Primary/ Revision/ Functional Rhinoplasty
Rhinoplasty, or nose surgery, is one of the most common plastic surgery procedures performed today. It can reshape, reduce or augment a person’s nose to achieve facial harmony and boost self-confidence. It may be performed as a reconstructive procedure to correct a birth defect or an injury such as a broken nose.
Rhinoplasty may be performed for functional rather than cosmetic reasons as well. Combining nose reshaping with septoplasty or endoscopic sinus surgery can effectively treat certain breathing problems, such as those caused by a deviated septum.
Goals of Rhinoplasty
Rhinoplasty is an excellent procedure for achieving the following:
- Balance the size of the nose with the other facial features
- Modify the width of the nose at the bridge
- Improve the nasal profile, including removing humps or depressions
- Contour a nasal tip that is too large, “boxy,” drooping or upturned
- Change the angle between the nose and the mouth
- Narrow and reshape the nostrils
- Correct asymmetry or deviation
Candidates for Rhinoplasty
The best candidates for rhinoplasty:
- Are at least 13 years old
- Have finished facial growth
- Are generally healthy
- Do not smoke
- Are seeking rhinoplasty for personal reasons, not pressure from others
- Have realistic goals for the procedure
Rhinoplasty is usually an outpatient procedure performed under IV sedation or general anesthesia.
Surgeons use one of two techniques when performing nose surgery. In a closed rhinoplasty, incisions are made within the nostrils. In an open rhinoplasty, the incision is made across the columella, the tissue between the nostrils. With both methods, the surgeon gently lifts the soft tissues covering the nose. He or she sculpts the bone and cartilage to the desired shape. Any additional cartilage needed to augment the nose can often be taken from the septum.
If the patient has a deviated septum, the surgeon will adjust the septum and the inner structures of the nose to improve breathing. Then the tissues are re-draped and stitched closed. If the patient desires nostril reshaping, this is done as the final stage of rhinoplasty.
The entire procedure generally lasts one to two hours.
Recovery and Results after Rhinoplasty
For a short time after surgery, patients may experience puffiness, nose ache or a dull headache, some swelling and bruising, bleeding or stuffiness. Most patients feel like themselves within two days and return to work in about a week.
The results of rhinoplasty become gradually apparent as the days pass after surgery and swelling recedes. Swelling may reappear from time to time in the first year after the procedure. It is typically more noticeable in the morning and fades during the day.
Contact lenses can be worn immediately, but glasses may need to be taped to your forehead or propped on your cheeks for up to seven weeks.
Patients with realistic goals for rhinoplasty are generally very happy with the new shape of their nose. The exact results depend on the patient’s nasal bone and cartilage structure, facial shape, skin thickness and age.
Risks of Rhinoplasty
Complications associated with rhinoplasty are rare and, when they occur, minor. These may include infection, nosebleed, or a reaction to the anesthesia.
Some people who undergo rhinoplasty are unhappy with their results and seek additional treatment to achieve the results they desire. Unsatisfactory results may occur because of a complicated condition, poor communication between patient and surgeon or because of the patient’s natural healing abilities.
In most cases, it is recommended to wait at least a year after the initial procedure before undergoing revision rhinoplasty, as full healing should be complete in order to achieve a successful revision procedure. This also allows patients to evaluate the full results of their rhinoplasty procedure before making the decision to undergo additional surgery.
Revision rhinoplasty is often more complex than a primary rhinoplasty, as there may be less cartilage available and a graft from the patient’s own body or a donor may be required in order to create the desired shape and proportion of the nose. Incisions for this procedure can usually be made in the nose to conceal any scarring.
It is important to choose a highly skilled and experienced surgeon to perform your revision procedure, and to ensure a clear understanding of your goals for surgery in order to achieve the most successful results. Dr. VanderWerf has extensive experience doing primary and revision rhinoplasty with excellent results. If you are interested in rhinoplasty surgery, schedule an appointment today to discuss your options.