Rhinoplasty
Nose Reshaping
What is a rhinoplasty?
Rhinoplasty refers to a surgical procedure to produce alterations in the nose. There are many variations on these techniques, which are performed for a variety of reasons. For some, rhinoplasty is performed to improve the function of the nose. Others undergo rhinoplasty to produce a change in their appearance.
What is a septorhinoplasty?
This is a rhinoplasty in which a septoplasty is also performed. The septum is the midline structure inside the nose which separates the nose into right and left sides. A septoplasty is a procedure to straighten or alter this structure. This is very commonly performed in conjunction with rhinoplasty.
What is a “nose job”?
This is a common term used to refer to rhinoplasty.
Why do people want a rhinoplasty?
People seek rhinoplasty for a variety of reasons. For some, difficulty breathing through their nose leads them to seek treatment. Nasal fractures are extremely common, and many times require rhinoplasty to correct deformities and asymmetries. Then there are patients who simply desire a change in the appearance of their nose. This is typically desired as a minor change, but for some the alterations can be quite dramatic.
How is it performed?
The structure of the nose is supported by a framework of cartilage and bone. This framework is reshaped during a rhinoplasty. The procedure is performed with hidden incisions to hide any evidence of surgery. Cartilage may be reshaped, minimized, or augmented. Some patients require augmentation of parts of the nose, and a variety of materials may be utilized to produce this enhancement. Typically this is the patient's own cartilage.
What age are patients who undergo rhinoplasty?
This procedure is performed on people of all ages, although rarely in children. It is often best to withhold rhinoplasty until facial growth is more advanced, into the teenage years. From this age on, rhinoplasty may be performed at virtually any age.
Is anesthesia required?
Most patients receive some form of systemic anesthesia, in addition to local anesthesia. This is the choice of the patient, after consultation with the surgeon and anesthesiologist. Most prefer a general anesthetic, but many instead choose “twilight” anesthesia, in which a sedative is administered during the procedure.
What is the recovery period after this type of procedure?
Most people take one week off from work or school after a rhinoplasty, or septorhinoplasty. This is because there is typically some swelling that takes some time to resolve. Often, an external splint is applied. This is usually left on for one week. At that time, any sutures which require removal are taken care of, and the splint removed. The swelling persists beyond this time, but to a lesser degree. The nose is stuffy typically for a few weeks after surgery. We usually ask patients to avoid strenuous activity (for example, heavy lifting) for three weeks after surgery. Flying in an airplane is also best avoided for three weeks. The swelling of the nose improves dramatically over the course of the first several weeks after surgery. However, it does take one year for the more subtle swelling to completely go away.
Is there much pain with this procedure?
Patients are prescribed pain medicines to alleviate the postoperative pain. Most patients, however, do not experience unacceptable levels of pain. More commonly, they describe an uncomfortable pressure sensation for the first several days.
Can someone choose the type of nose they want?
The decision to reshape the nose – the central feature of the face – is a very important one. The consultation process involves a discussion (or multiple discussions) between you and the surgeon to determine the best surgical plan. A significant amount of time is spent on facial analysis. This involves a comprehensive evaluation of the structure of your face, aided by digital photography. The proportions of the face, the skin type and quality, patient age, and nasal function must be taken into consideration. The surgical plan that results is intended to produce a nose that not only functions well, but fits harmoniously, naturally, and attractively with the rest of your face.
Does health insurance pay for rhinoplasty?
Patients with breathing problems who are appropriate candidates for surgical correction of nasal obstruction can often receive coverage for the procedure by their insurance company. Alterations made to change the appearance of the nose typically are not covered, although there may be exceptions in cases of traumatic or congenital deformities. Many patients who require a correction for nasal obstruction also want a cosmetic enhancement or alteration of their nose. In these cases, quite often the insurance company is billed for the functional portion of the procedure, while the individual is then responsible for the remaining balance.
Can anything go wrong with the surgery?
There are certainly no guarantees with any surgical procedure, but fortunately the complication rate with rhinoplasty and septoplasty is quite low. Most patients are quite happy with their results. A small proportion do not receive the degree of improvement initially sought however. Some bleeding can occur for a period of time after surgery. Numbness of portions of the nose is rather common for a period of time after surgery, although quite rare to persist. Scarring can occur which is troublesome to patients on rare occasion. Irregularities and asymmetries are also seen on occasion in patients who heal unpredictably.
How much does a rhinoplasty cost?
The cost of the procedure varies depending upon the type of procedure performed. The total cost, with facility fees and anesthesia included, typically runs between $4000 and $7000.
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