Are there risks associated with facial plastic surgery?

Yes. There are inherent risks with any surgical procedure, including bleeding and postoperative infection. As a double-board certified facial plastic surgeon, Dr. DeRosa is acutely aware of these risks, and her experience and training help to minimize them. There are multiple potential complications that may occur during or after rhinoplasty, and these risks should be discussed with your surgeon.
After rhinoplasty, there is a risk that one's breathing may be worsened after surgery, as the nose plays a vital role in breathing. Dr. DeRosa understands how to manage both the nasal airway and the external appearance will likely be able to reduce this risk significantly. Another risk with rhinoplasty surgery is damage to the nasal skin, which can be devastating and irreversible. Since the nose will continue to heal months, years, and decades after surgery, some problems may not be recognized or noticed right away. Dr. DeRosa believes that follow-up after surgery is very important to help try to prevent or reduce such problems. She also has extensive experience correcting such problems when patients have had previous nasal surgery/rhinoplasty. Although there are risks associated with rhinoplasty, undergoing surgery with a physician who is well qualified and experienced in rhinoplasty can help to reduce such problems.


Is there anything I can do to assist in the healing process?

Healing after facial plastic surgery is dependent on many factors, some of which can be positively influenced by the patient.
  1. Avoidance of a high-sodium diet can help to reduce any additional edema to the face during the first several weeks to months after surgery. A diet of less than 1200 mg sodium/day is recommended.
  2. Maintaining a healthy and balanced diet is also important to good healing. This includes avoiding smoking of any kind for at least one month before and after surgery.
  3. Elevation of the face above the level of the heart during waking hours and sleep can help promote gravity to reduce facial edema.
  4. Perhaps most importantly, following your physician's recommended follow-up schedule can be critical to achieving an optimal outcome. Your doctor will be able to monitor the amount of swelling and your rate of healing after surgery and may be able to give you specific advice to assist in your healing.


At what age can rhinoplasty be performed?

The earliest that a rhinoplasty is performed usually is when a teenager reaches full and stable growth. For girls, this is usually by age 15 or 16, and for boys, it's around age 16 or 17. An important consideration is also that a teen has reached an emotional maturity necessary to care for the nose after surgery. At the other end of the spectrum, there is no real age limit for when rhinoplasty can be performed, as long as the person is in good general health.


What different ways can rhinoplasty be performed, and where will my stitches be?

There are many different techniques that can be used to change the external appearance of the nose (i.e. rhinoplasty). One may hear of different methods such as external/open, endonasal/closed, etcetera, all of which describes an approach for rhinoplasty.
Which method is used is typically determined by the specific goals for surgery, the nasal anatomy, and the surgeon's preference. In general, there will be incisions along the inside of the nostrils, and dissolvable sutures (stitches) are used, which do not need to be removed. When the nose is opened using an external approach, there will be a scar along the columella (the area of the nose that touches the upper lip in the midline). Often there are stitches at this site that need to be removed typically within the following week. Most patients after rhinoplasty do wear an external cast on the nose for approximately one week.


How long will it take for the swelling in the nose to go down to the shape it will be for the rest of my life?

The initial swelling in the nose after rhinoplasty will last for approximately 4-6 weeks. After this time, the nose will start to take on the desired shape, but the full reduction in swelling may not be seen for up to a year. The amount of swelling after surgery is also dependent on a number of factors, such as whether or not the patient has had previous rhinoplasty and the thickness of the nasal skin.


What type of pain can one expect after rhinoplasty surgery?

Many people describe a feeling of nasal pressure or stuffiness after rhinoplasty. With that being said, however, we typically prescribe a medication to alleviate the pain for each patient undergoing rhinoplasty.


Typically, how long does it take before normal breathing is restored after rhinoplasty?

The time it takes for normal breathing to be restored can vary from patient to patient. Most of my patients will describe a temporary, noticeable improvement in their nasal breathing within the first day after surgery. After this time, however, the swelling that occurs on the outside of the nose also happens on the inside, so it is normal to feel stuffy and blocked for many weeks after rhinoplasty. Sometimes, we will ask our patients to use nasal saline spray or saline gel on the inside of the nose to help reduce the internal nasal swelling more quickly.


Why are ear and/or rib cartilage used in rhinoplasty?

Auricular (ear) and costal (rib) cartilage are sometimes used to help support and reshape the nose during rhinoplasty. The decision to use one or both materials is based on each patient's specific problems, goals for surgery, and the intricacies of nasal anatomy. Dr. DeRosa believes that it is important to use one's own natural materials when reshaping the nose whenever possible.

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