Rhinoplasty, or nose surgery, is one of the most common plastic surgery procedures performed today. It can reshape, reduce or augment a person's nose to achieve facial harmony and boost self-confidence. It may be performed as a reconstructive procedure to correct a birth defect or an injury such as a broken nose.
Rhinoplasty may be performed for functional rather than cosmetic reasons as well. Combining nose reshaping with septoplasty or endoscopic sinus surgery can effectively treat certain breathing problems, such as those caused by a deviated septum.
What can rhinoplasty do for me?
Rhinoplasty is an excellent procedure for achieving the following:
- Balance the size of the nose with the other facial features
- Modify the width of the nose at the bridge
- Improve the nasal profile, including removing humps or depressions
- Contour a nasal tip that is too large, "boxy," drooping or upturned
- Change the angle between the nose and the mouth
- Narrow and reshape the nostrils
- Correct asymmetry or deviation
- Repair an injury
- Open breathing passage
Rhinoplasty can involve modifying bone, skin or cartilage, or all three.
Am I a good candidate for rhinoplasty?
The best candidates for rhinoplasty:
- Are at least 13 years old;
- Have finished facial growth;
- Are generally healthy;
- Do not smoke;
- Are seeking rhinoplasty for personal reasons, not pressure from others; and
- Have realistic goals for the procedure.
How is the procedure performed?
Rhinoplasty is usually an outpatient procedure performed under IV sedation or general anesthesia.
Surgeons use one of two techniques when performing nose surgery. In a closed rhinoplasty, incisions are made within the nostrils. In an open rhinoplasty, the incision is made across the columella, the tissue between the nostrils. With both methods, the surgeon gently lifts the soft tissues covering the nose. He sculpts the bone and cartilage to the desired shape. Any additional cartilage needed to augment the nose can often be taken from the septum.
If the patient has a deviated septum, the surgeon will adjust the septum and the inner structures of the nose to improve breathing. Then the tissues are re-draped and stitched closed. If the patient desires nostril reshaping, this is done as the final stage of rhinoplasty.
The entire procedure generally lasts one to two hours.
What is the recovery from nose surgery like?
For a short time after surgery, patients may experience puffiness, nose ache or a dull headache, some swelling and bruising, bleeding or stuffiness. Most patients feel like themselves within two days and return to work in about a week.
The results of rhinoplasty become gradually apparent as the days pass after surgery and swelling recedes. Swelling may reappear from time to time in the first year after the procedure. It is typically more noticeable in the morning and fades during the day.
Contact lenses can be worn immediately, but glasses may need to be taped to your forehead or propped on your cheeks for up to seven weeks.
Are there any restrictions in the weeks following a rhinoplasty?
While you will be able to resume normal activities about a week after surgery, you will have to protect your nose while it heals by observing the following directives during the post-operative period:
- Avoid strenuous activities
- Take baths instead of showers
- Avoid blowing the nose
- Avoid becoming constipated
- Avoid exaggerated facial expressions
- Brush the teeth gently
- Avoid pulling clothing over the head
- Use sunscreen that has an SPF of 30 or higher
- Limit dietary sodium
- Do not use ice packs
Risks of Rhinoplasty
Complications associated with rhinoplasty are rare and, when they occur, usually minor. Surgical risks in general include infection or adverse reaction to anesthesia. In the case of rhinoplasty, specific risks include the following:
- Recurring nosebleeds
- Difficulty breathing through the nose
- Permanent numbness in or around the nose
- Persistent pain
- Discoloration of skin on the nose
- Perforation of the nasal septum
It is possible that a patient is not satisfied with the results of the rhinoplasty. In such a case, a second surgery, called a revision rhinoplasty, may be performed at a later date.
Will I like the results of my nose surgery?
Patients with realistic goals for rhinoplasty are generally very happy with the new shape of their nose. The exact results depend on the patient's nasal bone and cartilage structure, facial shape, skin thickness and age.
Are most patients please with the results of rhinoplasty?
Patients with realistic goals for rhinoplasty are generally very happy with the new shape of their nose. The exact results depend on your nasal bone and cartilage structure, your facial shape, the thickness of your skin and your age. While you will look and feel fine within a week or two, you may have minimal swelling for as long as a year after the rhinoplasty procedure. Although your appearance may not be absolutely optimal until a year has passed, you will more than likely be extremely pleased with the results of your nose surgery soon after the procedure.
What is revision rhinoplasty?
Revision, or secondary, rhinoplasty corrects deformities caused by a previous operation on the nose. It is a more difficult procedure to perform than primary rhinoplasty because there is less cartilage to work with and there may be scarring or tissue contracture. When performed by a highly skilled plastic surgeon, however, a revision rhinoplasty can improve both the appearance and the function of the nose.