What is Rhinoplasty?
Rhinoplasty, Nose job or Nose reshaping is a surgical and cosmetic procedure that enhances facial harmony and the proportions of your nose or improve breathing.
If you desire a more symmetrical nose, keep in mind that everyone's face is asymmetric to some degree. Results may not be completely symmetric, although the goal is to create facial balance and correct proportion.
What can a Rhinoplasty do ?
The motivation for Rhinoplasty is to change the appearance of the nose, improve and correct impaired breathing caused by structural defects in the nose.
The upper portion of the structure of the nose is bone, and the lower portion is cartilage. Rhinoplasty can change bone, cartilage, skin or all three
Rhinoplasty can treat :
• Nose size in relation to facial balance
• Nose width at the bridge or in the size and position of the nostrils
• Nose profile with visible humps or depressions on the bridge
• Nasal tip that is enlarged or bulbous, drooping, upturned or hooked
• Nostrils that are large, wide or upturned
• Nasal asymmetry
Rhinoplasty Process
Like all the surgeries, the procedure begins with the Anesthesia, your surgeon will recommend the best choice for you wether is general or local anesthesia depending on your case.
For Incisions, Rhinoplasty is performed either using a closed procedure (where incisions are hidden inside the nose) or an open procedure (where an incision is made across the columella, the narrow strip of tissue that separates the nostrils).
Through these incisions, the skin that covers the nasal bones and cartilages is gently raised, allowing access toReshaping the structure of the nose.
An overly large nose may be reduced by removing bone or cartilage.
Sometimes surgery of the nose may require the addition of cartilage grafts.Most commonly, cartilage from the septum, the partition in the middle of the nose, is used for this purpose. Occasionally cartilage from the ear or rarely a section of rib cartilage can be used.
Correcting a deviated septum, If the septum is deviated, it can be straightened and the projections inside the nose reduced to improve breathing.
Once the underlying structure of the nose is sculpted to the desired shape, nasal skin and tissue is redraped we proceed to Closing the incisions.
Can everyone have a Rhinoplasty ?
You may be a good candidate for rhinoplasty if:
• Your facial growth is complete
• You are physically healthy
• You have a positive outlook and realistic goals in mind for the improvement of your appearance
When planning rhinoplasty, your surgeon will develop a customized plan for you; considering your other facial features, the skin on your nose and what you would like to change.
Rhinoplasty is a highly individualized procedure. You should do it for yourself, not to fulfill someone else's desires or to try to fit any sort of ideal image.
What is a Revision Rhinoplasty ?
If you are not happy with the result of a Rhinoplasty, you may feel frustrated and upset that your expectations were not met. Don’t worry, you still can benefit from a revision Rhinoplasty.
Revision Rhinoplasty also called Secondary Rhinoplasty is a surgical procedure that revises or corrects a previous surgery. It is much more difficult than regular Rhinoplasty and it requires expertise, not every surgeon can perform it. His attention to detail and proportion are critical in achieving the best result. Also, close monitoring and appropriate intervention with the healing process is critical
When you consider your options, it is important to find a surgeon you trust, who listens to you carefully and understands your targeted result.
Instructions for better Rhinoplasty
The following instructions are general information to be followed before and after a Rhinoplasty procedure:
Pre-Operation:
Avoid aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), and other non-steroidal anti-inflammatory medications, Vitamin E, herbal supplements or any medications containing these compounds for 2 weeks before surgery. Acetaminophen (Tylenol or generic equivalent) and a daily multivitamin are fine.
Stop smoking 2 weeks before surgery. Nicotine and tobacco smoke delay healing and can result in scarring.
Avoid sun damage two weeks before surgery. We recommend wearing a SPF 30 or higher.
Do not eat or drink anything, including water, after midnight the night before your surgery.
Arrange for someone to take you home from the hospital. You will not be allowed to drive or leave alone. Arrange for someone to stay with you for the first 24 hours after surgery.
Post-Operation:
Don’t smoke or yuse any Nicotine products for 2 weeks after the surgery
Change dressing under nose (if present) until drainage stops.
Do not blow your nose for 2 weeks. You may sniff back gently, but no nose blowing. If you must sneeze, sneeze with your mouth open.
If you have nasal packs they will be removed before you leave the surgery center.
Keep the inside of your nose moist with nasal saline spray; 2 puffs per nostril 4-6 times or more per day will promote healing and provide comfort.
Using a cotton-tipped applicator, apply vaseline ointment to the stitches just inside your nostril and to the skin stitches. Avoid touching the areas with your fingers.
Keep your head elevated for the first 48 hours to minimize swelling. A recliner works well. Sleeping with an extra pillow or two is adequate.
Iced gauze pads (gauze pads dipped in ice water and wrung out) should be applied to the eyes and the cheeks for the first 48 hours to minimize swelling and discoloration. Do not use an ice pack of any kind.
Avoid foods requiring prolonged chewing and avoid excessive facial movements for one week.
