Rhinoplasty (Nose Job): From Tip to Turbinate

Andrew P. Trussler, MD
Article by
Austin Plastic Surgeon

Rhinoplasty or nose job is a very common operation, though an operation that is becoming less frequently performed by plastic surgeons. Typically plastic surgeons who perform a significant volume of rhinoplasty have additional training in cosmetic or craniofacial surgery. Rhinoplasty is one of the most popular procedures performed in the younger age group and in the male population. The indications for nasal surgery can be functional or cosmetic, or typically a combination of the two. This may include nasal tip refinement or reshaping, bone straightening and nasal contouring, such as shaving a nasal dorsal hump. Internal nasal surgery is usually reserved for nasal airway improvement, which includes septoplasty and lower turbinate reduction. The initial consult may incorporate computerized morphing to estimate the visual appearance of the nose after rhinoplasty.
The procedure is done in the operating room under general anesthesia, and is an outpatient or day surgery. The entire operation can take 2 to 3 hours depending on the complexity of the case. I primarily perform an “open” rhinoplasty which involves one small external incision and then the additional incisions inside the nose. This enables full control on correcting any nasal problem accurately and under direct vision. The procedure can involve removing part of the septum (septoplasty) and using it to help build up the nose with cartilage grafts. All incisions are closed with sutures and the nose is dressed with tape and a metal splint. Also silicone tubes are places in the nasal airway to maintain a patent airway. The sutures and splints are removed after one week. Swelling and bruising can be obvious for 3 weeks and the final result is usually not fully appreciated until one year. The most common complication is secondary nasal deformity caused by scarring and cartilage warping, though in the immediate phase, bleeding , especially in turbinate reduction can be seen in less than 1 % of patients. I would search for an experienced rhinoplasty surgeon that listens to your complaints and can carry out a thoughtful surgical plan that is individualized to your needs.