Description

Rhinoplasty is also called nose reshaping. It can be combined with other surgical procedures such as chin augmentation to enhance the aesthetic results.

Hollywood plastic surgeons agree that more than 2000 facial beautification operations have been performed among film players within the past few years. Among the most prominent rhinoplasties in show business were the siblings Michael, Janet and La Toya Jackson s. They received a dramatic reduction of nose size and change of shape. Marilyn Monroe had work carried out on her nose before her first film roles at the advice of her mentor Johnny Hyde. Jennifer Grey is another movie star whose looks transformed completely after a nose job.

Ethnic rhinoplasty

East Asian patients often want their noses to appear narrower. This can be done through the use of infractures, where the nasal bones are broken and moved in or reset to thin out the nasal area and add projection in the process. East Asian patients typically seek augmentation (adding material) of the bridge of their nose which will make the nose appear narrower as well. In Asia, patients typically use a variety of alloplastic implants including Gore-Tex, Med-Por or silicone. Due to the risks of alloplastic materials, natural materials to the bridge of the nose, such as rib cartilage (costal cartilage) or ear cartilage (auricular cartilage) are being used more commonly.

African patients commonly seek narrowing of wide nostrils. This procedure include removing sections of the base of the nostrils or sections of the nose where it meets the face. The tip of the nose can be restructured by removing tiny sections of cartilage to give the nose more shape or even adding cartilage to provide additional structure to the nasal tip.

Procedure

Nose plastic surgery can be performed under a general anesthetic or with local anesthetic. Incisions are made inside the nostrils (closed rhinoplasty). Sometimes, a tiny, inconspicuous incision is also made across the bit of skin that separates the nostrils (columella)(open rhinoplasty). The surgeon first separates soft tissues of the nose from the underlying structures, then reshapes the cartilage and bone. This is not a particularily painful procedure.

In some cases, the surgeon may shape a small piece of the patient s own cartilage or bone to strengthen or change the structure of the nose. Usually the cartilage is harvested from the septum although if there isn t enough which can often occur in revision rhinoplasty, cartilage can be taken from the concha of the ear or rarely the ribs. In the rare case, again usually revision rhinoplasty, where bone is required, it is harvested from the cranium or ribs. Sometimes a synthetic implant may be used to reconstruct the nose.

The surgical procedure for rhinoplasty takes 1.5 to 2 hours.

Recovery

Most people remain at home for a week. Strong pain medication and cool compresses are typically required during recovery. If there are external sutures, they are removed 4 to 5 days after surgery. For the first week after rhinoplasty surgery, a splint is worn on the outside of the nose. If there are internal stents, they are usually removed after 1 to 2 weeks. Severe nasal congestion typically lasts about 7 to 10 days. Bruising around the eyes and the majority of swelling typically resolves in about 2 weeks. Most of the swelling subsides in the first 2 months. For 6 to 7 weeks, eyeglasses must be secured in a manner that prevents them from resting on the nose. Due to wound healing, there are minor and subtle shifting and settling of the nose so that the final results can take up to a year to appear.

Complications

Rhinoplasty is usually safe and successful.

Poor cosmetic outcomes occur from 5% to 20% of rhinoplasties. Surgery can result in over- or under-correction. It can take a year for the final results to be visible. In the meantime, the look of your nose may not be desirable and the end result can be hard to predict.

A polly beak deformity is a nose of which the overlying nasal skin has a little shape look. It happens if too much of the underlying structure of the nose (cartilage and/or bone) is removed.

A saddle nose deformity is a nose of which the bridge sunk. It happens if the septum is not supported.

A miss piggy deformity is a nose of which the tip has been over rotated causing the nostrils to be too visible.

A pinched deformity is a nose of which the cartilages of the tip of the nose are over resected.

A crooked appearance caused by cartilage collapse several years after surgery.

The problem is that the results are always permanent.

Secondary rhinoplasty may be necessary to correct an unsatisfactory outcome. Secondary rhinoplasty is an extremely complicated procedure. This is self-evident because it is clear that even when the patient was operated upon for the first time, even when the tissues were "virginal" and untouched the desired result could not be obtained.

Disruption of the normal functioning of the nose:

Difficulty to breathe may be caused by adhesions which are scars that form to bridge across the nasalcavity from the septum to the turbinates. They are rare but cause nasal obstruction to breathing and usually need to be cut away.

Numbness of the nose happens if an incision is made across the collumella (open approach rhinoplasty). It may take months to resolve.

A septal perforation is a hole inadvertently made at the time of surgery in the septum. This can cause chronic nose bleeding, crusting, difficult breathing and whistling with breathing.

Other:

Post operative bleeding is uncommon and often resolves without needing treatment.

Infection is rare and can occassionally progress to an abscess that requires surgical drainage under general anesthetic.

Persistent swelling

Cost

In 2006, Ontario Canada the cost for cosmetic rhinoplasty varied between CA$ 1 000 to CA$ 10 000.
In the United States, rhinoplasty surgery cost from US$ 5 000 - US$ 15 000.

You will also have prescriptions for antibiotics and pain medications, which will cost extra.

Where to buy

Rhinoplasty is performed by either an otolaryngologist, maxillofacial surgeon or a plastic surgeon


This page has been updated on the 2017-12-18.