Healthcare Times, February 2002

Thinking about Fixing your Nose?
Most of us give little thought to our noses unless we become concerned with its appearance or develop breathing difficulties. Cosmetic nasal surgery has its origin in functional nasal surgery. In the early 20th century, improvements in anesthesia and operating room sterility fueled pioneering European physicians venturing into cosmetic nasal surgery. Forward thinking Chicago surgeons, such as Sam Fomon and Maurice Cottle, traveled to Europe, learned techniques from the European masters and imported them to America. Following WWII with the advent of antibiotics, a new affluence and a social renaissance that became accepting of self enhancing surgery, nasal reshaping gained momentum. Chicago became a focal point for educating future surgeons. Physicians such as Tresley, Becker and Tardy contributed new thoughts and techniques into nasal surgery. Today, Chicago still remains a destination for those wanting to learn the latest methods of nasal reshaping. Each year, Chicago plays host to scores of visitors, both local and international, who are interested in learning about the “Chicago method” of Rhinoplasty. As nasal surgery surges in popularity, below are frequently asked questions by many who are seeking nasal reshaping.

Is rhinoplasty for me?
Men and women of all ages desiring improvement in the appearance of their noses undergo rhinoplasty. According to a 2000 American Academy of Facial Plastic and Reconstructive Surgery survey rhinoplasty (nasal reshaping) surgery has increased 39 percent over the last 3 years. However, it is an individual question and usually one that has been well thought out. For some people, the desire to improve their nasal appearance stems from deep stinging teases experienced as a child. For others, it may be a desire to regain a nose they once had prior to an injury. Although there is no age that is too old for nasal surgery, adolescents who have yet to go through their growth spurt, or who are emotionally immature, are delayed until they reach a more ready age.

What if I have a broken nose or a deviated septum?
Because of the nose’s leading position on our face, it contains the most frequently injured bones on the face. This often leads to progressive nasal deviations and breathing difficulties. Often, forgotten or overlooked nasal injuries sustained as an infant or child lead to later day nasal obstruction, deviated septums and crooked noses. The nasal septum is the partition down the middle of the nose, which separates the two halves of the nose. It also serves to provide structural support to the bridge and tip of the nose. When injured, the septum may cause the nose to deviate or collapse. Deviated septums and broken noses are diagnosed at the time of an initial consultation, and commonly fixed at the same time as cosmetic nasal surgery. Following surgery, many are thrilled to be able to breathe through their nose again, not realizing the magnitude of difficulty they had with nasal breathing prior to their procedure.

Will rhinoplasty affect my breathing?
Cosmetic nasal surgery can adversely affect breathing, especially if the support of the nose is not taken into consideration before surgery. It is important to discuss with your surgeon your concern about maintaining good breathing function following the surgery. If cosmetic nasal surgery is being performed at the same time as a surgical procedure to improve breathing, the functional component of the surgery may be covered by insurance.If you have nasal breathing difficulties and have tried but failed to gain improvement with medicines (you may be a candidate.) Check with your insurance carrier.

Does it hurt?
Most patients are surprised to learn that there is very little to no pain experienced following rhinoplasty. An anesthesiologist makes certain you are comfortable during surgery. you may be uncomfortable for a day or two Following surgery. Swelling inside the nose will make you feel like you have a cold but can be expected to resolve within a week.

How long does it take to heal?
Significant bruising and swelling have become uncommon with modern day techniques. Also, uncomfortable nasal packing frequently used years ago is no longer favored. One week after surgery most patients return to their routines, however, high impact sports should be avoided for 4-6 weeks. One important point is to be patient. The final result will take up to one year to be realized. The definition and shape of the nasal tip continues to improve throughout the healing time.

Can I choose the type of nose I want?
you can choose your outcome Within reason. However, it is not like going to the grocer and picking a nose off the shelf to your liking. It is important to clearly discuss with your surgeon the aspects of your nose you want improved. Computer enhanced video imaging has been a helpful tool to communicate your desires and view what you would look like to see with your final result. Keep in mind that many factors determine your outcome, including skin thickness, underlying cartilage positions, and the dimensions of your face. Be realistic in your expectations. If you are looking to have the same nose as your favorite supermodel, it may not be possible. Additionally, goals of cosmetic nasal surgery, like styles, have changed over the years. Turned up cute button noses of the 50’s are no longer fashionable. Our aim now is to maintain a natural look that draws attention to and accents the best features of your face. The most common scenario is that you will still look like yourself but with a nose that is in better balance and blends harmoniously with the rest of your face.

Who performs rhinoplasty?
Rhinoplasty is a complex surgical procedure performed by well trained surgeons. Unlike many other cosmetic procedures, nasal reshaping has an origin in a functional procedure. Therefore, it is important to seek out an expert who frequently does the surgery and who respects the breathing mechanisms of the nose. Certainly board certification in a respected field is a strong prerequisite. Other relevant inquiries for the researching patient include hospital privileges for rhinoplasty, academic affiliations and peer reviewed published articles. It is essential that your surgeon be able to balance aesthetic improvements of the nose while maintaining or improving the functional competency of the nose.

If you are considering cosmetic nasal surgery, do your research, consider consulting with multiple nasal surgeons and then go forward taking comfort in knowing it is a commonly performed procedure with life long benefits.