Overgrowth of the turbinates is yet another cause of nasal congestion. (The turbinates are the tissues that line the inside of the nasal passages.) Sometimes the turbinates need treatment to make them smaller and expand the nasal passages. Treatments include injection, freezing, and partial removal. Allergies, too, can cause internal nasal swelling, and allergy evaluation and therapy may be necessary.

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