Nose plastic surgery is usually performed under general anesthesia with the patient intubated. This is done for several reasons, including:
- Patient comfort
- Limiting patient movement
- Protecting the airway from blood and aspiration
Major Steps of Surgery
1. Exposing the underlying structures
The first major step of rhinoplasty surgery is to expose the cartilage and bone that will be further manipulated to achieve the goals set forth by the surgeon and patient. This starts with choosing a surgical approach, open or closed, as discussed earlier. The surgeon then makes certain intentional incisions and exposes the necessary cartilage and/or bone in a safe manner, without disrupting the blood supply and without injuring these underlying structures.
2. Sourcing of Cartilage and other Building Materials
Since modern-day NYC rhinoplasty procedure involves providing adequate structural support for optimal form and function of the nose, your surgeon must decide where to get this material from. Materials used in the nose can be divided into four groups: autografts (same person), homografts (another person), xenografts (another species), and alloplasts (synthetic). The building material, which is primarily cartilage, typically comes from your own body. It can be harvested from the nose itself (septal cartilage), the ear (conchal cartilage), or the rib (costal cartilage). Other potential materials can be used such as cadaveric rib cartilage or synthetic materials such as high-density polyethylene (Medpor). In general, infection rates are lower and the stability of grafts is higher if your own body tissues are used.
3. Grafting
Once the underlying structures are exposed and the grafting material is selected, the necessary grafts are carved and placed.
There are many different types of nasal grafts used, including:
- Spreader
- Shield
- Columellar Strut
- Onlay tip
- Alar batten
- Alar rim
- Lateral crural strut
- Lateral crural spanning
- Butterfly
- Septal extension
- Dorsal onlay
- Radix
- Columellar plumping
As you can see there are many grafts that your rhinoplasty surgeon needs to be familiar with and adept at using depending on the specific situation. During your consultation, you should be comfortable asking your nose surgery doctor which rhinoplasty grafts he/she plans on using.
4. Bony work
Manipulating the bones of the nose, or adjacent structures happens throughout the rhinoplasty procedure. Osteotomies are bony cuts made in the nasal bones and parts of the cheek bones. Some people refer to this as “breaking the nose,” but it is really controlled cuts in the bone that allow resetting of structures. These cuts can be useful to straighten the nose since the cartilage is attached to the bone and often can be difficult to correct without altering the nasal bones. Also, there may be a crooked bony base to the nose along the floor and this area can be corrected during the septoplasty portion of the surgery to straighten the septum and therefore the external appearance of the nose.
5. Closing up
Once all required changes have been made to the bones and cartilages, the skin and soft tissue envelope is put back (redraped) and sutured closed with a combination of dissolvable and non-dissolvable sutures. Packing and splints are explained below.
How to Prepare for Rhinoplasty in Manhattan, NY?
Once you have decided to undergo a nose surgery, Dr. Linkov, top rated NYC rhinoplasty doctor will discuss in detail how to prepare for your surgery. There are a few steps you should take before your rhinoplasty in order to get the best results. These steps include:
- Avoiding certain medications and supplements that may thin the blood, such as:
- NSAIDS – ibuprofen (Motrin) and naproxen
- Aspirin
- Vitamin E
- Garlic, Ginger, Ginseng, St. John’s Wort, Ginkgo, Black Cohosh
- Stop smoking at least 2 weeks before surgery, as tobacco products can decrease blood flow to the skin and compromise the healing of the surgical site
- Stop all nasal sprays 2 weeks before surgery, except for saline which you can continue
- Pick up medications at the pharmacy, as you will be prescribed certain medications to take after surgery, such as:
- An antibiotic
- Pain medication
- Identify an escort home, as you will need someone to accompany you home and stay with you at least the first night
Read more: https://cityfacialplastics.com/rhinoplasty
Contact City Facial Plastics today to receive more information or to schedule an appointment by calling our office number (212) 439-5177.
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Monday: Closed
Tuesday: 8 AM–7 PM
Wednesday: Closed
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City Facial Plastics
635 Madison Ave # 1402E,
New York, NY 10022
(212) 439-5177
Web Address: https://cityfacialplastics.com
E-mail: [email protected]
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Upper East Side | Lenox Hill | Hell’s Kitchen | Midtown Manhattan | Murray Hill
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