RHINOPLASTY

Rhinoplasty, commonly referred to as a nose job or nasal reshaping, is a surgical procedure designed to improve the appearance of the nose to the patient’s unique specifications. 

It is important to note that a skilled surgeon will tailor the rhinoplasty or nose job to fit the exact needs of each individual patient. 

In addition to addressing the appearance of the nose, rhinoplasty (nose job) surgery can also improve the nasal function; including improved breathing through the nose with less mouth breathing, which can improve snoring in certain cases. 


What can be accomplished with a rhinoplasty?

It is helpful to think of the nose in 2 parts, the bridge and the tip. 

Common requests from patients include:

  1. Straightening the nose, this can be from a crooked bridge and/or tip
  2. Shaving down a hump on the bridge
  3. Refining and reshaping the nasal tip
  4. Making the nose smaller/less wide
  5. Improving nasal obstruction

Patients with a flat and/or wide (platyrrhine) nasal bridge may require additional height to the nasal dorsum (bridge), in addition to narrowing of the bridge and tip as well as adding structural support to the nose. 

One important consideration in the overall success of a nose job or rhinoplasty surgery is the quality of the nasal skin. If the skin is too thin or too thick, additional expertise is required to get the best overall outcome. 


Who is a candidate for rhinoplasty surgery?

First and foremost, a nose job or cosmetic rhinoplasty is an elective surgical procedure. This means that it is not medically necessary and anyone who is in poor overall health should not pursue a rhinoplasty surgery until and unless they are medically fit for surgery. 

Next, patient’s pursuing a nose job or rhinoplasty should have a healthy self-image. There is nothing wrong with wanting to improve one’s appearance, but if your appearance or self-image is causing severe anxiety or depression, you may be suffering from Body Dysmorphia and are not a suitable surgical candidate.

Finally, the patient and the surgeon should share a unified vision of what the nose should look like. Sometimes, surgeons want to dictate to patients what will look best without consideration of what the patient wants. Other times, the patients will make requests that are either unrealistic or simply fall outside of what the surgeon knows to be aesthetically pleasing. The surgeon and the patient must achieve a shared vision, this can be facilitated using image morphing software to make changes to the nose prior to a nose job or rhinoplasty in order to reach agreement about the final surgical outcome. 


What if you are unhappy with a previous rhinoplasty?

Revision rhinoplasty is defined as any non-primary rhinoplasty. It is necessary when a patient is unhappy with the appearance or function of a nose that has previously been operated on. Rhinoplasty surgery is arguably the most complicated and skill based cosmetic surgery procedure. When performed by a surgeon who has inadequate training or experience, the results are usually subpar. A revision rhinoplasty can be complicated by irreversible changes to the native nasal anatomy from previous surgery and/or scarring. A revision rhinoplasty specialist will be needed to address revision surgery. 


What is the downtime after rhinoplasty surgery?

Day 0 (immediately after surgery) patients rest in the recovery room for approximately 60 minutes. Then they are discharged home. Advances in surgical technique have made nasal packing much less common and the majority of patients go home without packing. In cases where there is a need for light nasal packing, the patients will return on post-operative day 1 to remove the light nasal packing. This is painless. The nose is also suctioned and this can help with breathing.

Day 8 – The patient returns to the office to remove the nasal splint and sutures (if open rhinoplasty is performed). Once the splint and sutures are removed, the nose is cleaned and suctioned. 

* Patients typically do not have issues with pain after rhinoplasty. 

** Historically, patients have had bruising around the eyes for up to 2 weeks, but with advances in techniques and the use of a medication called tranexamic acid (TXA) many patients develop minimal or no bruising. Patients are usually back at school or work in a week or less.

*** We advise our patients to avoid strenuous exercise for 6 weeks.

The amount of swelling and the duration of the swelling is dependent on the technique (open vs closed), length of surgery and whether it is a primary (less swelling) or revision surgery (more swelling).

In primary rhinoplasty cases you can expect:

*75 to 85% improvement in swelling at 1 month

* 85 to 95% improvement in swelling at 6 months 

* 99% improvement at 1 year