Nose Surgery (Rhinoplasty)
Nose surgery, or rhinoplasty, is a cosmetic surgery
procedure that enhances the shape, size and appearance
of your nose. Rhinoplasty is a very delicate procedure
and is typically performed for two reasons, to enhance
appearance and to correct breathing problems. The majority
of rhinoplasty procedures are performed to reduce the
size and shape of the nose. Rhinoplasty is often performed
in conjunction with other procedures, such as chin and
cheek implants, to improve the overall balance between
the nose and other facial features.
How is rhinoplasty performed?
The procedure can be performed in a variety of ways.
The most common procedures performed are the reshaping
of the tip, changing the width of the nose, narrowing
the nostrils and changing the angle of the nose in relation
to the upper lip and chin. Essentially there are two
types of surgery for Rhinoplasty- the "closed technique"
and the "open technique". In a "closed
rhinoplasty" procedure, the plastic surgeon makes
an incision inside the nostrils and performs the surgery
from within the nose. During an "open rhinoplasty"
procedure, a small incision is made across the columella
(the tissue area between the nostrils), and inside the
nose as well. Through these types of incisions, the
nose's framework of bone and cartilage is sculpted to
create the desired shape.
Rhinoplasty is usually performed through incisions
made inside the nose in order to avoid visible scarring.
A small percentage of people require external incisions
to reduce the size of the nostrils. These incisions
are placed in the skin's natural creases to make them
as inconspicuous as possible. In certain cases, a small
incision will be placed on the columella to provide
more complete operative exposure. Rhinoplasty can reshape
the nose by repositioning the bones or by applying cartilage
to different areas of the nose. Cartilage may be removed
from the tip of the nose giving it a more shortened
appearance. In some cases, an implant or cartilage from
another part of the body may be added to obtain your
nose's ultimate shape. The skin and soft tissues of
the nose are subsequently redraped over this new framework
creating a natural appearance.
Breathing partially depends on the structure inside
your nose, including the condition of the nasal septum
as well as the nasal turbinates. During your consultation,
your surgeon will examine the internal aspects of your
nose and evaluate if a breathing problem exists. To
correct breathing problems, your surgeon may need to
perform a septoplasty to straighten your septum (cartilage
that divides the inside of your nose), or perform a
turbinectomy to reduce the size of your turbinates (tissue
along the sides of the nasal wall).
How long does rhinoplasty take?
The length of time depends on the type, difficulty
and scope of the procedure(s) performed. Typically,
this procedure usually takes one to one and a half hours
to complete. Additional procedures, such as a septoplasty
or turbinectomy, can take an additional half hour, while
chin or cheek implants can take an additional hour.
What type of anesthesia is used?
Rhinoplasty is usually performed using local anesthesia
along with a light sedative to make you feel drowsy
and relaxed. General anesthesia may also be used, causing
you to be asleep during the whole procedure.
Where is this procedure performed?
Rhinoplasty is usually performed on an outpatient basis,
in the surgeon's office-based surgical suite, an outpatient
surgical facility or hospital.
When can I return home and resume normal activities?
Most patients return home the same day, although complex
procedures may require a short hospital stay. Typically
patients can resume normal activities within seven days.
How do I prepare for rhinoplasty?
During your initial consultation, your surgeon will
discuss the changes that you would like to make to your
appearance. Since the appearance of your nose is a matter
of personal perception and preference, you will need
to discuss your concerns in detail so your surgeon can
determine the appropriate alternatives. Your surgeon
may also point out other problems areas. For example,
some patients who want rhinoplasty also have weak chins
or flat cheekbones. In these cases, chin or cheekbone
implants might be considered as a part of the operative
plan. You also should make arrangements ahead of time
for someone to drive you to and from your procedure
and to assist you with your daily activities during
your recovery period.
Prior to your surgical procedure, the surgeon will
perform a complete health history and physical. Knowledge
of your allergies, medications and previous surgeries
should be brought to your surgeon's attention at this
time. Specific instructions to assist you in preparing
for this procedure will be given to you after the health
history and physical is complete. Depending on your
individual health status, the instructions may include
guidelines regarding your diet, alcohol intake, smoking
and which medications to take or avoid. Your experience
will be much smoother if you remain compliant with your
What precautions are necessary during
You should rest for the first 12 hours after your nose
surgery. At the end of the procedure, tape and a protective
splint are applied over your nose. These can normally
be removed after seven days. Your surgeon will give
you specific instructions regarding rest, sleeping positions,
sun exposure, bathing and breathing techniques.
What are the possible complications
The complications associated with rhinoplasty are minimal.
The most common complication is a small amount of bleeding
from the nostrils immediately following the procedure.
Please note that this is expected. The bleeding usually
stops in one or two hours. It is always important to
be informed about the possible complications before
any surgery. Be sure to discuss any concerns you may
have with your surgeon.
What results can I expect after rhinoplasty?
About one hour after the procedure you may experience
slight pain, as the anesthesia wears off. You will be
given pain medication, which will relieve the discomfort.
Swelling and bruising of the nose and around the eyes
is common after surgery and will last for several days.
Since the inside of the nose will be swollen as well,
breathing will be difficult for the first few days following
the procedure. Breathing will improve as swelling subsides.
Swelling and discoloration of the face usually last
two to three days. Reduction in swelling and bruising
begins on the fourth or fifth day. Any stitches outside
of the nostrils, will be removed after five days. Stitches
inside of the nostrils usually do not need to be removed,
as they resolve by themselves. Rhinoplasty is performed
to improve the aesthetic look as well as the internal
function of your nose. Most people are very pleased
with their results after the procedure and begin to
enjoy their new look.
Choosing the right surgeon
To obtain further information regarding ear surgery,
we advise you to consult with a qualified and experienced
board-certified plastic surgeon. Regardless of the type
of procedure you are considering, it is crucial to choose
the right surgeon for your individual goals. To receive
a complimentary consultation with a specialist in your
area, simply fill out our Online
Referral Form or call Toll