Functional Rhinoplasty (nasal surgery to improve breathing)

Background:

Functional rhinoplasty is done either to address distortion of the nose from injury or other trauma and/or to allow better breathing.

Nasal Evaluation:

Dr. Reilly will perform an in-depth analysis of your nose, from frontal, profile, base, and oblique views. He will discuss how changes to different areas of your nose may affect the contour and breathing functionality of the nose. With proper analysis, realistic patient expectations and the skills of a qualified facial plastic surgeon, functional rhinoplasty is a very successful procedure in the vast majority of patients.

You are considering an operation to improve the appearance and/or function of your nose. The operation is called rhinoplasty, which involves surgical incisions in the nose and nostril area. In some cases, cartilage from the ear is necessary to help rebuild the nose. When this is necessary, surgical cuts in the outer part of the ear are also required. Generally, this type of plastic surgery of the nose is not an emergency, but it may help improve and/or protect your physical health by helping you to breath more easily. Although complications and unsatisfactory results do rarely occur, in the vast majority of patients, the desired surgical result is readily achieved.

The possible complications of rhinoplasty surgery include but are not limited to the following:
Infection, bleeding, swelling, scarring, numbness, skin discoloration, nasal obstruction, palpable and/or visible irregularities, asymmetries, personality changes and mental difficulties following surgery (even if the operation is otherwise successful), and allergic or other negative reactions to one or more of the substances used in the operation.

Some of the complications of this operation may cause the need for further surgery. Some of the complications can cause prolonged illness and permanent deformity. As with any surgery, there are extremely small risks of a complication from anesthesia.

The technique involves first accessing the bone and cartilage support of the nose. This is done with a combination of incisions made inside the nose and in the area of skin separating the nostrils. Next, the underlying bone and cartilage is reduced, added to, or changed to create a newly shaped structure that addressed any post-traumatic deformity and/or nasal airway obstruction.

Once this work is complete, the tissues are then redraped over the new frame and the incisions are closed with dissolving sutures inside the nose and removable sutures on the outside. A small plastic splint is applied to the outside of the nose to minimize swelling and to help maintain the new shape while the nose heals. Soft, absorbent material is most often used inside the nose to maintain stability along the dividing wall of the air passages called the septum.

Upon completion of the surgery, you will be monitored in the post-anesthesia care area (PACU) until you feel well enough for discharge home. The majority of patients do not experience any significant pain, however, analgesic medications can be given as needed for post operative discomfort. Although Dr. Reilly does not typically use any nasal packing beyond the thin sheets of silicone, most patients will comment that their nasal breathing is limited in the first few days after surgery. This is a result of intranasal swelling and as the swelling subsides, the breathing improves. Your face will feel puffy,especially the first day after surgery. Some patients develop swelling and/or bruising around the eyes. This generally subsides in the first 5 days after surgery. Cold compresses will help minimize and reduce the bruising and any discomfort. Absorbable sutures are generally used inside the nose and do not need removal. Any external sutures, if required, are removed in 5-8 days. Nasal dressings and splints are also removed at 5-10 days after surgery.
It is imperative that you follow your surgeon’s post operative instructions. Keeping your head elevated will minimize swelling. It is important not to blow your nose and to avoid any impact to the nose while the structures inside and out are healing. Activities such as heavy lifting, excessive exertion, sun exposure or any activity that would increase the risk of injury should be avoided. If you wear glasses, you must be careful not to exert excess pressure on the bridge of the nose. Tape and other devices are sometimes used to permit wearing glasses without stressing the area during healing.
Follow-up care is crucial to success in rhinoplasty. Any concerns regarding your post-operative course such as excess bleeding, unexpected swelling, fever or significant pain should be reported to your surgeon immediately. It is essential that you keep your follow-up appointments with your surgeon. As your healing is being monitored, there may be techniques such as massage, use of nasal sprays or even small injections of cortisone like medications that can further enhance the desired result.