Rhinoplasty, or aesthetic nasal surgery, is one of the most artistic and challenging procedures in plastic surgery. "Even the most minute details in the surgery can make a tremendous difference," states Dr. Barrera.

Rhinoplasty usually takes an hour or two, though complicated procedures may take longer. During surgery the skin of the nose is separated from its supporting framework of bone and cartilage, which is then sculpted to the desired shape. The nature of the sculpting will depend on your problem. Finally, the skin is redraped over the new framework.

Dr. Barrera performs rhinoplasty from within the nose, making incisions inside the nostrils so there will be no visible scars. Through this approach, he can easily get to the bone and cartilage to reshape it and manipulate it as necessary to alter the external appearance. At the end of the surgery, a plaster splint is applied and ice compresses are recommended for the first 24 hours. The compresses will significantly reduce the swelling and bruising. The head of the patient's bed should be elevated to also help reduce swelling.

"Surprisingly," notes Dr. Barrera, "there is not too much pain after this operation. However, pain varies from patient to patient. If there is pain, medications can be prescribed."

"I rarely put packing inside the nose. This allows air to move through the nose which is more comfortable than having a nose full of gauze. Bruising and swelling is variable. It subsides, for the most part, after 10 to 14 days. Sometimes a minimal amount of swelling occurs."

After surgery -particularly during the first twenty-four hours- your face will feel puffy, your nose may ache, and you may have a dull headache. Plan on staying in bed with your head elevated (except for going to the bathroom) for the first day.

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