Surgery of the Nose (Rhinoplasty)

Rhinoplasty, or nose surgery, is one of the most common plastic surgery procedures. During a rhinoplasty, the surgeon is able to reshape, reduce or augment a patient’s nose for cosmetic, and sometimes functional, purposes. A rhinoplasty may be performed to correct a birth defect, to repair an injury, to improve breathing or simply to improve a patient’s appearance.

Candidates for rhinoplasty should be at least 13 years old since it is important that patients have finished their facial growth before proceeding with this surgery. Patients considering rhinoplasty should be in overall good health, should not be smokers, and should have realistic expectations about the outcome. Rhinoplasty is usually an outpatient procedure performed under IV sedation or general anesthesia and takes from 1 to 2 hours. There are two methods for performing a rhinoplasty: open and closed. The surgeon will choose the appropriate procedure for each individual patient.

Immediately after surgery, the patient’s nose and eyes are usually bruised and swollen. Splints and some packing material will remain inside the nose for a few days. Most patients feel like themselves within a few days and are able to return to regular activities in about a week. During recovery, the rhinoplasty patient should refrain from strenuous exercise and showering, use sunscreen of SPF 30 or higher and avoid nose blowing, vigorous toothbrushing or any activity that puts pressure on the nose.

As with any surgical procedure, there are risks involved in a rhinoplasty, including excessive bleeding, adverse reaction to anesthesia, and localized pain, discoloration or numbness. Occasionally, a patient may be dissatisfied with the cosmetic results of the operation and a second surgery, called a revision rhinoplasty, may be desired. For most patients, however, a rhinoplasty is an uncomplicated procedure with pleasing results.

What Are The Benefits Of A Rhinoplasty?

Rhinoplasty has several specific goals. Some facilitate breathing as well as improve facial appearance. During a rhinoplasty, the surgeon may make your appearance more pleasing to you by:

  • Removing a hump on your nose
  • Modifying the bridge of your nose
  • Reshaping the tip of your nose
  • Reshaping or resizing your nostrils
  • Repairing your nose after an injury
  • Increasing or decreasing the size of your nose

Are You A Good Candidate For A Rhinoplasty?

In order to be a candidate for a rhinoplasty procedure you must meet the following criteria:

  • Be at least 13 years old so that facial growth is complete
  • Be in overall good health
  • Not be a smoker
  • Have realistic expectations about the outcome of the surgery

How Is A Rhinoplasty Performed?

Rhinoplasty is usually an outpatient procedure performed under IV sedation or general anesthesia. It usually takes from 1 to 2 hours to complete. 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. The surgeon 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.

What Is The Recovery From A Rhinoplasty Like?

Immediately after surgery, your nose and eyes are usually bruised and swollen. Splints and some packing material will remain inside your nose for a few days. During this period, you may experience some nasal pain or a dull headache, as well as some bleeding and drainage from your nose. Most patients are comfortable enough to return to regular activities in about a week. Contact lenses can be worn immediately after the procedure, 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 your nose
  • Avoid constipation
  • Avoid making exaggerated facial expressions
  • Brush your teeth gently
  • Avoid pulling clothing over your head
  • Use sunscreen of SPF 30 or higher
  • Limit dietary sodium
  • Do not use ice packs

Are Most Patients Pleased With The Results Of A 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 Are The Possible Risks Of Rhinoplasty?

Complications arising from a rhinoplasty are rare and, when they do occur, usually minor. These may include infection, nosebleed, or a reaction to the anesthesia. Some few patients may experience recurring nosebleed or numbness in or around the nose. On rare occasions, the nasal septum may be perforated, but this can be repaired. In general, a rhinoplasty is considered a very safe surgical procedure.

Will Insurance Cover Your Rhinoplasty?

Insurance may cover the cost of your rhinoplasty if the surgery is being done as a reconstructive or medically necessary procedure. If you are having a rhinoplasty for purely cosmetic reasons, insurance will not cover the cost.

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.

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