Nose Surgery

Last updated date: 27-Apr-2023

Originally Written in English

Nose Surgery

Septoplasty, turbinoplasty, sinus surgery, and polypectomy are all types of nose surgery. These techniques are frequently used to alleviate nose breathing difficulties. Mouth breathing, sleep apnea, snoring, recurring sinus infections, or frequent nosebleeds can all be brought on by a blocked nasal airway. A deviated septum can produce an obstruction inside the nose, which can be fixed surgically with a septoplasty. Incisions are made inside the nose to accomplish this. The septum's cartilage and occasionally its bone is then cut, altered, relocated, or removed. Surgery to treat turbinates removes an obstruction brought on by enlarged turbinates. In the context of surgery, larger turbinates may have a bone or mucous membrane removed. More breathing space is the aim of these operations. Recurrent sinus infections require surgery because the sinuses get plugged and the mucus cannot flow. Colds and other infections, allergies, polyps, and a deviated nasal septum can all cause the sinuses to become blocked. Before surgery, a complete evaluation will be carried out, including medical history, physical examination, endoscopic examination, and CT scan.

 

Nose Surgery Benefits

Nose surgery is referred to as any surgery done on the inside or outside of the nose. Nasal surgery could be done to:

  • Enhance breathing
  • Correct any birth defects or acquired abnormalities
  • Altering the nose's size or form (cosmetic surgery) 
  • Get rid of abnormal growths like nasal polyps
  • Repair nasal injuries

Otolaryngologists, ear, nose, and throat (ENT) experts with specialized training in head and neck surgery, perform this kind of surgery.

 

Nose Surgery Types

Nose Surgery Types

Otolaryngologists, or head and neck surgeons, typically perform the following forms of nose surgery:

  • Septoplasty is known as the surgical treatment of irregularities and abnormalities of the nasal septum (the portion between the nostrils). It is most usually used to treat a deviated septum, a condition in which the septum isn't in perfect vertical alignment and obstructs airflow.
  • Rhinoplasty is the surgical correction of a nose deformity and may involve modifying the nose's size or shape, the nostrils' width, or the angle at which it meets the lips. It can be carried out for either medical or cosmetic reasons.
  • Turbinate reduction is a treatment that involves reducing the size of the turbinates, which are bony projections into the nasal passageways on the inner walls of the nose. They can get larger and restrict breathing by blocking nasal passageways. Turbinate reduction options include some of the following:
  1. Cauterization, Coblation, and radiofrequency ablation all involve heating a section of the turbinate from below the surface using energy provided by a unique instrument. The turbinate ultimately contracts due to the formation of scar tissue.
  2. A minimally invasive procedure called submucosal resection is used to remove a portion of the turbinate bone from beneath the mucous membrane.
  3. Resection entails surgically removing a piece of the turbinate's bottom.
  • Polypectomy is the surgical resection of polyps from the nose. A long, thin tube with a video camera called an endoscope is put into your nose after you receive either local or general anesthesia. Surgical tools and micro-telescopes are then used to remove polyps.

 

Nose Surgery Indications

Nose Surgery Indications

As a highly individualized technique, nose surgery may not be appropriate for everyone. Before making any decisions, always see your specialist plastic surgeon. Your surgeon will evaluate your condition and general health before planning the best course of action for you. There are certain important aspects to bear in mind when choosing to have nose surgery:

  • You can only change the form of your nose so much because your surgeon can only operate with the present bone and cartilage structure.
  • It is advisable to get medical help right soon if you require surgery to fix a broken nose. Otherwise, the tissue swelling could cause the surgery to be delayed for around five days.
  • To guarantee that surgery won't affect breathing, your surgeon will need to thoroughly assess the structure of your nose. This can stop you from getting some treatments.
  • Up to a year may pass before the final results become apparent, at which point your doctor will determine whether more surgery is necessary.
  • Before having nose surgery, the face and nose's bones must be properly developed. By the time they are about 17 years old for males, and 16 years old for girls, the nose will have developed to its final shape. While the nose is still developing, surgery may affect its normal growth and produce unexpected consequences.
  • Smokers are more likely to have problems. You should stop smoking if you plan to get surgery.

