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What is the Average Time for a Primary Rhino?

I had a consult for a primary rhino/septo, and the doctor told me it will take about 6-7 hours for the operation. Wanted to know if that is too long for a primary rhino?

Doctor Answers (16)

A primary Rhinoplasty should take no more than 2 hours on average

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Unless there is a major traumatic or congenital deformity, or if there is a need for rib grafting, which is unusual in primary rhinoplasty, the operation should take 2 hours, on average.  Add another 45 minutes for family, between the time they see you leave them and the time they see you in recovery.  Then add another 45 minutes for recovery time.  So, the entire experience should be less than 4 hours.  


New York Facial Plastic Surgeon
4.5 out of 5 stars 41 reviews

The Average Operation Time for a Rhinoplasty

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The average time for a primary rhinoplasty is not 6-7 hours. In a primary rhinoplasty, it is 1-2 hours. 6-7 hours is a significantly prolonged time for any primary rhinoplasty. I would definitely seek another opinion from someone who has expertise and experience in performing rhinoplasties.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 18 reviews

Average time for primary rhinoplasty

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The average time for a routine rhinoplasty procedure is approximately an hour and a half.  This is done under general anesthesia.  If cartilage-grafting procedures are needed, this can add an additional 30 minutes to the procedure.  Revision rhinoplasties with multiple cartilage grafts do take a little longer.  

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 58 reviews

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Time needed for a Rhinoplasty

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I must chime in with my opinion that 6-7 hours is too long for a rhinoplasty unless you have an extremely unusual nose.  A rhinoplasty is never routine, each is an individual work of art and a committment to an outstanding result.  But, routinely a rhinoplasty takes 1.5 - 2 .5 hrs. 

I would return to your surgeon for clarification, or seek a second-opinion.  Furthermore, confirm that your plastic surgeon is Board Certified by the American Board of Plastic Surgery or the American Board of Facial Plastic Surgery.  There are websites to check the doctor's credentials as well.   Ask where it will be performed -- a hospital or a surgicenter, or in the office, and ask about credentialing of those facilities.

Navin K. Singh, MD
Washington DC Plastic Surgeon
4.5 out of 5 stars 24 reviews

As much as time needed

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time is not an indicator in rhinoplasty as other plastic surgery procedures.

obviously different situations demand different time. there are more important criteria to choose your surgeon.

at the same token the dedicated time should be reasonable. 

M. Ryan Khosravi, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 7 reviews

6-7 hours for a Rhinoplasty is way to long

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I have performed Rhinoplasty and Revision Rhinoplasty, for over 20 years and WOW...6-7 hours is way to long for a Rhinoplasty of any kind, IMHO.  The Rhinoplasty, no ,matter how complicated and I'm talking being the 10th surgeon operating on some very tough Revision Rhinoplasty cases, should not take longer than 2 hours with a primary Rhinoplasty typically taking about 1 hour.

As previous Director of Facial Plastic Surgery, for almost a decade, at USC School of Medicine, I taught Rhinoplasty to surgeons in training and I would instruct them that the nasal tissues, once infiltrated with lidocaine with epinephrine which allows us to operate without the tissues bleeding uncontrollably...only lasts about 1 1/2 hours.  So, that's, IMHO, the time limitation for a Rhinoplasty of any kind 1 1/2 to 2 hours because after that, the effects of the injections wear off and the nose begins to bleed profusely making it impossible to see and operate upon.  I rarely say this, but honestly, you need to get another opinion from a qualified Rhinoplasty surgeon.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

Length of Operation

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The length of operation can vary from patient to patient.  However 6 to 7 hours seems very long for a primary rhinoplasty.  I am wondering if your doctor was telling you how much total time you will be at the hospital or surgical center.  Basically it would take them about an hour to get you ready for surgery, 2 to 3 hours to do the surgery and another 2 to three hours for recovery.  That would lead to about 6 to 7 hours.  You might want to seek clarification with your surgeon.

