Rhinoplasty is a surgical procedure done to reshape the nose. This surgical procedure can produce changes in the appearance, structure, and function of the nose. Rhinoplasty can reduce or increase the size of the nose, change the shape of the tip, narrow the width of the nostrils, or change the angle between the nose and the upper lip. This operation can help correct birth defects, nasal injuries, and help relieve some breathing problems.
There is no universal type of rhinoplasty surgery that will meet the needs of every patient. Rhinoplasty surgery is customized for each patient, depending on his or her needs. Incisions may be made within the nose or concealed in inconspicuous locations of the nose in the open rhinoplasty procedure. In some situations, cartilage grafts, taken from within the nose or from other areas of the body may be recommended to help reshape the structure of the nose. Internal nasal surgery to improve nasal breathing can be performed at the time of the rhinoplasty.
The best candidates for this type of surgery are individuals who are looking for an improvement in the appearance of their nose but have realistic expectations and are not fixated on perfection. Good health and psychological stability are important qualities for a patient considering rhinoplasty surgery. Rhinoplasty can be performed in conjunction with other surgeries.
This procedure can be done under local anesthesia (with or without sedation) or general anesthesia depending on the complexity of the case. Surgery time is usually less than 2.5 hours and recovery time is approximately 2 to 3 weeks.
Dr. Sian usually recommends that patients wait until they are at least 14 or 15, and possibly older for boys, before undergoing rhinoplasty. This is because the nose may not be fully developed at a younger age. If you are a teen, Dr. Sian will want to be certain that you have thought carefully about surgery and that the desire to change your appearance is based on your own feelings rather than those of your parents or friends.
Assuming you are in good health, there is no upper age limit for having your nose reshaped. Rhinoplasty is sometimes performed in conjunction with a facelift or other aesthetic procedures to correct aging changes of the nose such as a drooping tip.
Sometimes, Dr. Sian may coordinate with an ENT (Ear Nose and Throat) surgeon so that the surgery to correct your breathing problems can be done at the same time as your rhinoplasty surgery. Dr. Sian will be able to help you determine whether these structures should be modified along with reshaping your nose.
Questions on this page include:
- Am I a good candidate for rhinoplasty?
- How will Dr. Sian evaluate me for rhinoplasty?
- When will I learn about the cost of surgery?
- Where are the rhinoplasty incisions placed?
- How Will Dr. Sian Reshape my Nose?
- I understand that every surgical procedure has risks, but how will I learn more…
- How should I prepare for surgery?
- What will the day of surgery be like?
- How will I look initially?
- When can I resume my normal activities?
- How long will the results last?
- Maintaining a Relationship with your Plastic Surgeon
Am I a good candidate for rhinoplasty?
Some of the indications that you may be a good candidate for rhinoplasty are:
- your nose appears too large for your face
- there is a bump on the nasal bridge when viewed in profile
- your nose seems too wide when viewed from the front
- the nasal tip droops or plunges
- the tip is thickened or enlarged
- your nostrils are excessively flared
- your nose is off-center or crooked
- previous injury has made your nose asymmetrical
It is important that you have a clear idea of how you would like your nose to look and, at the same time, realize that there are limitations to the procedure. Patients with sufficient physical and emotional maturity who undergo rhinoplasty because they want to enhance their self-image are usually very satisfied with their decision.
Dr. Sian can provide further information if you have an interest in any of these additional procedures.
How will my plastic surgeon evaluate me for rhinoplasty?
During the initial consultation, you may be asked to look in a mirror and point out exactly what you would like to see improved. This will help Dr. Sian understand your expectations and determine whether they can be achieved realistically.
You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions you may have, medical treatments you have received, previous surgeries including repair of nasal injuries, and medications that you currently take. Dr. Sian may also ask whether you have difficulty breathing through your nose, suffer from allergies that may cause nasal stuffiness, or are a chronic user of nasal spray. It is important for you to provide complete information.
In evaluating you for rhinoplasty, Dr. Sian will conduct a routine and painless examination of your internal nasal structures. Your skin quality as well as the size and shape of your nose and its relationship to your other facial features will be carefully studied. In some instances, Dr. Sian may recommend surgery of your chin, making it either more or less prominent, to improve facial balance. This procedure can be done at the same as your rhinoplasty.
When will I learn about the cost of surgery?
It is understandable that you would like to have information about the cost of surgery as soon as possible. Dr. Sian must first complete a thorough evaluation before your individualized surgical plan can be developed. Following this, the fees required for your surgery will be discussed with you. While most insurance plans will not pay for aesthetic nose reshaping, they frequently will cover surgery performed on the internal structures of the nose to improve breathing problems. Dr. Sian can discuss this with you at the same time of consultation.
Where are the rhinoplasty incisions placed?
Because of individual factors, not everyone will achieve the same results from rhinoplasty. Dr. Sian’s goal is to obtain the best possible results for you.
Dr. Sian’s preferred technique is the “Open Rhinoplasty” where a small horizontal is made over the columella (the vertical structure separating the nostrils) to allow undermining and exposure of the underlying nasal support structures.
Alterations may be made to increase or decrease the nasal bridge, reduce the size or width of the nose, narrow the nostrils, change the angle between the nose and upper lip, or reshape the tip.
