Rhinoplasty surgery can help correct an unattractive nose or provide breathing relief, and is generally conducted as outpatient procedures under general or local anesthesia.
Medication may help alleviate swelling and pain during the healing process. Swelling may take four to six weeks to diminish; in this timeframe it is important to keep the head elevated and avoid strenuous activity.
Rhinoplasty
Rhinoplasty, also referred to as “nose jobs”, is a surgical procedure designed to alter the shape or proportions of your nose and improve breathing. A crooked nose can create breathing issues as well as aesthetic concerns; correcting these problems through rhinoplasty may improve both aspects of your appearance, and boost self-confidence, helping secure better jobs or attract greater social recognition.
Rhinoplasties are usually performed outpatient under general anesthesia; however, some patients prefer local anesthetic with sedation (numbing shots). Once you’re under, your surgeon will make cuts inside or between your nostrils before reshaping bone and cartilage structures as necessary; larger changes may involve extra cartilage being grafted from ears or ribs for added support; once they have finished they close incisions to complete this procedure.
If you suffer from septum deviation, an issue with the cartilage that separates your nostrils, rhinoplasty surgery can improve airflow through your nose and reduce congestion. Furthermore, this surgery may fix broken noses caused by accidents or birth defects as well.
As with any surgery, rhinoplasty requires time for your body to recover from. While initial results might appear instantly, swelling and bruising will persist for some time afterward – external sutures must also be removed one week post-op if applicable.
The surgeon will ask about your medical history, such as any prior surgeries or nasal blockages, before conducting a physical exam of both sides of your nose – including taking photos from various angles for before-and-after comparisons and to help assess what changes might need to be made; they may use computer software to show you what your nose may look like after surgery.
This procedure is an effective way to achieve the look you want, and if you’re considering it, you should learn more about rhinoplasty and consult with a qualified surgeon to understand what’s involved and how it can benefit you. Rhinoplasty explained can help you make an informed decision and feel confident in your choice.
Sinus Surgery
Sinus surgery can help alleviate recurrent sinus infections and improve breathing, with its aim being to correct anatomic abnormalities which promote inflammation within the sinuses, leading to chronic sinusitis. Surgery can address deviated septums, nasal polyps and any other causes of blocked or inflamed sinuses.
As part of this minimally invasive procedure, the surgeon inserts an endoscope – a thin tube equipped with lights and cameras at its tip — into one of your nostrils in order to visually magnify and visualize tissues inside of your nose and sinus cavity. With this information available to them, the surgeon can then identify diseased tissue such as enlarged turbinates before extracting them and restoring normal sinus passageways and drainage pathways.
Caldwell-Luc surgery is an uncommon but more invasive option used to address growths or relieve pressure on frontal sinuses by creating an opening between the maxillary sinus and roof of mouth (maxillary osteotomy), thus increasing drainage and improving ventilation.
Balloon sinus dilation, also referred to as sinus ostial dilation or balloon ostial dilation, is another minimally invasive surgical option available to treat sinus inflammation and congestion. To do so, this surgery involves making a small cut in the upper jaw above the second molar, inserting a thin catheter with an inflatable balloon inside a blocked sinus, inflating it and stretching open its affected portion for improved drainage and airflow.
Although rarely experienced, complications from sinus surgery may include excessive bleeding that requires a trip to the operating room for control, or spinal fluid leakage from beneath the skull which could lead to meningitis. Preoperative medications designed to optimize sinus conditions may help decrease risks associated with surgery.
Most patients experience mild to moderate discomfort after sinus surgery, which can be controlled with either narcotic or non-narcotic pain medication. Bleeding may occur initially but should be managed effectively with proper care. Your physician may also suggest antibiotics in order to avoid infection or complications like scar tissue formation.
Balloon Sinuplasty
Balloon sinuplasty (BSP) is a minimally invasive procedure performed in our office under local anesthesia and provides an alternative to more traditional sinus surgery, helping relieve chronic sinus infections, nosebleeds, thick post nasal drip and painful headaches. Furthermore, BSP may even be suitable for individuals living with certain medical conditions.
Start off by applying nasal spray to numb your nose & mouth before inserting an endoscope – a thin tube equipped with a camera – into both nostrils in order to view inside of sinus passages. When your doctor can identify where your blocked sinus begins, he then introduces balloon catheter over endoscope wire which gradually inflates gradually expanding & widening opening of sinus opening as you do so; once wide enough he/she can flush it with saline solution to flush it all away
In most cases, the new sinus opening is permanent. Furthermore, no cutting or removal of bone or tissue takes place; thus reducing pain, risk of infection, bleeding & swelling compared to traditional surgery techniques and helping most patients return to their daily activities more quickly than with traditional sinus surgery.
Since 2012, thousands of ear, nose and throat doctors worldwide have utilized this non-invasive procedure to successfully treat frontal, sphenoid, ethmoid & maxillary sinuses in adults over 18 years of age. It has FDA approval.
Dr. Cohen has been performing this in-office procedure under local anesthetic for 10 years, taking less than 30 minutes and providing effective results in decreasing sinus blockage.
While BSP may help address chronic sinus issues, it doesn’t address structural causes behind them; as such, more traditional surgeries are often combined with it for best results. Therefore, it is wise to discuss your symptoms and treatment options with an ENT prior to opting for any surgery; your ENT may suggest BSP or another sinus procedure instead. Most insurance policies cover this procedure; for more information regarding your coverage contact your insurance provider who will be happy to provide more details and confirm whether or not it fits within your benefits package.
Laser Turbinate Reduction
Inside your nose are three pairs of long, thin bones covered with tissue that can expand or contract to change their shape, called nasal turbinates. When these become enlarged or inflamed, airflow is restricted, and congestion develops; in these instances turbinate reduction can help improve breathing while relieving symptoms for many patients.
Surgery to unblock airways involves extracting all or part of the lower turbinate. The procedure may be conducted either under local anesthesia or general anesthesia with sedation to ensure your comfort during the operation. A small, high-speed device may be used to shave away extra tissue; alternatively it may be done through an endoscope that’s placed into each nostril to make this easier for surgeons.
Coblation-assisted turbinate reduction is an increasingly popular and effective technique used for turbinate reduction. To perform the procedure, a needle-sized tool is inserted into the nose and laser light or radiofrequency energy is used to heat the tissue of the turbinates until they shrink, which allows bones to be reduced without negatively impacting functional mucosa on top. The procedure can usually be completed under local anesthesia within 15 minutes – making for quick and pain-free results that can even be performed quickly in office environments under local anesthesia for maximum results!
Your symptoms of stuffiness will subside with time as your turbinates heal. In this timeframe, aspirin and other nonsteroidal anti-inflammatories should be avoided to decrease bleeding risk. As your turbinate will swell slightly with yellow or bloody crusting around its edges; most patients can resume normal activity within a few weeks.
If allergy medicines or nasal sprays do not improve your breathing, turbinate reduction surgery could be the answer to improving quality of life. Turbinate reduction surgery can also be combined with other nose surgeries like rhinoplasty or balloon sinuplasty to address issues like deviated septum deviation. For more information on its advantages and to see if it’s right for you, reach out to our office. Dr. Rubinstein would be more than happy to schedule a consultation session and discuss all of the available solutions tailored specifically towards your situation.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
