Rhinoplasty (RIE-no-plas-tee) is a surgical procedure that alters the shape of the nose. Reasons for getting rhinoplasty include changing the appearance of your nose, improving your breathing or both.
The upper portion of the nose is formed by bone, and the lower portion is cartilage. Rhinoplasty alters bone, cartilage, skin, or all three. Set up consultation with our surgeon about whether rhinoplasty is appropriate for you and what it can achieve.
When planning rhinoplasty, your surgeon will take into account your other facial features, the skin on your nose, and what you would like to change. If you are a candidate for surgery, your surgeon will create a customized plan for you.
Insurance may cover a portion of the total cost of a rhinoplasty or the entire cost.
Why it is done
Rhinoplasty can change your nose in terms of its size, shape, and proportion. This may be done to repair deformities from an injury, to correct a birth defect, or to fix breathing problems.
Before-and-after results of rhinoplasty
Risks of Rhinoplasty Surgery
As with any major surgical procedure, the risks of rhinoplasty include:
- An adverse reaction to the anesthesia
There are other possible risks specific to rhinoplasty, such as:
- A need for additional surgery
- Pain, discoloration or swelling that may persist
- A hole in the septum (septal perforation)
- Permanent numbness in and around your nose
- The possibility of an uneven-looking nose
- Difficulty breathing through your nose
Talk to your doctor about how these risks could apply to you.
How to prepare for surgery
Before having surgery, you must meet with your surgeon to determine whether the procedure is likely to work well for you.
This meeting generally consists of the following:
- Your medical history. Your doctor’s most important question will be about your motivation for surgery and your goals. Your doctor will also ask you questions about your medical history — including a history of nasal obstruction, surgeries, and what medications you take. Patients with bleeding disorders, such as hemophilia, may not be candidates for rhinoplasty.
- A physical exam. Your doctor will conduct a complete physical examination, which may include laboratory tests such as blood tests. He or she will also examine your facial features, your nose, and the inside of your nose.
- A physical exam allows your doctor to determine what changes should be made and how your physical features, including the thickness of your skin and the strength of the cartilage at the end of your nose, affect your results.
- The Physical exams are important to determine whether your breathing will be affected by rhinoplasty.
Photographs. Someone from your doctor’s office will take photos of your nose from different angles. Your surgeon may use computer software to manipulate the photos so you can see what kind of result you can expect. Your doctor will use these photos for before-and-after assessments, reference during surgery and long-term reviews. Most importantly, the photos permit a specific discussion about the goals of surgery.
- A discussion of your expectations. You and your doctor should talk about your motivations and expectations. He or she will explain what rhinoplasty can and can’t do for you and what your results might be. It’s normal to feel self-conscious about discussing your appearance, but it is very important to be honest with your surgeon about your desires and goals for surgery.
- If you have a small chin, your surgeon may discuss the possibility of augmenting your chin. This is because a small chin will give the illusion of a larger nose. It is not necessary to have chin surgery in those circumstances, but it may better balance the facial profile.
If you are having outpatient surgery, you will need to arrange for someone to drive you home once the surgery has been scheduled.
It is likely that you will experience memory lapses, slowed reaction times, and impaired judgment for the first few days after anesthesia. So ask a family member or friend to come stay with you for a couple days after surgery to help with personal care tasks.
Food and medications
For two weeks before and after surgery, avoid ibuprofen or aspirin (Advil, Motrin IB, others). These medications can increase bleeding. Take only those medications approved or prescribed by your surgeon. Furthermore, avoid over-the-counter supplements and herbal remedies.
If you smoke, you should stop smoking. Take only the medications your doctor has approved or prescribed for you. Smoking can make you more likely to get an infection after surgery and slows the healing process.
What to expect
Rhinoplasty does not have an ordered sequence of steps. Each surgery is unique and customized for the specific anatomy and goals of the person having it.
Rhinoplasty may require local anesthesia with sedation or general anesthesia, depending on the complexity of your procedure and what your surgeon prefers. Discuss with your doctor what type of anesthesia is most appropriate for you before surgery.
After the operation you need to rest in bed with your head elevated higher than your chest, to decrease bleeding and swelling. Your nose may be congested because of swelling or from the splints placed inside your nose during surgery.
More often than not, the internal dressings remain in place for one to seven days after surgery. Your doctor will also tape a splint to your nose for support and protection. It is usually there for about a week.
A few days after the surgery or after removing the dressing, patients will experience mild bleeding and drainage of mucus and old blood. Your doctor may need to place a drip pad — a small piece of gauze taped under your nose — to absorb the drainage. As directed by your doctor, change the gauze. Don’t place the drip pad tightly against your nose.
In order to further reduce the chances of bleeding and swelling, your doctor may ask you to follow precautions for several weeks after surgery. Your doctor may request that you:
- Take baths instead of showers while you have bandages on your nose.
- Refrain from blowing your nose.
- Avoid strenuous actions such as aerobics and jogging.
- Eat high-fiber foods, such as fruits and vegetables, to avoid constipation.
- Constipation can trigger you to strain, putting pressure on the surgery site.
- Wear clothes that fasten in the front. Don’t pull clothing, such as shirts or sweaters, over your head.
