Rhinoplasty Questions Answered
1.What Are The Benefits of Rhinoplasty, or a “Nose Job?”
Rhinoplasty can improve the shape as well as the functionality of the nose, such as breathing, if combined with a septoplasty or turbinate surgery.
Aesthetic goals of rhinoplasty can be achieved by:
- Shaving the hump on the nose
- Modifying the bony and cartilaginous bridge of the nose
- Reshaping the tip of the nose to be less boxy or bulbous
- Repairing the nose after a traumatic injury
- Increasing or decreasing the length of the nose
- Modifying the angle of the nose to the upper lip (nasolabial angle)
- Correcting any bony or cartilage asymmetry (correction of a crooked nose)
2.Who is a Good Candidate for Rhinoplasty?
To be a candidate for a rhinoplasty procedure, patients must meet the following criteria:
- Be at least 13 years old, the age at which the facial growth in relation to the nose is complete.
- Be in overall good health, with no significant heart or lung problems
- Have realistic expectations about the outcome of the surgery and the shape of the nose
- Desire the operation for self-image and personal satisfaction and not for appeasing others
3.How is Rhinoplasty Performed
Rhinoplasty is an outpatient procedure performed with the patient under light general anesthesia. It usually takes from 1 to 3 hours to complete. Surgeons often use one of two techniques: closed or open rhinoplasty. Each have their own unique advantages and disadvantages.
In a closed rhinoplasty procedure, the incisions are made in the nostrils. In addition, an endoscope can be used to evaluate and operate on internal nasal structures such as the septum and turbinates (see video).
In an open rhinoplasty procedure, the incision is made in stair-step fashion (see video) across the columella (the tissue between the nostrils). We believe this type of incision has the best aesthetic outcome, with minimal visibility after healing. More detailed work on the tip and external nasal structures can be accomplished with an open technique.
After the soft tissue is lifted, the cartilages of the midnose and are are shaped, the nasal bones are broken and reset if needed, and the hump is shaved. Any additional cartilage needed to shape the nose can often be taken from the septum with no negative consequences (an L-shaped strut is left for adequate structural support). If the patient has a deviated or crooked septum, we will adjust the septum and other inner structures of the nose to improve breathing. Then, the soft tissue is redraped and sutured closed with dissolvable sutures. Nostril reshaping is done at the end of the procedure, if needed.
4.What Is The Recovery From a Rhinoplasty Like?
Some bruising and swelling around the eye and cheek can be expected for several days after surgery. External splints and internal Doyle splints will remain inside the nose for exactly 7 days. Some small amount of drainage is expected for 24 to 48 hours after surgery, and, therefore, elevating the head with one or two pillows during sleep is helpful. Previously, rhinoplasty surgeons used internal nasal packing, which was very uncomfortable to remove and prevented breathing while it was in place. We use the breathe-through internal Doyle splints and do not pack the nose because we feel that it is not necessary. Although the Doyle internal nasal splints are designed to keep the nasal passages open, breathing is often difficult during the first 7 days after surgery.
We use a cooled Swiss Therapy Gel Mask to minimize swelling after surgery. Patients can take showers or baths after surgery, but they should avoid having the water hit the nose directly during the first 7 days, as extreme humidity and water can loosen the external splint.
Restrictions on flying for out-of-town patients is ideally 48 hours after the rhinoplasty. We recommend special medications to help with the discomfort of flying after rhinoplasty, including nasal stuffiness or ears plugging.
Most patients can return to regular activities after approximately 7 days. We prefer for no glasses to be placed on the bridge of the nose for 5 weeks after surgery, but contact lenses can be worn immediately after the rhinoplasty. Strenuous exercise should avoided for up to 3 weeks after the procedure.
5.Can Rhinoplasty Have Bad Results?
Absolutely. Correction of incorrectly done rhinoplasty or nasal deformity following any surgery can’t be done until the swelling is subsided, which can take up to a year or longer. For this reason, it is essential that you do your research and that rhinoplasties, especially secondary or tertiary rhinoplasties, be performed by expert surgeons.
