Rhinoplasty

Rhinoplasty Surgery of the Nose

Rhinoplasty, or surgery to reshape the nose, may be performed to improve appearance, to correct birth defects, or to relieve some breathing difficulties. During rhinoplasty the nose may be made larger or smaller, or the shape of the bridge or the tip of the nose may be altered. The angle between the nose and lip may be changed, as may the width of the nostrils.

Who May Consider Rhinoplasty?

People may wish to have rhinoplasty, or a nose job, either to improve their appearance, resolve breathing problems, or both.

Rhinoplasty for improving breathing problems
In some cases, nasal obstruction may be corrected by surgically widening the nasal passages, straightening the septum, or otherwise reshaping the bones or cartilage of the nose. Rhinoplasty for improving appearance

Many people consider the nose the defining feature of the face. If you are unhappy with the appearance of your nose (due to aging, trauma, or just its natural size or shape from birth), rhinoplasty can help by bringing the nose into better balance with your other facial features. Individuals who are unhappy with the cosmetic result of previous operations also come for corrections and refinement.

Revision Rhinoplasty
The experts in the division of Facial Plastic and Reconstructive Surgery at Columbia Presbyterian perform a large number of operations on individuals who have previously undergone rhinoplasty. In a majority of these individuals, prior surgery has been too aggressive, leaving the patients with an "operated look." Breathing is commonly problematic and needs to be corrected in these patients. Less commonly, the purpose of revision rhinoplasty is further reduction and narrowing of the nasal appearance.

Surgery does not create a perfect or ideal nose or face, but by bringing the features into better balance the overall appearance may be greatly enhanced. When considering rhinoplasty, some patients plan a simultaneous chin augmentation to further enhance this balance.

Patients must be at least 15 or 16 years of age, having reached full growth, except in cases in which breathing is severely disabled. Anyone undergoing rhinoplasty should be in good general health. Age, skin type, and expectations about surgery must all be considered.

How is Rhinoplasty Performed?

Patients may receive local or general anesthesia, depending on the nature of the procedure and individual preference. Patients under local anesthesia remain awake during the procedure, but unaware of pain. Under general anesthesia, patients sleep through the operation.

In some types of rhinoplasty, the surgeon lifts the skin of the nose, and then reshapes the bone and/or cartilage. Sculpting may be achieved through several techniques, using a chisel, rasp, or other instruments . The skin is then placed back over the reshaped structure and closed with tiny absorbable stitches.

In other types of rhinoplasty, the surgeon makes an incision either inside the nostrils, or in the skin separating the nostrils. Accessing the nasal structures from within permits some procedures to be performed without any visible scarring.

Procedures generally take an hour or two, but may take longer if they are complicated.

What to Expect After Rhinoplasty

After surgery, a small splint will be applied to help the nose heal in its new shape, and additional packs or soft splints may be inserted into the nostrils to hold the septum (the wall dividing the nasal passages). The splint may be needed for a week or so, but the packing is usually removed the day after surgery.

Patients usually experience discomforts including:
Puffiness of the face
Pain
Bruising and minor swelling in the eye area
Dull headache
Some bleeding
Stuffiness in nose

After rhinoplasty, most patients are up in about two days and able to return to work or school in about a week. Strenuous activity (anything that increases blood pressure), risk of injury, and sun exposure should be avoided, however, for two to three weeks.

Wearing contact lenses after surgery is no problem, but glasses may not rest on the bridge of the nose. Instead, they may be taped to the forehead or propped on the cheeks until the nose is fully healed, approximately two to four weeks.

Healing continues for some time. While most of the swelling ends in four to six weeks, some residual swelling (especially in the tip of the nose) can persist six months or longer, causing nasal stuffiness or, rarely, temporary diminished sense of smell. Most physicians agree that the final appearance manifests after a year or more.

About our Physicians

All surgeons in this division are certified otolaryngologists who have done additional fellowship training in facial plastic and reconstructive surgery, and are board certified by the American Academy of Facial Plastic and Reconstructive Surgery. Having limited the scope of their practice solely to the face, they offer the highest level of knowledge and experience available anywhere.