Rhinoplasty is a plastic surgery procedure used to correct and reconstruct the nose. There are two types: reconstructive surgery restores form and function, while cosmetic surgery improves appearance. The rhinoplasty procedure involves anesthesia, incisions to access the nasal structure, reshaping bones and cartilage, correcting deviations, and closing incisions. Post-operative care requires head elevation, medication, limited activity, and avoiding extreme facial expressions. Risks include infection, breathing issues, and an unsatisfactory result.

1. RHINOPLASTY
Mrs. REVATHY.A

2. INTRODUCTION
• Rhinoplasty is a frequent operation that only few
surgeons are considered to truly master the wide
scope of technical nuances.
• John Orlando Roe entered history as the father
of aesthetic rhinoplasty after having reported a
“simple operation” in 1887.

3. DEFINITION
☻Rhinoplasty commonly known as a nose job, is
a plastic surgery procedure for correcting and
reconstructing the nose.
• There are two types of plastic surgery used –
reconstructive surgery that restores the form and
functions of the nose and cosmetic surgery that
improves the appearance of the nose.

4. INDICATIONS
Indications for open rhinoplasty include the
following:
• Nasal tip modification
• Internal nasal valve dysfunction
• Thick nasal skin
• Repair of septal perforations

5. • Posttraumatic nasal deformity with a deviated
septum or dorsum
• Cleft lip and palate nasal deformity
• Nasal tumor excision
• Secondary rhinoplasty

6. CONTRAINDICATIONS
• Intranasal substance abuse (eg, cocaine)
• Psychological or psychiatric instability
• Comorbid medical conditions that preclude
surgical clearance
• Preoperative diagnosis of nasal dysfunction
(with or without aesthetic deformity) that may
be better treated with a closed approach (ie,
septoplasty for airway obstruction) or medical
management

7. • Patient refusal of external scar
• Very thick nasal skin in which postoperative
edema can be permanent

8. PREPARATION
• Avoid aspirin, ibuprofen (Advil, Motrin),
naproxen (Aleve), and other non-steroidal
anti-inflammatory medications.
• Refrain from smoking two weeks before and
two weeks after surgery.
• Avoid sun damage two weeks before surgery.
• NPO
• Consent
• Post operative teaching- nasal dressing

9. PROCEDURE
Rhinoplasty surgery includes the following
steps:
Step 1 – Anesthesia
intravenous sedation or general anesthesia.

10. Step 2 – The incision
• Rhinoplasty is performed either using a closed
procedure, where incisions are hidden inside the
nose, or an open procedure, where an incision is
made across the columella, the narrow strip of
tissue that separates the nostrils.
• Through these incisions, the skin that covers the
nasal bones and cartilages is gently raised,
allowing access to reshape the structure of the
nose.

11. Step 3 – Reshaping the nose structure
• An overly large nose may be reduced by removing
bone or cartilage. Sometimes surgery of the nose
may require the addition of cartilage grafts.
• Most commonly, cartilage from the septum, the
partition in the middle of the nose, is used for
this purpose. Occasionally cartilage from the ear
or rarely a section of rib cartilage can be used.

12. Step 4 – Correcting a deviated septum
• If the septum is deviated, it can be
straightened and the projections inside the
nose reduced to improve breathing.
Step 5 – Closing the incision
• Once the underlying structure of the nose is
sculpted to the desired shape, nasal skin and
tissue is redraped and incisions are closed.

13. POST OPERATIVE MANAGEMENT
• Provide head elevation (30degree)
• Administer analgesics, steroids and antibiotics
• Avoid strenuous activities such as aerobics and jogging.
• Take baths instead of showers.
• Not blow the nose.
• Eat high-fiber foods, such as fruits and vegetables.
• Avoid extreme facial expressions, such as smiling or
laughing.
• Brush teeth gently to limit movement of upper lip.
• Wear clothes that fasten in the front. Don't pull
clothing, such as shirts or sweaters, over the head.

14. RISKS
• Anesthesia risks
• Infection
• Poor wound healing or scarring
• Change in skin sensation (numbness or pain)
• Nasal septal perforation (a hole in the nasal
septum) is rare.
• Difficulty breathing
• Unsatisfactory nasal appearance
• Skin discoloration and swelling
• Possibility of revisional surgery