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What is Rhinoplasty? Rhinoplasty, or nose reshaping surgery, improves the shape, size, and symmetry of a person’s nose, bringing it into better proportion with the rest of the face. When performed by a skilled, qualified cosmetic surgeon, rhinoplasty can be a rewarding and life-enhancing procedure—patients often notice that their overall appearance has improved, as the nose they see now looks natural, like the nose they have always thought they should have.
QUICK FACTS: Rhinoplasty surgery can permanently improve the shape & size of your nose. Patients typically return to work after 1 to 2 weeks.Dermal fillers can be used to non-surgically reshape the nose for up to a year. Chin or neck contouring are popular options to enhance the results of rhinoplasty
The goals of nose reshaping are as individual as the patients who choose to have rhinoplasty. By reshaping the nasal structures, including bone, cartilage, and skin, a cosmetic surgeon can help achieve one or more of the following:
Men and women of all ages benefit from rhinoplasty. Nose reshaping is one of the more popular cosmetic surgery procedures for teenage patients too, although cosmetic surgeons take special care when evaluating whether or not a younger patient is ready for rhinoplasty. Physically, the nose must be fully developed—typically by around age 14 for girls and 16 for boys. Younger patients also need to demonstrate emotional maturity and understanding about the cosmetic surgery process.
For patients of any age, it is important to have realistic expectations. Rhinoplasty can help you improve upon your existing nose, but it cannot deliver “perfection” nor can it give you the nose of someone else. A skilled, qualified cosmetic surgeon will explain to you what is possible and help you achieve a nose that looks natural with your unique features.
Rhinoplasty is a highly complex procedure that demands a specially trained cosmetic surgeon. Choose a surgeon who has extensive experience in facial cosmetic surgery and performs rhinoplasty as a significant portion of his or her practice.
When consulting with potential surgeons, ask how many rhinoplasty procedures he or she has performed, and be sure to look at before and after photos of prior patients. The results you see should look natural to each individual patient, and you should like the results you see—this indicates a surgeon whose aesthetic sensibility aligns well with yours.
Nose surgery is highly individualized, and the exact techniques a cosmetic surgeon will use during a procedure will look a little different each time, depending on a patient’s anatomy and desired changes. In general, however, a cosmetic surgeon’s techniques will fall under one of the following procedural approaches.
For an “open” rhinoplasty, a small incision is made under the nasal tip, between the nostrils. This approach allows the cosmetic surgeon more complete access to the nasal structures, where he or she can then sculpt the nose into the desired shape. Because of this increased access, cosmetic surgeons will typically use the open rhinoplasty approach for patients requiring more extensive reshaping. The resulting scars are well-hidden in the natural contours of the nose so they are as inconspicuous as possible.
For a “closed” rhinoplasty, incisions are made inside the nostril. This approach is most commonly used for patients who need more minor adjustments to the nasal structures to achieve their desired improvements. The advantage of closed rhinoplasty is that there is no visible scarring after surgery; however, this approach may not be suitable for more extensive rhinoplasty procedures.
A “tiplasty” refers to the area of reshaping, rather than the incision techniques. As you might have guessed, tiplasty involves reshaping the nasal tip only, without affecting the other nasal structures. Cosmetic surgeons may use the open or closed approach for tiplasty.
In certain cases, the nose can be reshaped non-surgically with dermal fillers, providing improvements that last up to a year. By strategically injecting a filler at certain points in the nose, a skilled cosmetic surgeon can help smooth out bumps, reshape the nasal tip, and improve nasal symmetry. Although the results are temporary, this non-surgical approach can be a cost-effective way for patients to “test-drive” a nose reshaping procedure before committing to the permanent changes possible with surgical rhinoplasty.
Rhinoplasty is typically performed as an outpatient procedure using general anesthesia, although local anesthesia with intravenous sedation may be appropriate in certain cases. After your procedure, your nose may be placed in a splint. This helps to support your newly reshaped nose and protect it from accidental contact. You may also go home with packing inside your nostrils—this can be uncomfortable, but temporary. Packing is typically removed within the first week after rhinoplasty. Your cosmetic surgeon will prescribe pain medication to help minimize discomfort during your initial recovery.
