30420 Rhinoplasty, primary; including major septal repair

Name of the Procedure:

Rhinoplasty, primary; including major septal repair
Common name(s): Nose job, Nasal reconstruction

Summary

Rhinoplasty with major septal repair is a surgical procedure aimed at reshaping the nose and correcting any significant deviations of the nasal septum. This operation not only enhances the aesthetic appearance of the nose but also improves nasal function by addressing any structural issues that impact breathing.

Purpose

• Medical Condition: Deviated septum, nasal deformities, breathing difficulties.
• Goals/Outcomes: Improved nasal aesthetics, enhanced breathing function, correction of nasal structural abnormalities.

Indications

• Difficulty breathing through the nose
• Chronic nasal congestion or obstruction
• Nasal deformities or asymmetry
• Persistent nosebleeds
• Trauma to the nose causing structural issues

Preparation

• Pre-Procedure Instructions: Avoid eating or drinking 8 hours before surgery. Cease certain medications as advised by your doctor. Avoid smoking for at least two weeks pre-surgery.
• Diagnostic Tests: Physical examination, nasal endoscopy, imaging studies like CT scans, pre-operative photos.

Procedure Description

1. Anesthesia: General anesthesia or deep sedation is administered.
2. Incisions: Incisions are made inside the nostrils or across the columella (the tissue between the nostrils) for an open approach.
3. Reshaping the Nose: Bone and cartilage are sculpted to achieve the desired shape.
4. Septal Repair: The deviated parts of the septum are removed or repositioned for proper alignment.
5. Closure: Incisions are closed with sutures, and a nasal splint may be applied to maintain the new shape during healing.

Tools and Equipment: Scalpels, surgical scissors, nasal speculums, sutures, splints, and possibly endoscopes.

Duration

The procedure typically takes 2 to 4 hours, depending on the complexity.

Setting

Performed in a hospital or outpatient surgical center.

Personnel

• Surgeon (usually a plastic or ENT surgeon)
• Anesthesiologist
• Operating room nurses
• Surgical technicians

Risks and Complications

• Common Risks: Swelling, bruising, numbness, bleeding, infection, and septal perforation.
• Rare Complications: Difficulty breathing, unsatisfactory nasal shape, need for revision surgery, and adverse reaction to anesthesia.

Benefits

• Enhanced nasal appearance
• Improved breathing and nasal function
• Correction of deformities improving overall facial symmetry Expected benefits usually become fully apparent within 6 to 12 months post-surgery.

Recovery

• Post-Procedure Care: Elevate head while resting, avoid strenuous activities, follow a prescribed medication regimen, and attend follow-up appointments.
• Recovery Time: Initial recovery in 1-2 weeks, with full recovery and final results in about 6-12 months.
• Restrictions: Avoid blowing the nose, wearing glasses that rest on the nose, and exposure to sunlight.

Alternatives

• Non-Surgical Options: Nasal sprays, medications, and breathing strips for minor issues, though ineffective for major structural problems.
• Surgical Alternatives: Septoplasty (if only septal correction is needed), fillers for minor cosmetic improvements.
• Pros and Cons: Non-surgical options have minimal risks but limited effectiveness, while surgical alternatives can address specific issues but might not address overall nasal aesthetics and function comprehensively.

Patient Experience

• During Procedure: Patients are under anesthesia and will not feel pain or notice the procedure.
• Post-Procedure: Swelling, bruising, and mild discomfort managed with prescribed pain medications and ice packs. Expect congestion and drainage for several days. Pain management and comfort are prioritized throughout the recovery period.