NOSE

RHINOPLASTY

Purpose

Known to many as the “centerpiece of your face”, your nose can leave a lasting impression.  For that reason nose reshaping is performed for both cosmetic reasons, as well as functional concerns.  Nose reshaping, or rhinoplasty, is done to correct distracting features of a nose and/or to improve breathing.  The goal of a rhinoplasty, or revision rhinoplasty, is to eliminate the distraction so that the other facial features become more noticeable. Because rhinoplasty can improve (or worsen) breathing, it is important to find a surgeon who is trained in facial cosmetic procedures and understands the intricacies of the nasal anatomy.

Procedure

When evaluating the nose, the plastic surgeon must take into account the overall size and shape of the face, lips, and chin.  Dr. Ladner pays close attention to this assessing the internal structures of the nose and, in addition to correcting the shape of the nose, he will correct any internal abnormalities to optimize breathing.  Rhinoplasty can be performed through various approaches although the majority, if not the entirety, of the incisions are placed inside the nose to hide them. The bone and cartilage of the nose is then reshaped to optimize the length, profile, symmetry; and alignment with the lips and chin.  Dr. Ladner may recommend additional procedures, such as a chin augmentation, to complement the rhinoplasty and to provide optimal results. The length of the procedure can vary from 1-4 hours, depending on the concerns that need to be addressed. The procedure is typically performed under general anesthesia, and together with Dr. Ladner, the appropriate anesthesia plan will be determined.

Recovery

Most patients will feel up to returning to work within 3-5 days of the surgery.  At the time of surgery, a small splint is place over the nose for protection and this is removed within 7 days of the surgery.  Dr. Ladner generally does not place internal splints or packing, thus making recovery easier. You will be asked to sleep on your back for a few weeks to avoid injuring the nose. Bruising around the eyes may occur in cases when the nose must be straightened and generally disappears within 10 days.


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REVISION RHINOPLASTY

Purpose

Unfortunately it is possible to have a bad experience during a Rhinoplasty operation, and depending on the circumstance it can leave you with a noticeable defect that must be surgically corrected, this includes both cosmetic defects as well as breathing issues post rhinoplasty.  Communication between the patient and surgeon is essential to determine both mutual and realistic goals of the surgery. Dr. Ladner has significant experience with revision rhinoplasty and is known as a subject matter expert throughout the industry, in addition he has written on the subject for various texts and journals.  If you are seeking a consultation for revision rhinoplasty, please bring all of your before and after photos from your prior procedure(s) to your initial appointment.

Procedure

When evaluating the nose, the plastic surgeon must take into account the overall size and shape of the face, lips, and chin. Dr. Ladner also assesses the internal structures of the nose that affect breathing, correcting any internal abnormalities to optimize breathing.  In revision rhinoplasty, it is often necessary to provide additional structure and shape to the nose, which can typically be achieved using the patient’s own cartilage from the nose. It may be necessary to use cartilage from the rib or ear. As with an initial rhinoplasty surgery, the majority, if not the entirety, of the incisions are placed inside the nose to hide them.  The bone and cartilage of the nose is then reshaped to optimize the length, profile, and symmetry, aligning the nose with the lips and chin. Dr. Ladner may recommend additional procedures, such as a chin augmentation, to complement the revision rhinoplasty and provide the best results. The length of the procedure can vary from 2-5 hours, depending on the degree of irregularity.  They are typically performed under general anesthesia and together with Dr. Ladner, the appropriate anesthetic plan will be decided.

Recovery

Most patients will feel up to returning to work within 3-5 days of surgery.  At the time of surgery, a small splint is placed over the nose for protection, this is removed within 7 days of surgery.  You will be asked to sleep on your back for 2-3 weeks to avoid injuring the nose, additionally you will need to avoid blowing your nose for 2 weeks after the surgery.  Bruising around the eyes may occur in cases when the nose must be straightened and generally disappears within 10 days.

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SEPTOPLASTY

Purpose

The nose is divided internally into two sides by our nasal septum. The septum consists of both cartilage and bone. When the septum is crooked or deviated it can lead to breathing problems on one or both sides of our nose. This can be genetic or the result of a previous surgery or nasal trauma. Surgical removal of the crooked portions and straightening of the septum is necessary to improve breathing. In addition, creating a straight septum can often correct a crooked appearing nose.

Procedure

The incision is placed inside the nose and is completely hidden. The crooked and deviated portions of the septum are removed. These can often be straightened and placed back into their natural position should the patient ever require cartilage grafts in the future for a rhinoplasty. The incision is then closed. Unlike the days of old, no packing is required within the nose itself. The procedure is performed with general anesthesia to keep the patient comfortable. The procedure generally lasts 45 minutes or less.

Recovery

The patient can expect to return to work within a few days. There is generally minimal swelling around the nose for a couple of days. Nose blowing is to be avoided for at least 4 weeks after surgery. All sutures dissolve on their own.

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