What is Reconstructive Rhinoplasty?

J.M. Densing
J.M. Densing

Reconstructive rhinoplasty, also known as a "nose job," is surgery to correct defects on a patient's nose, which includes returning it to proper functioning condition and restoring its appearance. These defects can occur from trauma, developmental deformity, or certain illnesses. The surgery usually involves making incisions in the skin and reshaping the nasal structure. In some cases, it can involve completely rebuilding damaged parts using tissue from other areas of the body. Recovery from the surgery generally takes a few weeks.

Reconstructive rhinoplasty can be needed for a variety of reasons. Severe defects to the nose can drastically alter an individual's appearance, and even minor ones can cause issues that affect the person's quality of life. Aside from concerns about appearance, the defect can often cause difficulty breathing and pain. The goal of surgery is usually to restore a pleasing, symmetrical appearance and normal breathing.

There are many types of nasal defects that can make reconstructive rhinoplasty necessary. Broken noses frequently heal in a way that leaves them crooked, thereby altering appearance and partially blocking the airways, and causing breathing difficulties and discomfort. Skin cancer treatment can result in missing tissue after removal of malignant tumors, requiring reconstruction of the damaged area. Defects resulting from craniofacial malformations, such as a cleft lip or palate, can also be repaired with reconstructive rhinoplasty.

The process of reconstructive rhinoplasty can range from simple to extremely complex, depending on the severity of the defect. A simple surgery usually starts with incisions to the skin and soft tissues in a place where they will not be noticeable when healed, such as the area between the nostrils or the interior of the nose. This allows access to the structural components of the nose, such as the bones and cartilage, which the surgeon reshapes and repairs. Then the tissues are replaced over the repaired structure, and the incisions are closed.

More complex reconstructive rhinoplasty procedures can involve multiple surgeries. When extensive reconstruction is needed, additional surgeries are performed to harvest tissues for the process from other parts of the body, such as cartilage from the ears or skin and soft tissue from the forehead. The reconstructive process is often performed in stages with some time for healing between each step; cartilage, for example, might be rebuilt in one surgery followed by a separate skin graft procedure.

The recovery from reconstructive rhinoplasty takes at least a week. Packing or nasal supports called stents are typically placed inside the nose to provide stability for the first few days of the healing process. A splint is worn externally for at least a week for protection and added support. Most patients only report mild discomfort. Strenuous activity should be avoided for about two weeks, and contact sports aren't recommended for at least six months.

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