Rhinoplasty

Rhinoplasty, also known as a nose job, is one of the most common types of surgery performed on the nose. Although it is usually done for cosmetic reasons, rhinoplasty can have medical reasons, such as breathing impairment, as well. A cosmetic nose job surgery aims to reshape the nose to have a more symmetric, proportionate appearance. While a medical rhinoplasty improves a certain function of the nose. There are also cases in which the surgeon has to focus on both of these aspects.

The Reasons to Get a Nose Job 

• It can make the nose larger or smaller
• Remove obstructions that cause breathing problems
• Change the shape of the tip of the nose

• Adjust the size or position of the nostrils
• Reshape the nose after it has been injured
• Fix any humps or depression on the nose

For younger ages who plan to have a rhinoplasty for cosmetic purposes, they should wait until the nose has grown fully. This happens around the age of 15-16 in girls and 17-18 in boys. Of course, if the surgery has urgent medical reasons, this procedure can be performed at lower ages.

Risks and Side Effects of Nose Job Surgery

All surgeries generally involve risks of bleeding, infection, and anesthesia complications. In addition to these, rhinoplasty may expose the patient to risks such as:  

• Pain.
• Discoloration.
• Swelling and bruising: these are very common and usually subside after roughly 3 weeks.  
• Changes in the patient’s skin sensation that may cause pain or numbness.
• The shape of the nose could become asymmetrical.
• Breathing problems.
• Nerve damage.
• Nasal septum perforation: a condition in which the nasal septum is punctured.

Due to all these risks, additional surgeries may be required to fix the complications. Some complications may even be permanent; nasal septum perforation, for example, is permanent in some cases.

Your surgeon will provide you with a complete list of all the possible risks and complications and will only proceed with the surgery if you consent. Ask any questions that you have in this stage to make sure you are well-informed about the procedure.

Candidates for Rhinoplasty

One thing variable that every patient should have in mind is the reason of the procedure. If the patient wants a nose job surgery only to improve the appearance, it would be best to wait until he/she has fully grown. This happens around the age of 15-16 in girls and 17-18 in boys. However, patients with urgent cases including young patients with craniofacial abnormalities or breathing issues may receive the surgery at younger ages.

Moreover, here is a simple list of the characteristics of a good candidate:

• Preferably an adult who has fully grown. Teenagers whose bodies have fully grown can also qualify but will still need their parents’ consent.
• The patient should have realistic expectations.
• Being in good health.  
• A good candidate is not a smoker.

Patients with bleeding disorders (hemophilia, for instance) may not be good candidates due to higher risks of complications.

Cost and Insurance

The average cost of rhinoplasty is $5,500. This price is not the total sum as there are other factors that add up to the total cost:

• Anesthesia costs: this depends on the type of anesthesia that is used. General anesthesia is stronger than IV sedation and, therefore, costs more.
• The location of the nose job surgery is another factor. Hospitals are typically more expensive than an office-based facility. Moreover, areas with higher living costs will naturally be more expensive.
• The complexity of the procedure. For example, having a septoplasty (a nose surgery performed to correct nasal septum deviation in order to improve breathing) at the same time as a cosmetic nose surgery will cost more.
• There may be a need for a revision rhinoplasty, and this also raises the costs.

As for insurance, insurance companies may cover the costs in case the surgery corrects a functional defect. If you receive a cosmetic nose job that involves a septoplasty, the insurance company will cover the segment of the costs related to your septoplasty.

Preparing for Rhinoplasty

First, you will have a meeting with your doctor where you discuss everything related to the surgery. This involves:

• Your medical history, current medical conditions, and whether you are on any medication. If you are taking blood thinners such as aspirin, they will likely recommend you to stop taking these medications for a while.
• Your goals and expectations of the surgery. Be clear and straightforward about what you want to achieve.
• The risks of a rhinoplasty.
• Questions that you have regarding the surgery. It is advised that you make a list questions before the consultation.

Afterward, you will undergo a physical examination. Your surgeon examines the inner and outer skin of your nose, along with the cartilage to determine the changes your rhinoplasty requires. Your surgeon may ask for a blood test or other lab tests as well. Moreover, photographs of your nose will be taken. This helps the doctor better determine the expected results of the surgery. By using computer imaging, your surgeon can show you what to expect from the surgery.

After the examination, your doctor also discusses whether you need any other facial surgeries that enhance the results of your nose job surgery. For example, some patients are recommended to get a chin surgery that adjusts the size of the chin to make it more proportionate with the nose. This is not necessary, but it can sometimes contribute to nose job surgery.

Recovery after Rhinoplasty

After your nose job surgery, rest with your head in an elevated position on a couple of pillows. You will probably be discharged after you have been monitored for a few hours. Nevertheless, in some cases, it may take 1-2 days before the patient can leave the hospital. Be sure to have a friend or family member drive you home. You may experience memory lapses, impaired judgment, and slow reaction for a few days after a rhinoplasty.

Nasal splints may be placed inside and outside of your nose to keep it in shape and provide support during the healing process. These usually remain in place for a week. Your nose may feel congested because of the swelling and the splint. In addition, do not expose your nose to the sun for too long as it can discolor the skin of your nose permanently. Sunscreen is a good way to protect the nose from sunlight. Your eyelids may also be affected by a nose job. They may appear discolored or swollen for about 14 days. A drip pad is placed under the nose to collect blood and mucus from the nose. Your surgeon will teach you how to change it.

It takes six months for the swelling to subside. The nose usually fully heals after a year. The results will be permanent, but remember that the nose is continuously changing throughout one’s lifetime.  

Dos and Don’ts of the Recovery Process

• Avoid work or college for a week.
• Vigorous activities such as running, lifting, and swimming should be avoided for a 30-45 days.
• Making facial expressions may inflict pain. So avoid making facial expressions that involve a lot of movement.
• Refrain from putting any pressure on the nose, such as resting sunglasses on it.
• Breathing particles of dust will irritate the nose, so avoid places with too much dust.
• Do not blow your nose.
• Sneeze through your mouth not to pressure the nose.
• Turning your head too much may cause pain in your nose.
• Brush your teeth gently.
• Do not place ice packs on the nose after surgery.
• Try to eat foods rich in fiber. This will prevent constipation and, therefore, pressure on the nose.

FAQ

• How long should I wait before a revision rhinoplasty?
  • It would be best to wait at least a year before receiving your revision. The nose should have healed completely before a second surgery.

• What questions should I ask during my consultation?
  • Is the surgeon certified?
  • Have they specialized in the field of plastic surgery?
  • Will the rhinoplasty be performed in an accredited facility?
  • Am I a good candidate?
  • Where is the operation performed?
  • What do I need to do to get the intended results?
  • How long will the recovery take?
  • What medications should I get after the surgery?
  • How often should I visit for follow-up consultations?
  • What will my nose look like after the procedure? Can I do anything if I’m unhappy with the results?

• What is the difference between rhinoplasty and septoplasty?
  • A rhinoplasty is generally a surgery in which the surgeon reshapes the nose. Whereas a septoplasty is a type of nose surgery performed to correct nasal septum deviation in order to improve breathing. A rhinoplasty and septoplastycan be conducted at the same time.

• What kind of surgeons do the most nose job surgeries?
  • Otolaryngologists and plastic surgeons perform the highest number of nose job surgeries.