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BEFORE YOUR SURGERY
In the week before, you should not take any medications containing aspirin (acetyl salicylic acid), since these products affect the bloods clotting mechanism and therefore may lead to excessive bleeding during and after surgery, hence resulting increased bruising. Taking high doses of vitamin E preparations, eating large amounts of garlic and consuming alcohol can also produce the same result and should be avoided. If pain medication is necessary, we recommend you take ibuprofen/paracetamol.
It is in your own best interests to quit smoking, at least two weeks before and until 2 weeks after surgery. It is well known that smoking causes narrowing of the blood vessels, which leads to a decreased blood supply to the skin, thus slowing and interfering with the healing process.
Be sure to tell your surgeon if you've had any previous nose surgery or an injury to your nose, even if it was many years ago.
Ensure you inform your surgeon of any medications you take, as well as possible allergies including (drug, latex, plasters and so on).
Your surgeon will decide whether preliminary examinations are necessary, such as blood tests, an electrocardiogram, or x-rays of the lungs. If this is the case, these tests should be performed several weeks before the surgery.
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THE PROCEDURE
Your operation will take place at The Highgate Private Hospital, under General Anaesthesia, so you will sleep through the operation and be totally pain free. You may or may not need to stay overnight in hospital.
Rhinoplasty usually takes an hour or two, though complicated procedures may take longer. During surgery the skin of the nose is separated from its supporting framework of bone and cartilage, which is then sculpted to the desired shape. The nature of the sculpting will depend on your problem and your surgeon's preferred technique. Finally, the skin is redraped over the new framework.
Most Rhinoplasty procedures are performed from within the nose, making their incision inside the nostrils. Others times it is necessary perform an "open" procedure, especially in more complicated cases; where a small incision across the columella, the vertical strip of tissue separating the nostrils is made.
When the surgery is complete, a splint will be applied to help your nose maintain its new shape. Nasal packs or soft plastic splints also may be placed in your nostrils to stabilize the septum, the dividing wall between the air passages.
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AFTER THE OPERATION
After surgery, particularly during the first twenty-four hours, your face will feel puffy, your nose may ache, and you may have a dull headache. You can control any discomfort with the pain medication given to you. Plan on staying in bed with your head elevated (except for going to the bathroom) for the first day.
You'll notice that the swelling and bruising around your eyes will increase at first, reaching a peak after two or three days. Applying cold compresses will reduce this swelling and make you feel a bit better. In any case, you'll feel a lot better than you look. Most of the swelling and bruising should disappear within two weeks or so. (Some subtle swelling-unnoticeable to anyone but you and your surgeon-will remain for several months.)
A little bleeding is common during the first few days following surgery, and you may continue to feel some stuffiness for several weeks. You will be asked not to blow your nose for a week or so, while the tissues heal.
If you have nasal packing, it will be removed after a few days and you'll feel much more comfortable. By the end of one or, occasionally, two weeks, all dressings, splints, and stitches should be removed.
All surgery carries some risks and uncertainties
When rhinoplasty is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including infection, nosebleed, or a reaction to the anaesthesia. You can reduce your risks by closely following your surgeon's instructions both before and after surgery.
After surgery, small burst blood vessels may appear as tiny red spots on the skin's surface; these are usually minor but may be permanent. As for scarring, when rhinoplasty is performed from inside the nose, there is no visible scarring at all; when an "open" technique is used, or when the procedure calls for the narrowing of flared nostrils, the small scars on the base of the nose are usually not visible.
In about one case out of ten, a second procedure may be required, for example, to correct a minor deformity. Such cases are unpredictable and happen even to patients of the most skilled surgeons. The corrective surgery is usually minor.
Getting back to normal
Most rhinoplasty patients are up and about within two days, and able to return to work a week or so following surgery. It will be several weeks, however, before you're entirely up to speed.
You will be asked to avoid strenuous activity (jogging, swimming, bending, sexual relations; any activity that increases your blood pressure) for two to three weeks. Avoid hitting or rubbing your nose, or getting it sunburned, for eight weeks. Be gentle when washing your face and hair or using cosmetics.
You can wear contact lenses as soon as you feel like it, but wearing glasses are a little difficult. Once the splint is off, they'll have to be taped to your forehead or propped on your cheeks for another six to seven weeks, until your nose is completely healed.
Your new look
In the days following surgery, when your face is bruised and swollen, it's easy to forget that you will be looking better. In fact, many patients feel depressed for a while after plastic surgery-it's quite normal and understandable.
Rest assured that this stage will pass. Day by day, your nose will begin to look better and your spirits will improve. Within a week or two, you'll no longer look as if you've just had surgery.
Still, healing is a slow and gradual process. Some subtle swelling may be present for months, especially in the tip. The final results of rhinoplasty may not be apparent for up to a year.
If you have any further questions or queries about this procedure, please feel free to call and speak to either Dr Roberto Viel, Dr Maurizio Viel or any of our nurses. Please note that it is necessary to attend a consultation prior to your operation, this is also the case with existing patients, it may also be necessary to have repeat blood test.
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