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Are You Qualified To Get A Rhinoplasty? Here’s a Quick Checklist

One of the most common cosmetic procedures in the world today is Rhinoplasty. In the United States alone, over 220,000 Rhinoplasty procedures are performed each year.

The outcome of a nose job doesn’t depend only on the qualification and experience of the surgeon. The onus is also on the patient to precisely prepare for the Rhinoplasty procedure and follow the surgeon’s advice.

Getting the best possible results depends on how carefully the patient follows the care instructions given by the doctor. Knowing about the Rhinoplasty pre-op checklist and Rhinoplasty post-op essentials would help meticulously prepare for the nose surgery and ensure a faster recovery.

However, before going through the Rhinoplasty checklists, it is essential to understand the Rhinoplasty eligibility criteria. Why is this important? It is crucial because not everyone is qualified to get a Rhinoplasty.

The doctor would consult thoroughly with the patient, go through past medical history, and conduct several tests before concluding if you’re qualified for Rhinoplasty or not.

So, are you qualified to get a Rhinoplasty?

Going for Rhinoplasty is a very personal decision and an individualized procedure. If the motive behind going for Rhinoplasty is non-cosmetic, then decision-making is easier.

However, if you’re considering going for Rhinoplasty for cosmetic purposes, improving facial aesthetics and harmony, and boosting your confidence, decision-making can be confusing and even frightening at times.

Here are a few factors that determine if you’re a good candidate for Rhinoplasty:

  • Do it for yourself and not for someone else or to fit into the expectations of others. Be 100% sure!
  • For younger patients, you’re a good candidate for Rhinoplasty only after you have stopped growing. Boys mature later than girls, so be prepared to be asked to be patient if you present to a surgeon too young.
  • Ideally, smokers can have trouble with the Rhinoplasty procedure as smoking is not allowed pre and post-surgery. If you don’t smoke, you’re good candidate for nose surgery.
  • You need to be a pragmatic and realistic when it comes to the Rhinoplasty procedure. Don’t have unrealistic or exaggerated expectations from the Rhinoplasty procedure and about improving your facial appearance. Rhinoplasty helps with enhancing facial harmony and appearance but to a limited extent. The outcome of the nose surgery should be balanced well with other facial features.
  • You’re physically and mentally fit.

Knowing these factors would make it easier to self-determine if you’re the right fit for the nose surgery. Any air of confusion around the Rhinoplasty eligibility criteria can be further cleared by consulting with the surgeon.

Now, let us first go through the Rhinoplasty Pre-Op Checklist. Going through this checklist ensures you are ready for nose surgery.

Rhinoplasty Pre-Op Checklist:

  • Are you choosing to go for Rhinoplasty at the right time?
  • Have you chosen the right surgeon for Rhinoplasty surgery? Are they qualified and experienced enough?
  • Medical insurance rarely covers the cost of a Rhinoplasty procedure? If not, can you financially support the pre and post-surgery expenses and surgery costs?
  • Where does the Rhinoplasty procedure take place? Is it a licensed hospital or medical care facility?
  • Are you a smoker? Can you stop smoking for weeks before and after the surgery until the healing completes after the surgery?
  • Do you have a realistic approach towards the Rhinoplasty procedure and its outcome?
  • Have you consulted thoroughly with the surgeon about the Rhinoplasty risks?
  • Avoid anti-inflammatory, non-steroidal medications, herbal supplements, estrogen supplements, garlic supplements, green tea, green tea extracts, birth control medications, St. John’s Wort, and Vitamin E. Don’t take common pain relief medicines like Ibuprofen, Aspirin, and its substitutes.
  • Use SPF 30 and above to avoid sun damage, starting two weeks before the Rhinoplasty.
  • Fast from the night before the surgery. Don’t drink or eat anything.
  • Don’t drive to the hospital on your own. Arrange for someone you know to take you to the hospital where surgery is to take place.
  • Don’t wear jewelry.
  • Avoid wearing contact lenses. You will not be able to wear eyeglasses that place pressure on the bridge of your nose after surgery.
  • Keep your ID card and Insurance card handy, and bring them with you on surgery day.
  • Do not wear any make-up, lipstick, or nail polish.
  • Take leave from work for 10-14 days and arrange for support following the surgery, including childcare, driving, shopping, housework, etc.
  • Arrange someone to be around you for the first couple of days following the surgery.
  • Don’t stress too much over the surgery and its outcome. Consider mindfulness practices or stress reduction to help you.
  • Wear clean, comfortable, and loose-fitting clothes on the day of surgery.
  • Arrange for someone to cook food for you or deliver your food following the surgery.
  • Stock up on post-surgery medications like tylenol and ibuprofen, nasal saline sprays, and possibly prescription medications. (after consulting with the surgeon) and food (fruits, tea, fruit juices, etc.)
  • Take a shower night before the surgery, hydrate, and fast for 12 hours before the surgery.
  • The doctor may ask you to get several blood tests done before the surgery.
  • Avoid using skincare creams on your face at least four days before the surgery.
  • Don’t drink alcohol before the surgery or at least four days before the surgery.

