While there is no upper age limit for having rhinoplasty, it is often wise to wait until the nose has fully developed before undergoing nasal surgery (at age 14 or 15).
When contemplating a rhinoplasty procedure, both functional and aesthetic features are considered. The goals of surgery include:
- Refining the appearance of the nose.
- Preserving the ability to breathe.
- Not compromising the sense of smell.
In patients with obstructed nasal airflow, it is necessary to assess whether there is a "fixed" or "obstructed" component to the breathing difficulty. Sometimes, breathing problems are related to "fixed" internal nasal structures (e.g., the deviated septum). This problem can be corrected during the rhinoplasty procedure. In other instances, environmental allergies may be contributing to the symptoms. For these patients, performing a surgical procedure, without addressing the underlying condition, is not the best treatment for the patient.
During your initial office visit, Dr. Wall will inquire about your medical history and any specific "nose symptoms" that you may be experiencing (e.g., difficulty breathing, allergies, runny nose). Also, an internal and external examination of the nose will be performed. Skin quality, size, and the shape of your nose are carefully studied. Photographs will be taken from a number of vantage points to assist in explaining features unique to your anatomy.
With respect to appearance, most patients do not desire an "operated look", or a dramatically different appearance. They want to refine the shape of the nose and to bring it into better harmony with other facial features. During the evaluation, there will be an opportunity to discuss these concerns about your nose. It is important to have a clear idea of your hopes for the procedure. However, it is also important to recognize that there are some limitations to cosmetic nasal surgery. Communication is the key to ensuring that you will be pleased with the results of the operation.
During rhinoplasty surgery, work is performed on the cartilage and bone. Together, these elements form the underlying nasal framework. In some cases, the bones may be altered in order to make your nose look narrower or straighter. Other techniques are available to refine the appearance of the nose. In some cases, tiny pieces of cartilage are employed to enhance definition at the tip. (The cartilage is taken from the back of the septum, or from another part of the body.) In the post-operative period, the skin and soft tissues contract over the new framework of your nose.
In most cases, incisions will be placed on the inside of the nose (where they will be invisible). If a person has a particularly wide nose, the base of nostrils may be narrowed. External incisions are hidden in the crease where the nose and cheek join. A very small absorbable dressing may be placed just inside the nostrils for 24 hours. Large packs are not used.
A small splint remains in place for several days to protect the nose. Bruising may require seven to ten days to resolve; but make-up can be used as a concealer until the last traces are gone. Swelling can last a number of weeks, with residual swelling affecting just the nasal tip. Typically, several weeks are required before you are able to breathe normally through the nose. Some results are apparent shortly after surgery. However, several months are typically required for the final degree of refinement and definition to be achieved.