Rhinoplasty

Rhinoplasty, or surgery to reshape the nose, is one of the most commonly performed plastic surgery procedures. Rhinoplasty can be done for aesthetic purposes to restore natural appearing symmetry and balance between the nose and the rest of the face, or for functional problems such as difficulty breathing.

Noses that are disproportionately large for the face or that have a bump on the bridge that can be seen in profile can often be corrected through rhinoplasty surgery. Widened or crooked noses, and those that are asymmetrical due to trauma, can also be corrected. Surgery can also correct soft tissue problems at the tip and nostrils. Nasal tips that droop or are enlarged can be adjusted, and flared nostrils can be narrowed. Sometimes these procedures are done in conjunction with surgery on the chin to reduce or enhance its prominence and help restore facial balance.

Rhinoplasty may be done in a hospital, an ambulatory facility, or an office-based surgical suite. The location depends on several factors, including the patient’s medical condition and the extent of surgery being done. During surgery, the skin of the nose is elevated from the underlying supporting framework of bone and cartilage. The framework is revised, and the skin is then redraped. The incisions can be made inside the nostrils in what is called a “closed technique,” or extended across the columella, the vertical strip of tissue separating the nostrils, in an “open technique.” At the end of the surgery a splint is usually applied to the outside of the nose, and inner nasal packs or soft splints are sometimes used. Most patients go home within a few hours of surgery, but some require an overnight stay.

Head elevation and restricted activities are required during the first few postoperative days in order to minimize swelling and bleeding. Bruising and swelling around the eyes and cheeks are common. The coloration improves over the first week or two, and the noticeable swelling continues to decrease over several weeks time. Minor swelling can persist for several months. Packing and sutures are removed during the first week. Many people can return to work after a week to ten days, but full activity is usually avoided for a few weeks. Normal use of glasses may need to be avoided as the swelling decreases.

Many people undergo successful and satisfying rhinoplasty surgery every year. As with any other surgery, however, the patient needs to be informed of the risks involved. Risks of rhinoplasty include bleeding, infections, reactions to anesthesia, numbness of the skin, difficulty breathing, unsatisfactory contour, and need for revision surgery. Medical conditions and treatments, smoking, use of aspirin or other anticoagulants, nasal injuries and surgeries, difficulty breathing, allergies, and chronic use of nasal sprays are important to discuss during the consultation to minimize the risks of such problems.

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