Nose Reshaping Surgery
If you are located in the greater Houston area and are currently interested in undergoing a Rhinoplasty (Nose Job Surgery), the board-certified plastic surgeons at Memorial Plastic Surgery are here to help!
The nose is one of the most prominent features people notice when they look at someone’s face. For people unhappy or are currently experiencing problems with their noses, Rhinoplasty is a procedure that offers a safe, effective, and time-tested solution.
Types of Rhinoplasty
There are several types of Rhinoplasty that depend on the needs of the patient.
An Open Rhinoplasty creates an incision at the skin at the columella (the skin that separates the nostrils) and lifts it from the tip of the nose. This provides the surgeon with a vivid picture of the whole anatomy of the nose, thereby allowing him to accurately reshape the nose.
Dr. Hsu and Dr. Roehl offer this approach to patients who desire major changes in the nose or for patients undergoing post-traumatic surgery.
Closed Rhinoplasty is the most preferred procedure because it exposes the skin to minimal scarring. Incisions are made inside the nose where the skin is lifted to expose the cartilage and bone, which allows surgeons to remove, reshape, augment or rearrange the tissues to achieve the patient’s desired shape.
This method is usually performed for minor corrective procedures of the nose.
This is a term that describes the differences in nasal features in Non-Caucasian ethnicities such as African-American, Asian, and Hispanic, among others. Ethnic Rhinoplasty is more complex due to the natural intricacies that must be maintained by the surgeon in order to maintain symmetry. The goal of Ethnic Rhinoplasty is bring out natural features and maintain its natural integrity.
Rhinoplasty to Correct Breathing Difficulties
This form of Rhinoplasty widens the nasal passages and corrects the natural deformities in structure that cause breathing difficulties.
In most cases, the procedure is done inside the nasal passages without changing the appearance of the nose. There are methods that fix nasal deformities that include straightening a deviated septum (nasal septoplasty), reducing an enlarged turbinate (turbinate reduction), and nasal polyp removal.
In rare cases, this procedure commands the surgical treatment of the nose’s external structure. This repairs the collapsed nasal valve where the external passages are straightened and enlarged to free the air passages in between the nostrils and throat.
Rhinoplasty to Correct Genetic Defects
Fixes deformities acquired from birth such as a crooked nose and a deviated septum.
These procedures make no difference in correcting breathing problems since both address the same set of problems.
Secondary / Revision Rhinoplasty
Revision Rhinoplasty is similar to the initial procedure. People who undergo this procedure are often dissatisfied or wish to reverse complications from a previous surgery.
Secondary Rhinoplasty versus Primary Rhinoplasty
The most common distinction of a Secondary Rhinoplasty from a Primary Rhinoplasty involves the use of cartilage or bone grafting.
Secondary Rhinoplasty often requires the replacement of the bone or tissue removed from the initial surgery. The replacements usually come from cartilage in the ear or in other areas of the nose. In rare instances, cartilage from the rib can be used (Costal Cartilage Graft).
When performed with an altered septum or a blocked nasal passage, this procedure becomes more complex than the initial surgery.
The Rhinoplasty Procedure
Preparing for Rhinoplasty
In the weeks prior to surgery, our surgeons will advise you to eat fruits, vegetables, whole grains, and lean proteins to aid in the healing process. Supplements such as Vitamins A and C, and bromelain are also recommended to minimize the risk.
If you are currently taking medication, particularly aspirin, ibuprofen and blood thinners, our surgeons will advise you to temporarily take alternatives. If not avoided, it might lead to problems before and after the surgery.
On the night before the procedure, you will be advised to take a good night’s rest and not eat or drink anything after midnight.
The Rhinoplasty Consultation
During the pre-surgery consultation, there will be a discussion about the preparations and what you will feel during your recovery phase, along with a brief on your expected results. This allows patients to pose realistic expectations about the procedure.
In addition, you must provide a detailed medical history and your current health will be evaluated to avoid complications during and after the surgery. This is vital to cultivate trust between you and your surgeon to ensure your surgery is a success.
It is an out-patient procedure, but occasionally, our clinic will recommend a short hospital stay. Depending on the needs of the patient, the procedure can last two to four hours.
General Anesthesia is usually used for this procedure to keep the patient unconscious, but local anesthesia with IV sedation is also possible.
The choice of anesthetic depends on the patient’s preference and the surgeon’s recommendation. However, patients tend to be less anxious when asleep.
The incisions are created either inside the nostrils or on the columella. Once cut, the skin is gently lifted from the nose to gain a wider prespective of its anatomy.
