A Rhinoplasty is performed to reshape, re-contour and re-define the nose. Being one of the most common cosmetic facial procedures, a rhinoplasty can sculpt the nose to alter unwanted attributes (such as a bump), change the appearance of the nostrils and the bridge, or correct injury and other problems that may affect breathing. It can involve reshaping the bone, cartilage, or soft tissue of the nose. A rhinoplasty is usually performed under either local or general anesthesia and lasts one to two hours, or occasionally longer for more complex deformities.
Rhinoplasty is usually an outpatient procedure performed under IV sedation or general anesthesia. 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. The remaining incisions continue inside the nose, as with closed rhinoplasty. With both methods, the bone and cartilage is sculpted 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. The entire procedure generally lasts one to three hours, depending on the complexity of the problem.
Rhinoplasty is an excellent procedure for achieving the following:
• Balance the size of the nose with the other facial features
• Modify the width of the nose at the bridge
• Improve the nasal profile, including removing humps or depressions
• Contour a nasal tip that is too large, “boxy,” drooping or upturned
• Change the angle between the nose and the mouth
• Narrow and reshape the nostrils
• Correct asymmetry or deviation
• Improve breathing airway
For a short time after surgery, patients may experience puffiness, nose ache or a dull headache, some swelling and bruising, bleeding or stuffiness. Most patients feel like themselves within two days and return to work in about a week. The results of rhinoplasty become gradually apparent as the days pass after surgery and swelling recedes. Swelling may reappear from time to time in the first year after the procedure. It is typically more noticeable in the morning and fades during the day. Contact lenses can be worn immediately, but glasses may need to be taped to your forehead or propped on your cheeks for up to seven weeks.
Complications are rare and, when they occur, minor. These may include infection, nosebleed, or a reaction to the anesthesia (very rare).
Insurance may cover rhinoplasty if it is done for reconstructive or medical reasons, but likely not for cosmetic purposes (e.g. history of deviated septum). Some procedures can combine both, such as a patient who cannot breathe properly through their nose, but also desires an improvement in nasal contour. In those cases, the insurance carriers may pay for the airway portion of the surgery only. Insurance coverage is not guaranteed.
The best candidates for rhinoplasty:
• Are at least 13 years old
• Have finished facial growth
• Are generally healthy
• Do not smoke
• Are seeking rhinoplasty for personal reasons, not pressure from others
• Have realistic goals for the procedure
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 (tightening). However, skilled plastic surgeons can improve both the appearance and the function of the nose.
It may be important to avoid taking certain medications, vitamins and herbs two week prior to your surgery as some medications may cause you to bleed more than normal. Dr. Malek will determine which of your medications may put you at risk during your initial consultation.
Schedule an appointment with The Center to discuss your cosmetic needs. The Center will help you to develop a customized cosmetic plan to give you the results that you desire.