The nose is said to be the most prominent and noticed feature of your face. The nose should, above all, be in harmony with the rest of your face, in terms of size, shape, and contour. When the nose is out of proportion with other features of the face, it does not complement the face but rather detracts from your appearance. Certain features of the nose are common to certain ethnic groups or even families. While certain features of your family nose may complement the distinguished appearance of your uncle and grandfather, you may feel that the same nose on your face creates disharmony and impairment of your overall appearance.

Surgery to reshape the size and shape of your nose is called rhinoplasty. In a rhinoplasty, a small incision in made just below the tip of your nose. (Figure A) Through this “access” incision, cartilage can be repositioned using sutures to reshape the size and contour of your nose. The nose can be compared to the process of constructing a house. If you have ever seen a house being built, there are structural beams and framework set in place before the house is covered with stucco or siding. The structural beams in your nose are the cartilage. The stucco covering is your skin. Through surgery, the structure is changed by reshaping the cartilage. (Figure B) Then, the skin heals by “shrink-wrapping” around the cartilage framework, giving you the final appearance of a changed nose. (Figure C)

The surgery is done on an outpatient basis. You have a plastic flexible splint inside and outside your nose for one week. (Figure D) Swelling and bruising will subside in about 10 days.

Figure A		Figure B
Figure C		Figure D

Dr. Lee's postoperative instructions for rhinoplasty

1. Swelling and black-and-blue discoloration around the eyes are likely and be worse between 48 hours to 72 hours following surgery. This is not a cause for worry.
   
   
2. There is a plastic, flexible splint inside each nostril. There is a plastic rigid splint over the nose. DO NOT attempt to remove these splints. They will be taken out at your first follow-up appointment.
   
   
3. Take medications as directed. Do not take aspirin, anti-inflammatory medications (Motrin, Ibuprofen, Alleve) or Vitamin E supplements for 2 weeks after surgery.
   
   
4. No driving while under narcotic medications for pain.
   
   
5. Ask Dr. Lee in your first follow-up visit regarding going back to work.
   
   
6. You should sleep on your back with your head elevated on 2 pillows for 1 week following surgery.
   
   
7. Avoid alcohol or cigarette smoking for at least 3 weeks following surgery.
   
   
8. Call and make a follow-up appointment for 7 days following surgery.
   
   
9. You may have bleeding and drainage from your nose. This will slowly stop. You can change the gauze under your nose as needed.
   
   
10. Apply cold packs to your eyes to help with the swelling.
    
    
11. You can sponge bathe your body and face. Avoid soap and water around the nose, the splint and the packing.
    
    
12. Do not allow glasses to rest on your nose for 3 weeks following surgery. Glasses may be secured by taping the bridge to your forehead. Do not wear contact lenses for 7 days after surgery.
    
    
13. Your nose will be “stuffed up” after surgery. Try breathing through only your mouth. The stuffiness will improve with time.
    
    
14. DO NOT put anything inside your nose. DO NOT blow your nose for 2 weeks.
    
    
15. Use antiseptic mouthwash and brush teeth very gently.
    
    
16. DO NOT blow your nose or use any medications to clear your nose.
    
    
17. You can clean the suture line over the nose gently using peroxide and a Q-tip to loosen up the crusting. DO NOT try to pick the crusting off forcefully.
    
    
18. Keep your incision out of the sun. Sun exposure will make your scars red, raised, and persistently irritated for a long period of time. Make every effort to avoid the sun for up to 1 year following surgery. You can cover up the incision with sun screen (SPF 15 or above) or clothing.
    
    
19. You may return to normal activity and exercise at 3 weeks following surgery.
    
    
20. You may return to normal activity and exercise at 3 weeks following surgery.
    
    
21. Call with any questions or concerns. Dr. Lee is available through the office phone number 24/7. Don’t ever feel badly about calling.

For rhinoplasty in Newport Beach California contact this board certified plastic surgeon.