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Rhinoplasty is one of the most common of all plastic surgical procedures. Rhinoplasty can reduce or increase the size of your nose, change the shape of the tip of the bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip. Dr. Burt M. Greenberg uses computer imaging to see the possible outcome of your surgery, as well as a computerized presentation of past patients to illustrate different types of noses that are amenable to rhinoplasty. Rhinoplasty can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match an ideal. Before deciding to have surgery, think carefully about your expectations and discuss them with Dr. Burt Greenberg. The best candidates for rhinoplasty are looking for improvement, not perfection. Dr. Burt M. Greenberg prefers not to operate on teenagers until after they have completed their growing, around 14-15 for girls, but a bit later for boys. It is important to consider a teenager's social and emotional adjustments, making sure it is what they, and not their parents, actually want. Planning your SurgeryExcellent communication between you and Dr. Burt M. Greenberg is essential. In your initial consultation, you will be asked what you would like your nose to look like and your facial structure will be evaluated. Dr. Greenberg will explain the factors that could influence the procedure and its results including: the structure of your nasal bone and cartilage, the shape of your face, the nature of your cheek bones, the thickness of your skin, your age, and your expectations. Dr. Burt Greenberg will explain the techniques he uses, whether an external approach or, more likely, an internal approach without the need for an outside scar. There is always the possibility of complications including infection, bleeding, or reactions to anesthesia. Most insurance policies do not cover rhinoplasty surgery, however, if the procedure is also performed for septal deviation to correct a breathing problem or marked internal deformity, the procedure may be covered. THE SURGERYDr. Burt Greenberg performs the majority of rhinoplasties at The Great Neck Cosmetic Surgery and Laser Facility, which is accredited at the highest level ("C" level) by the American Association of Ambulatory Surgical Facilities (AAAASF). To prevent any inadvertent movement during the procedure, board-certified anesthesiologists deliver general or sedative types of anesthesia. Rhinoplasty usually takes one to two hours, though complicated procedures may take longer. During the surgery, the skin of the nose is separated from its supporting framework of bone and cartilage and then sculpted to the desired shape. The nature of the sculpting depends upon your problem. Lastly, the skin is redraped over the new framework. When the surgery is complete, an external, heat sensitive splint is applied to help keep your nose maintain its shape. Nasal packs and soft tissue splints may be placed in your nostrils to stabilize the septum, which is the dividing wall between the air passages. AFTER YOUR SURGERYAfter surgery, particularly during the first 24 hours, your face will feel puffy, your nose may ache, and you may have a dull headache. You can control the discomfort with pain medications prescribed by Dr. Burt Greenberg. Except for visiting the bathroom, plan on staying in bed with your head elevated for the first day. The swelling and bruising around the eyes will increase at first, reaching a peak after two to three days. Applying cold compresses will reduce the swelling and make you feel a bit better. Most of the swelling and bruising should disappear within two weeks. A little bleeding is common during the first few days following surgery and you may continue to feel some stuffiness for several weeks. Dr. Burt Greenberg asks that you not blow your nose for a week or so while the tissues heal. Nasal packing is removed after two to three days and you will feel more comfortable. By the end of one week, all dressings, splints, and stitches, where appropriate, are removed. Following a septoplasty, small clots, mucous plugs, and other debris may adhere to the suture line. Proper use of humidification post-operatively, including that of salt humidification and care of the internal septal suture lines with Bacitracin or simple Vaseline may help speed the healing process. In about one case out of ten, a second procedure may be required to correct a minor deformity. Most rhinoplasty patients are able to return to normal activities in a week. It may take several weeks, however, before you are entirely up to speed. Dr. Burt Greenberg recommends that rhinoplasty patients avoid strenuous activities such as: jogging, swimming, bending, and sexual relations for two to three weeks. It is very important to avoid hitting or rubbing one's nose or being exposed to the possiblity of sunburn for twelve week's time. Contact lenses can be worn as soon as practical within the first few days. Glasses are not recommended for the first week, since pressure on the nose may subtly change the architectural framework of the reconstructed cartilage and bones. Dr. Greenberg will ask that you see him several times in the following months after the procedure to check on progress and healing. It takes up to a year to resolve the last amount of swelling in the tip region and to see the final result. This is the normal, expected healing time for this procedure. |
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BURT GREENBERG,
MD. FACS
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