What is a Rhinoplasty?
A rhinoplasty (“nose job”) is a surgery performed to reconstruct the nasal airway and/or to improve the aesthetic appearance of the nose. It involves manipulation and repositioning of the bony, cartilaginous, and soft tissue structures of the nose. A rhinoplasty can be performed solely for reconstruction of the nasal airway in patients with nasal airway obstruction, or it can be performed for purely cosmetic purposes. Frequently, both objectives are achieved at the same time. The goal of any rhinoplasty surgery is to create an aesthetic that is appropriate and in harmony with an individual’s facial features and size. Of paramount importance, is to maintain a patent airway or correct any airway concerns at the time of surgery.
Who is a Candidate for a Rhinoplasty?
You may want to consider a rhinoplasty if you have:
- Concerns about the cosmetic appearance of your nose – including asymmetry, bumps on the bridge of your nose, wide nostrils, or a drooping or bulbous tip
- A nose that is disproportionate to surrounding features and size of the face
- Deviated septum that is congenital or secondary to trauma
- Difficulty with breathing through the nose, problems with snoring or frequent nighttime wakening secondary to nasal airway obstruction
- History of chronic nasal obstruction resulting in chronic use of intranasal steroids or nasal sprays
How is a Rhinoplasty Performed?
A rhinoplasty can be performed through closed (endonasal) or open techniques.
- In a closed rhinoplasty, incisions are placed on the inside of the nose. Good candidates for closed rhinoplasty are patients that do not need an excessive amount of work done on the tip of their nose.
- In an open rhinoplasty, there will be incisions on both the inside of the nose, and on the columella (middle skin bridge between the nostrils). These incisions provide great visualization for reconstructing the entire nasal construct, including the airway and the nasal tip. In an open procedure, the skin is released from the underlying structures and elevated off of the nose to allow for optimal visualization. It is then placed back into position at the completion of the rhinoplasty.
- Through both techniques, the cartilage and bones of the nose will be reshaped and repositioned as needed to provide an improved airway or improved cosmesis
- Through both techniques, a septoplasty can be performed for a deviated septum.
- Frequently, cartilage grafts are needed for reconstruction of the airway and for nasal support. Cartilage can be harvested from the septum, the back of the ear, or the rib.
Every rhinoplasty is as unique as the individual. At the time of your consultation with Dr. Rovelo, she will perform a detailed history and exam of your nose, and will listen to your concerns. A comprehensive surgical plan will be formulated to create a nose that is proportional and harmonious with your face and unique facial features.
All surgery is associated with risks. Risks associated with rhinoplasty include scarring, asymmetry, prolonged healing, poor aesthetic outcome, and need for revisional surgery. The most common reason for revisional surgery is persistent or new nasal airway symptoms. During your consult with Dr. Rovelo, it will be important to discuss the risks of your surgery and how the risks can be minimized to provide the best possible outcome.
A primary rhinoplasty is performed in the outpatient surgery setting and typically takes 2-4 hours. Patients will go home or to an aftercare facility the same day. At the completion of the surgery, patients will have external and/or internal nasal splints in place. During the recovery phase, patients will be asked to sleep in a reclined position and to use ice packs intermittently to help with swelling. Instructions will be given on how to clean and rinse inside of the nose. Patients will be seen in the office on post-operative day #1 and then again at a week for splint removal and suture removal (open rhinoplasty). After the external splint has been removed, patients will continue to apply tape to their nose to assist with swelling and proper healing. Patients will be seen in the clinic at regular intervals to assess the healing process. Patients who undergo the closed (endonasal) technique have a shorter recovery time, with less swelling. They can typically return to light activity and public life within 1-2 weeks. Patients who undergo an open rhinoplasty will have prolonged swelling, although they can frequently return to light activity and public life within 1-2 weeks, as well. Swelling may take up to 6 months to resolve, and final outcomes cannot be assessed until one year post-operatively.