 

Good Luck.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 57 reviews

Rhinoplasty: the surgery with the most variable time of all cosmetic procedures

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Rhinoplasty is universally regarded as the most complex of all cosmetic surgery procedures, which goes along with it being the most variable. I have been getting excellent results for over 10 years on patients with crooked noses with a hump after trauma-about an hour. Other patients requiring extensive tip modification, nostril reduction and  ear cartilage grafts, even in primary cases can run up to 4 hours, although usually 2 1/2 hours is enough. 6-7 hours in an inordinate amount of time for the actual surgery, but not for time spent at the facility from arrival to discharge.

Edmund Fisher, MD
Bakersfield Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Length of rhinoplasty varies greatly

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Most straightforward, non-deviated primary rhinoplasties that include both bridge and tip work can be done in 3-4 hours or less depending on your level of expectation or the complexity of your case.  This time estimate is from the time you enter the operating room to the time you leave the operating room, and includes the anesthesiologist's time.   Meanwhile, reconstruction or revision rhinoplasty, where the nose is reconstructed after severe trauma or botched rhinoplasty (usually from overresection), can take much longer (7-9 hours).  If you are seeking primary rhinoplasty but have significant nasal deviations, bony abormalities or nasal valve issues, then your nose may represent more of a revision-type situation, and your surgeon may also be including treatment of nasal valve collapse, septal work, cartilage grafting, bony deviation work, and soft tissue work with your primary rhinoplasty, all of which can take 5-6 hours.  Factor in induction and waking up from anesthesia, and your surgery can certainly take 6-7 hours.  The faster or more rushed a surgery, the less time there is to catch imperfections or oversights that might cause you to have a revision.   If you wish simply to have an "in-the-ballpark" improvement in your appearance, then you can decrease your operative time, but if you wish to have a certain look based on some computer simulations you and your surgeon discussed, then a longer surgery might be justified to attempt to achieve that look.  Ultimately, you are seeking superior results and low revision rate, not speed.  Early on in my career, most of my primary rhinoplasties were 2-2.5 hours in length, but in the last decade, as patients became more expectant of certain looks, and as the pitfalls of older techniques became revealed with long-term result studies, then those surgical times actually got longer to around 3-4 hours as more steps are added to the routine rhinoplasty.  The extra hour or two is nothing compared to a lifelong cosmetic result and proper breathing.

Of the 200 rhinoplasties I perform per year, approximately 60-70% of my patients are revision rhinoplasty patients who received unwanted nasal results after having rhinoplasty elsewhere.  Their most common complaint is that their primary surgeon spent too little time on their nose and missed all sorts of nasal breathing diagnoses and created the stigmata of the "cookie-cutter" or "done" look, namely retracted ala, scooped bridge, pinched tip, inverted-V, overly rotated tip, etc.  While longer surgeries do not necessarily mean better results, modern rhinoplasty concepts have indeed caused primary rhinoplasty cases to be longer in an effort to create the more natural results that patients seek.

Modern anesthesia is quite safe if you have little medical problems, but you should avoid having any set of procedures that  is overly long (some Mommy Makeover procedures that include rhinoplasty, facelift, browlift, blepharoplasty, etc. can take 8-10 hours, and you should avoid cases that take longer than this timeframe). 

When  seeking a rhinoplasty surgeon, be sure to view many before-after photos from your surgeon to understand what kind of look you might be getting yourself into.  See if your surgeon has a good track of achieving results similar to the simulations by speaking to other patients.  Also seek a surgeon who is experienced in and willing to perform revision rhinoplasty if your surgery does not go as well as you hope.  Realize that no surgeon will have a perfect track record, but some surgeons will be much more specialized in rhinoplasty and revision rhinoplasty and can give you the highest chance of  successful and optimal results.

Thomas T. Le, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 37 reviews

Time for rhinoplasty

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Time is not important if the surgeon is meticulous. As the saying goes "no one cares who was the fastest after the complication". Having said that however , 6-7 hours is probably on the very long side for a previously unoperated, non traumatized, non deviated nose. While many "fast" surgeons may do this in one and half hours or so, probably most are between one and half to two and a half hours. I'm "slow" and can take up to three. More then that is usually major revisions with ear or rib grafts or other corrections.  Probably the best thing is to ask how often he does the procedure and see before and afters of previous patients. See other doctors as well. If you like the "slow" surgeons work the best then stay with him.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.