Rhinoplasty (Nose Reshaping or Nose job)
Desiring a change in the shape of the nose is one of the most frequently requested facial plastic surgery procedures. The nose is the most prominent facial feature, and it is very common to meet patients who have been unhappy with the appearance of their nose for most of their lives. Patients can become shy and introverted, and in extreme cases their personal and professional life may suffer. Rhinoplasty can have a profound effect on appearance and, when done well, can boost confidence and self esteem.
Alternatively patients who have been very happy with the appearance of their nose undergo some form of physical trauma with a resultant nasal fracture and change in the shape of the nose. Uncorrected this can be devastating for some patients with a serious loss of self confidence that can affect personal relationships and work performance.
The object of rhinoplasty surgery is to create a harmonious natural appearing balance between the patient's nose and other facial features. It is extremely important for you to communicate your desires to Dr. Pincock, so that an exact plan is developed for your surgery that is tailored personally to your nose.
With any surgical procedure on the face it is important to ensure that your surgeon has the appropriate training, this is especially true of rhinoplasty. It is imperative to ensure that your surgeon is well trained and has the necessary skills for performing rhinoplasty. Many surgical maneuvers can be performed to change the nasal shape, making it smaller or shorter, making the tip narrower, straightening the nose, removing a dorsal hump etc. In modifying the shape of the nose, however, the function should not be sacrificed. Not all the surgeons undertaking this procedure have the knowledge, skills, or experience required to perform this complex surgery. Facial plastic surgery and otolaryngology training dedicates an extensive part of its program to rhinoplasty, and Facial Plastic Surgeons are often uniquely qualified to perform this procedure. They are not only trained in techniques that make your nose smaller or straighter, but also in those that preserve or improve your nasal breathing. For these reasons you should only ever have your rhinoplasty performed by a surgeon who has Ear, Nose and Throat (Otolaryngology) training.
Many people who are happy with the appearance of their nose require a rhinoplasty for breathing problems, this is often called "functional rhinoplasty" and sometimes it is necessary to straighten your septum or address your sinuses at the same time. In these cases, insurance may cover some or the majority of the costs involved with your surgery.
At your initial consultation, Dr. Pincock will perform a thorough diagnostic evaluation, occasionally including an examination with a small fiber-optic telescope. Other diagnostic tests can be done, depending on the severity of the problem, but they are seldom required.
With most modern rhinoplasty techniques the majority of incisions are made inside the nose, but occasionally a small incision will be made between the nostrils. The skin is then separated from the underlying bone and cartilage, which are then reshaped according to the desired shape, this may require cartilage grafts from the nasal septum, in revision rhinoplasty these grafts can be obtained from auricular (ear) cartilage, rib cartilage, cranial bone or implant materials. The incisions are then closed. A splint is typically applied to the outside of the nose and needs to stay for about a week.
Dr Pincock will see you in the office five to seven days after surgery to ensure that healing is progressing well and to clean out your air passages, so as to ease your breathing. Some swelling is expected after the surgery, and you may need to use medications or nasal spray to keep your nasal passages open. Keeping the head elevated and applying cold compresses helps to reduce the swelling. Pain is usually minimal, but you will be prescribed pain medications to take as needed. The splint and the sutures will be removed in about a week. The majority of the swelling resolves during the first month, but your nose will continue to adjust its shape over the next twelve to eighteen months.
Blepharoplasty (Eyelid Surgery)
The eyes are the focal point of the face and when we interact with others eye contact is perhaps the most important way we express ourselves. Bright open eyes convey beauty, vigor, and youth. However, eyes that sag due to excess skin and are puffy due to excess fat convey a tired older appearance even though you may feel energetic and rested. The Blepharoplasty, or eyelid surgery or eye-lift, can correct these problems. Two problems seen in aging eyelids cannot be corrected by Blepharoplasty alone, which are dark circles and wrinkles.For the upper eyelids the incision line is placed at the natural eyelid crease. Excess skin, muscle and fat are then removed. Because the incision is placed in a natural crease, it is frequently almost invisible after surgery. A number of options exist in performing lower eyelid surgery. The traditional subciliary approach places the incision just below the eyelashes. Excess skin and fat are trimmed. While this technique is used in some special cases there are more advanced techniques that have been developed that have a lower risk of scarring. The most common approach used by Dr. Pincock is the trans-conjunctival approach, where the incision is placed inside the eyelid, invisible from the outside. While excess fat can be removed through this incision, excess skin cannot. Excess skin can be removed just below the eyelashes in a "pinch technique" or in some cases laser resurfacing or a chemical peel can both tighten excess skin and remove wrinkles at the same time.
Most Blepharoplasty surgery is performed with either light sedation and local anesthesia or general anesthesia given by our specially selected anaesthetists. Sutures in an upper eyelid procedure are removed in five days, the sutures used in a lower eyelid procedure usually dissolve within a week. You can usually return to work in one week. Contacts can be worn after two to three weeks.
