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Rhinoplasty

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Cosmetic nose surgery, known as rhinoplasty or a “nose job,” is among the most common plastic surgery procedures performed, because the nose is such an integral facial feature. If you’re unhappy with your nose and think it’s too large, flat, pointed, down- or upturned, crooked, has an unflattering bump, or simply out of harmony with the rest of your facial features, you’re not alone. People who seek rhinoplasty often think that their nose detracts from their whole face. Fortunately, rhinoplasty can change the shape of your nose by altering the tip, bridge, nostrils, or change the angle of your nose. Rhinoplasty also can relieve some breathing problems you may have.

In determining the plan for your surgery, the surgeon will consider a number of factors, such as the prominence of your cheeks, jawline, facial dimensions, and skin thickness and quality. If breathing is also a concern, your surgeon will conduct an exam to advise you how this can be improved through surgery. Your breathing problems can be fixed in the same surgery.

Am I a good candidate for rhinoplasty?

If you are displeased with the appearance of your nose, whether it is disproportionate, or misshapen from an injury or congenital defect, you may consider undergoing rhinoplasty. If you were born with a nose that makes you feel unhappy and self-conscious about your appearance, you may wish that your nose could be reshaped to better balance your face. Even slight alterations to your nose can have a significant effect on your overall appearance.

People who are good candidates think carefully about what rhinoplasty can accomplish for them and will go in with the mindset that surgery can improve how they look, but not perfect it. Patients who are determined to be physically healthy, psychologically stable and have reasonable expectations are considered the best candidates. Age is another factor, and many surgeons will not operate on teenagers..

Before deciding to go through with rhinoplasty, there are important considerations you should make. Even though rhinoplasty is one of the most commonly performed plastic surgeries, the technique does not consistently deliver excellent results every time, because it is a highly complex procedure. In fact, revision rhinoplasty (a second rhinoplasty) is even more involved, so it is imperative to choose a competent surgeon with an excellent track record to get it right the first time. Your surgeon will have careful, extensive discussions with you to plan your surgery to achieve the changes you want.

Sometimes patients who consider rhinoplasty may anticipate that their overall appearance will still not be to their satisfaction after recovery, which may lead the plastic surgeon to recommend other facial procedures, as well. For instance, a common procedure that patients may choose to have at the same time as rhinoplasty is a chin augmentation, which can balance out the facial proportions better.

Before Rhinoplasty

During your initial consultation, you will be educated on the procedure and leave comfortable with the knowledge of the surgery and your expected results. Feel free to ask any questions that arise no matter how simple or complex. One of the most common concerns for rhinoplasty is avoiding the “nose job” look. This can mean a number of things, whether the nostrils are visible, the nasal tip is turned upwards or the nose is too small for the face.

The Rhinoplasty Procedure

Rhinoplasty surgery usually takes about 1.5 to 2.5 hours to perform and you will be under general anesthesia during the procedure. Most of the incisions will be on the inside of the nostrils, but some small incisions may be on the outside of your nose along the natural creases along the sides and near the base of the nose. These external incisions heal quickly and leave nearly invisible scar. During the surgery, the skin of the nose will be separating from its supporting bone and cartilage framework, and then sculpted to its desire shape, depending on your problem and the surgeon’s preferred technique.

Depending on the look you want, you many undergo an “open” or “closed” procedure. In more complicated cases, the surgeon will do an open procedure where the skin of the nose is separated from its framework, so the tip of the nose can be reconstructed. Less involved cases, such as when the patient only want the bridge reconstructed, can usually be done in a closed procedure.

Once your nose is sculpted and the surgery is complete, sutures will be applied and you will be given a splint that is applied over the nose to help maintain its new shape and protect it. You may be given nasal packing inside the nostrils to stabilize the septum, the dividing wall between your nostrils.

After Rhinoplasty

Once you wake up from anesthesia, you will find yourself in the recovery room. Your face will feel stiff and you will probably have to breathe through your mouth. Your face will feel puffy and your nose will probably ache significantly. Expect to have swelling and bruising around the eyes which will peak after about two or three days. You can apply cold compresses to reduce the swelling and pain. Most of the swelling and pain disappears within two or so weeks, and some subtle swelling may persist for several months which might not even be noticeable to you.

Pain will be controlled with prescribed medication. When you go home, plan on staying in bed and keeping your head propped up. You may experience some bleeding, which is a common side effect. You will also continue to feel congested for several weeks, and your surgeon will probably ask you not to blow your nose as the tissues heal.

In your follow up visits, the splint will be removed, dressings will be removed, and sutures will be taken out. During this time, you’ll feel much more comfortable. This will also be the first time your new look will be revealed to you. Your face will still be bruised and swollen, and you may feel depressed at first, but rest assured this will pass. Day by day, your nose will look much better and your spirits will improve. After about two weeks, you’ll notice a drastic difference and you won’t look like you just had surgery. Remember that healing is a slow process which cannot be rushed. The final results of your surgery, once swelling goes down, may not be apparent for up to a year, so you must be patient.

Risks of Rhinoplasty

Any major surgery has inherent risks, which include bleeding, infection or an adverse reaction to anesthetic. Serious risks resulting from rhinoplasty are rare, and the chance of serious complications can be minimized by following the instructions of your plastic surgeon both before and after surgery in order to heal properly and have the best possible results. The best way to minimize the chance of incurring complications is by choosing a highly-qualified, board-certified plastic surgeon.

