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 E N T (Ear Nose & Throat)

March 2011
Nosing Around
How to Get a Better Nose
Dr.Anup Dhir
 
"Cleopatra's nose, had it been shorter, the whole face of the world would have been changed."

Blaise Pascal, Pensées

The surgery to improve the shape and or function of the nose – rhinoplasty - is one of the most popular cosmetic surgery procedures worldwide.India woke up to the possibility of a nose job in the 80s, ever since Bollywood actress Sridevi got one done.The results were dramatically beautiful – and easy to notice since she was acting from the age of four. Since Sridevi’s face was captured on cameras from the Hindi, Telugu, Tamil and Malayalam industries in more than 260 movies, the nation collectively started dreaming of a better nose.

Rhinoplasty is a surgical procedure to reshape your nose to improve its appearance and proportion in relation to your other facial features. People most often select surgery to alter the size and shape of the bridge and tip of the nose. This can be just because they do not like the shape of the nose, or damage due to trauma to the nose or a birth defect.

Ancient Surgery
From what is known, the world’s first successful rhinoplasty was carried out in India - in 600 BC! An Indian surgeon named Sushruta used surgery and skin reconstructions to improve the shape of noses that had been injured or cut off as a way of punishment for thieves in India during this period of time.

Is it For You?
The earliest recommended age for a nose job is the mid-teens, a time when the nose is near full development.There is no upper age limit for a nose job. For older individuals, good health is the primary consideration.

Rhinoplasty need not always be for improving one’s looks. In some instances, there may be an internal deformity of the nose that can affect breathing. This may be due to an irregularity in the septum (the central structure of cartilage and bone that separates the two sides of the nose) or the turbinates (structures protruding internally from the lateral walls of the nose). Adjustment of these structures through surgery can improve the nasal airway.

How They Do It
  • Rhinoplasty can be done by the open or closed technique. This will depend on where the incisions are made. The surgeon will follow the technique which he feels would be best suitable for you.

  • Reshaping is generally done through incisions inside the nose.

  • There may also be an incision passing across the central portion of the nose between the nostrils. This entails removing small wedges of skin at the base of the nostrils.

  • The resulting scars usually fade very well and ultimately should be barely noticeable.

  • The nose is reduced, or in some cases built up, by adjusting its supporting structures - either by removing or adding bone and cartilage. The skin and soft tissues then re-drape themselves over this new scaffolding.
Post Surgery
After surgery, some pain, swelling and bruising of the nose are to be expected, but they will subside gradually. You will wear a splint for approximately a week or longer and can wear cosmetics after it is removed. Your routine will be severely restricted for only a day or two, but you should curtail activities that raise your blood pressure-such as bending, lifting or exercise-for a few weeks.

Reserve judgement on your rhinoplasty for several months, even a year, until your nose has had an opportunity to fully heal and settle. Often the best compliment you can receive from your family and friends is that your nose does not appear very different! Remember - intention of the surgery is for your "new nose" to blend in naturally with your face.

Practise Makes It Perfect
Revision rhinoplasty is performed to correct problems that develop or continue after a previous rhinoplasty. Also known as tertiary or secondary rhinoplasty, this procedure is to correct a previous unsuccessful surgery of the nose.

Sometimes the problems are minor and easily corrected, but if they are major, a revision rhinoplasty is always more difficult and requires more expertise than the first surgery. This is due to the fact that the normal nose is no longer intact and the tissue before the first surgery is now filled with scar tissue. This makes it difficult to separate and reposition the remaining bones and cartilage. Usually a revision rhinoplasty will give significant improvement.
 
  Dr. Anup Dhir is Sr. Consultant Plastic Surgeon at Apollo Indraprastha Hospitals, New Delhi


    
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