Commonly referred to as a nose job, rhinoplasty is a surgery done to reshape the nose.
- To change or improve appearance
- To improve breathing
- To correct an injury or birth deformity
- To open blocked nasal passages due to a deviated septum (in conjunction with a septoplasty)
Prior to procedure. You may be asked to provide a picture of the nose shape you desire. You may also be given a book to look through to choose a nose shape.
Your plastic surgeon will likely do the following:
- Blood tests
- Urine tests
- X-rays of the facial bones
- EKG or chest x-ray may be also required
- Take “before” pictures of your nose
Leading up to your nose surgery:
- Arrange for a ride to and from the procedure
- If you are having general anesthesia, do not eat or drink anything for at least eight hours before the procedure
Talk to your cosmetic surgeon about your medicines. You may be asked to stop taking some medicines or herbal supplements up to one week before the procedure, like:
- Aspirin or other anti-inflammatory drugs
- Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
- Ginkgo biloba or others
Anesthesia. You may have general or local anesthesia. You will be asleep with general anesthesia. Local will numb the area. In this case, you may also be given a sedation medicine. It will help you relax. The type of anesthesia used will depend on your procedure.
How a Rhinoplasty is performed
There are three main components of nose surgery:
- Lifting the skin of the nose from the bone and cartilage. The nose will be injected with a numbing medication and epinephrine. The epinephrine will prevent excessive bleeding. An incision will be made either inside the nostril, or outside the nostril, across the ridge between the nostrils. The skin will then be lifted off the cartilage of the nose.
- Remodeling bone and cartilage. Depending on the desired outcome, some nasal bone may be removed, fractured and reset to a new shape. Cartilage may also be trimmed. Other techniques involve placement of tissue grafts (bone, cartilage or mucosa) from the patient or a donor, or a synthetic graft. They will be used to help remodel the shape of the nose. For example, the tip of the nose may be narrowed or raised, the slope of the nose may be reduced or increased. The shape or size of the nostrils may also be changed.
- Redraping skin over the new base. Once the procedure is finished, the incisions will be closed. The skin will be redraped over the new bone structure. The skin will be tightly taped to keep it in place. A protective metal splint will then be applied on the outside of the nose. It will help to maintain the positioning during healing. Either soft plastic splints or gauze packing coated with petroleum jelly will be used as nasal packs. They may also be inserted into the nostrils as support during healing.
How long will it take? About two to four hours.
Rhinoplasty Aftercare and recovery
How much will it hurt? Anesthesia prevents pain during the rhinoplasty surgery. There will be some pain for about one to four weeks after the nose job procedure. You will be given pain medication to relieve this pain.
Average hospital stay. You will most likely go home on the same day.
Postprocedure care. To help ensure a smooth recovery:
- For the first few days after nose surgery, rest in bed with your head elevated to reduce swelling.
- Apply ice packs to your nose during the first two days. This will help to relieve discomfort.
- Take prescription or over-the-counter pain medications as directed by your plastic surgeon.
- Do not blow your nose at all during the first week. Do not blow your nose forcefully for one month.
- Protect your nose from any injury for eight weeks. Do not wear glasses. Be careful when washing your face.
- Avoid vigorous exercise for at least three weeks. Avoid contact sports for six months.
- Be sure to follow your doctor’s instructions.
Stitches will be removed after the first week. Nasal packing will be removed after one to two days. The splint is worn for one to two weeks or more. Numbness, swelling or bruising of the surgical area and around the eyes should be expected. Expect swelling and bruising to worsen over the first several days after the rhinoplasty surgery. You can also expect some bleeding from the nose, headache and a feeling of nasal congestion. Once the swelling and bruising have diminished, expect full healing in about three to four weeks.
Possible complications. Complications are rare but no plastic surgery procedure is completely free of risk. If you are planning to have a nose job, your cosmetic surgeon will review a list of possible complications, which may include:
- Poor healing of the skin
- Unsatisfactory cosmetic result
- Increased risk of nosebleeds
- Reaction to anesthetic
- Puncture of septum or collapse of nose bridge (relatively rare)
Factors that may increase the risk of complications include:
- Age — recommended age is after teen growth spurts and before middle age
- Prior nose surgery
- Prior trauma to the nose
- Medical problems
After you leave the hospital, contact your doctor if any of the following occur:
- Signs of infection, including fever and chills
- Persistent elevated temperature
- Redness, swelling, increasing pain, excessive bleeding or discharge from the incision site
- Pain that you can’t control with the medications you’ve been given
- Cough, shortness of breath, chest pain or severe nausea or vomiting
- Any new symptoms
In case of an emergency, call 911.
Schedule A Consultation
To learn more about Rhinoplasty consultations, please call our office today to schedule an appointment.
American Academy of Facial Plastic and Reconstructive Surgery
American Society of Plastic Surgeons
Sabiston DC Jr. Textbook of Surgery. 17th ed. Philadelphia, PA: WB Saunders Co.; 2004.
Sabiston DC Jr. Textbook of Surgery. 15th ed. Philadelphia, PA: WB Saunders Co.; 1997.
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VISIT the American Society of Plastic Surgeons (ASPS) site for more information on nasal surgery. more >>