Now that we have comprehensively covered the Rhinoplasty pre-op checklist let us delve into the Rhinoplasty post-op essentials.

Rhinoplasty Post-Op Essentials & Checklist:

  • Regularly change dressing until bleeding, if any, stops.
  • Keep the inside of the nose moist through a nasal saline spray.
  • Don’t blow your nose following the surgery.
  • Keeping the head in an elevated position for the first couple of days following the surgery would help reduce swelling. (at least 48 hours)
  • Eat easy and comfortable foods that don’t require too much chewing and excessive facial moments.
  • Be aware that the nose, eyes, and even upper lips may show some signs of swelling following the surgery. It is nothing to worry about.
  • Take ample rest, avoiding excessive facial movements.
  • Avoid extreme physical activity like exercising, running, talking too much, etc.
  • Don’t wear regular glasses for a few weeks to avoid pressure on the nose.
  • Take medications on time as prescribed by the doctor.
  • Keep the nasal cast undisturbed for a week or as long as a doctor prescribes following the Rhinoplasty procedure.
  • Avoid swimming for a month following the surgery.
  • Avoid overexposure to the sun.
  • Stock up on supplies – food, medications, pain relievers, water, etc.

The Rhinoplasty pre-op checklist and post-op essentials may seem extensive but are quite simple. Most of the items in the checklists and essentials are followed for most of the surgeries.

Rhinoplasty is a pretty common surgery these days, and not only does it help patients improve breathing but enhances facial harmony to a great extent.

Make sure to choose a surgeon specializing on Rhinoplasty with an excellent track record, experience, and qualification. It impacts the outcome of the nose surgery and ensures your expectations from the Rhinoplasty are met.

tollefsonAre You Qualified To Get A Rhinoplasty? Here’s a Quick Checklist
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Considering Rhinoplasty? – Here’s Everything You Need to Know

Rhinoplasty is one of the most common plastic surgeries, often referred to as “nose job.” It is a surgery that enhances facial harmony by modifying the nose’s shape through corrective procedures applied on skin, bone, or cartilage. This surgery is primarily performed to improve breathing or facial appearance.

One thing to note here is that Rhinoplasty is not for everyone. Before considering Rhinoplasty, the surgeon will consider a wide range of other factors, including your facial features, skin, bone structure, etc.

Once the surgery is finalized, the surgeon will help you understand the intricacies of the Rhinoplasty surgery, associated risks, dos and don’ts, treatment plan, post-procedure care, pre-surgery precautions, and more.

What is Rhinoplasty?