The surgical techniques employed will depend primarily on the goals established by you and Dr. Sian. Several of the incisions are placed inside your nose, where they will not be visible. If the base of the nose is narrowed or the nostrils reduced, small wedges of skin at the base of the nostrils will be removed. Incisions are hidden in the natural crease where the nostril joins the cheek.
Depending on the surgical technique used, a splint may be placed on the bridge of the nose to help hold the tissues/bones in place until they have stabilized.
Whatever incisions are used to reshape your nose, they will ultimately be very inconspicuous.
Fortunately, significant complications from rhinoplasty are infrequent. Every year, many thousands of people have their noses reshaped, experience no major problems and are pleased with the results. Anyone considering surgery, however, should be aware of both the benefits and risks. Risks involved include bleeding, bruising, swelling, wound healing complications, need for additional surgery, sub-optimal aesthetic result, etc..
How will Dr. Sian reshape my nose?
Through the small incisions described previously, work is done on the cartilage and bone that form the framework of your nose.
Sometimes, the position of certain bones may need to be altered slightly in order to make your nose look narrower and straighter. If your nose needs to be built up in some areas, this can be done using nasal cartilage, or perhaps bone or cartilage from another site. The skin and soft tissues then re-drape themselves over this new “scaffolding.”
The goal of Dr. Sian and his entire staff is to make your surgical experience as easy and comfortable for you as possible.
I understand that every surgical procedure has risks, but how will I learn more so that I can make an informed decision?
The subject of risks and potential complications of surgery is best discussed on a personal basis between you and Dr. Sian.
Some of the potential complications that may be discussed with you include hematoma (an accumulation of blood under the skin that may require removal), infection and reactions to anesthesia. Numbness of the skin following rhinoplasty may occur but is usually temporary. Occasionally, if the surgical outcome needs further improvement, additional surgery may be necessary.
You can help minimize certain risks by following the advice and instructions of Dr. Sian, both before and after your surgery.
How should I prepare for surgery?
If you are a smoker, you will be asked to stop smoking well in advance of surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery. Your surgeon will provide you with additional preoperative instructions.
If your rhinoplasty will be performed on an outpatient basis, be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night following surgery.
What will the day of surgery be like?
Dr. Sian usually performs rhinoplasties requiring general anesthesia at Clovis Community Medical Center. Less complicated rhinoplasties can sometime be done under local anesthesia in Dr. Sian’s office.
Medications are administered for your comfort during the surgical procedure. Frequently, general anesthesia is used for patients undergoing nose reshaping, although local anesthesia and intravenous sedation may be desirable in some instances.
When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. There may be some discomfort, but this can be controlled by medication which you may continue taking at home. Depending on the surgical technique used, a splint may have been placed on the bridge of your nose for the purpose of holding the tissues in place until they have stabilized. The splint will protect your nose while you sleep and shield it from accidental bumps. Frequently, you may also have a small triangular bandage beneath the tip of your nose. Packing or soft internal splints are sometimes used inside the nostrils, especially if work has been done to improve your breathing.
Most patients go home after a few hours once they have fully recovered from the effects of anesthesia.
How will I look initially?
It is important to realize that the amount of time it takes for recovery varies greatly among individuals.
The first couple of days after surgery, you should restrict your activities and sleep with your head elevated. This will help to minimize swelling and reduce the possibility of minor bleeding, which is not uncommon. Remember, you must not take aspirin or certain anti-inflammatory medications.
Generally, bruising around the eyes and cheeks is most apparent during the first three days following surgery. Most discoloration will disappear within a week. A few days after surgery, you can begin to use makeup as a concealer, if desired. Noticeable swelling may last for several weeks. Minor residual swelling affecting the nasal tip may continue for many months but this is usually very subtle and not readily noticeable. If packing inside your nose was used, it usually removed a few days after surgery. Stitches may also be removed at that time. You may need to continue wearing the nasal splint for up to a week, during which time you should avoid getting it wet.
Results of Your Rhinoplasty
The goal of rhinoplasty is a nose that looks natural and blends harmoniously with your other facial features.
Since the healing process is gradual, you should expect to wait up to a year or longer to see the final results of your rhinoplasty. You are likely, however, to begin enjoying your new look within weeks of your surgery.
Occasionally, a touchup may be desired to further improve the results. If this is the case, the additional procedure is usually less extensive than the original operation.
When can I resume my normal activities?
Straining, bending and lifting should be avoided during the early postoperative period. In many instances, you may be able to return to work within a week or ten days after surgery. Most normal activities including exercise can usually be resumed within three weeks.
It will be a few months before you can expose your reshaped nose to direct sunlight. Your nose will be sensitive during this time, and you must be conscientious about using a sunblock to protect your skin. If the bones of your nose were altered, it may be several weeks before you can wear glasses without special support such as tape.
How long will the results last?
In most instances, the results of rhinoplasty are permanent, except for possible changes associated with the normal aging process.
Maintaining a Relationship with Dr. Sian
You will return to Dr. Sian’s office for follow-up care at prescribed intervals, at which time your progress will be evaluated.
Please remember that the relationship with Dr. Sian does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information, you should contact Dr. Sian.