Nose Surgery (Rhinoplasty)

About the Procedure

Nose surgery (medically referred to as Rhinoplasty) is a process by which the shape and dimension of the nose is altered by a variety of techniques that can be enacted on the bone and cartilage tissue inside the nose. The specifics of the procedure are tailored closely to the goals of the patient.

One of the most common reasons for cosmetic rhinoplasty is the presence of a large “hump” down the front of the nose. In such a case, the surgeon would make several incisions in order to lift the soft tissue off of the support structure of bone and cartilage. The “hump” is made up of both bone and cartilage. The surgeon would use a bone chisel and a scalpel to remove excess bone and cartilage respectively. Once the desired shape has been achieved, the surgeon would then use files (also called rasps) to smooth out and more finely shape the remaining structure. Finally, the soft tissue is replaced and the incisions sutured shut. Commonly, an external cast is fitted to the patients nose, to support it's new shape while the incisions heal.

In other cases, the patient may wish to change the shape of their nose, which requires not only the subtraction of bone and cartilage, but the addition of such tissue to certain areas of the nose. If the patient wishes to add to the bridge of the nose, a synthetic implant is sometimes employed. More commonly however, bone and cartilage are taken from a part of the patient's body that has excess, and is then grafted to the desired are of the nose. Typically, the hip and cranium are good donor sites for bone, while the outer ear is a common donor site for cartilage tissue. Additionally, the rib cage is a popular donor site as both bone and cartilage can be harvested from it.

What to Know Before the Procedure

Like most forms of cosmetic surgery, it is up to the patient to decide exactly what their goals are. The more radical one wishes the results to be, the more complex the surgery becomes so it is important to have a clear and realistic idea of what you would like to accomplish and to have an experienced plastic or otolaryngologic surgeon who understands and shares those ideas.

Age can be an important factor in the surgery. If the patient is too young and their nose has not yet fully developed it is unsafe to have a rhinoplasty performed. If the nose continues to change and develop after the procedure, there can be major complications, including chronic bleeding from the nose or a collapse of the nasal passage. Generally, the male nose is fully developed at the age of 18 and the female nose at the age of 16. All young patients should consult their doctor about whether or not it is safe for them to undergo a rhinoplasty.

What to Know After the Procedure

You may notice swelling and darkening of the soft tissue around the nose and eyes after the operation. This is completely normal and should not be taken as cause for alarm. Infection is fairly uncommon, but most doctors will prescribe anti-biotics just as a preventative measure.

Within a week of the surgery it becomes safe to remove the external splint and stitches. Around the two week mark, the bruises and swelling subside. It is suggested that strenuous activity be avoided as much as possible for 3-5 weeks after as well.

This form of plastic surgery requires a great deal of precision and finesse. If after the new nose has settled, it does not meet the goals you set, or has resulted in undesired side effects, it is not unheard of to undergo a secondary procedure to alter or fix the issue. Be sure to report any abnormalities to your doctor and discuss options for remedying them.

If you Need to Travel Outside of your Local Hospital

Since a rhinoplasty procedure is typically done just once, with permanent results, this surgery is a prime candidate for medical travel, both domestically and abroad. More important than the location is picking a highly experienced surgeon. Be sure to research several surgeons before making a decision. Ask to be provided with before and after photographs of previous patients, and if you have any concerns over travel and post-operative care, be sure to discuss them.