For the first 1 to 2 weeks, many patients experience bruising and swelling. At first, you may not be able to see the improvements made during surgery. But don’t worry—the majority of bruising and swelling should subside after the first 10 to 14 days. Most patients feel ready to return to work or school after 1 or 2 weeks, depending on the level of activity required. Typically after 3 weeks, most normal non-contact activities can be resumed. However, limit activity according to your surgeon’s instructions and do not engage in any strenuous activities until you are cleared to do so.
While you will be able to see the improvements your cosmetic surgeon made during rhinoplasty after the initial bruising and swelling dissipates, it is normal to have some slight residual swelling present for up to a year. This is usually not noticeable to others, though.
The results of rhinoplasty surgery are permanent. While this means your new nose will be with you for a lifetime, it also makes it that much more important to choose a qualified cosmetic surgeon whom you can trust to deliver the results you desire.
If you’re considering rhinoplasty, the best way to learn about your options is to meet with a board certified cosmetic surgeon for a consultation.
The most common nasal procedures include turbinate reduction and correcting any septal deviations (septoplasty). Sometimes correction of external nasal deformities (rhinosseptoplasty) or sinus surgery will be necessary and it may be performed in combination with one of our colleagues from the rhinology or facial plastic surgery team. Nasal surgery alone rarely successfully treats OSA. However, it usually improves sleep quality and CPAP adherence and compliance.
Rhino means nose and plasty means to shape, mold, or form. Rhinoplasty was the fifth most common procedure one by plastic surgeons in 2012, according to the latest statistics released by the American Society for Aesthetic Plastic Surgery (ASAPS). Many plastic surgeons feel rhinoplasty is the most artistic and difficult cosmetic surgical procedure. I agree, because the surgeon makes three-dimensional changes which instantly alter other areas of the nose.
Accurate preoperative analysis is 50 percent of the outcome. I encourage my patients to bring in photographs of how they envision the results. Only a limited number of experts specialize in rhinoplasty, so do your homework.
Rhinoplasty is done on a same-day basis. I prefer to use general anesthesia because there tends to be bleeding in the back of the throat, and this may be a problem with a semi-conscious patient. Ultimately, however, I tend to let the patient decide what anesthesia they would like. There are various techniques, depending on the anticipated outcome.
Because rhinoplasty is a complicated procedure and the nose swells during the operation, there is a chance you may need to have some post-surgery touch- ups. About 15 percent of rhinoplasty operations require touch-up procedures.
At the conclusion of the procedure a long-acting numbing agent is used to ensure the patient leaves the surgery center pain-free. A splint is usually placed on the nose for one week. The nose will be noticeably swollen for several days, and shouldn’t be blown. Half of rhinoplasty patients have some bruising. It may take up to a year or even long before all minor traces of swelling disappear, but the nose will deﬁnitely look better by the time the splint comes oﬀ after surgery.
The biggest limitation with rhinoplasty is thick skin, because this is difficult to shrink and conform to the underlying framework of the procedure. A surgeon can only do so much with a large nose if the skin won’t contract. Risks include infection, postoperative nose bleeds, numbness, swelling, possible collapse of the nose, external scarring, fullness, residual deformity, and holes inside the septal area of the nose.
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Rhinoplasty, commonly known as a “nose job,” is a popular option for patients unhappy with the size or shape of their nose. In addition to the procedure’s well-known cosmetic benefits, however, rhinoplasty has evolved to have much more versatile applications, such as to improve nasal function after a traumatic injury or illness or to help with breathing problems that affect sleep and the ability to exercise.
The goal of rhinoplasty is to revise the nose to the patient’s desired appearance and functionality, keeping in mind skin type and the entire face architecture. Our plastic surgeons combine the science and art of rhinoplasty to give patients effective, lasting results.