Rhinoplasty

Rhinoplasty–the artful alteration of the form and function of the nose–is one of the most common plastic surgery procedures performed today.

Cosmetic reshaping of the nose can make remarkable changes to improve facial harmony, so often important to an individual’s sense of confidence and well being. Hereditary characteristics of a nose of disproportionate size or shape can be very distracting throughout adolescence into mid-life. Changes in size and shape of the nose and other facial features can be distressing even into advanced age.

The overly large or coarsely masculine nose can detract from the otherwise beautiful face of a young woman. Certain disproportions can lend a man a snide, unpleasant or even rodent-like appearance.

A sensitive analysis of the nose in the context of other facial features, ethnic characteristics, and the type and degree of change desired is critical to successful rhinoplasty.

Modern techniques strive to maintain proper nasal function while producing aesthetic changes without an “operated” appearance. The aim is to maintain structure and appropriate form through different stages of life.

Rhinoplasty is also designed to treat congenital or traumatic deformities and obstruction of the nasal airway. Functional rhinoplasty is often combined with straightening of the nasal septum (septoplasty), adjustment of the size and shape of the turbinates, and in certain cases endoscopic sinus surgery.

Goals of Rhinoplasty

• Maintain or improve nasal airway function
• 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

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 Procedure

Rhinoplasty is usually an outpatient procedure performed under IV sedation or general anesthesia.

Dr. Butler is experienced with the wide variety of rhinoplasty techniques. In endonasal (“closed”) rhinoplasty, incisions are kept within the nostril openings. In open rhinoplasty, a cosmetic extension of those incisions is made on the column between the nostrils. After healing this is rarely visible. Each approach may be ideal in a particular patient’s case.

The underlying bone and cartilage is sculpted. Often, fine sutures and one’s natural cartilage used as strengthening grafts are used. Obstructive deviation of the septum is altered and can also provide cartilage if needed for grafting.

At the conclusion, absorbable sutures are used for repair and a specialized dressing is applied.

Most rhinoplasty procedures require one to two and a half hours.

Recovery and Results after Rhinoplasty

Length of recovery and the results achieved depend on the extent of surgery, the patient’s tissue quality, skin thickness and age.

For most patients, swelling and bruising are minimal by ten to fourteen days after surgery, though the final subtle refinements may not be apparent for six to twelve months. Dull ache addressed with medication is common but problematic bleeding, infection, or healing problems are rare. Generally patients return to work or school after one week. Contact lens use can be immediate, but eyeglasses can not be rested on the nose for seven weeks. Some intermittent morning puffiness of the nose can occur during the post-operative year. Patients with realistic goals are generally very happy with the new shape of their nose.

Risks of Rhinoplasty

Significant complications associated with rhinoplasty are rare. These may include persistent pain, bleeding, infection or anesthetic reactions. In general complications are minor and handled simply in our office.