Awake rhinoplasty provides patients with an alternate surgical path for reshaping or enhancing their nose that puts less strain on their body. This technique has several applications in the plastic surgery field, where the patient is not placed under anesthesia while undergoing surgery. It works well with a range of cosmetic procedures, and it has become a core part of how modern surgeons approach rhinoplasty. In addition, there are several types of awake rhinoplasty techniques, and each is adapted to match the patient’s individual needs.
Although this concept may seem strange at first if you’re familiar with the traditional methods of rhinoplasty, where the patient is often placed under heavy enough anesthesia that they completely lose consciousness, awake rhinoplasty has created quite a reputation for itself recently, due to its quick recovery times and painless operation process.
Different Types of Awake Rhinoplasty Techniques
There are several different types of methods used for awake rhinoplasty, and if you’re considering scheduling this procedure for yourself, then it would benefit you to scan the following summary about some of the varieties that are available.
Awake Rhinoplasty: The Basics
Rhinoplasty procedures are perhaps one of plastic surgery’s most well-known and iconic procedures, having been performed in various cultures for decades. Also known as the “nose job,” rhinoplasty has distinguished itself as one of the definitive plastic surgery operations bolstered by continual improvement in techniques.
In fact, records exist of ancient peoples such as the Ancient Egyptians performing Rhinoplasties, with much of the same intention with which they are performed today: to bring greater levels of harmony and symmetry to the face, beautifying the individual in the process.
How Awake Procedures Work
In an Awake Rhinoplasty, instead of applying general anesthetic to the entire body to place the patient unconscious, the doctor applies a local anesthetic to the site of the surgery.
This experience might sound uncomfortable and strange, but the patient is able to remain comfortable throughout the procedure’s duration. As long as the surgeon is skilled, careful, and meticulous, there is no pain and the procedure functions safely.
This style of performing rhinoplasty has been used by Dr. Kim to allow patients to avoid general anesthesia, which can be one of the overall riskiest aspects of a surgery for some patients. It is not unheard of for lives to be lost while on the operating table under general anesthesia. This fact serves as part of the reason why Dr. Kim only provides awake procedures.
Advantages of an Awake Procedure
Patient Safety & Avoidance of Memory Loss
With any anesthetic that renders a patient unconscious, they are put at risk and will experience some memory loss, and the latter risk increases with the length of duration for the surgery. Awake procedures reduce overall risk and preserve the patient’s memory, with no memory loss occurring from the local anesthetic used. General anesthesia for over two hours is simply not worth the risk, and nose procedures typically last 2–5 hours. Avoiding general anesthesia allows patients to avoid its risks and negative impact on the brain and its nerves.
Reduced Pain Before and After Surgery
Performing an awake procedure requires enhanced precision in every aspect of the surgery, resulting in less damage to the nose’s tissues. By operating within certain planes of tissue, the surgeon can cause less damage and pain during the procedure, requiring only local numbing to keep the patient comfortable. This same aspect of the surgery also leads to less pain after a procedure, which typically can be managed with OTC pain medication such as acetaminophen.
Improved Recovery
An awake procedure has several benefits regarding recovery, including:
- Less time spent healing
- Decreased bleeding
- Minimal inflammation
- Less swelling
- Little to no bruising
No Scarring (Internal and External)
Many patients worry about external scarring, but traditional nose surgeries can result in internal scarring due to tissue damage. This scarring might not seem visible, but it can impact the nose’s shape significantly, leading to less refined results. An awake procedure avoids this scarring through more precise techniques.
Types of Awake Rhinoplasty
Generally speaking, any type of rhinoplasty can be performed as an awake rhinoplasty if the patient is ready to undergo local anesthesia for their operation. Depending on the specific type of rhinoplasty, this can take different amounts of time and subsequently demand different levels of commitment.There are six different major types of rhinoplasty, which are listed below. The main types are
- Open Rhinoplasty
- Closed Rhinoplasty
- Tip Plasty
- Septorhinoplasty
- Revision Rhinoplasty
- Liquid Rhinoplasty
Each one of these types of rhinoplasty has its own nuances in terms of how the surgeon approaches the operation in a general sense, and each of these operations has a different set of aesthetic goals and results ingrained in its process.
Open Rhinoplasty
Open Rhinoplasty is an operation where the surgeon really opens up the skin flaps of the nose in order to make major changes in the physical makeup of the muscle and cartilage underneath the surface.
Open rhinoplasties are considered of choice if you are looking to make more drastic changes in the appearance of your nose, as it allows the surgeon to take a deeper look at the underlying fundamental infrastructure of the patient’s nose.
One disadvantage that comes paired with an open rhinoplasty is that the operation leaves a small scar, which some patients will find distasteful.
In terms of an awake rhinoplasty, open rhinoplasties typically involve more surgery time and are more involved, which can mean that the patient is awake and aware for more of the surgical experience.
Closed Rhinoplasty
Closed rhinoplasties are considered to be of choice if your desired aesthetic changes are of a smaller or more minute nature.
Closed rhinoplasties are especially useful in situations where the surgery to be performed is reductive rather than additive in nature. Reductive rhinoplasty surgeries are generally considered to be simpler and easier to perform than reconstructive rhinoplasty surgeries.
Many patients will still opt for an open rhinoplasty after they learn about the nitty-gritty details of the surgical realities of what their desired aesthetic outcomes will entail, since through the consultation process, a patient will often learn more about the truly complex nature of the physiology of the nose.
One advantage of closed rhinoplasty is that it has less of a recovery period and less swelling in the post-surgical period, which may be attractive to various patients depending on what their needs will be after their procedure is over.