 

You might not be a good candidate for nose surgery if you are:

  • Unable to undergo anesthesia
  • Prone to bleeding issues or incapable of healing
  • Excessively high risk of surgical complications

 

If any of the following apply to you, you are a good candidate:

  • Your facial development is complete.
  • You have difficulty breathing.
  • You are uncomfortable with the way your nose looks.
  • You are in good physical health and don't have any illnesses that could prolong healing or make surgery risks more likely.
  • You have reasonable expectations for the results of having nose surgery.
  • You don't smoke or have given up smoking.

 

Before Nose Surgery

Before Nose Surgery

  • Nothing to eat or drink the night before the surgery after midnight. You could brush your teeth. If you don't adhere to these restrictions, you might not be able to have the procedure.
  • Any drugs, dietary supplements, or herbal therapies you use should be mentioned to your doctor. Ask if you need to stop taking them before surgery.
  • Refrain from using aspirin, aspirin-containing medications, ibuprofen (Advil, Motrin, Aleve), or vitamin E for a week before the procedure. If you are taking any drugs like warfarin or coumadin that cause bleeding, let the staff know. If you have any concerns regarding taking any medications, contact the facility.
  • On the day of surgery, make plans for an adult friend or family member to drive you home. You could experience sleepiness for up to 24 hours as a result of the sedative drug and/or general anesthesia. After 24 hours, avoid operating machinery or a vehicle. Do not consume alcoholic beverages for 24 hours, and do not sign any contracts or make any significant choices.

 

Nose Surgery Procedures

Nose Surgery Procedures

Turbinate Reduction

Turbinates are tiny structures located inside the nose that purify and humidify the air that enters the lungs through the nostrils. They consist of a bone structure that is encircled by vascular tissue and a mucous membrane on the outside. Allergies, irritation, and infections can cause them to swell and inflame, obstructing their airways and causing them to produce too much mucus, which causes congestion.

In a procedure called radiofrequency turbinate reduction, a needle-like instrument is introduced into the turbinate, and energy is delivered to the tissue to induce controlled damage. By the time the healing process is complete, the turbinates will have been reduced, improving airflow through the nose. Under local anesthetic, it is an outpatient procedure that lasts around 10 minutes. Typically, there is no discomfort throughout the healing process, no physical changes, and no long-term adverse effects, including a loss of smell sense. The patient needs to be advised that the crusting on their nose will last for roughly 3 weeks. Doctors advise applying antibiotic ointment and doing repeated nasal saline irrigations during this time. A second Radiofrequency operation can be required if the turbinates gradually grow larger once more.

They advise taking one day off of work and two days off of strenuous exercise following turbinate reduction. Even if they are uncommon, concerns including bleeding and infection should be considered.

 

Septoplasty

Septoplasty

The following steps are part of the septoplasty procedure:

  • Anesthesia. During the surgical procedure, you will receive medication for comfort. Both general anesthesia and intravenous sedation are options. The option that is ideal for you will be advised by your doctor.
  • Making an incision. When a septoplasty is done alone, the incisions are frequently made inside the nasal cavity. It may be necessary to make a small incision across the columella, the thin band of tissue that divides the nostrils, for complicated septoplasties or some of those done in conjunction with rhinoplasties.
  • Mucosal lining separation. The membrane that covers the septum's surface, the nasal mucosal lining, is then pulled away from the septum at one side. Since the lining is delicate and could tear or form a hole as the mucosa is pushed away from the septum, this important step must be carefully carried out. The mucosal lining on the opposing side is pushed away from the septum in a similar way.
  • Deviated septum correction. The distinct mucosal lining is left behind when the deviated septum (bone and/or cartilage) has been removed.
  • Closing the incision. The nasal mucosal lining is positioned around the septum and stitched back together once it has been straightened and placed in the proper position.