- Keep from making extreme facial expressions, such as smiling or laughing.
- Brush your teeth gently to limit movement of your upper lip.
In addition, you shouldn’t rest eyeglasses or sunglasses on your nose for at least four weeks after surgery to prevent pressure on your nose. You can rest your cheeks on the glasses or tape them to your forehead until your nose heals.
Wear SPF 30 sunscreen when you are outdoors, especially on your nose. You may develop a permanent irregular discoloration on your nose if you spend too much time in the sun.
For a period of two to three weeks, some swelling or black-and-blue discoloration of your eyelids can occur after nasal surgery. It takes longer for swelling of the nose to resolve. If you limit your dietary sodium, the swelling will subside faster. Do not put cold packs or ice on your nose after surgery.
Whether you have surgery or not, your nose changes throughout your life. Due to this, it is difficult to say when you obtain your “final result.” However, most of the swelling is gone within a year.
Before-and-after results of rhinoplasty
Very small changes to the shape of your nose, often measured in millimeters, can make a huge difference in how it looks. An experienced surgeon can usually produce results both of you are happy with.
Sometimes, the slight changes aren’t enough, and you and your surgeon might need to do a second surgery for further changes. If this is the case, you will need to wait at least a year for a follow-up surgery since your nose can change during this time.
Frequently Asked Questions
The answer is no. Rhinoplasty is a challenging procedure. This is due to numerous factors. First, your nose is a complex 3D shape that is in the middle of your face. Adjustments made during rhinoplasty are often very small. But these changes can make a significant difference in the way your nose looks and functions. Because these changes are minuscule, so is the margin for error.
During surgery, swelling and the placement of local anesthetic in the skin alter the shape of your nose, hiding many of the subtle changes made. Rhinoplasty also does not have a standard plan or set order of steps. Each operation is tailored to the specific needs of the patient by your Doctor.
Rhinoplasty is a surgery to alter the shape of the nose. Because breathing and the nose’s shape are interrelated, rhinoplasty may sometimes be performed not just to improve the look, but also to enhance breathing through the nose.
A nasal septoplasty is a surgery intended to improve breathing by straightening the nasal wall (nasal septum), which separates the nasal passages into two sides. When the septum is crooked, it can make it tougher to breathe through the nose. Often a septoplasty is combined with a rhinoplasty.
Plan to take a week off from work, school or other obligations. You will feel increasingly better each day during the first week. After a week, people usually feel like they are themselves again.
Expect that after surgery there will be some swelling. The swelling can take a long time to resolve, although most people stop noticing it after a few months. People usually return to most of their activities after a week and resume all activities after two to four weeks.
Almost everyone who has rhinoplasty is able to leave the same day after surgery. In rare cases, you may stay overnight if you are suffering from nausea or need to have your health monitored.
Every surgery has risks. Fortunately, rhinoplasty risks are small and the associated complications are rare. Before the operation, your doctor will discuss the surgery’s risks and benefits in detail with you.
Yes. Your doctor will take standardized photographs of multiple views of your face before your consultation. These photos can be altered to give you an idea of what your nose will look like after surgery.
Sometimes an insurance policy will pay for a rhinoplasty, but it depends on the policy. Your doctor can help you obtain written authorization from your insurance company before scheduling surgery. Even though this is not a guarantee of coverage, it is the only way to confirm that rhinoplasty is a covered benefit. Sometimes insurance will pay for a part of a nasal procedure, but not other parts. In these instances, you can contact the business office to get a quote for the operation.
The cost of a rhinoplasty depends on several factors, including the complexity of the procedure, the surgeon’s training and experience, and geography. At Radiance Surgery & Aesthetic Medicine, the cost of surgery will be the same regardless of location.
Not for most individuals. One day after surgery, most individuals report that pain ranges from 0 to 4 out of 10.
No. Packing is a very uncomfortable process. But a soft splint will likely be attached to your nose. These splints have a hole in them, to allow the wearer to breath through them for a few days. Doctors removed these splints easily during the one-week visit.
Bruising is uncommon. If you do experience minor bruising, it usually lasts for a week or two.
Plastic surgeons, facial plastic surgeons or otolaryngologists (ENT) perform most rhinoplasties. Training and board certification in one of these specialties is a good starting point. For best results you’ll likely want a surgeon who often performs rhinoplasty, and understand your unique aesthetic goals.
People around the country travel to see Dr.C Carson Huynh here at Radiance Surgery & Aesthetic Medicine because he is one of the few facial aesthetic surgeons worldwide who is double board certified. Highly awarded and nationally recognized, he has successfully performed hundreds of rhinoplasty surgeries on various patients of diverse ethnicities.
You’ll probably want a surgeon with a good reputation among patients and other doctors. If your doctor has published many papers in medical literature and is invited to speak at conferences, that is usually a sign that their peers recognize their expertise in rhinoplasty.
Dr. Carson Huynh is recognized as a leading plastic surgeon who has been both published and awarded numerous prestigious honors and fellowships. You can read more about his highly decorated career and surgical practice here.
Finally, make sure that your surgery will be performed in an accredited surgical facility. You should feel comfortable with your surgeon. Try to find a surgeon who can explain to you what will happen during surgery in understandable terms.