Rhinoplastie/Correction du nez
Traditionnellement on recommande d’attendre la fin de la croissance pour ce type d’opération. En effet le nez n’est pas complètement forme avant 14 -16 ans, voir plus tard pour les garçons. Lors de la consultation surtout chez un adolescent, le Dr Boss ( le médecin) voudra s’assurer que votre désir de changer d’apparence est uniquement basé sur vos sentiments et n’est pas l’expression des opinions de votre famille ou de vos amis.
Si vous êtes en bonne santé, il n’y a pas de limite d’âge pour avoir une correction du nez. Parfois cette intervention sera faite en même temps qu’un face lift ou une autre opération de rajeunissement (par exemple pour corriger une pointe tombante). Certains troubles de la respiration liées aux structures internes du nez peuvent être corrigées en même temps qu’une rhinoplastie esthétique.
Dr. Boss will be able to help you determine whether these structures should be modified along with reshaping your nose.
Qui est un bon candidat pour une rhinoplastie?
Les patients dont le nez :
- Semble trop grand pour leur visage
- A une bosse quand on regarde de profil
- Est trop large en vue de face
- A une pointe tombante, corbine ou trop large
- Déformé suite a un accident ou traumatisme
Il est important que vous ayez une idée précise de ce que vous voulez modifier et de l’apparence finale idéale pour vous, tout en acceptant qu’il y ait des limitations inhérentes à ce type d’intervention. Les patients, émotionnellement stables, dont la demande est murement réfléchie et réalisable chirurgicalement sont pratiquement toujours satisfaits par le résultat de leur rhinoplastie.
Pendant la première consultation vous devrez expliquer exactement ce que vous voulez modifier. Cela aidera le chirurgien (le Dr Boss) a comprendre vos attentes et vous confirmer qu’il est techniquement possible de les réaliser.
Les visites post opératoires se font a des intervalles réguliers pour évaluer la guérison et l’évolution du résultat.
Souvenez vous que votre traitement ne finit pas a la sortie de la salle d’opération.
Quel que soient vos questions ou vos demandes vous pouvez et vous devriez nous contacter.
How will Dr. Boss evaluate me for rhinoplasty?
You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions you may have, medical treatments you have received previous surgeries including repair of nasal injuries, and medications that you currently take. Dr. Boss may also ask whether you have difficulty breathing through your nose, suffer from allergies that may cause nasal stuffiness, or are a chronic user of nasal spray. It is important for you to provide complete information.
In evaluating you for rhinoplasty, Dr. Boss will conduct a routine and painless examination of your internal nasal structures. Your skin quality as well as the size and shape of your nose and its relationship to your other facial features will be carefully studied. In some instances, your plastic surgeon may recommend surgery of your chin, making it either more or less prominent, to improve facial balance. This procedure can be done at the same as your rhinoplasty.
How Rhinoplasty is Performed?
Because of individual factors, not everyone will achieve the same results from rhinoplasty. Your surgeon's goal is to obtain the best possible results for you.
Where are the rhinoplasty incisions placed?
Alterations may be made to increase or decrease the nasal bridge, reduce the size or width of the nose, narrow the nostrils, change the angle between the nose and upper lip, or reshape the tip. The surgical techniques employed will depend primarily on the goals established by you and your plastic surgeon. In many instances, all of the incisions will be placed inside your nose, where they will not be visible. If the base of the nose is narrowed or the nostrils reduced, small wedges of skin at the base of the nostrils will be removed.
Incisions are hidden in the natural crease where the nostril joins the cheek. Sometimes a very short incision is made across the vertical strip of tissue that separates the nostrils, called the columella. This technique is called an "open rhinoplasty." Whatever incisions are used to reshape your nose, they will ultimately be very inconspicuous.
Small wedges of skin, as shown, are removed to narrow the base of the nose or reduce the width of the nostrils. Incisions are placed inside the nose to provide access to the cartilage (blue shaded area) and brown (light brown shaded area) that form the nasal framework.
Depending on the surgical technique used, a splint may be placed on the bridge of the nose for the purpose of holding the tissues in place until they have stabilized.
How is Dr. Boss able to reshape my nose?
Through the small incisions described previously, work is done on the cartilage and bone that form the framework of your nose. Sometimes, the position of certain bones may need to be altered slightly in order to make your nose look narrower and straighter.
