Considering a Nose Job? Everything You Need to Know about Rhinoplasty

Often referred to as a “nose job,” rhinoplasty is a plastic surgery procedure that quite literally means, “change the nose.” It may be done to reshape and improve the appearance of the nose and, in some cases, improve nasal breathing. There are times when enhanced appearance and improved nasal function will both be goals of the procedure.

Because the nose is such central facial feature, it is important to choose a surgeon with expertise in this type of surgery as well as a keen sense of facial artistry – someone who understands the aesthetics of facial proportions. “Regardless of the primary reason for the procedure, the goal of rhinoplasty is always to achieve a result that is as balanced and natural-looking as possible, while preserving or enhancing nasal function,” says UH facial plastic surgeon and board-certified otolaryngologist, Cyrus Rabbani, MD

What are the different types of rhinoplasty?

• Cosmetic Rhinoplasty
  An elective procedure which changes the structure and appearance of the nose for purely cosmetic reasons. It may be done to make the nasal tip more refined, narrow the bridge of the nose, remove bony humps, or reshape the nose or nostrils.
• Cosmetic and Functional Rhinoplasty
  When performing a functional nasal surgery to improve breathing, many patients inquire about the ability to change the aesthetic of the nose at the same time. It is best to perform the cosmetic rhinoplasty in conjunction with any other functional nasal procedures such as a septoplasty. This is generally best performed by an ear, nose, and throat surgeon with a specialization in facial plastic surgery.
• Reconstructive Rhinoplasty
  A medically indicated procedure to repair or restore a nose that has been damaged due to accident, injury or as a result of cancer treatments such as surgical resection of the nose. It may also be recommended to improve breathing in people with a deviated septum – a condition in which the cartilage that separates the nostrils is misshapen or misaligned, causing partial nasal airway obstruction.
• Revision Rhinoplasty
  After rhinoplasty, a follow-up revision procedure may be done to further refine or alter the results of the initial surgery. Many revisions such as small bumps are minor and can be done under local anesthesia. Others may be more complex and require cartilage grafting and restructuring of the nose. Patients are advised to wait until they are fully healed and the swelling has completely resolved after their original surgery before considering a revision procedure.

How is rhinoplasty done?

There is no standard way to perform rhinoplasty. There are many different surgical techniques that a qualified surgeon may employ to achieve the desired outcome and every procedure is designed to meet each patient’s needs and expectations, while also taking into account their unique nasal structure.

The two main surgical approaches to rhinoplasty are:

• Closed. A procedure in which all incisions are made inside the nose where they are carefully hidden and result in no visible external scars.
• Open. The surgery is performed by making a small incision across the columella – the skin and tissue at the bottom of the nose between the nostrils. The skin that covers the nasal bones and cartilage is then raised, giving the surgeon access to the internal structures of the nose. After the procedure, the skin is placed back into position and the incision is stitched closed. The small incision typically heals very well with minimal scarring.

How long does rhinoplasty take?

The length of time it takes to perform rhinoplasty will vary depending on the complexity of the procedure, the surgical approach (open or closed) and the techniques required for an optimal outcome. In general, however, patients can expect the operation itself to take two to three hours. Complex cases and some revision rhinoplasty procedures may take longer.

Where is rhinoplasty done?

Rhinoplasty operations are almost always performed on an outpatient basis at an ambulatory surgery center or a hospital. Most patients will be able to go home on the same day as the procedure after a period of observation to ensure they are fully recovered from the anesthesia. All patients will be required to have someone there to drive them home after the surgery and, ideally, stay with them for the first night.

What will I experience at home after rhinoplasty?

After you are discharged to home (usually the same day as the procedure), you will be advised to refrain from any strenuous activities and exercise for at least two weeks to allow the nasal bones to heal and become more stable. Intense contact sports should be avoided for at least six weeks. Patients should plan to take at least one week off work, even if that work is not physically demanding. Additional symptoms you may experience include:

• Although pain and nausea are usually minimal, you may experience some tenderness and/or achiness in the first several days after surgery. Your doctor will provide you with pain medication to help manage any discomfort although most patients find they don’t need it for very long.
• There may be some nasal drainage and/or stuffiness for the first several days – this is normal and to be expected.
• Some bruising and swelling is to be expected but will usually resolve within a week to ten days. Ice compresses may be applied in the first few days to keep this to a minimum.
• You may have tape or a plastic splint on the outside of your nose. If a deviated septum was repaired, there may also be internal splints. These usually remain in place for one week.

Your doctor will provide additional instructions related to caring for the surgical site, how to avoid infection and when to schedule a follow-up visit.

When will my nose look normal again?

The initial swelling will typically subside within a few weeks. However, some swelling may persist for many months after surgery – it may come and go and will often be more pronounced in the morning. Even when the swelling is no longer visible, the nasal contours will continue to undergo subtle refinements for up to 12 months, at which time the final surgical outcome can be evaluated.

How do I prepare for rhinoplasty?

Your surgeon will provide you with detailed preparation instructions to follow in the days leading up to the surgery.

How long does rhinoplasty last?

A rhinoplasty permanently changes the structure of your nose and the results will typically last a lifetime. Normal aging may cause some gradual changes in the appearance of your nose but most of the improvements seen after rhinoplasty will be relatively permanent.

Does insurance cover rhinoplasty?

Most insurance companies will cover rhinoplasty when it is performed for functional reasons such as after severe trauma or external deformity causing nasal obstruction. Purely cosmetic rhinoplasty will typically be considered an elective procedure and not be covered. However, health insurance policies can vary greatly and patients are always advised to check with their insurance provider before any surgical procedure. Our team will help provide the appropriate coordination with insurance prior to the procedure if appropriate.

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University Hospitals has a team of highly trained surgeons with the expertise and experience to perform a wide range of facial plastic procedures, including rhinoplasty.