Rhinoplasty

What is rhinoplasty?

 

Rhinoplasty, sometimes referred to as a "nose job" or "nose reshaping" by patients, enhances facial harmony and the proportions of your nose. It can also correct impaired breathing caused by structural defects in the nose.

What surgical 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

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.


Case Study

Rhinoplasty surgery includes the following steps:

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation or general anesthesia. Your doctor will recommend the best choice for you.

Step 2 – The incision

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 to reshape the structure of the nose.

Open rhinoplasty incision across the columella

 

Step 3 – Reshaping the nose structure

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.

Step 4 – Correcting a deviated septum

If the septum is deviated, it can be straightened and the projections inside the nose reduced to improve breathing.

Step 5 – Closing the incision

Once the underlying structure of the nose is sculpted to the desired shape, nasal skin and tissue is redraped and incisions are closed.

Additional incisions may be placed in the natural creases of the nostrils to alter their size.

Step 6 – See the results

For a few days, splints and gauze packing may support the nose as it begins to heal. Get more information about rhinoplasty results

Specialist

During your rhinoplasty consultation be prepared to discuss:

  • Your surgical goals, with regard to both appearance and breathing
  • Medical conditions, drug allergies and previous medical treatments
  • Current medications, vitamins, herbal supplements, alcohol, tobacco and drug use
  • Previous surgeries

Your rhinoplasty surgeon may also:

  • Evaluate your general health status and any pre-existing health conditions or risk factors
  • The options available to you for nose reshaping
  • Examine and measure your face
  • Take photographs
  • Discuss your nose surgery options
  • Recommend a course of treatment
  • Discuss likely outcomes of a nose surgery and any risks or potential complications

The consultation is the time to ask your plastic surgeon questions. To help, we have prepared a checklist of questions to ask your rhinoplasty surgeon that you can take with you to your consultation.

It's very important to understand all aspects of your rhinoplasty procedure. It's natural to feel some anxiety, whether it's excitement for your anticipated new look or a bit of preoperative stress. Don't be shy about discussing these feelings with your plastic surgeon.

Disclaimer

The decision to have plastic surgery is extremely personal. You will have to decide if the benefits will achieve your goals and if the risks and potential complications of rhinoplasty are acceptable.

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks or potential complications.

Rhinoplasty surgery risks include:

  • Anesthesia risks
  • Infection
  • Poor wound healing or scarring
  • Change in skin sensation (numbness or pain)
  • Nasal septal perforation (a hole in the nasal septum) is rare. Additional surgical treatment may be necessary to repair the septum but it may be impossible to correct this complication
  • Difficulty breathing
  • Unsatisfactory nasal appearance
  • Skin discoloration and swelling
  • Possibility of revisional surgery

These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your plastic surgeon.

Frequently Asked Questions About This Procedure

Use this checklist as a guide during your rhinoplasty consultation:

  • Are you certified by the American Board of Plastic Surgery?
  • Are you a member of the American Society of Plastic Surgeons?
  • Were you specifically trained in the field of plastic surgery?
  • How many years of plastic surgery training have you had?
  • Do you have hospital privileges to perform this procedure? If so, at which hospitals?
  • Is the office-based surgical facility accredited by a nationally- or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?
  • Am I a good candidate for this procedure?
  • What will be expected of me to get the best results?
  • Where and how will you perform my procedure?
  • What surgical technique is recommended for me?
  • How long of a recovery period can I expect, and what kind of help will I need during my recovery?
  • What are the risks and complications associated with my procedure?
  • How are complications handled?
  • How can I expect my nose to look over time?
  • What are my options if I am dissatisfied with the cosmetic outcome of my nose surgery?
  • Do you have before-and-after photos I can look at for this procedure and what results are reasonable for me?

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