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Rhinoplasty, surgery to reshape the nose, is one
of the most common of all plastic surgery procedures. Rhinoplasty can reduce or
increase the size of your nose, change the shape of the tip or the bridge,
narrow the span of the nostrils, or change the angle between your nose and your
upper lip. It may also correct a birth defect or injury, or help relieve some
Job....Nose Plastic Surgery
A rhinoplasty can alter the shape and appearance of your nose
by changing the underlying cartilage and bone. Nose surgery can make a large
nose smaller, make a wide nose thinner, and make a long nose shorter. A nose job
can also make a big tip more refined. It can remove a hump or build up a flat
nose. The possibilities are endless, and your surgeon should tailor an operation
for you that addresses your concerns but does not give you more than you wanted.
Incision Options in Cosmetic Nasal Surgery
There are two main options for the incisions that your plastic
surgeon can use in a nose job: closed rhinoplasty and open rhinoplasty. Closed
rhinoplasty involves incision confined to the inside of your nose. Swelling
improves soon and recover is fast. However, your surgeon may have a limited
ability to achieve some changes in your nose because of her or his inability to
see parts of the inside of the nose. Open rhinoplasty, alternatively, involves a
small incision on the underside of your nasal tip, between the two nostrils, in
addition to incisions on the inside of your nose. Some surgeons prefer the open
rhinoplasty because it allows them greater visibility of some portions of the
nose. Unfortunately, swelling lasts longer. Either way, if you sleep with your
head elevated for several nights following your nose job surgery (preferably one
week), then you will find that your swelling subsides much faster. When deciding
on open vs. closed rhinoplasty, you should heed the advice of your plastic
Recovering From Your Nose Job
Anesthesia can either be sedation
or general. The Length of surgery ranges from 1-3 hours. You will go home
the same day. Discomfort is moderate. If your nasal bones are broken as
part of the procedure, expect 4-10 days of prescription pain medication. If not,
expect 2-5 days. Bruising improves in 3-7 days if your nasal bones are
not broken, and 7-14 days if they are. Black eyes are not unusual during this
time. Swelling Improves in 1-6 weeks following closed rhinoplasty and 1-6
months following open rhinoplasty. You can minimize this time by sleeping with
your head elevated for several nights after your nose surgery. Numbness
of the tip of your nose is expected and will last for several weeks. Bandages
usually include a cast and tape, which are removed in 5-10 days. Stitches
on the inside of your nose do not require removal. Stitches on the outside
of your nose, if you had an open rhinoplasty, will be removed in 4-7 days.
Packing may be used to control bleeding. If so, it will be removed in 1-7
days. You will be presentable in public in 1-2 weeks, but you may need
make-up to conceal your bruises. You may return to work within a week,
but your appearance will be the limiting factor. Exercise may be resumed
in 3-4 weeks. Avoid contact sports for 6 weeks if your nasal bones were broken
during surgery. Your final result: may be seen as soon as 3 months or as
late as two years after surgery. The majority see their final result within 6
Ask Your Plastic Surgeon About These Potential
Bleeding may occur during or
following any operation. If your bleeding is significant, you may require nasal
packing to control it.
Sinusitis is an infection of the
sinuses which can occur due to swelling of the nasal membranes following plastic
surgery of the nose - or any nose surgery. Once it is identified, it is often
remedied with antibiotics and medications that shrink the nasal lining.
Nasal obstruction may occur due
to inward placement of your nasal bones. This is not common, as the majority of
airflow through the nose occurs near the floor of the nose, not near the nasal
Undesirable appearance may occur.
Examples include a scooped out nose (which has a concave appearance on profile),
a polly beak (which looks like a parrot's bill on profile), a pug nose (which is
a small upturned nose), or a pinched tip. Some of these are preventable, but all
of them can make your nose appear unnatural. They are called telltale signs,
because they can only be attributed to previous plastic surgery of the nose. The
only way to correct these problems is through revision nose job surgery (see
Tips and Traps, below).
Tips and Traps of Rhinoplasty
- Know exactly what you want changed and how you want it
changed before you see your plastic surgeon. Make a list.
- Avoid a surgeon who downplays the difficulty of having a
- The older you are, the more difficult it will be for you
to adjust to your new nose. Consider this carefully if you are over 40.
People over 40 who have nose jobs tend to think the nose they see in the
mirror is attractive, but they don't think the person they see looks like
themselves. It can take years before they become accustomed to their new
look. The older they are, the longer it takes.
- Avoid all nasal medications for three months before
surgery. Many nasal medications can interfere with healing.
- Ask your plastic surgeon if he or she can avoid placing
nasal packing in your nose following surgery. Packing is often not necessary
and causes significant discomfort while it is in place and upon its removal.
- For the first two weeks following nasal surgery, use a
humidifier and nasal saline spray to keep your nasal passages moist and
- Sleep in a recliner or with your head elevated on pillows
for the first several days to minimize swelling. Frequent application of ice
is also important.
- Understand that there is a 20% chance you will want or
need revision rhinoplasty surgery. This is because plastic surgery of the
nose is difficult and your nose can also change in ways that cannot be
predicted following surgery. You must accept this risk before having
cosmetic nose surgery.
- If you require revision surgery, wait at least one year
from the date of your last nasal operation. If revision surgery is performed
sooner, it will be less likely to accomplish your desired result.
- Understand that revision nose surgery is MORE difficult
than the original nose job. If you need revision surgery, see someone who
has significant experience in this.