Brush teeth gently with a soft toothbrush only. Avoid manipulation of upper lip to keep nose at rest. You may have some numbness in your upper lip and upper teeth for about a week.
The nasal cast will be removed after 5-7 days at your follow-up appointment. Do not disturb it. Keep it dry; if it gets wet, gently pat it dry. You may wash your face if you avoid the cast. You may shower and wash your hair.
To prevent bleeding and increased swelling, avoid extreme physical activity including athletic activities and intercourse. You may resume light walking 3 days after surgery. Aerobic exercise, weight training, heavy lifting, and straining may be gradually resumed 3 weeks after surgery. Don’t swim for 1 month since injuries are common during swimming.
Absolutely avoid sun exposure, sun lamps, or tanning beds for 6 weeks after surgery. Heat may cause your nose to swell.
Do not wear regular glasses or sunglasses that rest on the bridge of your nose for at least 6 weeks. You may wear glasses on your cast. Contact lenses may be worn the day after surgery.
Don’t be concerned if the nose, eyes, and upper lip show some swelling after removal of the dressing – this usually resolves within 7 to 14 days. In certain patients, it may require 6 months for all swelling to completely subside.
Take only medications prescribed by your doctor.
After the doctor removes your cast, the skin of your nose may be gently cleansed with a mild soap. Makeup may be worn as soon as the cast is removed. Any discoloration may be covered using cover-up products.
DON’T TAKE CHANCES! If you are concerned about anything you consider significant, call your surgeon
Average Length of Stay7 Days
Length of Stay in Hospital1 Day
Operation Duration 2 Hours
AnesthesiaGeneral Anesthesia
Recovery Duration1 Weeks
FAQs
As with any major surgery, rhinoplasty carries risks such as:
Bleeding
Infection
An adverse reaction to the anesthesia
Other possible risks specific to rhinoplasty include but are not limited to:
Difficulty breathing through your nose
Permanent numbness in and around your nose
The possibility of an uneven-looking nose
Pain, discoloration or swelling that may persist
Scarring
A hole in the septum (septal perforation)
A need for additional surgery.
Rhinoplasty is a surgery to change the shape of the nose. Because both breathing and the nose’s shape are interrelated, a rhinoplasty may sometimes be performed not only to change the way the nose looks but also to improve breathing through the nose.
Septoplasty is a surgery to improve breathing by straightening the wall inside the nose that divides the nasal passages into a right and a left side (nasal septum). When the septum is crooked, it can make it harder to breathe through the nose. A septoplasty is often combined with a rhinoplasty.
No. Rhinoplasty is a challenging operation. This is due to several factors. First, the nose is a complicated 3D shape that is in the middle of the face. Changes made during rhinoplasty are often very small. But these changes can make a major difference in the way the nose looks and functions. Because these changes are small, so is the margin for error.
Swelling and the placement of local anesthetic in the skin distort the nose during surgery, hiding many of the subtle changes made. Rhinoplasty also doesn’t have a standard plan or set order of steps. Doctors tailor each operation to the needs of the patient.
Nearly everyone who has rhinoplasty is able to safely leave the hospital the same day after surgery. In rare cases, you may stay in the hospital for one night if you’re having a hard time with nausea or have other health problems that need to be monitored.
Plan to take a week off from work, school or other obligations. You will feel progressively better each day during the first week. One week after surgery, people usually feel like they are themselves again.
After surgery, there will be some swelling. The swelling can take many months to resolve, although most people stop noticing it after a couple of months. People are usually back to performing most activities after a week and resuming all activities after two to four weeks.
Sometimes insurance pays for a rhinoplasty, but it depends on the insurance policy. Before scheduling surgery, your doctor’s office will help you get prior written authorization from your insurance company. Although this isn’t a guarantee of coverage, it’s the only way to confirm that rhinoplasty is a covered benefit. Sometimes insurance will pay for a part of a nasal surgery, but not other parts.
Yes. Before your consultation, your doctor will take standardized photographs of multiple views of your face. These photos can be manipulated to give you an idea of what your nose might look like after surgery.
Not for most people. One day after surgery, most people rate their pain between 0 and 4 out of 10.
No. Packing can be very uncomfortable. But you’ll likely have some soft splints in your nose. These splints have a hole in them to make it possible to breathe through them, at least for a few days. Doctors easily remove these splints at the one-week visit.
Bruising is uncommon. If you do have some minor bruising, it usually lasts a week or so.
Plastic surgeons, facial plastic surgeons or otolaryngologists (ENT) perform most rhinoplasties. Training and board certification in one of these specialties is a good starting point. You’ll likely want a surgeon who often performs rhinoplasty.
You’ll likely want a surgeon with a good reputation among patients and other doctors. If your surgeon has published many papers in medical literature related to rhinoplasty and is invited to speak at educational conferences, that is usually one sign that their peers recognize expertise in rhinoplasty.
Make sure that your surgery will be performed in an accredited surgical facility or hospital. You likely should also feel comfortable with your surgeon. Look for a surgeon who can explain to you in understandable terms what is going to happen during your surgery.