Rhinoplasty (nose surgery) is a frequently performed plastic surgery procedure. During rhinoplasty, the nose is reshaped, reduced or augmented to improve its appearance. Rhinoplasty may be performed to correct a birth defect, or to remedy an injury like a broken nose. It is also often performed strictly for cosmetic reasons. For a patient with a deviated septum, it is often performed along with septoplasty, a procedure that corrects a deviated septum. In such cases, rhinoplasty effectively treats health and breathing problems, in addition to improving the patient’s appearance.

Candidates For Rhinoplasty

Candidates for rhinoplasty have finished their facial growth. Girls should typically be at least 15 or 16 years old; boys should be at least 17 or 18. Patients considering rhinoplasty should be in overall good health both mentally and physically and not smoke. It is important that candidates have realistic expectations about what rhinoplasty can do. Although undergoing rhinoplasty may boost self-confidence, it should not be viewed as a cure-all for personality or relationship issues, and should not be the result of social pressure.

Goals Of Rhinoplasty

There are several goals of rhinoplasty; they include facilitating breathing as well as improving appearance. During rhinoplasty, Dr. Jarrell may attempt to do one or more of the following:

Remove a hump to improve the nasal profile
Modify the bridge to affect its width
Reshape the tip to correct a boxy, drooping or upturned appearance
Reshape or resize the nostrils
Repair an injury
Open breathing passages
Increase or decrease size
Rhinoplasty can involve modifying bone, skin or cartilage, or all three. The goal of a rhinoplasty is not create a new nose, just a refined, aesthetically pleasing nose that lives in harmony with the rest of the features of your face.

The Rhinoplasty Procedure

Rhinoplasty is usually an outpatient procedure. It is a technically involved procedure performed under general anesthesia. Two techniques are typically used. In closed rhinoplasty, incisions are made within the nostrils. In open rhinoplasty, which is more commonly performed, an incision is made across the columella, the tissue between the nostrils in addition to incisions within the nose. With both methods, the soft tissues covering the nose are gently lifted, and the bone and cartilage are sculpted to the desired shape. This typically includes reducing a large hump on the bridge of the nose, straightening a crooked nose, reducing the width of the nose by making small breaks in the nasal bones, and refining the tip of the nose to make it less boxy or bulbous.

If additional cartilage is needed to augment the nose, it is frequently taken from the patient’s nasal septum. If larger sections of tissue are required, cartilage may be surgically removed from the ear or other parts of the body as well. If the patient has a deviated septum, the septum and inner structures of the nose are adjusted to improve breathing. The tissues are then redraped and stitched closed. If necessary, nostrils are reshaped in the final stage of rhinoplasty. Following surgery, the nose is taped and splinted to protect the repairs. The use of nasal packing is determined on a case-by-case basis.

Recovery From Rhinoplasty

Immediately after surgery, the patient’s nose and eye area are usually bruised and swollen. Head elevation and ice packs can help with this. Nasal packing may remain in the nose for a few days. Splints on the outside of the nose are left in place for approximately 1 week and removed in the office along with any external sutures on the nose. Occasionally, a splint may be placed inside the nostrils which may be removed in the office setting as well. During the recovery period, the patient may experience some nasal pain or a dull headache, as well as some bleeding and drainage from the nose. Most patients feel like themselves within a few days and are able 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 6-8 weeks to avoid pressure over the repairs.

To increase comfort, and decrease bleeding and swelling, rhinoplasty patients are advised to follow these post-surgical directives:

Avoid strenuous activities
Take baths instead of showers
Avoid blowing the nose
Avoid becoming constipated
Avoid exaggerated facial expressions
Brush the teeth gently
Avoid pulling clothing over the head
Avoid wearing glasses that place pressure on the nose bridge
Use sunscreen that has an SPF of 30 or higher
Limit dietary sodium

Strenuous activities such as exercise should be minimized during the first 6 weeks and no contact sports are allowed for the first 8 weeks. Although patients usually look “normal” a week or two after surgery, minimal swelling may be present for as much as a year.

Risks Of Rhinoplasty

Complications associated with rhinoplasty are rare and, when they occur, usually minor. Surgical risks in general include infection or adverse reaction to anesthesia. In the case of rhinoplasty, specific risks include the following:

Recurring nosebleeds
Difficulty breathing through the nose
Permanent numbness in or around the nose
Persistent pain
Discoloration of skin on the nose
Perforation of the nasal septum (which may require additional surgery to correct, but may be impossible to correct)
It is possible that a patient is not satisfied with the results of the rhinoplasty. In such a case, a second surgery, called a revision rhinoplasty, may be performed at a later date.

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 realized until a year has passed, you will more than likely be extremely pleased with the results of your nose surgery soon after the procedure.