Nose reshaping surgery, nose job, or Rhinoplasty is a commonly performed surgical procedure that enhances facial appearance or improves breathing by changing/rectifying the nose’s shape. The shape of our nose plays a pivotal role in our facial appearance. A deformed or poor nose structure can impact the overall appearance and look, making it one of the most requested and recommended cosmetic procedures to improve the overall appearance.

What are the Goals of Rhinoplasty Procedure?

There are many goals of Rhinoplasty, including the following:

  • Improving the shape of the nose
  • Preserving and improving breathing
  • Enhancing facial appearance
  • Creating a natural balance with other facial features
  • Increased confidence

Different people have different goals of the Rhinoplasty procedure, but it mainly revolves around the above-mentioned goals.

Factors to Consider Before Rhinoplasty

Many factors need to be considered before going in for the Rhinoplasty procedure. Your surgeon would guide you through the process and evaluate the considerations together to decide if you’re an ideal candidate for Rhinoplasty or not.

The below-mentioned factors impact the outcome of the Rhinoplasty procedure and help personalize the surgical plan. Let’s dive in.

Age

Ideally, the Rhinoplasty procedure is not performed at a very young age. It is recommended to go for Rhinoplasty after the growth is complete, usually 15-16 years for girls and 17-18 years for boys. Going for a Rhinoplasty procedure before complete growth can negatively influence the natural growth of the nose.

Moreover, if the nose job is done before completion of growth, any growth after the Rhinoplasty procedure would change the overall shape of the nose, causing unwanted results.

However, younger patients suffering from severe nasal obstruction and breathing problems may choose a nose job procedure.

Skin Thickness

The primary aim of nose surgery is to rectify or modify the nose’s underlying structure. The thickness of the skin plays a vital role in how the nose looks after nose surgery. For people with very thin skin, the changes made to the nose’s underlying structure are easily visible.

Similarly, changes made to the nose’s bone and cartilage is harder to notice in people with thick nasal skin. The thickness of nasal skin plays a crucial role in helping surgeons decipher Rhinoplasty risks and decide on a treatment plan.

Gender and Ethnicity

It’s a well-known fact that facial structure and nasal shape vary across genders and ethnicities. When it comes to Rhinoplasty procedures, one size fits all approach doesn’t work. After careful examination, the surgeon would define an operational plan that tailors specifically to your gender and ethnicity. Such a tailored approach is essential to get the desired outcome.

Surgical History

If the patient has had a Rhinoplasty procedure or deviated septum surgery done in the past, it can influence how the nose job surgery would be done. If you’ve had a nose job or any other facial procedure done, it is essential to tell your surgeon beforehand to decide the treatment plan.

Facial Harmony

The nose plays a critical role in the overall facial appearance of a person. The changes you desire from a nose job procedure should create facial harmony by improving, preserving, and uplifting the facial appearance.

It is essential to consider other facial features before deciding to go for a nose job. If you have multiple facial features that are off-balance, consider addressing all the facial features together to bring a facial harmony.

If not, the nose job procedure would create a dissonance that would negatively impact the facial appearance. For this reason, the surgeon suggests computer-generated image simulation to demonstrate and visualize how the face will look after the nose surgery.

Medical History

One other factor that is considered before the Rhinoplasty procedure is performed, is comprehensively checking your medical history.

It is vital to inform the surgeon about past surgeries (if any), current medications, and any allergies or medical conditions. It would help decide if Rhinoplasty can be performed while also influencing the recovery process.

Types of Rhinoplasty

The incision type decides the type of Rhinoplasty. There are two types of Rhinoplasty, including:

  • Open Rhinoplasty
  • Closed Rhinoplasty

Rhinoplasty Procedure

#1 Anesthesia

During the surgical procedure, the patients are administered medications for comfort, including either general anesthesia or intravenous sedation. The surgeon will choose which medication to administer as per your health, the scale of the nose job procedure, complexity, and other factors.

#2 Incision

As mentioned earlier, the Rhinoplasty procedure can be of two types – open or closed. In closed Rhinoplasty, the incisions are done inside the nose.

