Are you insecure about the appearance of your nose? If you are, you are one of many. Rhinoplasty surgery, or a “nose job”, is one of the most common cosmetic surgery procedures performed in the United States. Thanks to advancements in surgical techniques, nose reshaping by a board certified plastic surgeon can yield excellent results, and drastically improve the quality of life for the patient by eliminating feelings of low self-esteem and insecurity about their nose. However, rhinoplasty surgery may be necessary to improve breathing or other nasal functions; it may not be for aesthetic reasons at all. Rhinoplasty surgery may be performed in combination with other surgical procedures including chin augmentation to maximize the potential aesthetic results.
Successful Rhinoplasty Surgery Before and After
What Rhinoplasty Surgery Does For The Patient
Undergoing rhinoplasty surgery may change many aspects of a person’s face, including the size of the nose, the width of the nose around the bridge, the position and size of the nostrils, and the nose profile. Rhinoplasty surgery may also change the shape at the nose’s tip, improve the look of wide, large, or upwardly turning nostrils, and correct an asymmetrical nose. In terms of function, rhinoplasty surgery may correct problematic breathing conditions such as problems stemming from a deviated septum. In addition, nasal problems due to some birth defects or certain traumas such as sports or car accidents may be corrected with rhinoplasty surgery.
Simply put, rhinoplasty, or “nose job”, as it is commonly called, aims to reshape the nasal area. Subtle changes such as correcting hooks, bumps, or other structural deformities, improve the shape and size of the nose in relation to the face. Perhaps more importantly, breathing difficulties may also be corrected with this form of surgery.
Breathing difficulties caused by a deviated septum may have many serious manifestations if not corrected, including interrupted nightly sleep. The septum, when straight, equally separates the nasal cavities into halves. When the septum is deviated, it is shifted away from being centered. Severe cases may result in difficulty breathing in and out of the nose.
Getting Ready for Rhinoplasty Surgery
Rhinoplasty surgeons provide potential patients with a set of instructions before performing rhinoplasty surgery. Generally speaking, drinking or eating is prohibited after midnight on the night before surgery will take place. Moreover, smokers would be advised to quit before having nasal surgery. Smoking greatly compromises the flow of blood to the skin, meaning there is less than optimal oxygen to help with wound-healing, and death, or necrosis, of the skin may occur. In some instances, help with quitting smoking may be obtained from the surgeon. Consuming alcohol the week prior to rhinoplasty surgery is also highly discouraged, as alcohol may also interfere with the healing process.
Surgeons may also emphasize discontinuing a variety of medications a few days or even weeks leading up to the surgery date. For example, drugs like ibuprofen may increase the risk of excess bleeding, so this would be a drug to discontinue prior to surgery. In addition, even natural substances such as gingko, certain fatty acids, Vitamin E, and green teas may also increase the bleeding risk. Therefore it is very important to inform surgeons of everything that is being taken. In conjunction with this, never discontinue taking medications without consulting your doctor beforehand.
Surgeons may recommend homeopathic therapies prior to surgery, to minimize bruising or keep post operative swelling to a minimum. Arnica is an herb that is often prescribed to lessen bruising. In addition, prescription steroids are sometimes recommended before surgery to keep initial swelling at a low level.
Risks of Rhinoplasty Surgery
As a cosmetic procedure, rhinoplasty surgery is in the top five of plastic surgeries performed every year. The potential risks of such surgery must be considered, as they include complications from anesthesia, bleeding, infection, breathing complications, dissatisfaction with the cosmetic results, the need for additional surgeries, septal perforation, and death.
Different Types of Rhinoplasty Surgery
Essentially a nose-reshaping surgery, there are actually several types of rhinoplastic procedures. These procedures include two forms of primary rhinoplasty surgery, open and closed, referred to as “secondary”, and one type know as filler rhinoplasty.
With open rhinoplasty and major reshaping of the nose, the surgeon’s incisions are performed in the vertical bit of the skin that separates the nostrils. This bit of skin is referred to as the columella. The soft tissue and skin are raised off of the nose’s underlying structures so the surgeon has a clear view of the anatomical makeup of the nasal area.
With closed rhinoplasty and minor nose reshaping, surgeons tend to make their incisions within the nasal cavities. The skin on the nose is then removed from the attached cartilage and bone, which form the supporting framework. Once this area is exposed, the cartilage and bone may be reshaped, removed, adjusted or rearranged to form the new shape that is desired.
Secondary rhinoplasty, also referred to as revision rhinoplasty, is generally performed to correct any problems that persist or occur after a previous rhinoplastic procedure. Although minor problems may be easily corrected, however, sometimes major problems occur, making the second procedure more complicated. Secondary rhinoplasty may be performed as closed or open procedure.
Filler rhinoplasty involves using injectable fillers to fill in depressions, smooth out sharper angles or adjust the angle at the nose’s tip, thus restoring symmetry and making the nose appear more attractive and smaller in relation to the face. As opposed to excising, a surgeon would instead use some sort of injectable filler to even out the area. Other filler materials that may be used to further smooth out post surgical irregularities include Restylane, Radiesse, or Juvederm. It is important to note that with injectable fillers the results are not permanent.
