Rhinoplasty in Hyderabad, India – Best Hospital for Nose Job Surgery

Before rhinoplasty

• Patients who regularly take antiplatelet medication or other blood thinners should consult their surgeon because these medications can cause more bleeding after surgery. There may be a risk-benefit balance in which stopping them reduces the likelihood of bleeding but increases clotting, which could lead to a risk to their health. As a result, a thorough examination of risks and benefits may be required.
• Patients can continue taking their regular medications until the day of their procedure. If the surgeon or anesthetist advises against taking regular medicine, they will discuss the possibilities.
• Patients are instructed not to eat or drink (including water and chewing gum) for six hours before surgery, and the anesthetist may provide a pre-medication that will leave them dry-mouthed and comfortably sleepy.
• If patients have a smoke habit, they should be consider quitting for at least 2-3 weeks before and after the surgery. Smoking decreases oxygen levels in the blood, increasing the risk of respiratory issues during and after surgery.
• Patients need to have an escort to drive them home from the hospital. They are not permitted to drive or travel alone.
• People with long-term medical conditions, such as diabetes, hypertension, asthma, or epilepsy, need a check-up from their primary care physician.
• The patients will give their consent by signing the consent form authorizing the doctors to perform the surgery. Patients should carefully read the form; if there are any questions, they can ask the doctors.
• During the pre-surgical consultation, the patient nose will be photographed from various angles for before-and-after comparisons, reference during surgery, and long-term assessment.
• The surgeon may use the software to change the photographs to show you the potential outcomes of the surgery.
  

During rhinoplasty

• Rhinoplasty is performed with either general anesthesia or local anesthesia with intravenous sedation.
• Rhinoplasty is be performed using either an open or closed method. The skin covering the nose bones and cartilage is elevated via an incision to enable the nose's structure to be changed.
• The shape of the nose bones or cartilage is altered according to the structure of the nose and the amount of change required. The surgeon utilizes cartilage from the inside of the nose, rib, or ear. If the septum (the wall between the two sides of the nose) is deviated (bent or crooked), the surgeon can straighten it during this procedure to improve breathing.
• After the nose structure has been changed as desired, the nasal skin and tissue are reinserted, and the incisions are closed. Small stitches are utilized to secure the skin in place. Splints and gauze packs may be used to support the nose during the healing process, which could last from one to seven days.
  

After rhinoplasty

• Patients can experience mild to moderate pain after the rhinoplasty surgery.
• Swelling and bruising may be noticed, particularly around the eyes. The swelling will subside in a few days, and the bruises may resolve within the first week or two.
• Patients may experience the sensation of a stuffy or plugged nose and numbness.
• Patients are allowed to eat whatever they want; however, they may have to wait four or five hours before eating and drinking.
  

Although the possibility of significant complications is limited, functional and, more importantly, aesthetic complications may lead to social and psychological problems. Below surgical complications are classified as hemorrhagic, infectious, traumatic, functional, and aesthetic: 

Hemorrhagic complications

• Epistaxis: Postoperative bleeding is a common effect after rhinoplasty. It is usually minor and can be treated with head elevation, nasal decongestants, or compression. If the bleeding persists, an anterior tamponage is performed and the patient examined. If bleeding continues despite the anterior tamponage, posterior hemorrhage is suspected, and a posterior tampon is used. Although serious bleeds are rare, an endoscopic approach or angiographic embolization may be necessary.
• Septal hematoma: It is an early complication that, if left untreated, may result in serious damage. Septal hematoma manifests as a tender mass in the septum following the surgery. It is usually painful, and the patient may exhibit fever, anosmia, and airflow restriction. Septal hematomas should be drained as soon as they are suspected to avoid infection and cartilage loss. Following drainage, an anterior tampon should be placed in, and the patient should be re-evaluated in 24 hours. If a septal abscess is suspected, antibiotic therapy is initiated immediately.

Infectious complications

Infections resulting from rhinoplasty can range from mild cellulitis to serious systemic infections. Cellulitis is a possible early complication of rhinoplasty. It normally responds favorably to antibiotics, although regular monitoring is required to prevent progression. Septal abscesses result from untreated hematomas, and the preferred therapy is surgical drainage followed by antibiotics.

Traumatic complications

These include septal abnormalities or collapse caused by L-strut damage, cerebral injuries, and lacrimal system injury. Deformities are typically detected as a late consequence after an undetected septal injury, as the soft tissue envelope tightens over the nasal framework. Secondary procedures are frequently required to fix these issues. If a septal injury is found during surgery, it is corrected before closing. 

