Morphing in Rhinoplasty: Hump reduction in nose reshaping.

Reduction Rhinoplasty
Hump reduction alone (depicted through morphing of the picture on the left)blogwowmstamp
Reduction & Augmentation Rhinoplasty
Here instead of depiction of hump reduction alone, supra-tip and Radix area have been shown (through morphing of the picture on the left) as if they have been augmented, along with conservative hump reduction.
augment-radix-and-supratip-stamp
The choice is dictated by which change will be more in harmony with the rest of face and person.
 
Digital Morphing is an invaluable tool in my Consultation process
to describe options, complications, visual impressions to my patients. 

Recovery after Rhinoplasty: 24/7 Direct Line with your Surgeon

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Munish Shandilya

After care of Rhinoplasty surgery in our Clinics


PAIN  Is surprisingly not a common complaint and most patients complain of discomfort of not being able to breath through the nose and a dry sore throat. Approximately 1 in 10 complain of severe pain. 

PACKS are generally avoided or kept very small to make their removal comfortable. These usually come out the morning after.                               

SUTURES in case of an External approach Rhinoplasty will come out from 5-7 days. Prophylactic Antibiotics are given in case of External approach since a skin incision is involved.  
                    
POP CAST is a Plaster of Paris cast that comes off in a week but you are asked to keep it dry.

ANTIBIOTICS are used routinely in case of External or Open Approach / Conchal Cartilage grafts.

BOLSTER DRESSING under your nose To collect ooze and prevent you from dabbing with tissues which can introduce infection.

DIET advised is your normal diet.

EXERCISE is restricted and brisk Walking is allowed in 2 weeks, Running in 6 weeks, Contact sports in 12 wks with protection.

BRUISING is less common with controlled atraumatic technique but most of our patients develop a slight lower lid discoloration of medial half … perhaps from the pressure of the dressing. This usually clears in 8-10 days.

NOSE BLOWING to be avoided for 4 weeks.

MOBILE NUMBER IS MADE AVAILABLE TO TEXT THE SURGEON IN EMERGENCY

Rhinoplasty & Contact Sports

sport

The patient numbers in our ongoing Audit of Nasal Fracture Management in Ireland has crossed the 550 mark over the last three years out of which about one third are sports related injuries.


Youngsters participating in contact Sports are often advised to defer surgical intervention till they stop playing sports … in sports loving Ireland that would mean a sentence to live with a blocked and/or a crooked nose for a decade or few.

My experience with nasal fracture management & rhinoplasty has helped me to make these observations that I share with my patients who ask me “will my nose be weaker after the nose surgery”.


1. Nose should be protected from further sport injury for at least 12 weeks after nasal surgery.
2. Nasal Bones are stronger and thicker after healing is complete
3. Nasal cartilage is generally weaker & its strength depends on the cartilage remaining in the nose & the scar tissue component. The paucity of cartilage remnants in the nose may necessitate cartilage harvest from ears (Concha) in case revision surgery is necessitated by further trauma.

In an individual case I evaluate the above factors and advise accordingly. A blanket ban on all youngsters who are actively playing sports and have a functional or cosmetic nasal problem is perhaps excessive.

The decision should be left with the sportsperson and their family after their education and counseling.

RHINOPLASTY SWELLING AFTER A NOSE SURGERY / RHINOPLASTY

SWELLING OF NASAL DORSUM AND THE NASAL TIP AREA ARE FREQUENTLY A CAUSE OF CONCERN TO A PATIENT.
Four stages of Swelling seen in my practice with External Approach Rhinoplasty
  STAGE 1. Minimal swelling at the removal of cast (As seen below right)

dm-3-weeks-swelling

STAGE 2. within 24 hours the nose swells (As seen below Right) .

dm-3m-swelling

     STAGE 3. This swelling dissipates in about 3 months to the level seen when the nasal cast & dressing comes off.
           STAGE 4. Approximately 9-12 months when the swelling and healing are close to complete.