Men and women with realistic goals for rhinoplasty are generally very happy with the new shape of their nose following rhinoplasty. The exact results depend on the nasal bones, other facial features, thickness, and quality of nasal skin. While you will look and feel fine within a week or two, you may have minimal swelling for as long as a year after the rhinoplasty procedure. Although the final results can’t be assessed up to one year following the surgery, you will likely be very happy with the results after the splints are removed 7 days after the procedure.
6.What Are The Possible Risks of Rhinoplasty?
Complications arising from a rhinoplasty are highly unlikely and usually minor. Infections are rare. Nose bleeds rarely happen after surgery, but, when present, they usually subside without the need for intervention. In general, rhinoplasty is considered a very safe surgical procedure
7.Will Insurance Cover Rhinoplasty?
Insurance covers corrective rhinoplasty procedures that improve function or that are required as a result of trauma or previous injury. Septoplasty is usually covered if done to improve breathing or decrease migraines.
8.What Is Revision Rhinoplasty?
Revision, secondary, or tertiary rhinoplasty corrects deformities caused by a previous rhinoplasty. Many factors can cause negative results from a primary rhinoplasty, such as faulty scarring, an inexperienced surgeon, an inadvertent trauma after the surgery, or a spring back memory in the cartilage, which will result in nasal deviation.
Revision rhinoplasty is a far more difficult procedure to perform than primary rhinoplasty because of scarring and less available cartilage. The difficulty and complexity of these procedures, particularly tertiary rhinoplasty (ie, a patient’s third or more procedure), require an expert-level approach. Therefore, it is advisable that an experienced and highly skilled rhinoplasty surgeon performs any of these surgeries.
We will evaluate every case individually and offer expertise in both secondary and tertiary rhinoplasty.
9.What are the Common Reasons for a Revision Rhinoplasty?
Common reasons for a revision rhinoplasty include:
- Minor cosmetic imperfection
- Nasal deviation
- Nostril asymmetry
- Septal tears
- Septal holes
- Breathing difficulties
- Bulbous tip
- Bulky tip
- Boxy tip
- Hanging columella
- Nostril notching
- Saddle nose
- V-shape deformity of the nose
10.What are Considerations of a Revision Rhinoplasty Procedure?
In cases of revision rhinoplasty, if any additional cartilage is needed to sculpt or build the nose back up and if not enough septum is available due to previous use, we will use ear or rib cartilage with no consequences to the donor site. These incisions are designed masterfully to avoid any significant visible scar. In the case of ear cartilage, virtually no deformity is left when we borrow the cartilage.
Artificial cartilage is also an alternative that has been promising over the past few years.
Injection with bioabsorbable fillers, such as Restylane, is also a novel concept that we have been using to correct minor deformities in patients who do not wish to undergo revision surgery.
11.How Much Does Rhinoplasty Cost?
The average cost of rhinoplasty has three components: the surgery fee, the anesthesia fee, and the operating room fee. The surgery fee can range from $3000 to $6000, depending on the level of difficulty and complexity of the procedure. The Anesthesia and operating room fee varies between our 3 locations of Dallas , Frisco and Dubai .
During your consultation, Dr. Amirlak’s staff will discuss the total cost of your procedure with you.
Dr. Amirlak accepts all forms of payment, including cash, check, and credit card. If you require a payment plan or financing, a member of Dr. Amirlak’s staff will be happy to discuss options with you to accommodate your financial needs. We can refer patients to several different companies for financing.
If you are seeking a corrective rhinoplasty or septoplasty for a breathing issue, your procedure may be covered by insurance. A member of our staff who specializes in such cases will be happy to help you file your insurance claim and ensure that you are getting the greatest benefit.
Any remaining question?
Please visit our contact us page and get in touch with us with any remaining question you may have...