Nose Job (Rhinoplasty)
Rhinoplasty, or surgery to reshape the nose, is one of the most common of all plastic surgery procedures and can change the shape of your nose or improve its function by reducing or increasing the size of your nose, changing the shape of the tip or the bridge, narrowing the span of the nostrils, or changing the angle between your nose and your upper lip. It may also correct a birth defect or injury, or help relieve some breathing problems.
Frequently Asked Questions (FAQ’s)
The information presented below is only for informational purposes. Your surgeon will talk to you about details regarding your specific procedure.
Who are the best candidates for a nose job?
A good candidate for a cosmetic nose job is anyone who is unhappy with the appearance of his or her nose and is looking for an improvement in the way he or she looks. Candidates should also be in good physical health, be psychologically stable and have realistic expectations. Rhinoplasty can be performed to meet aesthetic goals or for reconstructive purposes to correct birth defects or breathing problems.
What are the possible complications and risks for a cosmetic nose job?
There is always a possibility of complications, including infection, nosebleed, or a reaction to the anesthesia. You can reduce your risks by closely following your surgeon's instructions both before and after surgery.
After surgery, small burst blood vessels may appear as tiny red spots on the skin's surface; these are usually minor but may be permanent. As for scarring, when rhinoplasty is performed from inside the nose, there is no visible scarring at all; when an "open" technique is used, or when the procedure calls for the narrowing of flared nostrils, the small scars on the base of the nose are usually not visible. In about one case out of ten, a second procedure may be required-for example, to correct a minor deformity. Such cases are unpredictable and happen even to patients of the most skilled surgeons. The corrective surgery is usually minor.
What is an initial surgical consultation like?
In your initial consultation, the surgeon will ask what you'd like your nose to look like, evaluate the structure of your nose and face, and discuss the possibilities with you. He or she will also explain the factors that can influence the procedure and the results. These factors include the structure of your nasal bones and cartilage, the shape of your face, the thickness of your skin, your age, and your expectations. Your surgeon will also explain the techniques and anesthesia he or she will use, the risks involved, and any options you may have. Be sure to tell your surgeon if you've had any previous nose surgery or an injury to your nose, even if it was many years ago. You should also inform your surgeon if you have any allergies or breathing difficulties; if you're taking any medications, vitamins, or recreational drugs; and if you smoke. Don't hesitate to ask your doctor any questions you may have, especially those regarding your expectations and concerns about the results.
What type of anesthesia will I receive?
Rhinoplasty can be performed under local or general anesthesia, depending on the extent of the procedure and on what you and your surgeon prefer. With local anesthesia, you'll usually be lightly sedated, and your nose and the surrounding area will be numbed; however you'll be awake during the surgery, but relaxed and insensitive to pain. With general anesthesia, you'll sleep through the operation.
How long does the surgery last?
Rhinoplasty usually takes an hour or two, though complicated procedures may take longer. During surgery the skin of the nose is separated from its supporting framework of bone and cartilage, which is then sculpted to the desired shape. The nature of the sculpting will depend on your problem and your surgeon's preferred technique. Finally, the skin is re-draped over the new framework. Many plastic surgeons perform rhinoplasty from within the nose, making their incision inside the nostrils. Others prefer an "open" procedure, especially in more complicated cases; they make a small incision across the columella, the vertical strip of tissue separating the nostrils. When the surgery is complete, a splint will be applied to help your nose maintain its new shape. Nasal packs or soft plastic splints also may be placed in your nostrils to stabilize the septum, the dividing wall between the air passages.
What can I expect after the surgery?
Especially during the first twenty-four hours post-op, your face will feel puffy, your nose may ache, and you may have a dull headache. You can control any discomfort with the pain medication prescribed by your surgeon. Plan on staying in bed with your head elevated for the first day. You'll notice that the swelling and bruising around your eyes will increase at first, reaching a peak after two or three days. Applying cold compresses will reduce this swelling and make you feel a bit better. In any case, you'll feel a lot better than you look. Most of the swelling and bruising should disappear within two weeks or so. (Some subtle swelling-unnoticeable to anyone but you and your surgeon-will remain for several months.) A little bleeding is also common during the first few days following surgery, and you may continue to feel some stuffiness for several weeks. Your surgeon will probably ask you not to blow your nose for a week or so, while the tissues heal. If you have nasal packing, it will be removed after a few days and you'll feel much more comfortable. By the end of one to two weeks, all dressings, splints, and stitches should be removed.
When can I return to my normal activities?
Most patients are up and about within two days, and able to return to sedentary work a week or so following surgery. It will be several weeks, however, before you're entirely up to speed. Your surgeon will give you more specific guidelines for gradually resuming your normal activities. They're likely to include these suggestions: Avoid strenuous activity (jogging, swimming, bending, sexual relations; any activity that increases your blood pressure) for two to three weeks. Avoid hitting or rubbing your nose, or getting it sunburned, for eight weeks. Be gentle when washing your face and hair or using cosmetics. You can wear contact lenses as soon as you feel like it, but do not wear glasses for a while.