Microdermabrasion is a gentle and affordable procedure that helps to renew the skin and treats the effects of sun-damaged skin, fine wrinkles, age spots, and acne.

Nose Reshaping (Rhinoplasty)

Overview

Rhinoplasty, commonly referred to as nose reshaping or a nose job, is a surgical procedure in which the structure of the nose is changed. It is one of the most common cosmetic surgeries performed in the United States, totaling over 300,000 procedures in 2006. Rhinoplasty is most often performed for cosmetic reasons and improving one’s appearance, although it can also correct some breathing problems. The size and shape of the nose has a great impact on how a person looks and making slight modifications can greatly enhance one’s face. For the men and women who are dissatisfied with the appearance of their nose, rhinoplasty is an option to consider.

Rhinoplasty can improve the appearance of the nose by:

reducing or increasing the size of the nose
decreasing the span of the nostrils
changing the angle between the nose and upper lip
altering the tip or bridge of the nose

A person may want to change the size and shape of the nose for several reasons. Some people are unhappy with the nose they were born with, some are unhappy with the way aging has changed their nose, some may have a misshapen nose due to an injury, and others may have difficulty breathing. The structure of the nose can be changed by adding or removing bone or cartilage, grafting tissue from another part of the body, or implanting synthetic material into the nose.

About Nose Surgery

A successful rhinoplasty begins during the consultation with the plastic surgeon. It is important that you trust your surgeon and feel comfortable talking honestly about your expectations. The first step is to choose a medical doctor who is board-certified in plastic surgery and specializes in rhinoplasty. Physician expertise greatly affects your safety and helps ensure a successful outcome.

When you meet with your surgeon, he or she will want to discuss your expectations, make recommendations for treatment, and determine if you are a good candidate for rhinoplasty. The surgeon will consider your age, skin type, ethnic background, and overall health. For young patients, nose surgery will not be considered until full growth is reached. The only exception is if the procedure is being considered to correct extreme breathing difficulties.

As you prepare for nose surgery, your surgeon will discuss the surgical options and what to expect before, during and after surgery.

If the procedure is a simple rhinoplasty, the surgery will only take an hour or two and be performed in an outpatient surgery center or in the surgeon’s office. A patient will be able to go home right away, but will need someone else to drive them for safety reasons. If the procedure is more complex, the surgery may be performed in a hospital and require a short stay.
Anesthesia is administered prior to surgery for pain control and patient comfort. The surgery may be performed with either local anesthetic or general anesthetic, depending on the length and complexity of the procedure as well as doctor recommendation. When a local anesthetic is used, the patient is usually first lightly sedated and then the surgical area is numbed.
The surgeon can operate on the nose either internally or externally. Internal rhinoplasty involves making all incisions from the inside of the nose, thus the scars are not visible. External rhinoplasty, also known as an “open” procedure, requires making an incision across the skin tissue that separates the nostrils and may leave a slight scar. This technique is used for more complicated procedures because it allows the surgeon to expose the bone and cartilage more fully.

When surgery is complete, a splint will be placed over the nose to help the bones maintain their new shape. The nose may also be stuffed with nasal packs or soft plastic splints to help stabilize the septum (dividing partition in the nose). The nasal stuffing is often removed the day after surgery, while the splint is left on for about a week. Most surgeons use absorbable stitches which do not have to be removed.

Recovery

The surgeon will provide specific instructions for post-surgery care, including: hygiene, pain medications, when to schedule a follow-up appointment, and when to resume exercise and normal activity. It is important for patients to follow their surgeon's post-surgery instructions to reduce complications and ensure a successful outcome.

The first day after surgery, patients are usually advised to rest at home with their head elevated. It is common to experience puffiness and swelling of the face, bruising, nose pain, and headache in the first few days after surgery. Slight bleeding is also normal. The surgeon will usually prescribe pain medication to help reduce discomfort. Cold compresses may also be advised to reduce bruising and pain.

After a few days, the swelling and bruising will start to lessen. Patients should avoid blowing their nose for a week after surgery in order to not disrupt healing. Strenuous activities should be avoided for two to three weeks in order to reduce the risk of injury. Excessive sun and sunburn should also be avoided. For patients who wear glasses, alternative measures must be taken so that the glasses do not rest on the bridge of the nose while the nose is healing. Most patients can expect to be up and walking a couple of days after surgery and back to work or school after a week.

Risks and Complications

Any surgical procedure involves some degree of risk, even with a skilled surgeon under the best of circumstances. Before undergoing an elective cosmetic procedure such as rhinoplasty, a patient should consider both the benefits and risks of surgery. Unexpected events, such as an infection or reaction to the anesthesia, are always a possibility.

Other possible complications of rhinoplasty include:

Rupture of tiny blood vessels on the nose
Bleeding (hematoma)
Blood clots
Nose asymmetry
Numbness
Long-term pain
Scarring
Skin contour irregularities
Skin discoloration
Nasal airway changes may interfere with breathing
Nasal septal perforation
Possibility of revisional surgery

Cost of Rhinoplasty

The average total cost of rhinoplasty ranges from $3,000 to $8,000. What you pay will vary based on the surgeon’s fee, the extent of structural and cosmetic changes made to the nose, and the geographic location. The surgeon’s fee is the primary expense, which is greatly determined by the surgeon’s training, skill, and experience. Other expenses include hospital or surgical facility costs, anesthesia fees, pre-op tests, pain medications, follow-up appointments, and revisions. You will be able to get a more accurate estimate after your surgeon performs an examination and works out a treatment plan.

Results

Recovery after nose surgery is a slow and gradual process. It can take several months for the swelling to go down, especially in the tip of the nose. Final results may not be realized for up to a year, as healing continues to take place in the cartilage and tissue of the nose. Even before healing is complete, however, a patient will be able to enjoy noticeable improvements in the appearance and proportion of the nose. Rhinoplasty enhances overall facial looks and can bring an overall sense of happiness and satisfaction in one’s appearance.