Reshaping of the nose
Rhinoplasty and nasal reconstruction are areas of particular interest for Dr. Breidahl. Through his work at the Royal Children’s Hospital he has vast experience in correcting congenital nasal anomalies commonly associated with cleft lip, Binder’s syndrome and other rare craniofacial conditions.
As the Plastic Surgeon appointed to the Cleft and Craniofacial Transition Clinic at the Royal Melbourne Hospital Dr. Breidahl extended this work to adult patients – offering a wide range of surgical techniques to patients seeking cosmetic rhinoplasty.
For people who feel unhappy with the shape or size of their nose, Rhinoplasty may be effective in helping to improve their appearance, self-confidence and self-esteem.
Dr. Breidahl employs advanced plastic surgery techniques to:
- Increase or decrease the size of the nose
- Change the shape of the tip
- Change the shape of the bridge
- Decrease or increase the span of the nostrils
- Remove a hump
- Improve asymmetry (while surgery can often improve the symmetry of a crooked nose, it is not always possible to achieve perfect symmetry)
- Improve a poor relationship between the nose and upper lip.
Rhinoplasty may be performed to correct:
- A birth deformity
- Damage to the nose and its internal structures due to injury, infection, tumours or other disease
- Breathing passages to improve capacity to breathe through the nose
Nose reconstruction for severe deformity may require two or more operations, with lengthy periods of healing between operations.
Reshaping of the chin can be performed at the same time as a Rhinoplasty. This can help to achieve a more balanced and natural-looking profile. It is important to have an analysis performed of the whole face to make sure that a pleasing balance between the nose, the chin and cheeks is achieved.
The Surgical Procedure
Most of the incisions are inside the nose. Sometimes there will be a small incision in the columella, the narrow strip of skin between the nostrils. This incision usually heals well and is hard to see after a few months.If the patient has flared nostrils, part of the incision may be outside the nose. The techniques used to reshape the nose are planned before the operation. They involve reshaping of bone and cartilage to achieve the desired changes. Occasionally, cartilage grafts may have to be taken from the ears or ribs. Bone grafts may have to come from the ribs. This will be discussed before surgery. When the surgery is finished, soft plastic splints may be placed inside the nose to stabilize the septum. A splint is usually placed down the length of the nose to maintain its new shape. The surgery usually lasts for about one or two hours. Some cases take longer.
If the surgery is done inside the nose, no scar is visible. If incisions need to be made on the outside of the nose, they are usually placed at the base of the nose and nostrils in the natural folds of skin where they are harder to see.
Recovery after Surgery
Immediately after surgery, you will be transferred from the operating theatre to a recovery room. Nursing staff will monitor your heart rate; blood pressure, breathing and general recovery from the procedure.Before surgery, arrange for friend or relative to drive you to and from the hospital. After you return home, an adult should stay with you for at least 24 hours.
Swelling and Bruising
The face may feel puffy, and the nose may ache. You may have a dull headache and probably will not be able to breathe through the nose. You should stay in bed with your head elevated for the first 24 hours to help these side effects subside. The nose and the area around the eyes will be swollen and bruised and then begin to go down after four to five days. By 10 days, the bruising and swelling are usually greatly reduced. Some subtle swelling may remain for several months.
It may be difficult to breathe through the nose for several days.
External skin stitches are removed after four to seven days. All dressings, splints and stitches are usually removed in one or two weeks.
It is common to experience a little bleeding from the nose for the first few days after surgery.
The skin of the nose may be numb. Sensation usually returns gradually.
Returning to Normal Activities
Dr. Breidahl will advise you not to blow your nose for at least a week. You should also avoid any activity that increases blood pressure (such as jogging, swimming or bending) for two to three weeks. Take every precaution to avoid having your nose hit, rubbed or sun burnt for at least eight weeks after surgery.
Do not smoke. Smoking contributes to wound breakdown and delayed healing, as well as causing other health problems.
Patients have aching in the nose and surrounding areas after surgery. Dr. Breidahl will prescribe a pain reliever.
Dr. Breidahl will schedule appointments for you over the following months to check your progress.