Specific risks associated with rhinoplasty include:

  • Recurrent nosebleeds
  • Difficulty breathing through the nose from nasal obstruction
  • Sinus infection
  • Stiffness in the upper lip
  • Loss of sensation in and around the nose, either temporary or permanent
  • Asymmetrical results
  • Pain, which may persist
  • Discoloration
  • Persistent swelling, which may not subside fully for 12 months
  • Unattractive scarring
  • Unsatisfactory results
  • The need to have follow up surgery to improve results, which is much more complicated

Other Types of Rhinoplasty

Revision rhinoplasty: this procedure is for patients who have had a previous rhinoplasty, but had unsatisfactory results. Some patients may feel that their nose is still too big for their liking, or their “new nose” has thrown the proportions of the rest of your face off and you are left feeling unhappy. Most patients who have revision rhinoplasty have a specific complaint they would like to address, which as a slightly twisted tip of the nose, or a functional problem such as difficulty breathing. The decision to undergo a second rhinoplasty should not be taken lightly, as it is much more complicated than a primary rhinoplasty, because the surgeon must have a sophisticated understanding of the nasal structure and technique. The procedure usually costs more and takes longer to perform, because certain anatomical landmarks of the nose have likely been repositioned during the primary rhinoplasty. Usually revision rhinoplasty requires grafting to build up the structure of the nose and support the airway.

Most patients have to wait at least a year after their first rhinoplasty to have a revisional surgery, since it takes about a year for all of your nasal swelling to subside. Also, the scar tissue will be much softer after a year, even if you have had several rhinoplasties in the past. Scars that are too firm are difficult to surgically manipulate and give you the adequate correction you are seeking.

Pros and Cons

Here are some of the pros and cons of rhinoplasty to consider before committing to going through with the surgery. Rhinoplasty can permanently change the appearance of your nose in a number of ways.:

PROS

  • Reshaping the nose if it is out of proportion with the rest of your face, whether that means it is too small or too large.
  • Correcting a bump on the bridge of the nose which is especially prominent when viewed in profile.
  • Narrowing a nose which is very wide when viewed straight on.
  • Reshaping a nasal tip which either droops or plunge or is too thick.
  • Correcting an off-center, crooked or asymmetrical nose.
  • Because the nose is such a prominent facial feature, surgically changing its appearance can have significantly positive impact on your self-esteem.
  • Rhinoplasty can correct a number of congenital or acquired abnormalities to the nose. Congenital abnormalities may include cleft lip/or palate or breathing problems. Acquired abnormalities include conditions such as fractures, burns, or bites, among others.
  • Rhinoplasty may be indicated for defects and deformities caused by unforeseen conditions such as skin cancer affecting the nose.

CONS

  • Although it is one of the most commonly performed cosmetic procedures, rhinoplasty is one of the most complex plastic surgeries to complete. Even the most qualified plastic surgeon has patients who are not 100% satisfied with their results, and patients should be aware that revision (secondary) rhinoplasty is much more complex and expensive than a primary rhinoplasty.
  • Some patients are initially depressed after rhinoplasty, because results may not be evident for several weeks, months or longer afterwards. Healing can take time, especially for the tip of the nose.
  • Sometimes patients are not pleased with the reactions they receive from family, friends or acquaintances. For example, family might be upset that you’ve changed a feature which they view as a family or ethnic feature.
  • Approximately one out of ten rhinoplasty patients may require a second procedure to correct minor deformities, which is an unpredictable occurrence.

You will learn all of the potential risks and complications associated with rhinoplasty during your consultations. You will be required to sign consent forms to ensure you fully understand what can potentially happen as a result of rhinoplasty. Risks include but are not limited to the following:

  • Nosebleeds
  • Infection
  • Difficulty breathing through the nose
  • Numbness
  • Asymmetrical results
  • Pain which may persist
  • Discoloration
  • Scarring
  • Unsatisfactory results

Rhinoplasty Cost

The total cost for rhinoplasty in Los Angeles, including the fees for the plastic surgeon, anesthesiologist, and facility fee, ranges from $5,500 to $10,000. Health insurance does not pay for the cost of rhinoplasty in the majority of patients, because it is an elective procedure. Exceptions to this include patients who get rhinoplasty to correct congenital deformities, such as a cleft lip, or to improve breathing with a septoplasty. Financing options are available for patients who wish to make monthly payments.

Your New Look

After your nose surgery, you can expect to have the defects you disliked changed, so your nose no longer has a flat bridge, a pointy tip, a crooked bridge, or a wide boxy tip you dislike. Any features you dislike from before surgery can potentially be corrected through rhinoplasty. Please be careful when selecting your rhinoplasty Plastic Surgeon as nose surgery is one of the most complex surgeries available and even slight changes to the nose can make a drastic change to your appearance.

A reshaped nose can completely change the appearance of your face. If you're ready to see the sexy nose you've always wanted, with minimally invasive procedures from board certified plastic surgeons, it's time to call West Medical. To learn more about rhinoplasty in Los Angeles, please contact West Medical at (855) 690-0565, and our helpful medical staff will answer any questions you may have.

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