Our surgeons typically utilize a conservative method in removing or grafting the tissues to limit the impact of the surgery, thus achieving the desired shape.
Once the procedure is done, the skin is laid back to its new contour and the area is closed with incision.
We advise our patients to have sufficient rest and keep their heads elevated within the first 48 hours after the surgery. In addition, patients should keep the following in mind:
- Wear button down shirts instead of T-shirts or V-necks
- Apply cold compress on the eyes and cheeks every day
- Maintain a light diet and consume food with nutrients and fiber
- Minimize the consumption of sodium to avoid the swelling
- Take baths while the bandages are present rather than showers
- Avoid stress on the nasal passage; e.g. sneezing through the mouth instead of nose.
- Avoid wearing glasses or sunglasses
- Regularly change the bandages
During your post-operative consultation, often a week after the procedure, the cast will be removed. You will observe an improvement despite swelling.
Two weeks after the surgery, avoid strenuous activities to protect the soft tissues of the nose. You can return to work and resume other activities.
Our surgeons will continue to monitor your progress on a monthly basis.
Rhinoplasty Risks and Complications
Like any surgery, nose surgery can have risks and complications:
- Scarring at the base of the nose
- Ruptured small blood vessels on the skin’s surface
- Nerve damage
- Over or under correction of the nose that may demand a Secondary Rhinoplasty
If symptoms persist, consult your surgeon immediately.
Scars often minimal and it will be barely visible to most.
A Closed Rhinoplasty involves making incisions inside the nose, making the scar invisible. Open Rhinoplasty while done using external cuts, only leaves a barely visible scar.
You will begin to notice results in the weeks following surgery. While bruising and swelling occurs, the nose will eventually settle perfectly into its final shape.
The results normally take a year to develop, which is why surgeons often discourage patients from undergoing Revision Rhinoplasty in the year following the surgery.
A Rhinoplasty costs $7,500 to $10,000. Several factors affect the cost of the surgery which should be discussed in the initial consultation, including the financial options. These factors include:
- Experience of the surgeon
- Anesthesia used
- Post-operation consultations
Rhinoplasty and Insurance Issues
Most insurance companies only cover procedures performed to resolve breathing problems, and not procedures for cosmetic purposes.
A clinic’s administrative staff can help in determining the patient’s qualifications for insurance, and sometimes assists in filing the paperwork.
Since most Rhinoplasty procedures are not covered by insurance, in-house financing options are offered. Memorial Plastic Surgery offers patients a low or fixed interest repayment plan, if their credits are approved. Some also offer discounts if they have made full payments before the treatment.
Others consider third party financing since some debtors offer fixed interest plans. No-interest plans are available if paid within a specific timeframe.
The most common reason people have a nose job is to improve the appearance of the nose. It improves facial symmetry, shape, size, and frees the area from bumps and crookedness. Likewise, it also resolves birth defects and breathing problems.
Most importantly, the changes from Rhinoplasty can boost a person’s self-esteem and quality of life.
Non-surgical Rhinoplasty Alternatives
The safest non-surgical alternative for Rhinoplasty is Hyaluronic acid fillers (e.g. Juvéderm and Voluma) with results that usually last for a year and a half. It is worth noting that fillers are not a permanent alternative for surgery, since it only smoothens and improves external appearance of the nose.
This is usually for patients who wish to have bigger noses.
Are You a Candidate for Rhinoplasty?
Candidates for Rhinoplasty must be in good health and have realistic expectations about the results of the surgery. In particular, it is best for people who:
- Are unhappy with the look of their nose
- Have a nose that is too large for their face
- Have a bump on the nose bridge
- Have a large protruding nasal tip
- Have pinched or flared nostrils
- Have a crooked nose
- Have an asymmetrical nose due to injury
- Have difficulties in breathing due to a deviated septum
How to Choose a Rhinoplasty Surgeon
It is best that patients take the time to find a plastic surgeon who:
- Is a certified surgeon with the American Board of Plastic Surgeon
- Is comfortable to talk to and listens to the concerns of his patient
- Has facilities that are approved by American Association for Accreditation of Ambulatory Surgery Centers
- Has experience and specializes in facial procedures and nose reshaping
- Has hospital privilege in at least one local medical center in case of emergency
- Has a good reputation for success
Popular celebrities who had Rhinoplasty
Rhinoplasty is one of the most popular plastic surgery procedures in United States, with 200,000 performed in 2013 alone.
In addition, celebrities have also opted to undergo the procedure. As a guide, Memorial Plastic Surgery has created a video of popular celebrities (including Scarlett Johansson) who have had their noses reshaped.