(Overview)WHAT IS  Rhinoplasty

**NEED A SUMMARY** 

One of the most common plastic surgery procedures, rhinoplasty, also known as, a nose job or nose surgery, is performed to reshape, reduce or augment a person’s nose. 

Dr. Giuffre has been performing rhinoplasty procedures with excellent cosmetic results for many years. Whatever your reasons for surgery are, Dr. Giuffre personalizes the procedure according to your needs and treatment goals to obtain your nose.


Types of Rhinoplasty Procedures

If the nose is too big, a REDUCTION Rhinoplasty is done. This involves reducing and removing a small amount of bone and cartilage under the skin of the nose to create the desired shape and size change. Some large noses may also have very thick skin.  The bone and cartilage of the nose can be adjusted but the thickness of the skin cannot be reduced with surgery or any other means.

If the nose is too small, or short, or flat, an AUGMENTATION Rhinoplasty is done. This involves adding bone graft and/or cartilage graft to the nose. In some parts of the world, the use of silicone implants may be used to augment the nose rather than bone or cartilage grafts.


AM I A GOOD CANDIDATE FOR Rhinoplasty

People have their own personal perception of what they think is an attractive nose. This is influenced by their race and colour, culture, family, friends and where they live. Therefore, there is no perfect nose. 

The ideal candidate for rhinoplasty is generally healthy and has finished facial growth.

Each individual seeking a cosmetic improvement to the appearance of the nose will have specific things they want corrected.

 

Rhinoplasty Consultation

Whatever your reasons for rhynoplasty surgery, Dr. Giuffre personalizes the procedure according to your needs and treatment goals to enhance your natural nose.

Prior to your procedure, Dr. Giuffre will meet with you to discuss your goals and expectations for rhinoplasty surgery. He will also review the details of your chosen procedure, the associated risks, and welcome any questions or concerns that you may have. This discussion is important,  helping you to communicate your vision with your surgeon in order to achieve the results you desire.  During the Rhinoplasty consultation with your surgeon, it is very important that the surgeon understands the specific changes to the nasal appearance the patient desires. Some changes are not achievable surgically, while others are. An unsatisfactory result may occur if this patient/surgeon's understanding are  not clear.

All post surgical results vary from patient to patient, as no two bodies respond to and heal from surgery identically. Each consultation is completely customized and designed with the individual patients goals in mind.

 

Rhinoplasty PROCEDURE

Dr. Giuffre performs rhynoplasty procedures at a private surgical suite adjacent to his Meadowlark Health Centre Office. The procedure lasts one to two hours and is performed either under General Anaesthesia or Local anesthesia with intravenous sedation.

If there is the need for a bone reduction and a nasal bone fracture or grafting, the procedure is most often done under a General Anaesthetic. If there is only soft tissue work that is being done, then a local anaesthetic with intravenous sedation is an option. The surgery is done in a private surgical facility adjacent to Dr. Giuffre’s office.

Dr. Giuffre uses one of two techniques when performing nose surgery. In a closed rhinoplasty, incisions are made within the nostrils. In an open rhinoplasty, the incision is made across the columella, the tissue between the nostrils. With both methods, the surgeon gently lifts the soft tissues covering the nose. He or she sculpts the bone and cartilage to the desired shape. Any additional cartilage needed to augment the nose can often be taken from the septum.

If the patient has a deviated septum, the surgeon will adjust the septum and the inner structures of the nose to improve breathing. Then the tissues are redraped and stitched closed. If the patient desires nostril reshaping, this is done as the final stage of rhinoplasty.

Lastly, Dr. Giuffre will close the incisions with both dissolving a sutures and a cast is applied that remains on for 7 days. (It is to be kept dry) If nasal obstruction corrective surgery is done, vaseline gauze is inserted into the nostrils for 24 hours. This is removed by Dr. Giuffre’s staff the following morning.


RECOVERY AFTER Rhinoplasty

After the surgery is completed, the patient is kept in the recovery room for an hour before they are escorted home by their ride.  They will have to arrange a ride and aftercare with a responsible adult. Patients are not permitted to leave unaccompanied or in a taxi. If your driving distance from Edmonton exceeds 90 minutes, you should make arrangements to stay overnight in Edmonton. The surgical centre does not have an overnight care facility. You will then be seen the following day for dressing removal and assessment by Dr. Giuffre and his staff.

