Nose Surgery (Rhinoplasty)

“He that has a great nose, thinks everybody is speaking of it.”

- Thomas Fuller

There is no doubt that the nose is key to project facial harmony. Rhinoplasty, or nose surgery, is one of the most common plastic surgery procedures performed today. It can reshape, reduce or augment a person’s nose to achieve facial harmony and boost self-confidence. It may be performed as a reconstructive procedure to correct a birth defect or an injury such as a broken nose.

Rhinoplasty may be performed for functional rather than cosmetic reasons as well. Combining nose reshaping with septoplasty or endoscopic sinus surgery can effectively treat certain breathing problems, such as those caused by a deviated septum.

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Goals of Rhinoplasty

Rhinoplasty is an excellent procedure for achieving the following:

• Balance the size of the nose with the other facial features
• Modify the width of the nose at the bridge
• Improve the nasal profile, including removing humps or depressions
• Contour a nasal tip that is too large, “boxy,” drooping or upturned
• Change the angle between the nose and the mouth
• Narrow and reshape the nostrils
• Correct asymmetry or deviation

Candidates for Rhinoplasty

The best candidates for rhinoplasty:

• Are at least 13 years old;
• Have completed facial growth;
• Are generally healthy;
• Do not smoke;
• Are seeking rhinoplasty for personal reasons, not pressure from others; and
• Have realistic goals for the procedure and Share their expectations with their plastic surgeon.

Rhinoplasty Procedure

Rhinoplasty is usually an outpatient procedure performed under IV sedation or general anesthesia.

Careful pre procedure planning based on your expectations, examination and detailed review of your photos is what you should expect from your plastic surgeon.

Dr. Sawan uses one of two techniques when performing nose surgery. In a closed rhinoplasty, incisions are made within the nostrils in the inside of the nose. In an open rhinoplasty, the incision is made across the columella, the tissue between the nostrils. With both methods, Dr. Sawan gently lifts the soft tissues covering the nose. He sculpts the bone and cartilage to the desired shape. Any additional cartilage needed to augment the nose can often be taken from the septum. Sometimes more cartilage is needed and this can be taken from the ear or ribs. Dr. Sawan will discuss the procedure with you at length so you are informed and know what to expect.

If the patient has a deviated septum, Dr. Sawan will adjust the septum and the inner structures of the nose to improve breathing. Then the tissues are re-draped and stitched closed. If the patient desires nostril reshaping, this is done as the final stage of rhinoplasty.

The entire procedure generally lasts two to three hours.

Recovery and Results after Rhinoplasty

Dr. Sawan will give you specific post surgery instructions, but in general you should expect to have a “splint” on the bridge of the nose and sometimes packing on the inside. You will usually be seen the following day to remove the inside packing. The external splint stays for approximately a week to allow for swelling to be reduced.

For a short time after surgery, patients may experience puffiness, nose ache or a dull headache, some swelling and bruising, bleeding or stuffiness. Most patients feel like themselves within two days and return to work in about a week.

The results of rhinoplasty become gradually apparent as the days pass after surgery and swelling recedes. Swelling may reappear from time to time in the first year after the procedure. It is typically more noticeable in the morning and fades during the day. The results over the bridge of the nose are noticeable early but the finer details of the tip of the nose take months to show.

Contact lenses can be worn immediately, but glasses may need to be taped to your forehead or propped on your cheeks for up to seven weeks.

Patients with realistic goals for rhinoplasty are generally very happy with the new shape of their nose. The exact results depend on the patient’s nasal bone and cartilage structure, facial shape, skin thickness and age.

Risks of Rhinoplasty

Complications associated with rhinoplasty are rare and, when they occur, minor. These may include infection, nosebleed, or a reaction to the anesthesia.