I'm considering a nose job. What can I expect from the rhinoplasty procedure itself? How long does it last, what goes on?
Rhinoplasty Procedure - What Results Are Possible?
Doctor Answers 19
What to Expect From Rhinoplasty
A cosmetic Rhinoplasty seeks to reshape the nose to better fit the patient's aesthetic goals. Better nasal proportions and shape can have a pleasing, even dramatic affect on facial appearance.
Reshaping the nose primarily involves changing the nasal skeleton, bone and cartilage, which can be reduced, reshaped or augmented to produce the desired changes.
Surgery is usually an out-patient procedure done with general anesthesia or IV sedation.
Time away from work is usually in the range of 5 days.
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Rhinoplasty: What To Expect The Day Of Surgery
Because each surgeon has a different approach, philosophy, and surgical technique, rhinoplasty will vary somewhat depending on who performs your surgery, where it is done, and how it is done.
In general, rhinoplasty surgery lasts anywhere from 1 to 4 hours. Many surgeons perform the surgery with their patients under general anesthesia, which means you are completely asleep and don't feel or remember anything. After surgery, patients go to a recovery room area for 1-2 hours before being disharged home.
At the conclusion of the surgery, most surgeons place and external cast or splint on the outside of the nose to help preserve the operative result. This usually remains in place for a week.
Swelling & Bruising
Bruising and swelling are a normal part of rhinoplasty recovery. They are dependent on several factors related to both the surgical technique and the patient. Techniques that increase bruising and swelling include whether or not the nasal bones were broken (osteotomies), the extent of soft tissue dissection/elevation from the bony-cartilaginous framework, and whether the surgery was performed open or closed. Patient factors include age, skin thickness, nutrition, bleeding tendencies/disorders, and medications that thin the blood.
Obviously, not many of these variables are within the control of the patient; however the extent of the bruising and the severity of swelling can be minimized by following these tips:
- Avoid any medications that thin the blood for a minimum of 2 weeks before surgery and do not resume them until your physician directs you to. These medications include (but are not limited to): aspirin, ibuprofen, anti-inflammatories, heparin, lovenox, coumadin, plavix.
- Avoid multivitamins/herbal remedies/teas etc that contain high levels of Vitamin E, Ginseng, Ginko -- these can cause you to bleed more freely.
- If you have a tendency to bleed or bruise easily, have a history of a bleeding disorder, or have a family member with a bleeding disorder, you should discuss this with your physician before surgery.
- Ice packs to applied to the cheeks for the first 48 hours
- Keep you head elevated higher than your heart. This will help minimize the amount of edema (swelling).
- Avoid smoking
- Herbal supplements such as bromelin, papaya extract, and arnica may be of benefit, but few studies have proven their effectiveness.
- Most of all, be patient. Most of the bruising and swelling will gradually subside over the first one to two weeks after surgery.
During the first week, most patients will have moderate swelling . Usually, by the end of the second week, much of the bruising and swelling have subsided to the point that it is not obvious to the casual observer that the patient has had surgery. However, the nose will look swollen or puffy to the patient for 3 to 4 months. It usually takes a full year for the residual swelling to resolve and the final result be apparent.
The "Rhinoplasty" will shape nasal bone, cartilage and skin. Therefore, you can expect a change in the shape of your nose. Look at lots of before & after photos of nose jobs and learn about the procedure on the internet. Make an appointment with a Facial Cosmetic Surgeon and bring in photos of "likable noses."
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Predicting Rhinoplasty Results
Predicting rhinoplasty results is challenging as it is one of the most difficult operative procedures that we do in aesthetic surgery. It is a surgery of millimeters and long term results which change over time. The best predicator of results is really two-fold. It is being able to deliver the operative technique precisely and concisely and then how you heal post operatively, which is the greatest factor. Unfortunately, how you heal is genetically based.
The Rhinoplasty Experience
Most patients are pleasantly surprised at how easy it is to go through the Rhinoplasty experience. The operation is typically short, lasting from 1-2 hours with minimal post operative discomfort. Bruising is to be expected if the nasal bones are repositioned but this will clear up within several weeks. A nasal splint can make you a bit conspicuous for a week after the procedure as well. Probably the main thing I hear from my patients is that they had to breathe out of their mouths for 3-4 days after surgery. Of course the above are typical but not universal experiences. If you choose your surgeon wisely then your experience will most likely be positive. Good Luck
Rhinoplasty what to expect
In the hands of a confident and experienced rhinoplasty surgeon a standard uncomplicated Rhinoplasty should be no more than 45 minutes operative time. A complicated rhinoplasty or one involving grafting can take 2 hours. The proceedure can be done with IV sedation or general endotracheal anesthesia. Minor touch-up and tip work can be done under local anesthesia. Everyone goes home 1 hour after surgery. You are up and around the next day.... most major swelling and black and blue is gone in 7 days. You are back to work and most activities in 7-10 days. Serious exercise or sports can be resumed in 3-6 weeks depending on the activity. Heavy thick skinned noses are the hardest to achieve desired results in. Most others can come pretty close to the desired result
A rhinoplasty is a rearrangement of the underlying cartilage and bone structures under the skin. Skin thickness is also important. A qualified surgeon will guide you to what the elements of your nose are and how they can be put more in balance. Your surgeon will also help you explore the elements of your body image and your desire to change them.
Wishing you all the best,
Tal Raine MD
It all depends on what you started with and who treats you
Rhinoplasty is a procedure that should last a lifetime. It is not like a facelift that eventually develops more sagging of the skin. Rhinoplasties are reconstructive when they correct an airway obstruction and cosmetic when they are done primarily to improve the appearance. Depending on what you're nose looks like initially and what your goals are, will determine how much work will need to be done, to remodel the nose. When a plastic surgeon evaluates the nose, he is looking at the bony structure which makes up the upper third of the nose as well as the cartilage support which makes up the lower two thirds of the nose. Your surgeon will discuss with you what bothers you and then he should be able to tell you what he feels he can do to improve that. Make sure that you are comfortable with your surgeon and seek a second opinion if necessary. Look at before and after photos and speak with some of his former patients if possible
During a rhinoplasty, most of the incisions are made inside the nose. Sometimes there are small incisions acress the columella of the nose and sometimes the upper bridge of the nose, but these external incisions will heal with virtually invisible scars. Through the incisions the surgeon makes, the nose can be modified in many ways: the overall size may be reduced, a hump on the bridge of the nose can be removed or the tip of the nose may be narrowed or elevated or the nostril size might be reduced. One or all of these alterations can be done in a single operation. The length of the operation depends on the doctor and what sort of corrections are being made.
Post-op, you will be asked to wear a nose splint for about a week, and you will experience bruising that should fade after about 2 weeks. The healing process is very gradual, so don't expect to see the ulimate result until several months later.