Tip Plasty
As its name implies, a tip plasty might be for you if you’re only looking to have some slight modification performed on the tip of your nose.
This type of rhinoplasty is generally speaking considered to be one of the least invasive forms of the procedure and additionally has one of the shortest recovery times.
A tip plasty is the perfect choice if you’re only looking to modify the very end of your nose, and pairing with that, it is a very easy choice for an Awake Rhinoplasty due to its short recovery and minimally invasive nature.
Septorhinoplasty
Septorhinoplasty is a multifaceted procedure that focuses on the septum of the patient. This procedure is performed both for aesthetic and medical reasons and is also known as a deviated septum rhinoplasty.
During a septorhinoplasty, your physician repositions your nasal septum to the middle of your nose, which can be performed either for aesthetic preference or, in the case of a deviated septum, as an operation that can relieve you from some of the respiratory issues that come paired with that condition.
A septorhinoplasty is considered a minor surgery with relatively short and low-impact recovery periods. Despite this, the procedure can have major benefits if you are in the target group it is intended for.
Revision Rhinoplasty
Revision rhinoplasty is the surgery of choice if you have already received some form of rhinoplasty and are unhappy with the results.
In revision rhinoplasty, you’ll likely schedule a consultation with your physician to discuss the parts of your original surgery that you were unhappy with and subsequently attempt to modify the appearance of your nose to better fit your expectations and aesthetic preferences.
Revision rhinoplasty’s explicitly aimed towards those who are unhappy with their initial surgery results, meaning that unless you fit into that category, you will likely find little appeal in the process.\
Liquid Rhinoplasty
Liquid Rhinoplasty is a unique, non-surgical option where the surgeon utilizes dermal fillers to create an entirely new nose shape.
Liquid rhinoplasty, by its nature, cannot be reductive surgery, so if you’re looking to have a procedure where the shape of your nose is reduced, this might not be the right procedure for you.
However, if you have a clear picture of the aesthetic results that you’re trying to achieve from your rhinoplasty, a liquid Rhinoplasty can be an interesting and possibly preferable method to achieve the aesthetic results you desire at a high level of specificity.
Preparing For Your Rhinoplasty
Regardless of what type of rhinoplasty you decide to undertake, you’ll undergo a series of consultations with your physician to determine whether you are eligible to receive treatment from your doctor.
This will include assessments of your current physical health, your medical history and history of surgeries, and any types of prescription medication and supplements you might be taking.
Your physician will advise you on a number of steps to take to prepare for your surgery in order to maximize the results that you can expect to receive. Some of these steps include things like:
- Limiting alcohol intake
- Quitting tobacco use
- Arranging for a friend or loved one to transport you to and from surgery
- Arranging for childcare and pet care if necessary
- Limiting your intake of aspirin, ibuprofen, and herbal supplements
Depending on your personal medical situation, your physician may also have additional advice to help prepare you for your operation. The specific type of rhinoplasty that you elect to undergo may also have an impact on your specific level of preparation.
After the Surgery: Faster Recovery from Awake Procedures
Each type of rhinoplasty has its own nuances in terms of how the recovery period will go. Despite this, it’s always wise to take stock of the kinds of steps you might want to take in order to make your own recovery period as comfortable and stress-free as possible.
You’ll have to assume that you will be in a vulnerable and fragile state in the post-surgical period, and thus it makes sense to prepare your home environment to be as accommodating as possible for this fragile period. However, with an awake procedure, this initial recovery period is significantly reduced. While complete recovery can take some time, the less traumatic methods of an awake rhinoplasty allow for a milder, quicker recovery period. In some cases, patients only need mild painkillers like Tylenol to manage any discomfort for about two days.
During your pre-surgery consultation, you will be able to discuss with your doctor the specific needs and recovery periods that you’ll face for whatever type of Awake Rhinoplasty that you decide to undertake.
Giving Southern California the Best Service Available
Dr. Kenneth Kim and the award-winning team of Dream Medical Group offer Southern California the highest quality plastic surgery operations available at reasonable rates. If you would like to schedule a consultation to determine which type of Awake Rhinoplasty would be the most appropriate for your needs, then take a visit to our website to ascertain more details.
References
- Elsayed M, Alosaimy RA, Ali NY, et al. Nerve Block for Septorhinoplasty: A Retrospective Observational Study of Postoperative Complications in 24 Hours. Cureus. 2020;12(2):e6961. Published 2020 Feb 12. doi:10.7759/cureus.6961
https://pubmed.ncbi.nlm.nih.gov/32190509/ - Jeong JY, Oh S, Suh MK, Kim CK, Kim KK. Effective Use of a Silicone-induced Capsular Flap in Secondary Asian Rhinoplasty. Plast Reconstr Surg Glob Open. 2014;2(6):e172. Published 2013 Nov 19. doi: 10.1097/GOX.0000000000000126
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4174244/ - Kim KK, Seo JW, Oh SJ, et al. Correction of Severely Contracted Nose. Plast Reconstr Surg Glob Open. 2016;138(3):571-582. Published 2015 Aug 21. doi: 10.1097/PRS.0000000000002516
https://pubmed.ncbi.nlm.nih.gov/27140037/ - Tasman AJ. Rhinoplasty – indications and techniques. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2007;6:Doc09.
https://pubmed.ncbi.nlm.nih.gov/22073085/ - Thong HY, Liang BC. Dual-Plane Injection Technique With Microscale Tumescent Solution for Asian Rhinoplasty. Dermatol Surg. 2021;47(7):1015-1016. doi:10.1097/DSS.0000000000002798
https://pubmed.ncbi.nlm.nih.gov/34167134/
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