How is this procedure done?

With a few exceptions, the nose shaping incisions are made inside the nose so there are no visible scars. Using specialized instruments, your surgeon cuts the nasal bones and moves and narrows them to reshape your nasal structure. The tip of your nose may be shortened or raised by removing or adding appropriate cartilage. In some cases, an implant or cartilage from another part of the body may be added to obtain your nose's ultimate shape.

At the end of the procedure, taping and a protective splint are applied over your nose. These are generally left in place for seven days. The nose is usually packed with light gauze packing for five days. Placement and removal of the packing are painless. A small amount of bleeding from the nostrils immediately following the procedure is normal. This usually stops in one or two hours, but occasionally, you may have intermittent oozing for a day or two. If there are stitches outside of the nostrils, these are removed in five days. Stitches inside of the nostrils are the dissolving type and do not have to be removed.

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How do I prepare for my nose shaping procedure?

During your initial preoperative visit with your surgeon, be prepared to give a complete medical history including all your medications, allergies and previous surgeries. You will undergo a thorough physical examination and blood tests. If you are over age 50, an electrocardiogram may be taken. Photographs are important aids in planning and performing your nose shaping. They become a permanent part of your patient record and are taken before and several months after your procedure. During your consultation, you will be given specific directions to help you prepare for your procedure. Instructions generally include taking vitamins, cautions about taking certain medication and drinking alcohol, the shaving process and use of antibacterial soap. Do not get a suntan or sunburn in the week prior! You must not eat or drink anything eight hours before your procedure. If you take daily medication, ask your surgeon if it is safe to take before your procedure. You cannot use illicit drugs for three weeks prior to and three weeks after the procedure as they interfere with anesthesia and healing process. If you have any sores on your body, if you have a cold, sore throat or allergic condition, inform your surgeon so you may be examined prior to your procedure

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How long does the procedure take?

The time varies depending on the amount of shaping necessary. Sixty to ninety minutes is the usual range. Work done to improve your breathing (septal) may add twenty minutes, while performance of a chin or cheek implant can add an hour.

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What form of anesthesia is used?

Local anesthesia combined with light sedation is used for some individuals or general anesthesia is given by an expert anesthesiologist M.D. (medical doctor); so you will be totally unaware. Be sure to discuss your options and preferences completely with your surgeon.

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Can I return home the same day?

Yes. Nose shaping is done on an outpatient basis. Be sure to arrange for someone to drop you off, pick you up, take you home and stay with you for at least 24 hours.

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What precautions should I take during my recovery?

You should remain quiet for the first 12 hours after your nose shaping. Visitors and telephone calls should be kept to a minimum. Moderately active sports such as swimming, tennis, and golf may be resumed three weeks after your procedure. Sports involving body contact such as football, wrestling, etc. are prohibited for six weeks. Sun exposure is permitted immediately afterwards, but if you are going to be exposed to strong sunlight a sunscreen with a sun protection factor (SPF) of 15 should be used to protect nasal skin for three months after your shaping. You will be given specific instructions regarding rest, sleeping position, washing your face and hair and breathing techniques.

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How long before I can return to normal activity?

Most individuals may return to normal activities within seven days.

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What are some of the complications that can occur with nose shaping?

Nose shaping rarely produces serious complications. The most common problem is bleeding from the nose. This occurs in about one percent of individuals. While the bleeding may be troublesome, it usually stops spontaneously. In rare circumstances, bleeding may require hospitalization. Infection almost never occurs. Other complications are possible but rarer still. It is important to enter into your procedure aware not only of the benefits, but also of the possible complications. Talk to your surgeon about every question and concern you may have.

In most people, nose shaping is performed through incisions made inside the nose so that there are no external visible scars. In about ten percent of men and women, small external incisions are necessary to reduce the size of the nostrils. These incisions are placed on the nasal sill and in skin creases to make them as inconspicuous as possible. In about five percent of people (most often but not always those who have had previous nasal shaping), a small incision will be placed on the midline structure at the bottom of the nose (columella) to provide more complete operative exposure. This scar is also made as inconspicuous as possible. While external scars are rarely noticeable, you should be aware that all scars are permanent and that their final width, height, and color are not totally predictable.

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What can I expect immediately after my procedure as well as later on?

You may experience slight pain when the anesthesia wears off about one hour after the procedure. If so, you will be given pain medication. The discomfort usually subsides in 30 to 45 minutes with or without pain medication. Pain medication is available should you desire it. However, that most individuals do not ask for any form of post-operative medication.

Swelling of the nose and bruising around the eyes is usual following nose shaping and should not alarm you. Swelling and discoloration peak at 48-72 hours. Reduction in swelling and bruising begins on the fourth or fifth day. Since the internal parts of your nose will be swollen, you may not be able to breathe through your nose for the first few days following your procedure. Breathing will improve as swelling subsides.

Internal healing and fine remodeling as well as subtle improvements in the shape of the nose will continue for a few months. In some individuals, the nose continues to refine in overall appearance for as long as two years. Chances are very strong that you will be even happier with your nose shaping if you realize that the final results may not be immediately apparent. Your nose shaping is designed to improve external appearance as well as internal function. Be sure to address any questions or concerns about this procedure to your surgeon immediately. Your health and satisfaction are the most important considerations any time.

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