Rhinoplasty or nose surgery is a cosmetic procedure to change the shape and contour of your nose. It can be done for a variety of reasons including to improve the appearance of your nose or to correct a defect from an injury or birth defect. The upper portion of the nose is bone, while the lower portion is cartilage. Both of these areas can be sculpted to change the shape of the nose.

There are several different types of techniques including open, closed, filler and secondary. The open procedure is used for major nose reshaping while the closed option is used for more minor nose reshaping. Filler rhinoplasty is not permanent but it is a method that allows a surgeon to make minor corrections by inserting fillers to even out bumps or dents in the nose. The secondary procedure is also known as revision rhinoplasty and used to correct earlier surgical results or correct problems that develop after earlier surgeries.

If you are considering the surgery, the first step is having a cosmetic surgeon evaluate your nose and talk to you about your expectations. Your doctor will go over your options and what technique will work best for you as well as the risk factors you should be aware of. As with any surgery there are several risk factors that must be considered including infection, bleeding, recurring nosebleeds, difficulty breathing or persistent pain and swelling.

Before you can be scheduled for surgery you will have to stop smoking, if you are a smoker since this presents an obstacle to your recovery. Your doctor will also want you to stop drinking alcohol at least a week before your surgery since this can also impact your healing process.

Certain medications can increase your risk of bleeding so you will need to discuss with your doctor all the over the counter medication, vitamins and prescription drugs you are currently taking to assess which medicines you may need to temporarily discontinue taking before your surgery.

After your surgery you will experiences some normal post op drainage and bleeding and you will have to limit some activities such as exercising, swimming, and even blowing your nose because it can aggravate your healing process.

The healing process itself can be slow and you should be prepared to have a nose splint on for a week. The swelling in your nose will continue to go down over the course of several weeks and all post op dressings and splints can be removed by the end of week two. Your doctor may need to place a soft splint inside your nose to help prevent scarring.

Scarring can lead to difficulty breathing through your nose later on. Most of the swelling (85%) will be gone within a month but it can take up to a year for the results of your rhinoplasty to be evident as the remaining swelling goes down so you will have to be patient to see how your final nose looks.

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BDD) is a relatively common yet often unrecognized body image disorder that can leave people completely preoccupied with their appearance. It can be severe, leaving those with the condition in distress withthoughts of their perceived flaws in their appearance. They believe there's something wrong with how they look, even if others do not see it. Some people can continue to function just fine, but for others, it can be debilitating and can impact their daily lives.

People who suffer from BDD are obsessed with a certain area of their body, which can include anything from their skin, eyes or nose to hair,weight or even the shape of their face. As a result, those with the disorder will attempt to mask or hide their perceived flaws, and often go through excessive grooming treatments, frequently check mirrors and ask others for reassurance, among other obsessive habits.

According to from Katherine Phillips, MD, of theat Rhode Island Hospital and Canice Crerand, PhD, of The Children's Hospital of Philadelphia, up to 31 percent of people who suffer from this very real disorder seek help in the form of plastic surgery such as breast augmentation or rhinoplasty,or minimally invasive procedures such as chemical peels, microdermabrasion, and injectable fillers. Their research also indicates that seven to eight percent of all plastic surgery patients in the United Statesmay suffer from BDD.

While in theory that should help with their obsession, the researchers' findings indicate that only two percent of those who go through cosmetic or minimally invasive procedures actually experience any long-term benefit from it. They either return to the same obsession or become fixated on another body part.

Their findings also indicate that physicians were significantly less likely to refuse a surgical or minimally invasive treatment than other procedures (dermatological, dental and others). Phillips says, "This suggests that many surgeons were not aware of the patient's BDD or do not consider BDD a contraindication to treatment. In a survey of 265 cosmetic surgeons, only 30 percent believed that BDD was always a contraindication to surgery."

As a result of their findings, the researchers believe that if a patient has BDD, they should not be allowed to undergo the requested cosmetic surgery or procedureas it is not a cure for their condition. Phillips points out, "Physicians need to be aware that psychiatric treatments for BDD such as serotonin reuptake inhibitors (a medication)and cognitive behavioral therapy appear to be effective for what can be a debilitating disorder."

If you think you may have BDD, you can take a self-screening test . Treatment is available throughthe body image program at Rhode Island Hospital. For more information you can call them at 401-444-1644.

Do you have or do you know someone with BDD? Did you take the test? Share your experience -- it could help other readers.

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