Answers to Rhinoplasty Frequently Asked Questions (FAQs)

by

What is Rhinoplasty?

Rhinoplasty (nose job) surgery is a common cosmetic or reconstructive procedure for the purpose of improving the appearance or the function of the nose.

How Do I Find A Qualified Rhinoplasty Surgeon?

Rhinoplasty can be performed by either Plastic Surgeons or Ear, Nose, & Throat (Otolaryngology) Surgeons. Regardless of your surgeon's specialy, it is important to find a surgeon who is Board Certified in either of these two specialities. Because rhinoplasty is considered one of the most difficult cosmetic surgery procedures, not all plastic surgeons and ENT surgeons routinely perform rhinoplasty. Therefore, you should choose a rhinoplasty surgeon to get the best nose job result.

How is Rhinoplasty Performed?

Nose reshaping is performed either via an open or closed approach. Closed Rhinoplasty is performed by making incisions on the inside of the nose. The bone and cartilage framework of the nose is modified underneath the skin to give the nose its new shape.

Open Rhinoplasty refers to a nose job in which a small incision is made across the narrow column of tissue between the nostrils and connected with incisions on the inside of the nose. This allows the surgeon to directly visualize the nasal framework to ensure that after modification the framework is smooth, symmetric, and stable. There is no right or wrong technique, however, some noses are more easily corrected with one approach versus another.

For example, a nose with a slight hump on the bridge is easily corrected by shaving of the bone and cartilage through a closed approach. Other nasal types, such as the deviated nose or a nose with a bulbous tip, often requires more extensive reconstruction that is more easily accomplished under the direct visualization afforded by the open approach.

What is the Recovery Period After Rhinoplasty? How Long Will I Be Swollen?

Patients are encouraged to take at least one week off from school or work. During that first week, swelling and bruising around the eyes are common. A cast or splint is usually placed on the bridge of the nose for one week. When the cast comes off, the nose typically looks swollen, but the improvements in the shape are usually apparent even with the swelling. 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.

When Can I Exercise After a Nose Job?

Generally, patients are discouraged from doing any strenuous activity that raises their heart rate for a minimum of two weeks after surgery. After that time, patients can gradually increase their activity level as tolerated. The reason for this is that the increased heart raised combined with an increase in blood pressure increases the possibility of a post-operative nose bleed. Even after patients resume their normal exercise regime, they will often report that their nose feels temporarily more swollen or "throbs" for several hours afterwards.

How Long After Rhinoplasty Can I Fly?

You will need to follow your surgeons instructions, but generally, patients are able to fly several days after surgery.

When Can I Start Wearing Glasses After Rhinoplasty?

Wearing glasses during the recovery period after a nose job can negatively impact your results. Patients are discouraged from wearing glasses for 6-8 weeks after surgery for several reasons. If the nasal bones were surgically broken or repositioned, they are susceptible to shifting during first 2 weeks after surgery. Additionally, the pressure exerted by the eyeglasses can leave indentations along the nasal bridge that sometime do not improve.

How Much Does a Nose Job Cost?

The price of a rhinoplasty can vary significantly. Factors that affect the price include your surgeon's geographic location, level of experience, and the techniques and time required to perform your surgery. The American Socieity for Aesthetic Plastic Surgery's Statistics on Cosmetic Surgery note that the national average surgeon's fee for 2007 was approximately $4800. You should check with your doctor to find out what other fees are involved, such as anesthesia fees or surgical center fees.

Will Insurance Pay for a Rhinoplasty?

Most insurance companies will not pay for nasal surgery performed for cosmetic reasons. Occassionally, they will cover surgery performed to correct post-traumatic deformities. Insurance will, however, pay for the portion of a rhinoplasty that is done to improve your breathing -- i.e., correcting a deviated septum (septoplasty) or reconstructing collapsed breathing passages (spreader grafts). You should check with your physician to see if he accepts insurance and whether or not you are a candidate for these types of procedures.

What Are the Potential Risks/Complications of Rhinoplasty?

Rhinoplasty, as with any other surgery, carries the risk of bleeding or infection. Other common risks include impairment in nasal breathing(temporary or permanent), septal perforation, and new or residual deformity. There are other less common potential complications that you should discuss with your surgeon.

What is Secondary (Revision) Rhinoplasty? When is it Required?

Secondary Rhinoplasty is when additional surgery is required to correct problems that arise from the original rhinoplasty. It is done to fix cosmetic deformities or breathing problems. Secondary rhinoplasty is much more complex that primary (first-time) rhinoplasty and requires significantly more expertise. Therefore, if you have had a prior nose job, you should seek a qualified revision rhinoplasty expert.

Article by
Dallas Facial Plastic Surgeon