A rhinoplasty is an operation to improve the appearance of the nose. It can also be used to improve breathing. A successful rhinoplasty requires careful preoperative planning. Each part of the nose, including the dorsum (or “bridge” of the nose), the tip, the nostrils and their relationship and proportions to each other must be carefully analyzed. The effect that a manipulation of one part will have on the appearance of another must be predicted and calculated. Rhinoplasty is truly a combination of art and science.
During a consultation, detailed pictures are taken of the nose from various angles. Computer simulation is used to demonstrate expected results of the procedure. These are reviewed with the patient. The computer simulations are then used as a guide during the actual surgery.
A rhinoplasty can be performed in one of two ways. My preferred approach is the “Closed” approach. Another approach is referred to as the “Open” approach. Both are valuable techniques. Each has its advantages and disadvantages. The choice of which approach to use depends on the findings during an examination. Ultimately, the goal is to create a natural and aesthetically pleasing and balanced result.
A “Closed” approach refers to a technique of rhinoplasty in which no external incisions are made. All incisions are made within the nose. The advantage of this approach is that no external scars are created. All scars remain hidden with this technique. This is my preferred method of rhinoplasty.
Most people seeking rhinoplasty will be good candidates for the closed approach. This is because most individuals will have great improvement in the appearance of their nose with changes to the dorsum (“bridge”) of the nose, and minor changes to the tip of the nose. The closed approach is successful in treating these areas.
The closed approach can also be used to treat minor breathing difficulties.
If an individual needs major revision of the tip of the nose, more complex maneuvers to the dorsum of the nose, or has major breathing difficulties, the “Open” approach is a better option.
An “Open” approach refers to a technique in which a small incision is made across the “Columella” (which is the small bridge of tissue between the nostrils leading up to the tip of the nose). The incision is designed so that when it heals, it is inconspicuous. Furthermore, when someone is being viewed at eye level, this part of the nose and the scar are generally not visible.
The open approach is preferred when major changes to the tip of the nose are needed. It is also useful when complex work needs to be done to the dorsum, or “bridge” of the nose. In addition, if a patient has major breathing difficulties, the open approach will be a better technique to use.
The choice of technique will depend on what is found on a careful examination. A thorough discussion of each technique will be conducted during the consultation.
The recovery for a rhinoplasty goes through several stages. Patients can go home after the surgery. Surprisingly, there is relatively little pain after rhinoplasty. This is true even if you had to have your nasal bones fractured. There is a lot of swelling and bruising the first 4-5 days after surgery. The bruising begins to improve after about 5 days. Everyone must wear bandages and a splint over the nose during the first week after surgery. The bandages and splint are removed from the nose after 7 days. Most people will look good after about 7 days. However, I always recommend that patients take more time off from work in order to allow the maximum time for the bruising to improve. I tell patients to wait at least 2 weeks after surgery before attending any important social events. Patients look very good after about 3-4 weeks after surgery. This is when patients will begin to see what their final result will be like.
Swelling persists for many weeks after surgery. As already mentioned, most of the swelling is gone after about one month. However, there is still swelling present after 6 months. It takes approximately 12 full months before all of the swelling is finally gone. The final result is seen after 12 months have passed.
Rhinoplasty is a very safe procedure. The main risk with having a rhinoplasty done is that the patient may not be completely satisfied with the result. Bleeding and infection can happen, as with any surgery, but are very rare. Asymmetry and irregularities can also occur, but again, these are rare. This can be discussed in further detail during the consultation.
A rhinoplasty is one of the most satisfying and rewarding procedures done. A well trained board certified Plastic Surgeon can create the result desired while maintaining a beautiful and natural look. To achieve this, a careful consultation must be completed and careful preoperative planning done. When done properly, a rhinoplasty is very safe and has a relatively easy recovery. A rhinoplasty can create the look and result you have always desired.