Rhinoplasty (Nose Reshaping)

Some people are unhappy with the noses they were born with, and some with the way aging has changed their nose. For others, an injury may have distorted the nose, or the goal may be improved breathing. But one thing is clear: nothing has a greater impact on how a person looks than the size and shape of the nose. Because the nose is the most defining characteristic of the face, a slight alteration can greatly improve one’s appearance.


What Is Rhinoplasty?

Rhinoplasty, otherwise known as nose reshaping surgery or a nose job, is a form of cosmetic or reconstructive plastic surgery that modifies the shape and size of the nose. While most of these procedures are performed for aesthetic reasons, rhinoplasty can also be used as a solution to structural defects that may cause breathing problems (septorhinoplasty), removing any internal obstructions that may be blocking breathing through the nose. The goal of rhinoplasty is a nose that looks natural and blends harmoniously with your other facial features.


Who Is a Good Candidate for Rhinoplasty?

Rhinoplasty is a popular procedure for both men and women. In fact, the American Society of Plastic Surgeons has reported that nearly 24 percent of procedures are performed on males. Individuals who are interested in receiving nose reshaping surgery should be at least in their mid-teens, in order to ensure that the nasal bone has mature and the shape of the nose has stabilized. It is recommended that girls be at least 14 years old, while boys should be at least 15 years old. Patients who are unhappy with their appearance due to certain ethnic characteristics are also able to receive rhinoplasty.

In addition to being in good general health, it is important for potential rhinoplasty candidates to have realistic expectations regarding the procedure. It is important to discuss your specific needs with your surgeon, and make certain that these results are practical and can be achieved.


How Should You Prepare for Rhinoplasty?

The initial consultation with your surgeon will require your complete medical history, so you will want to be prepared to provide the necessary information. You must be completely open and honest with your surgeon. If there is any medical problem, you will be referred to a specialist.

With all of this information, your surgeon can plan the best procedure for your needs and tell you how to adequately prepare for the procedure by giving you guidelines.

Preoperative laboratory studies will need to be done several days in advance. Aspirin, or any product containing aspirin, should not be taken within 10 days of the date of surgery. Non-steroidal anti-inflammatory medications (such as Advil) should not be taken within 7 days of the date of surgery. Smokers should make every effort to stop smoking, or at least reduce the number of cigarettes. This will help to reduce postoperative coughing and bleeding.


How Is Rhinoplasty Performed?

A rhinoplasty can be performed under either local anesthesia with sedation or general anesthesia. Surgery generally lasts about one to two hours. An incision is made either across the bottom of your nose between your nostrils (an open technique) or in the mucosal lining of your nostrils (a closed technique). Your surgeon will decide the best treatment option for you based on your desired results.

The surgeon then may use surgical tools to shave down a hum, remove or rearrange cartilage, or break and rearrange bone to reshape the nose. After surgery is done, the incisions are closed. Your nose may be packed with gauze or other material and a splint or cast may be applied.


What Is Recovery Like After Rinoplasty?

Swelling and bruising of the nose, upper lip, cheeks, or around the eyes for several days after surgery is a normal occurrence. This will gradually go away over the next 7 to 10 days. Ice on the face, bridge of the nose, and eyes as much as tolerated will help to minimize these problems.

A nasal splint or cast will cover the outside of the nose, and will usually be removed one week following surgery. As swelling subsides, the splint tends to fit less tightly. If the cast gets wet it may come off prematurely; this is usually not a problem and does not affect the outcome of the procedure.

Moderate bleeding from the nose is normal, and will gradually decrease.

It is best to eat a light, soft, and cool diet as tolerated after recovery from the anesthetic. Avoid hot liquids for several days. It is best to go slowly with food immediately after the procedure to prevent postoperative nausea and vomiting.

Antibiotics are prescribed after surgery. It is important to finish all the pills that have been ordered. Some form of a pain killer will be prescribed (usually vicodin) which is to be taken as needed.

Rest for the first week following surgery. Avoid excessive talking, smiling, hard chewing, strenuous activities, and lifting heavy objects, bumping the nose, and bending over. Try not to rest glasses on the bridge of the nose until soreness and swelling subsides. Contact lenses can be worn once eye swelling and any irritation has resolved. Alcohol and tobacco should be avoided because they may prolong swelling and healing. Smoke, dust, and fumes may irritate the nose and cause an infection.

Facial tanning is discouraged for 6 months after surgery. Number 15 or greater sun block is recommended during any sun exposure. Make-up may be worn anytime after surgery.

The cast is removed about 7 days postoperatively. You may feel a slight stiffness in the upper lift after the cast is removed because the swelling moves downward. This will subside in a matter of hours. Be very careful not to bump your nose for several weeks after the cast has come off as it is vulnerable to breakage. Your nose will not be as strong as it was before the rhinoplasty until it completely mends in about 2 months.

If you had a rhinoplasty to narrow flared nostrils, you will have your sutures removed when the cast comes off.


Will the Results of Rhinoplasty Be Permanent?

In most instances, the results of rhinoplasty are permanent, except for possible changes associated with the normal aging process.

Since the healing process is gradual, you should expect to wait up to one year to see the final results of your rhinoplasty. You are likely, however, to begin enjoying your new look within weeks of your surgery.

Occasionally, a touchup may be desired to further improve the results. If this is the case, the additional procedure is usually less extensive than the original operation.


What Are Possible Complications From Rhinoplasty?

When the procedure is performed by a highly qualified cosmetic surgeon complications are rare and usually minor. However, as with any surgery, there are potential complications and risks. Your physician will spend time discussing these with you during your scheduled consultation. Be sure to bring a list of questions or concerns with you.  All patients are instructed to discuss the general surgical risks with their surgeon.

As with all surgical procedures, there are risks involved with rhinoplasty. Bleeding, infection, and reactions to medication or anesthesia are possible side effects of rhinoplasty surgery.

In addition, there are several risks that are unique to nose reshaping surgery. These include burst blood vessels that can lead to red spots and small scars on the underside of the nose.

You may lose your sense of smell for a period of time; in rare cases, this is permanent.