Nasal recontouring

Nasoseptal recountouring is also called rhinoplasty. After trachea shave, nose reshaping is probably the most common facial procedure for TSs. Because the nose is in the middle of the face, it can often make a dramatic difference. It tends to make the eyes look larger, bring out the cheekbones and add delicacy to the overall facial impression.

The procedures

Most rhinoplasties are performed by making an incision under the nose, between the nostrils. The surgeon then can make changes to the cartilage and the bony hump on the ridge. There are also procedures which make one's nose thinner in width by reducing the flare of the nostrils.

Sometimes this procedure can also be used to correct a deviated septum (hole between the nostrils) or can correct certain breathing problems by widening nasal passages.

In some cases, the surgeon will insert a permanent form in the nose to help maintain the shape.

Recovery

Rhinoplasty is done under a general anesthesia. When you wake up, you will have packing in your nose, stitches closing the incision between the nostrils, and a cast taped to your face to keep the nose protected as it heals.

The worst part for most people is being unable to breathe through their nose until the packing is taken out. Your mouth and lips can dry out very easily, and swallowing can be difficult. Try drinking a glass of water while you pinch your nose shut, and you'll see. Usually the packing stays in for 2 to seven days, although sometimes it's necessary to have it put back in for a longer period.

You have to keep the cast and stitches dry. The first few days you may have small pieces of gauze to tape under your nose to catch any drainage and hold in the packing.

Usually the stitches underneath the nose come out in a week to ten days.

You may be given instructions by your surgeon for exercises to ensure the nose heals properly. Be sure to do these as often as directed.

The cast usually comes off in one to two weeks. The nose is usually very tender at that point, and extra care must be taken to avoid bumping it or sleeping on it.

After the cast comes off, you are usually not to wear glasses or anything that rests on the nose for one to four months. The pressure from glasses can alter the shape of your nose as it heals. If you wear glasses, you should get contacts to wear during the healing.

Most people get bruising around the eyes and cheeks, which can sometimes migrate to the neck and chest. This can range from mild to severe, and can last from a week to a month.

Some swelling, especially around the eyes, is common, but it usually resolves itself in a week or two.

Although the basic shape will look normal in two to four weeks after surgery, the nose will continue to "settle" for many months after surgery. Often it takes half a year or more to feel fully healed.

In some cases, the surgeon may insert a tube into the nose to allow nasal passages to maintain their width during healing. This may stay in for many months after surgery.

Some people have difficulty swallowing from the breathing tube inserted during surgery.

Complications

Besides the *serious complications* you should consider, there are some specific to rhinoplasty.

Poor cosmetic results are unfortunately too common, and some women require additional surgery for correction. Common problems include uneven results, too much or too little reduction, uneven nostrils, calcification that forms a hump at the bridge.

Mucus buildup is a problem for some after nostrils have been altered. Runny noses or plugged up noses might happen more. You might find yourself sniffing a lot more than before.

Nosebleeds occur in some patients for months afterwards, and for some, they continue long after surgery. This is more common if you are exposed to a lot of cold, dry air.

Numbness can make it difficult to feel if your nose is running. There is a chance of permanent change in sensation after rhinoplasty.

Hypersensitivity, especially in cold and dry air, can cause headaches. It also makes some people sneeze more frequently.

Nasal surgery can alter the quality of your voice, making it sound more nasal or pinched.

Breathing can be affected, in some cases improving and in others getting harder.