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The operation is performed using local anesthetics with intravenous
medications or a general anesthetic to make you comfortable throughout
the procedure. The anesthesiologist monitors all patients to ensure
their safety and comfort.
Most of the incisions for reducing or recontouring the external
nose are made inside the nose. Occasionally, an incision will be
made across the base of the columella, the strut between the two
nostrils. Rarely incisions may be required at the base of the nostrils
if they are to be narrowed. The skin is lifted away from the cartilage
and bone and the excess tissue is removed. Instead of resecting
tissue, it may be necessary to put grafts into depressed areas to
reshape the nose satisfactorily. Such grafts may be taken from the
septum, or a silicone rubber implant may be discussed as an option
to using your own cartilage.
The nasal tip cartilage will be refined and the nose shortened
if necessary. The excess skin left by the reduction of the underlying
bone and cartilage is elastic and readapts itself to the new framework.
An important aspect to the predictability of a desired result is
the thickness of the patient's skin; thick skin will not drape out
as well post-operatively over new framework as will thinner skin.
Conversely, while minor irregularities of the cartilage or bone
can be expected to be hidden by thicker skin, they may become clearly
visible in the thin-skinned individual.
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