Services for Nose
The development of rhinoplasty occurred primarily as a plastic surgery technique to restore a proportional nose shape, whether after injury or due to a birth defect. In addition to these corrective procedures, surgeons now use cosmetic plastic surgery to perform subtle aesthetic changes to nose size and shape. However these techniques are often used, over used and misused, thus creating problems where none need exist.
This clinic has assisted patients from around the world for help in correcting some of the most challenging cases in rhinoplasty and their complications. Dr. Desai specializes in obtaining natural looking results by using skill and knowledge in aesthetics as an artist and as a surgeon to shape the nose to fit the face, rather than make it appear artificial. In addition to his work with revision rhinoplasty, Dr. Desai also specializes in providing tailored results that look proportional to an individual's ethnic and racial features.
A rhinoplasty is usually an augmentation or a reduction (shortening or lengthening) rhinoplasty. It may also involve deviation of either the cartilaginous or the bony dorsum and usually involves some degree of narrowing and straightening of the nose.
It may also involve straightening of the septum, the central partition separating the 2 nasal passages. For patients suffering concomitant sinusitis, it may also be possible to combine this procedure with endoscopic sinus surgery. INCISIONS AND RESHAPING: CLOSED vs. OPEN Open Rhinoplasty. For major nose reshaping, the incisions are not made inside the nose. Instead, a v—shaped incision is made in the vertical strip of skin separating the nostrils. This is called the columellar incision, which is then extended to each side within the nose, and therefore this extension remains invisible. This more complex procedure is referred to as "open" rhinoplasty. This technique allows for more precise re-shaping of the tissues and the scar is almost invisible. This is the more preferred technique in the surgeon's hands as precise symmetry is achieved.
The next step is to re-shape the tip of the nose. This is done by working on the lower lateral cartilages and narrowing them in the region of the dome. This narrows the tip of the nose.
The hump of a prominent nose usually consists of a bony and cartilaginous part. Both are reduced to the required degree. Then the upper part of the nose which is formed by the nasal bones is narrowed by osteotomies, which means precise controlled fracturing of the bones. There are many reasons that the surgeon would want to narrow the nasal bones during a rhinoplasty. Maybe the bones make the nose appear too wide. Maybe either bones, or only one bone, have been pushed abnormally wide in a car accident.
After the cartilage and bone have been altered, the nose tissues are redraped over the newly shaped structures and the incisions are closed.
Closed Rhinoplasty. For minor reshaping, many surgeons make incisions within the nose. The skin of the nose is then separated from the bone and cartilage, which forms its supporting framework. Once exposed, bone and cartilage can be augmented, removed, reshaped, or rearranged to achieve the desired new shape. For example, to make the nasal tip narrower, cartilage can be removed from within the nose.
The nose area will be bruised and puffy after surgery. This bruising may extend to the eyes and all areas of the face. Common post-surgery instructions include a cold compress to reduce swelling, pain medication to reduce discomfort, and elevating your head for the first twenty-four hours.
Most of the swelling and bruising should disappear after 10 days. You may experience slight bleeding for the first few days. Normally after two weeks, all stuffing, splints, and other post-surgical dressings are removed. There will be some internal swelling within the nose for some months, but this will not be noticeable to anyone but you and the surgeon.
- Do not blow nose until instructed. Wipe or dab nose gently with Kleenex if necessary.
- Change dressing under nose (if present) until drainage stops.
- The nasal cast will remain in place for approximately one week and will be removed in the clinic. Do not disturb it; keep it dry.
- Avoid hard foods or foods that require prolonged chewing. Otherwise, your diet has no restrictions.
- Avoid extreme physical activity. Obtain more rest than you usually get and avoid exertion.
- Brush teeth gently with a soft toothbrush only. Avoid manipulation of upper lip to keep nose at rest.
- You may wash your face - carefully avoid the dressing.
- Avoid smiling, grinning, and excess facial movements for one week.
- Do not wash hair for one week unless you have someone do it for you. DO NOT GET NASAL DRESSINGS WET.
- Wear clothing that fastens in front or back for 1 wk. Avoid slipover sweaters or T-shirts.
- Absolutely avoid sun for 3 weeks after surgery; heat may cause the nose to swell. Thereafter, use sunscreens.
- Don't swim for one month, since injuries are common during swimming.
- Following removal of the dressing, the nose, eyes, and upper lip generally show some swelling & discoloration - this usually clears up in 2-3 weeks. In certain patients it may require 12-18 months for all swelling to completely subside.
- Take only medications prescribed by your doctor(s).
- Do not wear regular glasses or sunglasses which rest on the bridge of the nose for at least 4 weeks. We will instruct you in the method of taping the glasses to your forehead to avoid pressure on the nose.
- After the doctor removes your nasal cast, the skin of the nose may be cleansed with a mild soap or Vaseline Intensive Care Lotion. BE GENTLE. Makeup may be used as soon as the bandages are removed. To cover discoloration, you may use a makeup as directed by our office.
- DON'T TAKE CHANCES! - If you are concerned about anything you consider significant, call the clinic. When the splint is removed, your nose will be swollen and may remain so for several weeks. In fact, it takes at least 3-6 months for all swelling to subside.
Fee Structure:Typically a rhinoplasty procedure with hospitalization for 3 days and anesthesia should cost approximately US$ 1500-2000/- inclusive of all charges. The patient is able to return to his home in 1 week and can resume work in 10 days following surgery.
Medications :Please inform our staff 1 week in advance if you are taking the following medications:
- Pain killers & anti-inflammatory drugs including Brufen, Combiflam
- Anti-platelet agents such as Disprin or Clopidogrel
- Anti-epileptic medications
- Anti-diabetic medications
- Anti-hypertension medications
- Anti-depressants or psychiatric medications
If you have any doubts regarding your medications, please show your personal physician this list or call us.
Do not take any aspirin containing medication including cold formulas for at least one week prior to surgery. These compounds have a tendency to decrease the average clotting capacity and increase bleeding during surgery. Crocin or Calpol may be used instead as it does not have these untoward effects.
Smoking and alcoholSmoking and alcohol significantly increases the risk of complications, bleeding and wound healing problems. Therefore, DO NOT SMOKE for at least two weeks before and six weeks after surgery . This also applies to second hand smoke; therefore do not stay in the room with cigarette smokers.
DO NOT DRINK ALCOHOL for at least 1 week before and 1 week after surgery.
Pre-operative LabsPreoperative blood investigations must be obtained and reviewed prior to surgery. You will be asked to visit the hospital where you will meet with the doctors.
Soap for BodyUse Dettol soap (over-the-counter antibacterial skin cleanser) in the shower instead of soap for three days prior to surgery.
Shampoo your hair and wash your face on the morning of the operation.
DO NOT OIL YOUR HAIR.
In case you are having a throat operation, please brush your teeth.
In case you are having a nose operation, males should trim their moustache.
Notification of IllnessesNotify our office promptly if cold, fever, or any illness appears before surgery. Call in any allergies, medications, or conditions which you may have forgotten to tell us about.
The Night Before SurgeryDo not eat or drink anything after midnight the night before surgery. This includes gum, chocolate, milk, tea, coffee and water.
If you are diabetic and take insulin you will be instructed how to take your medication and discuss this with your anesthesiologist during the preoperative visit.
FAILURE TO COMPLY WITH THESE INSTRUCTIONS MAY RESULT IN CANCELLATION OR DELAY OF YOUR OPERATION.
IF YOU HAVE ANY DOUBTS OR QUESTIONS, PLEASE CONTACT US FROM 4:00PM TO 11:00PM ON ANY WORKING DAY.