Month: January 2012

M50
N7       GET A COFFEE AT THE GREEN PUMP
M7
M9 WATERFORD EXIT FROM KILCULLEN
FOLLOW N9(N25) THE BIG TOLLBRIDGE IS VISIBLE

GO TO N9
GO THROUGH TOLL HAVE €1.80 READY

AFTER THE TOLL TURN LEFT


GO THROUGH TWO SMALL ROUNDABOUTS TILL YOU COME TO BUTLERSTOWN ROUNDABOUT


B&Q IS TO YOUR LEFT
BMW TO THE LEFT ACROSS THE ROUNDABOUT


TAKE THE THIRD EXIT AT THE BUTLERSTOWN ROUNDABOUT
WHITFIELD CLINIC IS TO THE LEFT IMMEDIATELY AFTER THE PETROL STATION

Munish Shandilya

After care of Rhinoplasty surgery in our Clinics

PAIN  Is surprisingly not a common complaint and most patients complain of discomfort of not being able to breath through the nose and a dry sore throat. Approximately 1 in 10 complain of severe pain. 

PACKS are generally avoided or kept very small to make their removal comfortable. These usually come out the morning after.                               

SUTURES in case of an External approach Rhinoplasty will come out from 5-7 days. Prophylactic Antibiotics are given in case of External approach since a skin incision is involved.  
                    
POP CAST is a Plaster of Paris cast that comes off in a week but you are asked to keep it dry.

ANTIBIOTICS are used routinely in case of External or Open Approach / Conchal Cartilage grafts.

BOLSTER DRESSING under your nose To collect ooze and prevent you from dabbing with tissues which can introduce infection.

DIET advised is your normal diet.

EXERCISE is restricted and brisk Walking is allowed in 2 weeks, Running in 6 weeks, Contact sports in 12 wks with protection.

BRUISING is less common with controlled atraumatic technique but most of our patients develop a slight lower lid discoloration of medial half … perhaps from the pressure of the dressing. This usually clears in 8-10 days.

NOSE BLOWING to be avoided for 4 weeks.

MOBILE NUMBER IS MADE AVAILABLE TO TEXT THE SURGEON IN EMERGENCY

The patient numbers in our ongoing Audit of Nasal Fracture Management in Ireland has crossed the 550 mark over the last three years out of which about one third are sports related injuries.


Youngsters participating in contact Sports are often advised to defer surgical intervention till they stop playing sports … in sports loving Ireland that would mean a sentence to live with a blocked and/or a crooked nose for a decade or few.

My experience with nasal fracture management & rhinoplasty has helped me to make these observations that I share with my patients who ask me “will my nose be weaker after the nose surgery”.


1. Nose should be protected from further sport injury for at least 12 weeks after nasal surgery.
2. Nasal Bones are stronger and thicker after healing is complete
3. Nasal cartilage is generally weaker & its strength depends on the cartilage remaining in the nose & the scar tissue component. The paucity of cartilage remnants in the nose may necessitate cartilage harvest from ears (Concha) in case revision surgery is necessitated by further trauma.

In an individual case I evaluate the above factors and advise accordingly. A blanket ban on all youngsters who are actively playing sports and have a functional or cosmetic nasal problem is perhaps excessive.

The decision should be left with the sportsperson and their family after their education and counseling.