 

Rhinoplasty

Rhinoplasty

The steps involved in rhinoplasty surgery are as follows:

  • Anesthesia. During the surgical procedure, you will receive medication for comfort. General anesthesia or intravenous sedation are the options. The option that is ideal for you will be advised by your doctor.
  • Making an incision. An open rhinoplasty involves making an incision across the columella, the thin strip of tissue separating the nostrils, as opposed to a closed rhinoplasty, which conceals incisions inside the nose. The skin covering the nasal bones and cartilages is gradually raised through these incisions, providing access to modify the nose's structure.
  • Reshaping the nose structure. Bone or cartilage removal may be used to reduce an excessively large nose. In some cases, cartilage grafts may be added during nose surgery. The cartilage most frequently used for this purpose comes from the septum, the division in the middle of the nose. On rare occasions, a piece of rib cartilage or ear cartilage may be used.
  • Correcting a deviated septum. To optimize breathing, a deviated septum can be corrected and the protrusion inside the nose can be reduced.
  • Closing the incision. The nasal skin and tissue are sewn, incisions are closed, and the nose's underlying structure is sculpted into the desired form. To change the size of the nostrils, further incisions may be made in their folds.

 

After Nose Surgery

After Nose Surgery

  • Nasal hygiene. Along with a discharge, you could also notice that your nose feels congested. Maintain the nasal entry's clarity according to the nasal douching guidelines. This is typical after nose surgery and the nasal entrance is obstructed with dried blood and mucous. One teaspoon each of salt and bicarbonate of soda (baking soda) should be dissolved in one pint of cooled (body temperature) previously boiling water. Sniff the solution gently up both sides of the nose several times per day. This will aid in breaking up any crusts or blood clots (follow this for several weeks). On the outside of your nose, you might also have paper strips or a splint; try to keep it dry. Following discharge, you'll be informed of the removal date and time.
  • Dental hygiene. Use a soft toothbrush to gently brush your teeth, paying specific attention to the upper row.
  • Eating. Avoid foods that take a lot of chewing and spicy foods that could cause you to sneeze. For up to two weeks, abstain from alcohol.
  • Smoking. Avoid smoking, smoking people, and smoke-filled spaces.
  • Going out. In particular, stay away from crowds and public areas for the first 10 days following surgery. Don't interact with people that you know are sick or have colds.
  • Clothes. Avoid wearing anything with a tight neck that goes over your head. In particular, if the nose has been reset, this could upset it.
  • Exercise. Avoid vigorous exercise; wait until your surgeon gives the all-clear to jog, do aerobics, swim, or play contact sports.

 

Nose Surgery Complications

Nose Surgery Complications

  • Fast bleeding. If this happens, take an ice cube and form an ice pack by filling a plastic bag with frozen peas or ice cubes and wrapping it in a cloth. Place this pack against your forehead and nose's upper bridge. Contact the hospital for help if the bleeding lasts longer than 15 minutes.
  • Minor bleeding. After the procedure, the nose may ooze for a few days, initially blood-stained but eventually becoming clear.
  • Infection. This is unusual. Contact the Hospital or your GP for help if your nose is hot to the touch and you detect a foul, green discharge coming from it.
  • Pain. You might experience pain for a day or two after nose surgery, though this is infrequent. You will be provided with painkillers to take home, but if your pain is unbearable, call the hospital or your doctor for guidance. Get in touch with the hospital immediately if the pain worsens, you feel a throbbing sensation, and your temperature rises (you develop a fever).
  • Misalignment. Your nasal bones might not have realigned correctly if they were displaced. No surgeon can promise that after an operation, your nose will be perfectly straight. Following your operation, the positioning of the bones will be evaluated.
  • Sense of smell. Your sense of smell may vary from time to time, although permanent changes are uncommon.
  • Supratip dip. During the procedure to remove the septum, a small depression may form between the tip of the nose and the nasal bones. Rarely does this occur; if it does, it can usually be fixed during surgery, and if it does so afterward, you can be given the option of having corrective surgery.
  • Scarring. Sometimes scars develop inside the nose; in this case, the scars must be divided. A local anesthetic is typically used during this procedure in the outpatient clinic.

 

Nose Job Cost

The American Society of Plastic Surgeons' most recent statistics show that the average cost of a rhinoplasty is $5,480. Anesthesia, operating room equipment, and other related costs are not included in this average cost, which represents only a portion of the whole cost.

 

Conclusion

Nose surgery, which involves surgical operations to resize and reshape the nose, is widespread among both men and women. Nose surgery, one of the rare surgeries that have both cosmetic and reconstructive goals, can treat nasal issues as well as breathing difficulties by treating septal deviation (crookedness within the nose), whether you have had facial trauma or were raised with a nose that you dislike.