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The nose is one of the most dominant and distinctive features of the human body. Its central location only serves to confirm its importance. However, when it is the center of attention as well, you can be relatively certain that something is out of balance. The cosmetic procedure of recontouring the nose is one of the most popular procedures sought by plastic surgery patients today. Reasons for such requests range from recontouring or reshaping the external nose, to straightening a previously injured nose and/or improving the patient's ability to breathe. The ideal nose varies from face to face depending on skin type, ethnic background, age, and other variables. The most important matter sought today by plastic surgeons is to provide a natural looking nose that goes accordingly to the patient's own facial appearance. The patient may elect also to have chin or cheek implants at the same time to enhance and balance their facial features. THE PROCEDURE Most of the incisions for reducing or recontouring the external nose are made inside the nose. Occasionally a small external incision is necessary, depending on the complexity of the problem. The nasal skin is lifted away from the cartilage and bone and excess tissue is removed. Then the cartilages at the tip of the nose are sculpted to refine the nasal tip. Sometimes instead of resecting tissues, it is necessary to place grafts that may have been harvested from the patient's own septum or ear. The procedure is sometimes combined with septum surgery to correct deviations of the nose. Finally, the skin is redraped over the new framework. When the surgery is complete, a splint will be applied to help your nose maintain its new shape and an internal packing is applied for 24-48 hours depending on the extent of the procedure. POST-OPERATORY This surgery is done as an outpatient procedure, so if the operation is performed in the morning, you will be discharged in the afternoon after resting in your suite and feel comfortable to go. Cold compresses are generally applied at frequent intervals for the first twenty-four hours to minimize bruising and swelling. You will need to keep your head elevated at all times for the first week, as this will reduce bruising and swelling. You will be able to to shower and wash your hair but keep the dressing dry. After the first week of surgery the splint is removed and a much lighter external dressing is applied if necessary. Patients are usually able to return to desk jobs 3-4 days after the surgery, but most wait a full week to do so to allow for splint removal.
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