Rhinoplasty

Nose reshaping, or rhinoplasty, is the surgical reshaping of the nose in order to make it proportional to the rest of the face, or to repair the nose after it has been injured. Rhinoplasty can address both the outer appearance of the nose and the inner air passages, so the procedure can be cosmetic, functional, or both.

Am I a candidate for nose reshaping (rhinoplasty)?

You may be a good candidate for rhinoplasty if:

  • you feel your nose is too big or disproportional to the rest of your face
  • your nose is too wide when viewed from the front
  • your nose is crooked or off-center, or asymmetrical
  • your nose has a bump or bulge
  • the tip of your nose is too large
  • your nose is too up-turned or down-turned, too long, pointy, or flat
  • you have flared or wide nostrils

Nose surgery can also address functional problems such as difficulty breathing through the nose, which can usually be treated at the same time as the outer appearance of the nose. Our doctors can tell you if your nasal breathing problems can be alleviated through rhinoplasty at time of consultation.

Nasal deformities can be present from birth, the result of an injury, or they may develop with aging. Traumatic injuries (broken nose) or changes from previous surgeries may result in significant acquired deformity.

There is no upper age limit for rhinoplasty, provided the patient is in otherwise good health. There is a lower age limit, however, for nose surgery. This is because the nose is still developing through the age of 14 or 15, so it is best to wait until the nose has fully grown before performing rhinoplasty.

Nose surgery can be done at the same time as other surgeries, such as a facelift, LiteLift™, or brow lift. Chin augmentation with a small implant may be recommended to help create better facial harmony and an improved profile, making the size of the nose more proportionate to other facial features.

Rhinoplasty is actually a diverse range of procedures with many options which must be tailored to balance the patient’s facial features. This is why it is so crucial to select a highly skilled surgeon with years of experience.

How is a rhinoplasty performed?

Nose surgery is usually done on an outpatient basis in a surgery center. The procedure can be done under local anesthetic with intravenous sedation, or under general anesthesia. Patients requiring grafts typically require general anesthesia.

Cosmetic rhinoplasty normally only involves hidden incisions within the nostrils. Through these incisions, the surgeon will be able to correct the placement of cartilage and bones, which are the framework of your nose.

Additional incisions may be necessary depending on your needs and goals. For example, to narrow the nasal bone base diameter, a small nick in the skin, a few millimeters, is sometimes placed at the upper nose near the corner of the eye. These heal as imperceptible scars in the vast majority of our patients.

More complex nasal operations, such as a tip rhinoplasty, often require a small incision in the skin at the base of the nose (columella). This tiny scar is barely visible, yet it allows the surgeon to “lift” the nasal skin and directly view all of the cartilage and bone requiring correction. This is termed an “open rhinoplasty.” To narrow the base of the nose, small incisions are placed in the groove where the nostril meets the cheek.

If a cartilage or bone graft is needed for your nose surgery, it is usually taken from within the nose itself, from the ear, or rarely from the rib. Rebuilding the nose using synthetic implants and materials, such as silicone, is also possible. This is referred to as augmentation rhinoplasty and is done when there is not enough of one’s own cartilage or bone available to reconstruct the nose.

Recovery from rhinoplasty

Patients will leave the surgery center with a splint or special tape on their nose. The splint is meant to hold your tissues in place while they set, and to prevent damage from accidental bumps. This will be removed after 7–10 days. When surgery is performed on the septum, splints may be worn inside the nose for 1–3 weeks.

Initial discomfort after rhinoplasty is easily controlled with oral medication and head elevation. The majority of swelling and bruising subsides progressively over 2-4 weeks. External sutures (if any) are removed in 4-6 days. Internal sutures dissolve on their own.

Your early result will be evident after 3 months. Final results will appear over the course of 12–14 months, which is the time necessary for complete tissue softening.

Areas of sensitivity or numbness will slowly resolve; the tip of the nose will feel stiff or “woody” and this will improve over the first several months.  Other temporary conditions may include some airway or sinus blockage, nasal drainage, lumps, and irregularities.

Rhinoplasty patients typically return to work within 7–10 days after surgery. Heavy activity, including bending and lifting, should be avoided early on. After three weeks, most normal activities and exercise can be resumed.

The results of rhinoplasty are generally permanent, except for changes which may occur with the natural process of aging.

Risks of nose surgery

Rhinoplasty, like any other surgery, carries a degree of risk. Fortunately, complications which affect the outcome of the surgery are quite rare. Minor complications which do not affect the surgical outcome occasionally happen. Patients further maximize their likelihood of a good result by following post-operative instructions carefully.

For more information

For further information on nose surgery, or to schedule a consultation with one of our expert surgeons, please call our office at (949) 720-3888 or (949) 720-3888.