In open nose surgery, the incisions are done on the tissue known as Columella, which separates the nostrils. The incisions help raise the skin covering cartilages and nasal bones, reshaping and restructuring the nose.

#3 Reshaping the Nose Structure

Reshaping a large nose may include removing cartilage, and at times, cartilage grafts may be added. The cartilage present in the middle portion of the nose called the septum is often used for this purpose. At times, cartilage from the rib cartilage or ear can be used as well.

#4 Correction of Deviated Septum

The deviated septum can be corrected by straightening and reshaping the projections in the nose structure. It helps to improve breathing, and enhances appearance and facial harmony.

#5 Closing the Incision

The incision is closed once the underlying bone and cartilage are restructured and reshaped as desired. The nasal tissue and skin are redraped after the surgery.

#6 Results – Post Surgery Care

For a few days after the surgery, the nose would be supported using gauze and splints to support and accelerate healing. The patient has to follow the post-surgery care instructions given by the surgeon. Some of the standard post-surgery instructions include:

  • Not blowing the nose for few weeks post-surgery.
  • The head should be elevated for a few days while sleeping post the surgery.
  • Avoid sun post-surgery.
  • Don’t exert the nose region for any reason and minimize risks causing any injuries.
  • Consult with the surgeon immediately in case of any changes in the surgical area or any abnormal pain. These indications include – excessive bleeding, visual impairment, high fever, unbearable pain, skin rash, and other abnormalities.
  • Visit the surgeon regularly for routine checkups after the surgery.

Rhinoplasty Recovery Time

Patients are discharged from the hospital after 3-4 days or a week after the surgery. However, the Rhinoplasty recovery time may exceed 4-5 weeks, depending on the scale and complexity of the nose job procedure.

Rhinoplasty Risks

As with any other major surgery, nose surgery comes with a few risks as well. While medical science has advanced and modern procedures carry far fewer risks than earlier, it is always a possibility. Some of the significant Rhinoplasty risks include:

  • Infection
  • Bleeding
  • Adverse reaction to generation anesthesia
  • Difficulty in breathing through the nose
  • Results not as expected – the final nose shape doesn’t appear as desired.
  • Pain, swelling, and discoloration may last for a long time, sometimes even for life.
  • Scarring
  • Septal perforation
  • Additional surgery may be required at times

However, it needs to be noted that risks and complications with Rhinoplasty are far less than most other major surgeries. The risks and complications mentioned above are rare.

Consulting with a surgeon beforehand to tailor a treatment plan and following post-surgery care instructions would help achieve the results you seek with Rhinoplasty. So, if you have a deformed or poorly shaped nose, going for Rhinoplasty is an ideal solution.

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Born with a Cleft Lip and Palate. What are the Challenges Ahead?

The birth of a baby is a joyous time for new parents, which comes with its own challenges. However, for the parents of a child born with certain facial differences like cleft lip and/or palate, the challenges may seem overwhelming. Children with cleft lip and palate encounter many different challenges throughout their life, but it will be alright.  There are biological factors that can affect their speech, hearing, and dental appearance and function. In addition, the type of cleft, age, and gender also affect individuals.  

What is a Cleft Lip and Palate?

Children with cleft lip and palate are born with an opening in the roof of their mouth, and it leaves a hole between the upper lip and the nose resulting in a split. A cleft lip can be a unilateral cleft lip or on both sides of the lip. The cleft may vary in size and can be just a tiny notch, or others may extend through the upper gum up till the nostril.