If your nose needs to be built up in some areas, this can be done using nasal cartilage, or perhaps bone or cartilage from another site. The skin and soft tissues then redrape themselves over this new "scaffolding."
I understand that every surgical procedure has risks, but how will I learn more so that I can make an informed decision?
The subject of risks and potential complications of surgery is best discussed on a personal basis between you and Dr. Boss. Some of the potential complications that may be discussed with you include hematoma (an accumulation of blood under the skin that may require removal), infection and reactions to anesthesia.
Numbness of the skin following rhinoplasty may occur but is usually temporary.. Occasionally, if the surgical outcome needs further improvement, additional surgery may be necessary. You can help minimize certain risks by following the advice and instructions of Dr. Boss, both before and after your surgery.
Your Surgical Experience
The goal of Dr. Boss and his entire staff is to make your surgical experience as easy and comfortable for you as possible.
How should I prepare for surgery?
If you are a smoker, you will be asked to stop smoking well in advance of surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery. Your surgeon will provide you with additional preoperative instructions.
If your rhinoplasty will be performed on an outpatient basis, be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night following surgery.
What will the day of surgery be like?
Your rhinoplasty may be performed in a hospital, free-standing ambulatory facility or officebased surgical suite. Medications are administered for your comfort during the surgical procedure. Frequently, local anesthesia and intravenous sedation are used for patients undergoing eyelid surgery, although general anesthesia may be desirable in some instances. For your safety during the operation, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood. When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. There may be some discomfort, but this can be controlled by medication which you may continue taking at home. Depending on the surgical technique used, a splint may have been placed on the bridge of your nose for the purpose of holding the tissues in place until they have stabilized.
The splint will protect your nose while you sleep and shield it from accidental bumps. Frequently, you may also have a small triangular bandage beneath the tip of your nose. Packing or soft internal splints are sometimes used inside the nostrils, especially if work has been done to improve your breathing.
You probably will be permitted to go home after a few hours, although some patients may stay overnight in the hospital or surgical facility.
How will I look and feel initially?
It is important to realize that the amount of time it takes for recovery varies greatly among individuals. The first couple of days after surgery, you should restrict your activities and sleep with your head elevated. This will help to minimize swelling and reduce the possibility of minor bleeding, which is not uncommon.
Remember, you must not take aspirin or certain anti-flammatory medications. Generally, bruising around the eyes and cheeks is most apparent during the first three days following surgery. Most discoloration will disappear within a week. A few days after surgery, you can begin to use makeup as a concealer, if desired.
Noticeable swelling may last for several weeks. Minor residual swelling, most frequently affecting the nasal tip, may continue for many months, but generally this should not be apparent to others. If packing was used, it will either dissolve by itself or be removed three to seven days after surgery. Stitches may also be removed at that time. You may need to continue wearing the nasal splint for up to a week, during which time you should avoid getting it wet
When can I resume my normal activities?
Straining, bending and lifting should be avoided during the early postoperative period. In many instances, you may be able to return to work within a week or ten days after surgery.
Most normal activities including exercise can usually be resumed within three weeks. It will be a few months before you can expose your reshaped nose to direct sunlight. Your nose will be sensitive during this time, and you must be conscientious about using a sunblock to protect your skin. If the bones of your nose were altered, it may be a number of weeks before you can wear glasses without special support such as tape.
Results of Your Rhinoplasty
The goal of rhinoplasty is a nose that looks natural and blends harmoniously with your other facial features. Since the healing process is gradual, you should expect to wait up to one year to see the final results of your rhinoplasty.
You are likely, however, to begin enjoying your new look within weeks of your surgery.Occasionally, a touchup may be desired to further improve the results. If this is the case, the additional procedure is usually less extensive than the original operation. In most instances, the results of rhinoplasty are permanent, except for possible changes associated with the normal aging process.
Fortunately, significant complications from rhinoplasty are infrequent. Every year, many thousands of people have their noses reshaped, experience no major problems and are pleased with the results. Anyone considering surgery, however, should be aware of both the benefits and risks.
EAR PIN-BACK (OTOPLASTY)
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(c) American Society for Aesthetic Plastic Surgery, reproduced with permission.
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