Rhinoplasty, often referred to as a “nose job,” is a surgical procedure typically performed to reshape the nose in order to create facial harmony. The operation may also be performed to correct structural defects that interfere with breathing, eating or sleeping.
Ideal Candidates
Once a patient’s facial features have reached maturity, usually about one year after puberty, the patient can be a candidate for rhinoplasty. Ideal candidates for the surgery are healthy adults between the ages of 15 and 80 who do not smoke and who are realistic in their goals for the procedure.
Reasons for Nose Surgery
There are two primary reasons for rhinoplasty, aesthetic and functional, although in many cases both sets of reasons are addressed.Aesthetic ReasonsThe procedure can correct existing imperfections or deformities by altering the size and/or symmetry of the nose so that it is in balance with the patient’s other facial features. During the procedure, the surgeon can remove bumps or depressions, widen or narrow the nostrils or bridge, alter an enlarged, bulbous, upturned, hooked or drooping tip, correct flaring or pinched nostrils, alter the angle of the nose relative to the upper lip.
Functional Reasons
Because of structural defects, a nose may require a reshaping in order to function properly. Patients may be born with, develop, or acquire through an accident or physical confrontation nasal defects that that interfere with breathing, eating, or sleeping.
Benefits of Cosmetic Nose Surgery
or those who need the surgery, there are a great many benefits to having a rhinoplasty performed. The benefits of structural changes that will improve nasal function are self-explanatory, including easier breathing, less mouth breathing, less difficulty eating or swallowing.Patients who have undergone the procedure for cosmetic reasons express numerous emotional benefits as well, including feeling:
- More physically attractive
- Less self-conscious
- More self-esteem
- More comfortable with one’s physical image
- More at ease in social situations
- Greater ease communicating
It is no coincidence that a rhinoplasty can provide such a wide range of emotional benefits. After all, the nose is the most prominent feature of the face and, as such, can detract from other beautiful features, such as the eyes or lips, or even interfere with spoken words, if it is enlarged or misshapen.
Preparation for Rhinoplasty
Preparation for a rhinoplasty is similar to preparation for many other surgical procedures. The patient has to be cleared by having a medical history taken and having a physical examination, including a chest X-ray, and EKG (electrocardiogram), and blood tests. This is done to make sure the patient is in good health before undergoing the surgical procedure.Patients are instructed to avoid smoking and to stop taking aspirin or any other anti-inflammatory medications or herbal supplements that may increase the risk of bleeding. In some cases, a patient’s current medication regimen may have to be altered temporarily.
The Closed Rhinoplasty Procedure
There are two basic types of rhinoplasty: open and closed. During an open rhinoplasty, an external incision is made in the columella (the area between the nostrils), whereas during a closed rhinoplasty all incisions are made through the nostrils, inside the nose.Dr. Tobias performs only closed procedures which have many advantages over open surgeries, including:
- No visible scarring
- Very little pain
- Less postoperative bruising and swelling
- Shorter recovery period
A rhinoplasty usually takes about 2 hours, but may run up to an hour longer in certain complicated cases.The rhinoplasty procedure is a complicated and delicate one for the doctor, but an easy one for the patient. The surgery takes place in a full-service hospital to provide the utmost safety and comfort. First, the patient is put under general anesthesia by a highly trained anesthesiologist. Because Dr. Tobias only performs closed surgeries, there will be no incision made in the columella (the area between the nostrils). Instead, the entire operation will take place through the natural opening of the nostrils. Once the incisions are made, the skin covering the nasal bones and cartilage is gently lifted to allow Dr. Tobias access in order to reshape the nose. He is almost always able to use existing cartilage during the surgery, though depending on the individual case, tissue may be removed or added before skin is redraped over the nose.Once the rhinoplasty has been completed, the inner nose will be stitched closed, and the nose will be splinted and bandaged. The patient, who has slept soundly throughout the surgery, will soon be moved to the recovery room where he or she will be monitored until fully awake.
Recovery From Rhinoplasty
Once the rhinoplasty is completed, the patient awakens in the recovery room with a splint inside the nose and with a splint or bandages on the outside to support and protect newly shaped structures during healing. Although many nasal surgeons use packing after surgery, which is very uncomfortable, Dr. Tobias does not find this necessary.Patients should expect some bruising, swelling and pain after surgery, but Dr. Tobias’ patients usually experience minimal difficulties and very little pain. Most patients are able to return to work or school after a week to 10 days and can resume more strenuous activity in about a month. Improved appearance and/or function will be noticeable within days and will continue to improve as swelling goes down. Although, patients and their families, friends and associates will admire results almost immediately, optimized aesthetic results will be evident after a year.
Risks of Rhinoplasty
There are risks inherent in any surgical procedure. These include the risk of excessive bleeding, adverse reaction to anesthesia, and the risk of postoperative infection. There is also some very minor risk of poor wound healing, postoperative numbness, or dissatisfaction with the aesthetic results of the surgery. Nonetheless, rhinoplasty is an extremely safe and commonly performed procedure. The vast majority of patients recover quickly and completely and are delighted with the results.