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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.

Who is a good candidate for rhinoplasty?

You may be a good candidate for rhinoplasty if:

  • Your facial growth is complete
  • You are physically healthy
  • You don’t smoke
  • You have a positive outlook and realistic goals in mind for the improvement of your appearance

During your rhinoplasty recovery, a splint and/or packing may be placed inside your nose and a splint or bandages placed on the outside to support and protect the new structures during initial healing.

While initial swelling subsides within a few weeks, it may take up to a year for your new nasal contour to fully refine. During this time you may notice gradual changes in the appearance of your nose as it refines to a more permanent outcome.

Swelling may come and go and worsen in the morning during the first year following your rhinoplasty surgery.

You will be given specific instructions that may include:

  • How to care for the surgical site
  • Medications to apply or take orally to aid healing and reduce the potential for infection
  • Specific concerns to look for at the surgical site or in your general health
  • When to follow up with your plastic surgeon.

The results of rhinoplasty surgery will be long-lasting. While initial swelling subsides within a few weeks, it may take up to a year for your new nasal contour to fully refine. During this time you may notice gradual changes in the appearance of your nose as it refines to a more permanent outcome.

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.

Rhinoplasty risks and safety

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.

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