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Rhinoplasty is surgery to repair or reshape the nose. It is one of the most common plastic surgery procedures. It can be used to reduce or increase the size of the nose, change the shape of the tip or the nasal bridge, narrow the opening of the nostrils, change the angle between the nose and the upper lip, correct a birth defect or injury and help relieve some breathing problems. Rhinoplasty can be performed under local or general anesthesia, depending on the extent of the procedure and the patient's preference. It may be performed in a hospital, or an outpatient surgery centre. Complex procedures may require a short inpatient stay. The procedure usually takes an hour or two, but may take longer.
With local anesthesia, the nose and the surrounding area is numbed. The patient will usually be lightly sedated, but awake during the surgery – relaxed and insensitive to pain. General anesthesia allows the patient to sleep through the operation, and is typically used on children.
The surgery is usually done through an incision inside the nostrils. A splint (metal or plastic) will be applied externally to maintain the newly shaped bony structure when the surgery is complete. Soft plastic splints or nasal packs may also be placed within the nostrils to stabilize the septum (the dividing wall between the air passages). Immediately following the surgery, the nose and face will be swollen and painful. Headaches are common. Pain medications will control these discomforts. Swelling and bruising around the eyes will increase and reach the peak after 2 or 3 days. Keeping the head raised (elevated) and placing cold compresses to the eyes can help reduce the swelling. Within 2 weeks, most of the swelling and bruising disappears. Some subtle swelling remains for several months, but this is generally unnoticeable to anyone but the patient.
During the first few days, minor bleeding from the nose is common. Do not blow the nose, pick the nose, or insert items into the nose for the first week while tissues heal. The nasal packing is usually removed after 3 to 5 days and the patient will feel much more comfortable. All dressings, splints, and stitches should be removed within 1 or 2 weeks.
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