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Aug 22, 2019

How Your Nose and Sinuses Can Be Fixed In The Same Surgery

Chronic sinus issues can make your life a dreary nightmare. Although some sinus issues are caused by infections and allergies, others are caused by physical problems with the sinuses that block drainage and airflow; these issues can only be corrected by surgical means. The prospect of undergoing surgery is never a pleasant thought even if it can alleviate unpleasant symptoms.

Photo by Min An from Pexels
Many people are also not very satisfied with the shape or size of their nose. As the center point of the face, the exact shape and size of the nose can dramatically alter a person's appearance and attractiveness. A proud jutting nose may perfectly complement the face of someone with the proper cheekbones and jaw structure, but such a nose may look completely out of place on a differently shaped face. Also, nose injuries can cause noses to be crooked and humped. Considering the dramatic impact a nose can have on a person's appearance, it is not surprising that rhinoplasty, more commonly referred to as a "nose job,'' is one of the most popular cosmetic surgeries performed today.

Something that most people don't know is that sinus problems can be corrected and rhinoplasty can be performed in a single surgical procedure. You can get the nose of your dreams and cure your sniffling, obstructed breathing, and chronic headaches all at once.

What changes to the nose can be made during a rhinoplasty?
According to the American Society of Plastic Surgery, a nose job can:

  • Change overall nose size
  • Change the width of the bridge of the nose
  • Change the width of the end of the nose
  • Correct a crooked nose
  • Correct humps or depressions in the bridge of the nose
  • Change the shape of the end of the nose
  • Change the shape and location of the nostrils
  • Correct any nasal asymmetry

During the consultation, the surgeon will carefully examine your nose and the rest of your face and discuss your goals and desired nose look. Most surgeons have computer software programs available that can show how each person will look after alterations of their nose. It is important to keep in mind there is no "perfect nose" since the shape of the rest of the face alters how a nose looks. Plunking your favorite star's nose down in the middle of your face may result in a rather ridiculous look. Mark Glasgold, a rhinoplasty expert from New Jersey, writes that the surgeon's goal is to achieve a nose that complements and enhances the appearance of each individual person.

What sinus problems can be corrected during a rhinoplasty?

Deviated septum
The most common sinus problem is a deviated septum. According to ENT Health, around 80% of the population has a septum that is deviated to some degree. The septum is the structure that separates the two breathing passages behind the nostrils; when it is off-center, producing two breathing passages of unequal sizes, it is referred to as deviated. A slightly deviated septum generally doesn't cause any problems, but a more severely deviated septum can cause problems such as:

  • Difficulty breathing
  • Noisy breathing especially while sleeping
  • Mouth breathing
  • Nosebleeds
  • Sinus infections

A deviated septum that is causing symptoms can only be corrected by surgery.

Nasal polyps
Nasal polyps are soft benign growths that develop in some people's sinuses. According to the Mayo Clinic, they seem to be caused by long-term irritation of the sinuses, such as might occur in response to allergies or asthma. Nasal polyps can cause sleep apnea, obstructed breathing and drainage of the sinuses, leading to frequent or chronic sinus infections. Generally, they need to be surgically removed.

Turbinate issues
The turbinates are structures inside the nose that act to filter, warm, and moisturize inhaled air. Unfortunately, in some people, the turbinates become enlarged or even displaced, leading to obstructed breathing. Healthline says that many of the same conditions that can cause nasal polyps, as described above, can also lead to enlarged turbinates. A deviated septum can also squash and distort some of the turbinates, contributing to breathing difficulties. Some enlarged turbinates can be treated with cauterization, where a special device is inserted into the nose to destroy some of the turbinate tissue, but many enlarged turbinates require surgery to remove the excess, displaced, or damaged tissues.

What happens during a rhinoplasty?
Most rhinoplasties are performed under general anesthesia, although sometimes they can be performed under sedation and local anesthesia. The incisions are placed inside the nose where they cannot be seen or sometimes are made across the thin strip of tissue that separates the nostrils. The exact process depends on what work needs to be done. If parts of the nose need to be reduced, tissue and cartilage will be trimmed away. If parts need to be enlarged, tissue and cartilage will be added. Cartilage grafts can be taken from inside the nose or, more rarely, from an ear to enlarge or repair structures. Any sinus issues will be addressed, such as straightening the septum, reducing the size of the turbinates, and removing any polyps. Then the incisions are closed and splints/packing placed to support the tissues for a few days while they heal.

What is the recovery like?
There will be swelling and bruising of the area for the first few days after the procedure, and a splint may need to be worn for about a week. All signs of the procedure will have vanished about two weeks after the surgery, but strenuous activity should be avoided for at least four weeks. As soon as the swelling begins to go down, the new shape of the nose should become apparent and resolution of the sinus issues should be apparent immediately after the surgery.

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