Surgery of nose, ears, and lips
Nasal surgery includes any surgery performed on the outside or inside of the nose. A common type of reconstructive and cosmetic surgery, nasal surgery may be performed to accomplish the following: improve breathing, correct congenital or acquired deformities, change size or shape of nose (cosmetic) and repair nasal injuries.
The following are some of the different types of nasal surgery: septoplasty – septoplasty is the surgical correction of defects and deformities of the nasal septum (the partition between the nostrils). Examples of septoplasty include the following: correction of a deviated septum – a deviated septum is a condition in which the partition (septum) between the nostrils is not in a straight vertical alignment. A deviated septum can cause obstructed airflow. A deviated septum can be caused by a birth defect or injury.
Correction of cleft defects that affect the nose and nasal cavity – rhinoplasty.
Rhinoplasty is the surgical repair of a defect of the nose, including reshaping or resizing the nose. Rhinoplasty may be performed to accomplish the following: change the size of the nose, change the shape of the nose, narrow the nostrils, change the angle between the nose and lips.
Possible complications associated with nasal surgery may include, but are not limited to, the following: infection, nosebleed, anesthesia problem.
Preparing for nasal surgery:
The specific type of surgery will be determined by your physician based on: your age, overall health, and medical history, severity of the deformity, your tolerance of specific medications, procedures, or therapies your opinion or preference.
Although each procedure varies, generally, nasal surgeries follow this process:
Location options may include: surgeon’s office-based surgical facility, outpatient surgery center, hospital outpatient, hospital inpatient.
Anesthetic options may include local anesthesia or general anesthesia. Average length of procedure: about two hours.
Recuperation period usually up and around in a few days, usually return to school or sedentary work a week or so after surgery.Surgeon will provide guidelines for resuming normal activities
Some possible short-term side effects of surgery: a splint may be applied to nose to help maintain the new shape.
Nasal packs or soft plastic splints may be placed inside the nostrils to stabilize the septum. The face will feel puffy.The nose may ache. You may experience a dull headache, swelling around the eyes, and/or bruising around the eyes. A small amount of bleeding is normal in the first few days. Small burst blood vessels may appear as tiny red spots on the skin’s surface.
Healing is a slow and gradual process. Some swelling may be present for months, especially in the tip of the nose. Final results of nasal surgery may not be apparent for a year or more.
When a traditional open surgical technique is used, or surgery is performed to narrow flared nostrils, small scars will be located on the base of the nose. The scars usually are not noticeable. Scarring is not visible when rhinoplasty is performed from inside the nose.
Chin augmentation – augmentation mentoplasty (Genioplasty)
Surgery to reshape or enhance the size of the chin to restore facial harmony and chin projection.
The facial profile can be balanced by extending the chin in relationship to the nose. Reconstructive mandibular sliding surgery to correct bite dysfunction can be performed in conjunction with chin surgery.
In children general anesthesia is used to eliminate apprehensiveness and produce sleep throughout the operation. In adults, clinical assessments including X-rays of the face and chin are used for preoperative planning.
One surgical approach is to make an incision inside the mouth along the inferior sulcus (a “landmark” inside the lower gum) to gain access to the chin bone. A horizontal cut (called an osteotomy) is made through the jaw bone (mandible) with a bone saw or chisel. The lower portion of the separated bone is moved forward to the desired position and wired or screwed in with titanium plates. The mental nerves are carefully protected. The incision is closed with sutures and an external pressure dressing is applied. There is no visible scarring since the surgery is performed through an incision inside the mouth.
When only a modest degree of chin augmentation is required to provide contour, the surgeon may use a prosthetic chin implant (artificial — made of silicone, teflon, or dacron), or may use bone only. The incision is made either inside the mouth or externally under the chin. A pocket is created in front of the chin bone and under the muscles, and an appropriately sized prosthesis or chin implant is inserted. The incision is closed and a pressure dressing is applied. The resulting external scar is barely visible.
The best candidates for genioplasty are patients with weak or receding chins (microgenia), but with a normal dental bite. Expectations of looking and feeling better after surgery should be discussed with the plastic surgeon before any surgery, keeping in mind that the desired result is improvement, not perfection.
Movement or displacement of the implant, bruising (ecchymosis), and swelling of the chin are the most common complications. Infection and blood clots are rare postoperative problems. Nicotine from smoking can delay healing.
There is some discomfort and soreness, which is easily controlled by medication. A liquid diet may be advised for a day or two. Light activity can resume the same day as surgery.
Return to work and usual activity is allowed within 7 to 10 days. Within a week of surgery, the external dressing is usually removed.