{Aired 04.05.14}

A rhinoplasty also know as a “nose job” is one of the most popular & difficult procedures according to the American Society of Plastic Surgery. The act of reshaping the nose includes shaving off bone and cartilage, a delicate procedure that requires skill, patience and general knowledge of the function of the nose. This is typically an out patient surgery with 5 to 10 days recovery time while wearing a nose splint. Bruising around the nose and eyes common after the procedure as well.

Realistic expectations should be approached with this procedure because many people bring photos of celebrities to their consultations seeking a type of nose and not considering the symmetry of their face. Most trained surgeons will explain what changes can be made to achieve the look you desire rather than selecting a nose from a picture.

Functional Benefits to a Rhinoplasty

Insurance may cover a portion of the cost if the revision to the nose is functional. A septoplasty, also know as a deviated septum,  opens up the septum to help the patient breathe better. A crooked nose will often have this side effect and cause snoring or breathing through your mouth during low impact cardio activities.

A turbinectomy  is a procedure in which some or all of the turnbinate bones attached to mucus membranes in the nasal passage are removed. Turbinates can get swollen due to allergies and hinder breathing in patients. A turbinectomy does have side effects (chronic dry nose) but the benefits of creating a smaller nose is the outcome.

Both procedures have functional benefits and when seeing your surgeon you should describe any discomfort you may feel as a result from a crooked nose or enlarged nose. Your insurance provider may cover the cost for repairing these functions.

Cosmetic Benefits to a Rhinoplasty

Because the nose is located in the middle of the face it is important to look for symmetry when considering a rhinoplasty. A rhinoplasty can make the nose larger or small, change the angle of the nose in proportion to the face, correct bumps, indentations, alter the tip of the nose and other defects.

Nose grafting is possible to add more to a nose when trying to elongate the tip of add to the bridge. However, patients typically seeking a nose job are looking to make the nose smaller or to remove a bump. When you meet your surgeon ask their opinion on the symmetry of your face. Sometimes with a nose job you can expect additional procedures such as ear pinning or chin implants to help balance the face.

Psychological Factors to Consider

The popularity of a rhinoplasty is increasing among children the ages of 13-17.  Although this may sound extreme in some cases the benefits of having this surgery will effect the child’s self esteem. Every surgeon will have a limit as to how young they will accept a patient. Commonly, surgeons will wait until the patient is 17 years old and speak with the teenager about their goals for having the surgery whether it being to improve a functional aspect, improve their appearance or prevent further bullying.

How to Select the Right Rhinoplasty Plastic Surgeon

There are a lot of general surgeons that will perform a rhinoplasty however you should seek a board certified plastic surgeon who specializes on this part of the face and understands the functional aspects of the nose. A revision rhinoplasty will limit a surgeon’s ability to achieve your desired look so it is important you research your surgeon and have confidence in their skill. Here are some qualities when considering a surgeon for this procedure:

  • Valid medical license
  • Board Certified in plastic surgery
  • Know their malpractice history
  • Is this their Specialty Niche
  • Can the Surgeon Provide Patient Testimonials
  • What are their Online Reviews
  • Review all Before & After Photos in their Portfolio
  • Ask for a Computer Image of your Revised nose to help get a better picture of the outcome
  • KEY – The Consultation – Were Your Questions Answered & Did They Listen to You

Recovery Time

Like any surgery it is important for patients to know surgery is a process with recovery time. Although rhinoplasty has a relatively pain free recovery time immediately after the surgery there will be swelling which will hinder breathing, however the recovery is still 5 -1o days. Just in any other surgery there will be a possibility of bleeding, swelling and a level of discomfort. Because rhinoplasty is an out patient procedure some patients have the perception that this procedure is an “in & out” technique. A skilled surgeon will inform their patients of all the risks post surgery, what to expect and how important it is to keep the splint on the nose to prevent any movement to the delicate cartilage.

Ethnic Rhinoplasty

Many different races request a more Caucasian looking nose which is common because usually the bridge of the nose can be too short or the tip can be rather large depending on the race. Knowing a patient’s motivation with rhinoplasty is important due to the placement of the nose. If a patient is trying to NOT look like their race their expectations will be difficult to meet and their psychological motivation is not ideal. Trying to hide the qualities of their race can become a slippery slope with addiction to plastic surgery.

Non-Surgical Approaches to Rhinoplasty

The following trends can be dangerous with seeking a “quick fix” to a mishaped nose. Some of the following non-surgical approaches can do more harm to the nose than most would think. Please research any non surgical techniques a non board certified surgeon will recommend.

  • Face Filler – such as Juvederm, only lasts 6-8 months; trying to make the hump of the nose disappear.
  • Plastic Nose Inserts – temporary; can harm the nasal passage due to their firmness that creates pressure on the lining and skin of the nose. Daily use will erode the skin and eventually kill the skin.
  • Platelet Rich Plasma – inserted into the nose to help reshape; this is mostly a fix for facial deformities and not typically recommended for  the nose.

 

Thank you to special guest, Dr. Fred Aguilar for your insight with this week’s topic – Rhinoplasty.

“The greatest joy in my work is the finished product.”

Dr. Fred Aguilar