Rhinoplasty

Dr. Michael Schwartz discuses rhinoplasty.

Many people are unhappy with their nose, some might say I should be unhappy with my nose, but it is working for me so far, but people are unhappy with the appearance and the function of their nose. People often commonly cannot breathe through the nose, which is a functional problem. It is possible and common that we combine functional surgery to improve breathing with cosmetic changes to the nose. Some people of different ethnicities have larger noses that require reduction and some ethnicities have smaller flatter noses that need to be augmented or built up, and so we do both of those things here. We do all kinds of combinations. Rhinoplasty is probably the most difficult cosmetic surgery to perform. It is the most difficult to do in terms of achieving the desired results knowing what the outcome is going to be while maintaining a natural look. People are always worried about the pain and recovery associated with rhinoplasty. I do a few things that I think are specific and special for the recovery period. One is that I use long-acting numbing medicine called Marcaine and I use that to do nerve blocks in the cheek and all throughout the nose. This has two functions. One is to prevent bleeding or minimize bleeding during the surgery and therefore minimize bruising after the surgery. I also found that if a patient wakes up with no pain in recovery, which is the majority of the time, then they really never develop pain. Packing is another issue. In the past, people used yards and yards of gauze that had to come out of the nose and people dread this. I use a small little rubbery splint to compress the septum, which comes out on the fifth day, but through which you can breathe, so there is no extensive packing removal. The removal of the packing itself is not painful and generally people have a stuffy nose and are slightly uncomfortable, but there is no real pain involved with this anymore.