A cleft may happen when the bones, muscles and the skin of the baby’s upper jaw, mouth, and nose fuse together to form the roof of the mouth in the early weeks of pregnancy. While doctors still don’t know why it happens, some factors increase the chances of such congenital disabilities like:

  • Genetic factors
  • Exposure to some chemicals during pregnancy
  • Not getting prenatal nutrients
  • Consuming certain medicine during pregnancy
  • Drinking alcohol, using drugs, or smoking cigarettes during pregnancy

There are a number of side effects of cleft lip and palate, such as feeding difficulties, speech and language delay, ear infections, hearing loss, and dental problems. The only way to repair cleft lip and palate is with surgery. Treatment for cleft lip or cleft palate will extend over several years, needing multiple surgeries, and is best coordinated with an accredited Cleft and Craniofacial Team.  This team will include specialists in communication, speech, hearing, dental, social work, feeding, nursing, genetics, and others.

Psychosocial Challenges of Adolescents and Teens with Cleft Clip and Cleft Palate

With the advancement in medical services and awareness among people, it is rare to find any adult with cleft lip and palate that have not been operated upon. Most children who have their cleft lip repaired early on have a healthy social life. But teenagers with cleft lip/palate are at a higher risk of developing psychosocial challenges, especially those relating to appearances, peer relationships, and self-concept. The psychosocial challenges in adolescence and teens with cleft lip and cleft palate can affect their confidence, self-esteem, and the way they engage in social relationships.

Some of the problems that adolescents and teens with cleft lip/ palate encounter include:

  • Staring
  • Teasing and bullying
  • Name-calling
  • Self-consciousness
  • Questions about their deformity
  • Overprotection of their parents
  • Discomfort in social settings
  • Difficulty being understood

Overcoming Negative Social Attitude and Stigma

While many individuals with cleft lip/cleft palate have experienced negative experiences due to their facial conditions, they resisted it through:

  • Joining cleft lip support groups
  • Different coping strategies and methods such as restructuring thoughts, problem- solving, and regulating their emotions
  • Timely intervention such as surgery

Support from Family and Friends

According to a number of studies, psychosocial challenges among adolescents with cleft lip or palate see a positive impact on their self-esteem with high family and family support. It resulted in:

  • Better adjustment to social situations
  • Less stress
  • Lower psychological distress

While they have certain dissatisfaction about their facial differences, they were more content with other facial features like their eyes, hair, and even teeth compared to their peers with no facial deformity. Reconstructive surgeries help raise their confidence levels, and this feeling is heightened due to the comparison of their past feelings about their appearances before the surgery.

Coping as an Adult

Individuals with cleft lip and/or palate may experience emotional distress persisting into adulthood. As they venture into adulthood and outside the safety net of their friends and family, many experience fear and anxiety. Social comfort levels are put to the test as adults delve into many new experiences like:

  • Meeting new people
  • Taking job interviews
  • Getting into romantic relationships

Empowering teens to be open at their medical appointments helps them start their journey on the road to independence and boosts their confidence. Integrating a cleft lip support group right from an early age is highly recommended, and so is the right information for adults with cleft lip who are about to complete their treatment. Adults with cleft lip may also benefit from support with the following:

  • Accessing information about new treatments
  • Concerns about their appearance and speech
  • Making the transition from their childhood treatment services
  • Self-esteem, confidence, and social anxiety
  • Dealing with social stigma at the workplace
  • Intimacy
  • Impact on their parenting style

While most adults cope well, some may need additional support to deal with any ongoing issues along with any new issues arising in adulthood. Thorough psychological screening for adults with a cleft lip is also recommended for managing cleft palate problems in adulthood and to ensure good emotional well-being. Ensuring ongoing support can help build confidence and greatly improve the quality of life that is going to last a lifetime.

tollefsonBorn with a Cleft Lip and Palate. What are the Challenges Ahead?
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First Article

Serving the Greater Sacramento area, Northern California, the Central Valley and Nevada, facial plastic & reconstructive surgeon Dr. Travis Tollefson dedicates his attention to restoring and repairing the face for patients of all ages. Dr. Tollefson firmly believes that each patient’s treatment care plan must be individualized to create a balanced and natural result.

tollefsonFirst Article
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