Nose Reshaping (Rhinoplasty)


What Is Rhinoplasty?
Rhinoplasty is the term for surgical procedures which improve the form (appearance) or function of the human nose.  Included under the general term of rhinoplasty is “septoplasty” or “turbinectomy”, performed on the support structures of the interior of the nose to improve airflow.  Altering the shape of the nose and the nostrils (“weir excision”) improve the appearance of the nose for a more pleasing appearance.  Additionally, implants may be used to add height to the bridge of the nose.

Who should consider Rhinoplasty?
Rhinoplasty can be performed to meet aesthetic goals, or for reconstructive purposes to correct trauma, birth defects or breathing problems.  Some ethnic groups have genetically inherent displeasing nasal shapes that can be surgically corrected.  Simply put, some noses are out of proportion for the face it was born to and if this bothers you, cosmetic rhinoplasty is a consideration.  “Secondary rhinoplasty “ is performed to correct or revise an unsatisfactory outcome from a previous rhinoplasty surgery.

Why do people choose Rhinoplasty?
Cosmetic rhinoplasty surgery should improve your appearance.  Your face is generally the first impression you make upon the world around you.  People who choose rhinoplasty as an aesthetic surgery usually have been unhappy about their nose for a long time.  Making the personal choice to have this surgical procedure to correct a nose that has troubled them for so long, and being pleased with the outcome, enhances the self-confidence a person feels when they are comfortable with their appearance. 
Reconstructive rhinoplasty is performed to restore the normal shape and function of the nose following damage from a traumatic accident, disease, intra-nasal drug abuse, previous displeasing cosmetic surgery, cancer involvement or congenital abnormality.  Rhinoplasty can restore skin coverage, recreate normal contours, and re-establish nasal airflow.

What are the risks?
Rhinoplasty is usually considered to be safe and successful, with a speedy recovery.  Several complications can arise.  Post operative bleeding is uncommon and often resolves without needing treatment.  Infection is rare and can occasionally progress to an abscess that requires surgical drainage under general anesthetic.  Adhesions, which are scars that form to bridge across the nasal cavity from the septum to the turbinates, are also rare but cause nasal obstruction to breathing and usually need to be cut away. A hole can be inadvertently made at the time of surgery in the septum, called a septal perforation. This can cause chronic nose bleeding, crusting, difficult breathing and whistling with breathing.

What is “Non-Surgical” Rhinoplasty?
With the introduction of some of the newer fillers on the market it has become possible to alter the shape of the nose by layering an injectable product (we use Radiesse) under the skin and close to the bone.  Obviously, this won’t make any nose smaller, but by altering the dimensions and planes of the nose we can make it appear more proportionate, alter the tip, or visually straighten it by recontouring the bridge with the Radiesse filler.  It is a temporary fix, 9 months to 2 years per treatment, but it’s a great option for the right problem.

What is the recovery period for surgery?
The patient returns home after the surgery.  Oftentimes a small plaster cast is placed over the bridge of the nose to stabilize the bones. It is removed in one week. If there are external sutures, they are usually removed 6-14 days after surgery.  If there is any bruising, as many times there isn’t, it may take as long as two weeks to dissipate.  If there was a reason for an exceptional amount of interior reconstruction of the nose, there is the possibility that internal packing or stents would be placed that would be removed 4-10 days following surgery, but the use of packing is no longer commonplace.  You will be prescribed antibiotics and pain medications but it is generally not a painful experience and little in the way of pain medications are generally needed.  Most people choose to remain home for a week (until the plaster is off), although it is safe to do things outside of home. Healing time is unique to each individual.  Swelling is usually moderate and as time goes by there will be subtle shifting and settling of the nose.  A final result usually is 6 months to 1 year following surgery.