Nose Surgery (Rhinoplasty)

What is Rhinoplasty?
Rhinoplasty is one of the most comonly performed cosmetic surgery procedures. Rhinoplasty is a surgical procedure in which the bony portion of the nose is reshaped to achieve better balance with the other facial features as well as a greater sense of self-confidence. Typically performed for cosmetic reasons, rhinoplasty may involve the shortening, narrowing or straightening of the nasal bone; minimization of a hump on the bridge; improvement in the angle of the nose and upper lip; narrowing of the nostrils; or changes to the tip of the nose.

Who is a Candidate for Rhinoplasty?
Cosmetic rhinoplasty is best performed once the nose is fully developed, in females, around age 16 or 17; in boys, around age 17 or 18. Certain instances, such as significant deformity due to injury, may justify surgery at an earlier age. The best candidates for rhinoplasty are people who are looking for improvement, not perfection, in the way they look. If you're physically healthy, psychologically stable, and realistic in your expectations, you may be a good candidate. Septoplasty (repair of a deviated septum) and turbinectomy (full or partial removal of nasal passage filters which have become enlarged and interfere with normal breathing) are noncosmetic procedures often performed at the same time as rhinoplasty.

The Procedure
Rhinoplasty takes 2 to 3 hours and is performed on an outpatient basis under general anesthesia. An incision is made between the two nostrils; after which a tiny incision may be made on each side of the nose. To narrow the base of the nose or reduce the size of the nostrils, small incisions are made at the base of the nostrils to remove small wedges of skin. The skin covering the nose is then lifted to facilitate cutting and reshaping of nasal bones and surrounding cartilage. "Open" rhinoplasty is superior to the closed or blind-incision method because it provides better access to and visibility of the inner tissues. The incisions are closed with a few sutures, and a plastic splint is usually taped over the nose to facilitate recovery. Packing may be inserted into the nostrils to stabilize the internal nasal structures. Your surgeon will thoroughly discuss the details of surgery, including the appropriateness of noncosmetic procedures, as it applies to your specific needs.

Recovery
If used, packing is taken out in 2 to 3 days. The splint, tape and/or external sutures are removed in a week. Swelling, bruising, minor bleeding, stuffiness in the nasal passages, and dryness of the throat are common in the first few weeks of recovery. In general, however, discomfort is minimal and easily controlled by keeping the head elevated, applying cold compresses, avoiding strenuous activities that raise the blood pressure, and pain medication. Bruising and any slight incision lines can usually be hidden with a good concealer, such as Dermablend®, after the first week.

You can expect to resume sedentary or light activity in about a week, but should refrain from significant manual labor or moderate to heavy lifting and bending for at least 2 to 3 weeks. Keep in mind that it can take up to a year, sometimes longer, before the nose is at or near 100 percent of its original strength and to see the final result.