Functional complications

• Nasal adhesions: Synechiae may appear between abraded mucosal surfaces. If identified postoperatively, they need to be surgically separated.
• Septal perforation: When a perforation arises postoperatively, it can range from a minor perforation that causes whistling when breathing to major perforations that cause epistaxis and rhinitis because of turbulent airflow. If the symptoms are minor as a result of a tiny perforation, therapy may not be required. Larger perforations will necessitate surgical treatment with flaps, which has a high recurrence rate.
• Rhinitis: This is usually a temporary problem, particularly when a blocked airway has been resolved. It may cause nasal discharge, dryness, and breathing difficulties. Topical treatments are commonly used to treat it. If rhinorrhea continues for several weeks, a cerebrospinal fluid leak should be examined.

Aesthetic complications

These are often late complications that might occur in various nasal regions. Grafting can cause asymmetries and abnormalities in the tip area. This is affected by various factors, including skin thickness and the number of grafts employed. Their resolution should be delayed for at least one year following the first surgery.

The majority of people have low to no pain. Patients may go home with nasal packing that will be removed at the hospital in 1-2 days. Patients frequently report slight pain, similar to nasal congestion, during the first week. Some bleeding from the nostrils is normal and disappears after 4-5 days. The trauma and surgical expertise level determines the degree of swelling and bruising. Most patients are comfortable going out two weeks after surgery.

Questions that the patients can ask the healthcare team about rhinoplasty surgery?

Septoplasty vs rhinoplasty

Septoplasty and rhinoplasty are two nasal surgical procedures that can be performed together or separately. Despite their similarities, there are some differences. Below are some of the parameters that help in differentiating septoplasty and rhinoplasty: 

What is rhinoplasty? 

Rhinoplasty (often known as a 'nose job') is surgery that repairs or reshapes the nose. This procedure may be done for cosmetic reasons, such as changing the appearance and proportion of the nose and increasing a person's self-confidence. Plastic surgery of the nose is also performed to treat respiratory issues caused by structural abnormalities in the nose.

Is rhinoplasty painful?

Rhinoplasty surgery is a type of short-stay, low or medium-pain elective surgery that is especially prone to overprescription and, as a result, it can be easily reduced by opioids using standardized perioperative therapies.

Does rhinoplasty require general anesthesia? 

Rhinoplasty can be performed either under local or general anaesthesia, depending on the extent of the surgical procedure and the preferences of the patient. Local anesthesia numbs (no sensation) the nose and surrounding area. Patients will most likely be minimally sedated but awake during the operation (relaxed and pain-free). General anesthesia allows patients to sleep throughout the procedure.

Is nonsurgical rhinoplasty painful?

Nonsurgical rhinoplasty causes little pain and frequently requires no pain medication. While bleeding can be easily stopped with pressure, bruising is infrequent and self-limiting when it does occur. To decrease edema and potential consequences, patients should refrain from excessive nasal manipulation, sleep with a raised head, and avoid intense activity for 2-3 days.

What is augmentation rhinoplasty? 

Augmentation rhinoplasty is a surgical procedure that uses autogenous tissues or implants to treat patients with low nose height that is caused by congenital abnormalities, trauma, infection, excessive reduction rhinoplasty, or submucosal resection.

Why is it called rhinoplasty?

Rhinoplasty, also known as a nose jobs, is a technique for modifying the nose. Rhinoplasty originated from two Greek terms: rhino means "nose," and plasty means "shaping. " Therefore, it is a technique for shaping the nose.

How long does rhinoplasty take? 

The rhinoplasty surgical procedure may take 1.5 to 3 hours. Patients probably need to stay in the hospital for one or two nights. After the surgery, patients will have a dressing on their nose and a splint taped over them for seven days.

How long does it take to wait for revision rhinoplasty?

In general, people who have had a previous rhinoplasty and are unhappy with the outcome should wait at least one year before any examination of the definitive outcome or another surgery is carried out.

Can otolaryngologist perform rhinoplasty? 

Yes, an otolaryngologist (ENT) can perform rhinoplasty surgery. Rhinoplasty is regarded as one of the most difficult surgeries in otolaryngology (head and neck) surgery. Plastic surgeons and otolaryngologists (ENTs) frequently perform facial surgery and rejuvenation operations.

How to sleep after a rhinoplasty?

To reduce swelling and ecchymosis, the patient needs to ice the bridge of the nose and eyes for the first 24 hours, need to sleep with the head elevated for one week and avoid strenuous exercise for two weeks. 

Is rhinoplasty an outpatient procedure? 

Many people believe that rhinoplasty is a surgical treatment that requires an inpatient stay. This could be because the procedure is considered to be traumatic, with a risk of epistaxis and periorbital hematoma.