Rhinoplasty

As a person ages, subtle changes occur to the nose. The nasal skin can become thicker especially at the tip of the nose. Also the nasal tip may droop due to relaxation of the soft tissue attachments of the cartilage. This gives the appearance of the nose “growing.” Because these changes usually don’t occur until the fifth or sixth decade of life, you should retain the shape of your nose for many years after your surgery.

A deviated nasal septum can certainly be performed at the same time as a rhinoplasty. Many patients of mine have breathing difficulties and an undesirable nasal appearance. I believe that it is best to address both problems with one operation.

After your rhinoplasty procedure, you will have swelling on the inside of your nose that will affect your breathing. In general, you should wait three to four weeks to resume a light workout. It takes approximately six weeks for the nasal bone and cartilage remodeling to stabilize. You should avoid any strenuous activity before this time that would risk accidentally hitting your nose. Too much vigorous activity before the nose heals could result in unforeseen nasal injury and a suboptimal result.

It is not uncommon to perform a chin augmentation at the same time as rhinoplasty in those patients who have a weak chin. Most patients undergoing rhinoplasty do not require a chin implant, but when indicated it provides a balanced profile with dramatic results.

I always try to use a natural implant in the form of a nasal septal cartilage graft or an ear cartilage graft. Cartilage can easily be carved and shaped and used to modify the nasal tip region. Because it is your own substance, it incorporates into it’s new location with minimal complications. However, if all you need is a graft to enhance your profile an artificial graft can be safely used. Success of any graft depends on avoiding infection, avoiding undesirable visibility of the graft, and providing a natural appearance.

Patients who have had significant injury to their nose during an accident resulting in a crooked nose are candidates for a nasal fracture repair. This is not considered a cosmetic rhinoplasty procedure, and this will be filed under your medical insurance plan. However, if you desire any cosmetic changes, such as nasal tip reduction, there may be a reduced cosmetic rhinoplasty fee with your surgery.

Yes, that is one of the most common reasons patients schedule rhinoplasty consultations. Another common nasal deformity complaint is a big nasal tip. Also, I will evaluate the inside of your nose to see if you have any breathing difficulties that could be addressed during your rhinoplasty procedure. During the initial consultation, we will take a picture of your nose and computerized digital imaging and simulation will be performed to show you your desired changes to your nose.

It sounds like you have an over-rotated nose that may be a little too pointed. Correction of this often involves lengthening the nose to create a less “turned up” appearance. Modification of the nasal tip mostly involves repositioning the tip cartilage rather than resecting too much, which could weaken nasal tip support. Also, placement of cartilage grafts onto the nasal tip can soften undesirable features.

Most patients who I see for rhinoplasty consultations generally know what they do not like about their nose. For instance, the nasal bones and/or tip is too wide from the front view, or the profile is undesirable. I find it extremely valuable to perform digital image simulation during consultation to show what I think is cosmetically acceptable. Patients sometimes do not know exactly how to voice their desires, but seeing the changes available to them through imaging helps express likes and dislikes. I would encourage you to seek out a rhinoplasty consultation, although you might not know what you want. Sometimes the solution is much more straightforward than you think.

Minor adjustments to the nose can be made with the use of a variety of injectables. This is intended to correct minor contour irregularities but not to impart a major change to the nose. This can only be done with surgery. Because this procedure involves the injection of a small amount of product, precise placement takes only a matter of minutes. If you want a significant, long-lasting change to your nose, I would recommend surgical intervention.

Patients who have had significant injury to their nose during an accident resulting in a crooked nose are candidates for a nasal fracture repair. This is not considered a cosmetic rhinoplasty procedure, and this will be filed under your medical insurance plan. However, if you desire any cosmetic changes, such as nasal tip reduction, there may be a reduced cosmetic rhinoplasty fee with your surgery.

Yes, it is certainly possible to have your nose repaired after more than one injury and also after years have passed since the last injury. The extent of damage varies from patient to patient, and some cases are more complex than others. This can only be determined by a thorough examination of your nose. Nasal fracture repair should always address the nasal airway, and nasal breathing difficulties can be corrected during this operation.

