Rhinoplasty, or nasal reshaping surgery, is one of the most common plastic surgery procedures. Rhinoplasty allows the nose to be reshaped, by decreasing or increasing the size of the nose, changing the width of the nose, altering the profile and bridge, refining the shape of the tip, narrowing the span of the nostrils, or changing the angle between the nose and the upper lip. In some cases, rhinoplasty can correct a breathing problem. In every case, the goal is to sculpt a nose which is in harmony with the rest of the face.
The shape of the nose and the thickness of the nasal skin vary greatly from one patient to the next, and are affected by both age and race. Some patients, including Asians and African-Americans, may require implants to increase the dorsal height of the nose, whereas others, including South Asians, require reduction of their nasal bones. Surgery on teenagers is generally deferred until at least age 16 in girls and age 18 in boys in order to ensure that their facial growth is complete. The risks and benefits of surgery will be discussed with you, and Dr. Naidu’s assistant will provide you with scheduling and financial information.
Once you have decided to proceed with surgery, you will be scheduled for a second consultation. Prior to this visit, we will send you to have medical photographs taken, in order to allow you to review these with Dr. Naidu. These photographs are an important part of your medical record and are essential in planning your surgery. They will never be shown to another patient without your written permission. At the visit, Dr. Naidu will detail her plan for reshaping your nose, to ensure that this meets your expectations and desires from surgery. The goal is always to provide a natural result that is in balance with the rest of your face.
Procedure: Rhinoplasty is performed through incisions inside the nose, and occasionally also through a small incision across the columella (the vertical strip of tissue separating the nostrils). In cases in which only a bump on the nasal bridge needs to be addressed, Dr. Naidu typically uses a closed approach, using incisions on the inside of the nose only. For those patients on whom additional work is required on the tip of the nose, she uses an open approach with the additional incision across the columella. The nasal skin is then separated from the underlying framework of bone and cartilage, which is sculpted to the desired shape. In some cases a graft of bone or cartilage may be used to provide support to the framework. The patient’s individual anatomy and desires from surgery determine the specific techniques that are used in this process. After the framework has been established, the skin is redraped and sutures are placed. Dissolvable sutures are used in the nose, and very small removable sutures are placed on the outside if needed. Rhinoplasty surgery takes two hours to perform, and is done under general anesthesia in the hospital or an outpatient surgical center. Patients are able to return home that day.
Recovery: Following surgery, a splint will be placed on the nose both for protection and to help it maintain its new shape. The splint is removed five days after surgery. Internal sutures dissolve on their own, while any external sutures will be removed at the same time as the splint. Many patients have swelling and bruising around their eyes, which can be reduced with the use of cold compresses for 48 hours after surgery. The nose will be moderately swollen and stuffy for several weeks, and the remainder of the swelling will gradually resolve over the course of the next 6-12 months. Patients with thicker skin will typically have more swelling for a longer period of time. In addition, patients may note that swelling resolves on one part of the nose, such as the dorsum, before it resolves on another area, such as the tip. For this reason, the final result of the procedure may not be seen until one year or longer after surgery. Most patients may return to work one week after surgery. Strenuous activity should be avoided for three weeks. Contact sports should be avoided for three months after surgery to prevent trauma to the nose.