RHINOPLASTY

Rhinoplasty is a procedure that changes the size and shape of the nose, either by increasing or decreasing the bridge, changing the angle, narrowing the nostrils, or reshaping the tip. Although many seek a rhinoplasty simply to change the shape of their nose, others may choose nose surgery after a facial injury or to help relieve nasal obstructions. When having surgery to correct such a functional problem, medical insurance may cover a part or all of the surgical costs.

Introduction

Rhinoplasty is usually a safe procedure with infrequent complications. When performed by a qualified cosmetic surgeon, this popular procedure can bring significant improvement in the appearance of the nose. This procedure is often one of the most gratifying procedures performed.

To ensure a successful outcome, the patient should be a good candidate, the cosmetic surgeon should be well trained in rhinoplasty techniques, and the surgeon and the patient should be very clear about what can and will be accomplished during the procedure.

Who is a Candidate for Rhinoplasty?

Healthy individuals with realistic expectations
Although there is no upper age limit for nose reshaping and nasal reconstruction, most surgeons prefer to delay surgery on younger patients until they have completed their growth spurts – usually in the mid teens (onset of menses) for girls and the mid to late teens for boys.

RHINOPLASTY procedure

Intended Results

Enhance facial appearance and proportion of nose to face
Favorable nose size
Unobstructed nasal passages and ease of breathing

Procedures

Most rhinoplasties are performed on an outpatient basis and usually take an hour or two, depending on the extent of the correction.
The procedure is commonly performed under a local or general anesthetic, depending on the patient and surgeon preferences.
Different surgeons prefer different surgical techniques. Some surgeons will use a “closed” technique, where the incisions are made inside the rim of the nostrils. Others make their incision across the base of the nostrils and nose (the “open” technique). This technique may be used in more complicated cases, because the surgeon can more easily see the surgical area.
In either case, the soft tissues of the nose are then separated from the underlying structures allowing access to the cartilage and bone. The cartilage and bone are then altered and sculpted into shape. At the same time, internal problems, such as breathing obstructions can be improved by removing the obstruction or changing the shape of the obstructing matter.
If the nostrils are too wide, the surgeon can remove a small wedge of skin from the base for a more harmonized look.

Recovery & Healing

A lightweight splint may be placed on the nose for several days after to help maintain its new shape and for protection. Your surgeon may also use nasal splints inside the nose to stabilize the septum.
All splints, packing and stitches – if they’re not dissolved – will be removed usually by the end of one week. In some cases, splints may remain in place for several weeks, depending on the patient’s condition.
After surgery, patients will likely experience swelling and bruising around the nose and eyes. This will peak and begin to subside after the second or third day but may last for up to 2 weeks.
Most patients can resume normal activities within 10 days.
A small amount of bleeding may occur during the first few days.
It is common to experience some nasal stuffiness, particularly if surgery was performed on the septum.
It may be a week or two before your surgeon will allow you to gently blow your nose.
Patients must be careful not to hit or bump their nose during the post operative period.
Sun exposure should be limited as well as it can lead to prolonged swelling.
Strenuous activities should be avoided for 4-6 weeks. Elevated blood pressure during exercise can lead to additional bleeding which can significantly affect the final result.
It is recommended to avoid wearing glasses for a few weeks until the nose is completely healed.

Notes

The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation with your cosmetic surgeon. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.

Reviewed by J. Kevin Duplechain, MD, FACS