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Nose Surgery (Rhinoplasty)

What is rhinoplasty surgery?

Rhinoplasty or nose surgery, sometimes referred to as "nose reshaping" or a "nose job," improves the appearance and proportion of your nose, enhancing facial harmony and self confidence. Surgery of the nose may also correct impaired breathing caused by structural abnormalities in the nose.

Enhancing your appearance with nose plastic surgery

While the shape of your nose is usually the result of heredity, the appearance may have been altered in an injury or during prior surgery.

What can surgery of the nose accomplish?

Rhinoplasty surgery can change:

  • Nose size, in relation to the other facial structures
  • Nose width, at the bridge
  • Nose profile, with visible humps or depressions on the bridge
  • Nasal tip, that is large or bulbous, drooping, or too upturned
  • Nostrils that are large, wide or upturned
  • Nasal asymmetry and deviation

Is it right for me?

Nose cosmetic surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else's desires or to try to fit any sort of ideal image.

A rhinoplasty procedure is a good option for you if:

  • Your facial growth is complete and you are 13 years of age or older
  • You are physically healthy
  • You do not smoke
  • You have specific, but realistic goals in mind for the improvement of your appearance

What to expect during your nose surgery consultation

The success and safety of your nose surgery depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle before rhinoplasty surgery.

Be prepared to discuss:

  • Why you want the surgery, your expectations and desired outcome
  • Medical conditions, drug allergies and previous medical treatments
  • Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
  • Previous surgeries

Dr. Barnthouse may also:

  • Evaluate your general health status and any pre-existing health conditions or risk factors
  • Examine and measure your face
  • Take photographs for your medical record
  • Discuss your options and recommend a course of reshaping your nose
  • Discuss likely outcomes of a nose surgery and any risks or potential complications
  • Discuss the type of anesthesia that will be used

Preparing for nose surgery

Before nose surgery, you may be asked to:

  • Get lab testing or a medical evaluation
  • Take certain medications or adjust your current medications
  • Stop smoking well in advance of surgery
  • Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:

  • What to do on the night before and the morning of surgery
  • The use of anesthesia during your nose surgery
  • Post-operative care and follow-up

Dr. Barnthouse will also discuss where your procedure will be performed. Surgery of the nose may be performed in an accredited office-based surgical center, outpatient or ambulatory surgical center, or a hospital.

You’ll need help

If your nose surgery is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Rhinoplasty risks and safety information

The decision to have nose surgery is extremely personal and you’ll have to decide if the benefits will fulfill your goals and if the risks and potential rhinoplasty complications are acceptable.

Dr. Barnthouse will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

The risks of rhinoplasty include:

  • Rupture of small surface vessels of the nose
  • Infection
  • Poor wound healing
  • Anesthesia risks
  • Bleeding (hematoma)
  • Nose asymmetry
  • Cardiac and pulmonary complications can occur in longer surgical procedures and may be associated with the formation of, or increase in, blood clots in the venous system
  • Change in skin sensation (numbness)
  • Nasal airway alterations may occur after a rhinoplasty or septoplasty that may interfere with normal passage of air through the nose
  • Nasal septal perforation (a hole in the nasal septum) may develop but is rare; additional surgical treatment may be necessary to repair the nasal septum but in some cases, it may be impossible to correct this complication
  • Pain, which may persist
  • Unfavorable rhinoplasty scarring
  • Skin contour irregularities
  • Skin discoloration and post rhinoplasty swelling
  • Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
  • Possibility of revisional surgery

Be sure to ask questions:

It’s very important to ask Dr. Barnthouse questions about your nose procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with Dr. Barnthouse.

When you go home

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another minor surgery may be necessary to reach the intended aesthetic goal.

Be careful

Following Dr. Barnthouse’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during your recovery from rhinoplasty. Dr. Barnthouse will give you specific instructions on how to care for yourself.

Rhinoplasty surgery steps

Step 1 – Anesthesia

Medications are administered for your comfort during rhinoplasty surgery. The choices include intravenous sedation or general anesthesia. Dr. Barnthouse will recommend the best choice for you.

Step 2 – The incision

Surgery of the nose is performed either using a closed procedure, where incisions are hidden inside the nose, or an open procedure, where an incision is made across the columella, the narrow strip of tissue that separates the nostrils.

Through these incisions, the soft tissues that cover the nose are gently raised, allowing access to reshape the structure of the nose.

Step 3 – Reshaping the nose structure

Surgery of the nose can reduce or augment nasal structures with the use of cartilage grafted from other areas of your body.

Most commonly, pieces of cartilage from the septum, the partition in the middle of the nose, is used for this purpose.

Occasionally a piece of cartilage from the ear and rarely a section of rib cartilage can be used.

Step 4 – Correcting a deviated septum

If the septum is deviated, it is now straightened and the projections inside the nose are reduced to improve breathing.

Step 5 – Closing the incision

Once the underlying structure of the nose is sculpted to the desired shape, nasal skin and tissue is redraped and incisions are closed. Additional incisions may be placed in the natural creases of the nostrils to alter their size.

Step 6 – See the results

Splints and internal tubes will likely support the nose as it begins to heal for approximately one week.

While initial swelling subsides within a few weeks, it may take up to a year for your new nasal contour to fully refine.

During this time you may notice gradual changes in the appearance of your nose as it refines to a more permanent outcome. Swelling may come and go and worsen in the morning during the first year following your nose surgery.

A nose surgery procedure to improve an obstructed airway requires careful evaluation of the nasal structure as it relates to airflow and breathing. Correction of a deviated septum, one of the most common causes of breathing impairment, is achieved by adjusting the nasal structure to produce better alignment.

My nose surgery recovery

You will be given specific instructions to follow during your recovery from rhinoplasty: How to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with Dr. Barnthouse.

Be sure to ask Dr. Barnthouse specific questions about what you can expect during your individual recovery period.

  • Where will I be taken after my surgery is complete?
  • What medication will I be given or prescribed after surgery?
  • Will I have dressings/bandages after surgery?
    When will they be removed?
  • Are stitches removed? When?
  • When can I resume normal activity and exercise?
  • When do I return for follow-up care?
  • How long will swelling after rhinoplasty surgery persist?

Nose surgery results will be long-lasting

It may take several months for swelling to fully dissipate and up to a year - and sometimes longer - for the outcome of the surgery to fully refine after rhinoplasty surgery.

Although the results of nose surgery are usually permanent, cartilage may continue to reshape and move tissue that may change the outcome over time.