Yara Zakharia, Esq.
Since making its debut in the late 1800's, rhinoplasty or nose surgery has come a long way. Performed on more than 300,000 Americans each year, this nose-reshaping procedure which boasts a proven safety record and serves reconstructive and cosmetic objectives is today the most requested cosmetic surgery in the U.S.
Alternatively referred to as a nose job, rhino (which stands for 'nose' in Latin) and plasty (which translates into sculpting or shaping in Greek) helps patients improve the appearance and function of their nose. Some of the most prevalent complaints of men and women about their nose are as follows:
- Bent nose
- Bumpy nose
- Flat nose
- Fractured or deformed nose
- Large nose
- Long nose
- Narrow nose
- Short nose
- Twisted nose
- Upturned nose
- Wide nose
The extent of the surgical work involved and the patient's goals generally dictate whether the rhinoplastic transformation will be subtle or dramatic in nature. Impeccable nose jobs go undetected, at least by lay person's eyes, trigger positive emotional changes, and boost patients' self-esteem and confidence. Some of the ways that rhinoplasty can alter the appearance of a clients nose are as follows:
- Reduction or enlargement of the nose
- Shortening of the nose
- Change in shape or size of the nostrils
- Alteration of the shape of the bridge or tip of the nose
- Alteration of the angle between the upper lip and the nose
- Correction of an irregularly-shaped nose due to birth defect or injury
- Correction of a nasal imperfection such as a deviated septum or nasal hump
Common Reasons for Nose Reshaping
The following are some of the most commonly-instituted nasal changes:
- Narrowing of the nose by eliminating tissue from the base and bringing the nostrils closer together
- Alleviate breathing difficulties
- Abridging the upper nose
- Elevating the tip of the nose by adding cartilage to support it
- Changing the angle between the lip and nose by truncating the septum
- Fixing a hump on the nasal bridge by trimming the bone and eliminating cartilage
- Diminution of wide nostrils by removing skin tissue from the base of each nostril.
Is Rhinoplasty Right For Me?
In rhinoplasty, plastic surgeons aim at highlighting attractive features of the patient's nose while dissimulating its negative aspects. The over-arching goal is to ensure that the re-created nose blends naturally and aesthetically with the patient's face and avoids any hint of surgery. Optimal candidates for nose jobs are those in good physical shape and with a sound emotional state and realistic expectations. Additionally, revision rhinoplasty is available to patients who are unhappy with their previous procedure.
Generally, rhinoplasty is an outpatient procedure that is performed in an office, surgical facility, or hospital. Whether a local or general anesthetic is utilized is the decision of both patient and surgeon. At the initial consultation, the physician conducts a thorough evaluation of the patient (i.e. structure of face and nose) and asks him or her about his medical history. Risk factors are assessed, and pre-existing conditions are taken into account.
The surgeon informs the client of the various surgical possibilities and offers a pragmatic picture of the likely end results. The patient is also furnished pre-operative instructions and information on the type of anesthesia to be utilized, the surgical technique to be applied, the surgical center where the operation will take place, as well as fees and costs. Many surgeons also offer their clients the opportunity to view before and after photos of former patients.
Nose plastic surgery may be performed via either an open or closed technique. In both methods, the surgeon makes an incision in the interior of the nostrils. In an open rhinoplasty, the incision is external, the skin is peeled back, and the cartilage and tissue are exposed. The plastic surgeon makes a small incision in the area separating the nostrils. Open rhinoplasty offers surgeons greater visibility of the internal portions of the nose. However, bruising and swelling tend to heal slower than with a closed rhinoplasty, in which the only incisions made are those inside the nose. Furthermore, there are no resulting scars.
After making the incision, the surgeon loosens the skin from the bone and cartilage supporting it and molds the latter to conform to the desired shape. In an open rhinoplasty, the surgeon then re-drapes the skin and seals the incisions. Upon completion of the surgery, a metallic or gauze splint is applied to the external portion of the patient's nose and remains attached for a period of 5-7 days.
Nose Surgery Side Effects and Recovery
The average nose job takes 1-2 hours and results in only minor side effects such as facial puffiness and stuffiness, mild headache, swelling, bruising, minor bleeding, which are controlled via pain medication prescribed by the surgeon and which subside within two weeks after the operation. The majority of patients are back on their feet within two days and can return to work within two weeks following the nose surgery. Final results are visible in a period ranging from 4 months to a year or when the nose has completely healed.
On average, the cost of rhinoplasty in the U.S. runs anywhere from $3,000 to $8,000 depending on numerous factors such as amount of work necessitated, region of the country, and location of the surgery. Insurance providers only cover the cost for a nose job when it is intended for medical purposes (i.e. a deviated septum, breathing difficulties).
Because of the delicate and intricate nature of rhinoplasty and the defining characteristic of the nose in a person's face, it is paramount that prospective patients choose a skilled, board-certified, and experienced facial plastic surgeon that they trust and with whom they feel comfortable.
[page updated December 2008]