Reduction rhinoplasty (Aesthetic nasal surgery) by Dr.Chettawut, Bangkok, Thailand

Rhinoplasty or nose surgery is a very individualised procedure and requires a thorough evaluation of the bones and cartilages that make up the skeleton of your nose.

My goals for the surgery focus on how to achieve maximum improvement in the most natural-looking manner.

The structures on the inside of the nose are carefully assessed and the relationship of the nose to your overall facial structure is evaluated.

Most people having rhinoplasty surgery are concerned about the size of the nasal hump (bridge or bump) or the shape of the nasal tip (pointy end of the nose). Usually modifications are made to both.

My rhinoplasty technique involves:

1. Skeletonization: Exposing the underlying skeleton of bone and cartilage from the overlying skin. All incisions are normally placed either inside the nose (closed technique).

2. Refining the tip: A resection of a portion of the tip cartilage can be undertaken to help achieve refinement or 'narrowing' of the nasal tip.

3. Shaping the profile: (Taking down the hump): The bone-cartilage hump has been removed by osteotome (bone knife).

4. Rasping: A surgical file or rasp is commonly used to smooth the bony hump, in order to achieve more precise results.

5. Osteotomies: If the bridge of the nose is wide, I will can make it narrow by fracturing (cutting) the bone on each side and moving it closer to the center.

Osteotomies are usually required when reducing the nasal hump and are also often used to improve a twisted nose.

The common procedures done together with rhinoplasty are:

1. Alarplasty: The flared nostrils can be reduced by removing a small wedge of tissue from the base of the nose.

2.Chin implant: The chin implant can give greater definition to your chin and provide balance with your nose.

Anesthesia for your rhinoplasty

I prefer general anesthesia, you will be completely out, sleeping throughout the operation.

After your surgery

Immediately after nose surgery a splint (cast) is usually applied to the nose to maintain the shape. Nasal packs also may be placed in the nostrils to stabilize the modified bone and cartilage.

The nasal packs and splint will be removed at your first post operative day 3 and 6 respectively.

After surgery, your nose and eyes will be swollen and bruised, and your face may look puffy. The swelling and discoloration increase in the first few days and then will subside after the first week or so.

List of possible complications:

Asymmetry

Bleeding (may require nasal packing to control it)

Discoloration

Infection (risk is less than 1%)

Internal scar/adhesions

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