Rhinoplasty (Nose) Surgery Procedure

The rhinoplasty surgery is used to reshape the nose and this cosmetic surgery can be rewarding for the patient. The plastic surgeon can use the rhinoplasty surgical procedure to practice the artistic techniques and the effects of his skill are visible on patient’s increased face beauty.Before performing the surgical rhinoplasty procedure , the plastic surgeon must be well aware of the expectations of the patient .The patient usually need to alter  his nose’s appearance by changing the shape or size of the nose, the tip of the nose, nasal bumps, size of the nostrils ormight require a surgery for non-cosmetic reasons to rectify a deformity or breathing problem.         
The rhinoplasty procedure is performed with the patient under local anesthesia with sedatives or under general anesthesia. Depending upon the severity of procedure, the rhinoplasty surgery might take around 2 – 4  hours. On the night before your surgery, you must avoid eating or drinking after midnight. When inside the operating room, the anesthesiologist administers the type of anesthesia requested. Prior to any incision the nose is anesthetized with local anesthesia . Often a mixture of  cocaine and/or epinephrine is used that helps to shrink the mucous membranes, thus controlling bleeding.
There are two types of rhinoplasty: open rhinoplasty surgical technique and closed rhinoplasty surgical technique.

Open Rhinoplasty Surgery: If a major reshaping of nose is required, the incisions are not made inside the nose but are made in the vertical strip of skin, called columella, separating the two nostrils. The surgical procedure is quite complex and is used in more complicated cases.

Closed rhinoplasty Surgery: In this surgery, the incision made is restricted to the inner side of your nose. Here the swelling subsides early and recovery is speedy. The procedure involves separating the skin of the nose from the bone and cartilage that outline its supporting framework. The bone and cartilage, once uncovered, are detached, reshaped, augmented and finally reorganized to attain the preferred shape.
If the surgical procedure is done to narrow the nose, the cartilage is removed from the front spine of the nose. Then the cartilage and bone are reshaped and the nose tissues are wrapped over the newly formed configuration, after which the incisions are closed. But there are limitations to this surgery as the surgeon might have a restricted capability to change your nose as he might be unable to see the parts of the inside of the nose.
Some surgeons have a preference for the open rhinoplasty surgery, as the visibility of nose is better in this case. The swelling and bruising lasts for a longer period in case of open rhinoplasty surgery. You must sleep with your head elevated at least for nearly a week after rhinoplasty; swelling will be subsiding at a faster rate. After the incisions are closed, a soft material is inserted inside the nose to uphold the newly created structure. After surgery, an external splint is also applied to keep up the new shape of the nose. The splint gives an extra protection to the nose during healing. In the open tip rhinoplasty, the plastic surgeon can sculpt the nasal tip and form a symmetrical nose tip.       
If the top of the nose has bumps, it is changed with a rasp or a particular tool called an osteotome that is used for configuring the bony tissue of the nose.In a surgical procedure called osteotomies the actual bony tissue of the nose is broken and the put in desired position. The narrow piece of cartilage that divides the two parts of the nose is called the septum. At times it is bent by birth and causes breathing problems. The surgery to straighten it or shorten it in case it is too long or to remove the deviated portion of the sputum is known as deviated septum rhinoplasty. The septum is also trimmed to change the angle between the nose and upper lip.

Summary:  The rhinoplasty surgery is used to reshape the nose as desired. The surgeon performs open rhinoplasty, closed rhinoplasty or deviated septum rhinoplasty depending upon the condition of patient.