Examining Your Nose For Rhinoplasty Surgery
A surgical evaluation is the initial step in determining whether or not to go through with rhinoplasty surgery. During the meeting with the surgeon of choice, he or she will most likely take pictures focusing on the nose at a variety of angles. The surgeon will also discuss expectations and ensure that they are practical and realistic.
The potential patient should bring along pictures of noses that would be appealing to help in the dialogue about realistic expectations and also to give the doctor a clearer picture of the desired outcome of rhinoplastic surgery. In addition, the surgeon may present pictures of other patients with similarly shaped noses, which may assist the patient in better understanding the most likely results. As an added offering, many surgeons now make use of 3-D and sometimes 4-D computer images to show patients what to expect after your rhinoplasty surgery.
In conjunction with rhinoplasty surgery, some patients may need to consider undergoing additional facial procedures. A major goal of a nose job is to achieve proportion and balance. Oftentimes this is why chin augmentation is performed along with rhinoplasty surgery.
How Rhinoplasty is Performed
The majority of rhinoplasties are usually performed as an outpatient procedure in a surgical suite or within a hospital. The length of the procedure depends on the version of rhinoplasty surgery to be performed. As an example, primary rhinoplasty generally requires one to about three hours of surgery, while revision rhinoplasty may be completed in as little as fifteen minutes.
In terms of anesthesia, the surgeon will most likely recommend a local one along with some form of sedation, or a general anesthesia for a primary rhinoplasty procedure. Secondary rhinoplasty may include general anesthesia because of the complexity involved in such a procedure. Filler rhinoplasty requires only local anesthesia.
As alluded to earlier, the surgeon’s incision will either be of a closed nature, where the incisions are actually hidden inside of the nose, or of an open nature, in which case the incision is created at the columella. The surgeon will then raise the soft tissues covering the nose at the incision site, gaining access to reshape the nose’s structure. At this point the surgeon may augment or reduce certain nasal structures by using grafted cartilage acquired from other bodily areas. These cartilage pieces may be derived from the ear, rib cartilage, or most likely the septum. If the septum happened to be deviated, removing some of the cartilage will most likely straighten it. Moreover, any existing projections in the nose will be diminished, which may improve breathing.
Once the nose’s underlying structures have been sculpted, the surgeon closes the incision after redraping the tissue and nasal skin back into place. In many instances a splint or cast may be applied as well. Recovery time is dependent upon the type of procedure that has taken place. As anxious as a patient may be to see the new nose, it is important to be patient after such a surgery, as rhinoplasty recovery and final results are far from immediate, with complete results not evident until a year after surgery has passed.
Recovery From Rhinoplasty Surgery
The postoperative experience may include an inability to breathe through the nose during the initial twenty-four hours, due to any nasal packing that may be used, or due to postsurgical swelling. There may also be a bit of general discomfort, which may be alleviated with pain medicines. Generally speaking patients who undergo such procedures are able to stop taking pain medications after about forty-eight hours. If stomach upset is present after surgery, antinausea medications may prove to be helpful.
Limited bleeding may be evident in the first few days after surgery. If so, the surgeon may recommend applying cold compresses to the nose to lessen swelling and to elevate the head for the initial twenty-four hours. It is extremely important to avoid any and all trauma in the nasal area in the first week after rhinoplasty surgery. Such trauma includes nose blowing, which may be difficult, as stuffiness is often experienced after nasal surgery. In this scenario, decongestants may offer relief.
The surgeon will remove the splint or cast approximately one week after surgery. At this point the nose may still be rather swollen, but a majority of the swelling may be greatly diminished after about two weeks. All of the splints, nasal packing and post surgery dressing would be removed at this point as well. A protective splint may be placed on the outside portion of the nose so as to protect as well as help to hold the new shape as the healing process continues. In addition, a softer interior splint may be inserted in the nose to help prevent scarring.
After one month has passed, about eighty-five percent of the selling will most likely have diminished. It may be up to one year until the remaining swelling has subsided. For this important reason, waiting at least a year before considering revision rhinoplasty is highly recommended.
The Cost of Rhinoplasty Surgery
Rhinoplasty surgery cost includes the anesthesia fee, operating room fee, and the surgeon’s fee. Rhinoplasty costs about $5,000 to $7,000. Secondary rhinoplasty may cost up to triple this amount, due to its more complex nature. Filler rhinoplasty generally costs merely in the hundreds of dollars, but it is important to remember that the results of this type of procedure is temporary.
Although insurance does not usually cover the costs associated with cosmetic procedures, rhinoplasty surgery for the purpose of improving breathing may be considered as reconstructive and therefore may be included as a covered cost. Prior to deciding on any of the aforementioned surgeries, contacting the insurance company to be clear on policy details is essential.
Deciding if You Want Rhinoplasty Surgery
When contemplating rhinoplasty surgery, be sure to review treatment options with a plastic surgeon that is properly certified. A qualified plastic surgeon will have completed general surgery residency training, followed by a plastic surgery fellowship. Board certification verifies that your potential surgeon has successfully completed extensive training and is current regarding new technology and techniques.