Dr. Giuffre provides his home phone number to his cosmetic patients in case there is a patient concern.  In the rare instance that a patient requires hospitalization, Dr. Giuffre has admitting privileges to all of the major hospitals in Edmonton.

At one week after surgery, the cast is removed and replaced with tape by Dr. Giuffre. The tape is worn for one more week.

At the end of the second week, the patient will remove this tape and apply tape to the nose in the evening before bed and remove it in the morning. Dr. Giuffre will instruct the patient on how this is done. This is done for 6 weeks.

At 6 weeks after surgery, the patient returns to the office. The preoperative photos will be given to the patient, and Dr. Giuffre will assess the result with the patient. At this time the nose will still have some swelling and firmness to the tissues.

The patient will return to the office at the one year anniversary of the surgery for a final assessment of the result. It takes a full year for the nose to heal completely following Rhinoplasty surgery. If there are minor surgical adjustments that could be made to improve the result, these would be discussed with the patient. They are done after the one year mark following the Rhinoplasty when healing is complete.

The recommended recovery time is two weeks off work. You should limit strenuous activity for at least six weeks. Male patients who wish to shave their facial beard should avoid a rotary electric razor for 6 weeks. Dr. Giuffre will give you specific instructions for your individual recovery.  


Rhinoplasty RESULTS

Results depend on the patient’s nasal bone and cartilage structure, facial shape, skin thickness and age (teenagers should have had their growth spurt).

Profile changes that can be achieved with surgery:


  • The nasal hump and tip projection angles can be adjusted. 

  • The angle between the forehead and nose (radix) and the angle between the upper lip and the nose (columella) can be adjusted. These angles are different for men and women. 

  • The length of the nose can be adjusted.


The frontal view of the nose can be changed with surgery:

  • The width of the nasal tip and the upper bony part of the nose can be adjusted. 

  • The width of the nostrils can also be adjusted. 


A crooked nose can be straightened (during the consultation with Dr. Giuffre, the symmetry of the patients face will always be assessed: some patients have facial asymmetry with one side of the face longer than the other, therefore their nose sits on a slightly crooked facial platform).


Patients with a recessed chin, **(Please see FAQ Chin) will have a nose that appears larger due to the short chin. The results of the Rhinoplasty procedure will be improved with a correction of the recessed chin.


Patients with thick heavy skin over their nose will not achieve the same result as patients with thinner skin over the nose.


The goal of Rhinoplasty surgery:


The upper and lower part of the nose, in the profile view, and the frontal view, should be balanced.


The angles should be balanced.

The nose should be balanced within the patient’s face, (a small petite nose in a large man’s face is poor balance).


The surgical result should have a natural non-operated appearance.


RISKS OF Rhinoplasty

With any surgery there are surgical and anesthetic risks.


Aside from the rare risks of an anesthetic event, some of the general and specific surgical risks for this procedure would include:

  • Scarring if an open technique is done

  • Swelling and bruising which can last 7-10 days

  • Discomfort

  • Time off work and exercise

  • Bleeding from the nasal obstruction correction

  • Contour asymmetry

  • Extrusion of the implant in an augmentation rhinoplasty using silicone implants (**Please note implant extrusion image below.)


This list is not complete.


**During the consultation with the patient, Dr. Giuffre will outline and explain each of the risks in detail.



FAQS

What is the goal of Rhinoplasty surgery?

  • The upper and lower part of the nose, in the profile view, and the frontal view, should be balanced.

  • The angles should be balanced.

  • The nose should be balanced within the patient’s face, (a small petite nose in a large man’s face is poor balance).

  • The surgical result should have a natural non-operated appearance.

How often do I need to come back for a checkup after the surgery?
Postoperative visits include:

  • 24 hours to remove the nasal packing

  • 1 week visit to remove the cast

  • 6 week visit to review the early result and photographs

  • a one year anniversary visit

If there are any patient concerns, Dr. Giuffre provides his home phone number for patient's direct access. 

After the 6 week visit, if there are any future requests for an appointment, they are made directly with Dr. Giuffre office and an expedited visit is arranged.