Rhinoplasty: What to expect with nose surgery

It's the nose you were born with, but you're unhappy with how it looks and the way it makes you feel. You've thought about having cosmetic nose surgery (rhinoplasty), but you're unsure if this procedure is for you.

Educate yourself about what you can realistically expect, including the benefits and risks involved with rhinoplasty. Understanding these issues can help you make the best decision.

How do you prepare for rhinoplasty?

Before scheduling rhinoplasty, you need to meet with your surgeon to discuss the important factors that determine whether the procedure is likely to work well for you. This meeting generally includes:

• Your medical history. Your doctor asks questions about conditions you have or have had, as well as any current medications.
• A physical examination. Your doctor conducts a complete physical examination, including any laboratory tests, such as a blood test. He or she also inspects your skin and the inside and outside of your nose.
• Photographs. Someone from your doctor's office takes photographs of your nose from different angles. Your doctor uses these photos for before-and-after assessments, reference during surgery and long-term reviews.
• A discussion of your expectations. You and your doctor should talk about your motivations and expectations. He or she explains what rhinoplasty can and can't do for you and what your results might be.

Before rhinoplasty, you may also need to:

• Avoid medications containing aspirin or ibuprofen for two weeks before and after surgery. These medications may increase bleeding. Take only those medications approved or prescribed by your surgeon.
• Avoid exposing your skin to the sun for one week before surgery and two to three months after surgery. Too much sun may cause permanent irregular coloration in the skin of your nose.
• Avoid applying makeup or facial cream the morning of the surgery.

What can you expect during rhinoplasty?

Rhinoplasty requires local or general anesthesia, depending on the complexity of the surgery and your surgeon's preferences. Local anesthesia, usually used in an outpatient setting, is anesthesia limited to a specific area of your body. Your doctor injects the pain-numbing medication into your nasal tissues and sedates you with medication injected through an intravenous (IV) line. This makes you groggy but not fully asleep.

For general anesthesia, you inhale the analgesic or receive it through an IV line. This type of anesthesia affects your entire body and induces a temporary state of unconsciousness. Discuss with your doctor beforehand which kind of anesthesia is best in your case.

Rhinoplasty usually takes one to three hours. After the surgery, you will be in a recovery room, where the doctor's staff monitors you for any complications. You might leave later that day or, if the procedure is done in a hospital, you might stay overnight.

What are the risks of rhinoplasty?

As with any major surgery, rhinoplasty carries risks such as bleeding, infection and an adverse reaction to the anesthesia. Other possible risks specific to rhinoplasty include:

• Recurring nosebleeds
• Difficulty breathing through the nose
• Reduced sense of smell
• Numbness in and around the nose
• Possibility of an uneven-looking nose
• Scarring

Talk to your doctor about how these risks apply to you. Understanding what's involved in rhinoplasty and weighing the benefits and risks can help you decide if this procedure is a good option.

Charcot's joint

Charcot's joint

What is it?
Charcot's joint, also called neuropathic arthropathy, occurs when a joint deteriorates because of nerve damage — a common complication of diabetes. Charcot's joint primarily affects the feet.

What are the symptoms?
You might have numbness and tingling or loss of sensation in the affected joint. The joint may become unstable, swollen or deformed.

How is it treated?
Early treatment — such as immobilization of the affected joint or use of crutches, braces or other support to reduce weight on the joint — can stop bone destruction and promote healing. Surgery is generally avoided.

Diabetic hand syndrome

Diabetic hand syndrome

What is it?
Diabetic hand syndrome, also called cheiroarthropathy, is a disorder in which the skin on the hands becomes waxy and thickened. Eventually finger movement is limited. What causes diabetic hand syndrome isn't known. It's most common in people who have a long history of diabetes.

What are the symptoms?
You may be unable to fully extend your fingers or to press your palms together flat.

How is it treated?
Stretching exercises can help stabilize or improve joint movement and function. Tight control of blood sugar levels may improve symptoms. Pain relievers or anti-inflammatory medications may help, too.

DISH

DISH

What is it?
Diffuse idiopathic skeletal hyperostosis (DISH), also called Forestier's disease, is a hardening of tendons and ligaments that commonly affects the spine. DISH may be associated with type 2 diabetes, perhaps due to insulin or insulin-like growth factors that promote new bone growth.

What are the symptoms?
You may experience pain, stiffness or decreased range of motion in any affected part of your body. If DISH affects your spine, you may experience stiffness in your back or neck.

How is it treated?
Physical therapy can reduce stiffness. Medication and regular exercise can help, too.

Dupuytren's contracture

Dupuytren's contracture

What is it?
Dupuytren's contracture is a deformity in which one or more fingers are bent toward the palm. It's caused by thickening and scarring of connective tissue in the palm of the hand and in the fingers. Dupuytren's contracture is common in people who have a long history of diabetes, perhaps due to the metabolic changes related to diabetes.

What are the symptoms?
You may notice thickening of the skin on the palm of your hand. Eventually, you not be able to fully straighten one or more fingers.

How is it treated?
Mild cases may not require treatment. If you're in pain or you're unable to complete daily tasks, surgery may be an option.