Yes, that could be done at the same time, depending on the size of the mole and the goals of your rhinoplasty surgery. A thorough preoperative physical examination will confirm whether this would be possible.

Rhinoplasty surgery is recommended once the nose has reached maturity. I usually recommend waiting until the junior or senior year of high school to consider rhinoplasty procedure.

Most rhinoplasty procedures are to make the nose smaller, but sometimes, patients have insufficient nasal projection of either the nasal tip or the nasal dorsum.  Depending on your nasal characteristics, the nose can be augmented or enlarged using your own cartilage and/or bone or using specially made implants designed for the nose.  I would certainly encourage you to come in for a consultation to explore your rhinoplasty possibilities.

Revision rhinoplasty surgery can take somewhat longer to heal than primary rhinoplasty. Most of the bruising and swelling will subside after 2-3 weeks, but a small percentage of residual swelling will persist for several months. It may take up to a year for the subtle swelling to fully subside.

Most of the bruising and swelling after rhinoplasty will subside between 2-3 weeks after surgery.  Depending on your profession, you may return to work after the dressing is removed seven days postoperatively as long as there is no strenuous activity required.  However, if you want to safely avoid work without visible bruising, plan to take off work 2-3 weeks after your procedure.

As in any surgical procedure you seek out, I advise you to choose a surgeon in your area who is experienced, provides good postoperative results, takes excellent care of their patients, and has a good professional reputation.  Patients requesting rhinoplasty surgery often suffer from nasal obstruction and/or chronic sinus issues.  As a board certified facial plastic surgeon and otolaryngologist, I always address these issues with my patients.  CT scanning of the sinuses may reveal if there are any other problems present.  If recommended, sinus surgery and nasal airway relief procedures can be performed at the same time as rhinoplasty.  This is a significant advantage in choosing a surgeon who is both an otolaryngologist and facial plastic surgeon in performing your surgery.

A visible nasal hump best seen on profile view is called a dorsal hump.  If it is small and you have a depression in the upper portion of your dorsum (called the radix), sometimes an injectable filler could improve your profile temporarily.  The fillers I use last approximately one year, but I very rarely use them for nasal contouring.  This would be only a temporary fix.  Surgery is the standard of care for correction of a dorsal hump.

Yes, there is.  When patients consult with me for rhinoplasty, I always obtain digital photographs.  During the consultation, I provide simulations of the photographs on a computer software program to show the patient what I think would be an appropriate reshaping of the nose.  This not only allows the patient to see themselves with a different nose, but also to make sure that both myself and the patient have the same goals in mind.

If you are in good health, you would be a great candidate for rhinoplasty.  In my practice, that is the number one most reason for patients desiring to have their nose reshaped.  It sounds like you may have a small chin as well.  Often patients are candidates for chin implantation, or chin augmentation.  One may achieve dramatic results by combining rhinoplasty with a chin implant.

I perform a septoplasty at the same time as rhinoplasty if the patient has a deviated septum.  Also, nasal obstruction can occur due to large inferior turbinates.  These can be reduced in size to improve nasal breathing as well.  Lastly, rhinoplasty surgery should address the nostril shape and size.  A physical examination of your nose would allow your surgeon to discuss the available options for you.

Nasal reconstruction after injury dies not guarantee that your nose will be restored to its original appearance.  For minor injuries with little deformity, chances are better that the nose will be very close to pre-injury appearance.  However, with more severe injuries, there is no guarantee that there will not be some permanent visible alteration of the nose.

Nostrils can be narrowed during either primary rhinoplasty or revision rhinoplasty.  If the nostrils are too wide or flared,  they can be reduced in size by removing a carefully measured amount of skin from the part of the nostril that is next to the cheek skin.  This can even be performed as an isolated procedure on the nose, without performing a complete rhinoplasty.

It may happen, that during reduction rhinoplasty, a profile hump can be over-resected and result in a depression and not a smooth appearance.  Minor indentions can be corrected with injectable fillers that can improve the appearance.  More significant depressions in the profile that give a “scooped out” look may require a revision rhinoplasty.  Often, nasal septal cartilage or auricular cartilage or a manufactured product such as Goretex can be used as grafts to augment the profile for a smoother look.