Augmentation Rhinoplasty & Alarplasty
There are several techniques used to perform this procedure. An incision may be made under the rim, or within the nose, and the soft tissue separated.
1. Open or Reduction Rhinoplasty. The bone and cartilage are re-sculpted and the skin sealed with fine sutures to minimize scarring. Patients with a deviated septum may have it corrected during surgery to improve breathing problems. The surgeon may place drops in your nose to eliminate bleeding during surgery and constrict blood vessels.
2. Augmentation Rhinoplasty. The sharp subcutaneous dissection is carried on from the incision to the lower border of the nasal bone to create a symmetrical pocket over the tip and supra-tip area. The sub-periosteal dissection is continued with periosteal elevator from the lower border of the nasal bone. The upper dissection is limited at the marked line for the superior border of the pre-planned prosthesis pocket. The lateral dissection is performed to achieve the adequate pocket space, which depended on the size of the prosthesis. The dissected pocket is irrigated with normal saline and the hemostasis is secured. The custom-made S-shape implant is inserted. Finally, the contour and position are checked by the surgeon.
The surgeons recommend atleast one night hospital admission for Reduction Rhinoplasty. Whilst Augmentation Rhinoplasty and Alarplasty are out Patient procedures. Hospital Admission is not necessary.
Duration of Operation
Three to five hours for Reduction Rhinoplasty
Two to three hours for Augmentation Rhinoplasty and Alarplasty
Reduction Rhinoplasty is performed under general anaesthetic.
Augmentation Rhinoplasty and Alarplasty are performed under local anaesthetic.
Pre Operative Care
Surgeons advised that patients to do the following prior to the rhinoplasty to avoid post operation bleeding or any complications:
• Inform the surgeon of any allergies, all medical conditions, and any medication that the patient are taking (both prescription and non-prescription)
• Avoid aspirin and any medication containing aspirin or brufen for two weeks before surgery.
• Avoid smoking for two weeks as smoking can affect body’s reaction to the anaesthetic and slow down the healing process.
• Checkup for any major medical problems such as diabetes, high blood pressure, heart disease
During your consultation, you should discuss your expectations of the outcome of the surgery and listen to the surgeon’s opinion.
Post Operative Care
After nose job, the patient may experience some pain associated with the surgery. When the procedure is completed, a patient is advised of the following:
• Splint and Dressings Following surgery your surgeon may ask you to wear a splint to support the position of the nasal bones. This usually stays in place for about 2 weeks. Gauze packing inside your nose may also be needed to avoid bleeding. This is usually taken out the day after surgery.
• Medications. Prescriptions for pain medication that the patient will take as needed and antibiotics are administered to avoid any potential risks.
• Swelling and bruising. There may be some swelling and bruising around the nose area, but this will generally fade within 2 weeks after the surgery.
• Strenuous Activities. Avoid any strenuous activities that may increase your blood pressure such as running, swimming or bending as this may cause your nose to bleed in the first month. Your surgeon will advise you when you may resume normal activities.
• Nose Care. You should not blow your nose for the first two weeks after surgery and avoid bumping or rubbing your nose for the next 3 months. Glasses should not sit on the bridge of the nose for the first month. Be gentle when washing your face and avoid fragrances that may cause you to sneeze.
• Recovery Most Rhinoplasty patients recover quickly and are able to move around shortly after surgery. You may not wish to return to work for approximately 2 weeks as you may suffer severe bruising and swelling around the eyes.
Risks and Complications
Risks are inherent to any surgical procedure. But do not worry, all precautions are taken by Plastic Surgery Phuket’s surgeons to avoid these risks.
Complications are very rare. However, here are the most common risks of this surgery:
• Small blood vessels may appear on the skin’s surface
As for scarring, there is no visible scarring at all when Rhinoplasty is performed from inside the nose. When an “open” technique is used, or when the procedure calls for the narrowing of flared nostrils, the small scars on the base of the nose are usually not visible.
After 2 weeks your bruising and swelling should have subsided and no one will be able to tell that you have had surgery. The result is a natural appearance with your nose more in proportion to the rest of your face. It may take up to 12 months before you see your final result.