Nasal Surgery (Rhinoplasty)
Top New York plastic surgeon Dr. Darrick Antell is board certified in plastic surgery, emphasizing aesthetic cosmetic surgery. One of the cosmetic surgery procedures he performs is nose or nasal surgery, also known as rhinoplasty.
Rhinoplasty can change the size, shape, or contour of your nose, or change the angle between your nose and your upper lip and other facial features. It may also help relieve breathing problems. If you are considering rhinoplasty, this will give you a basic understanding of the procedure.
Considering Nasal Plastic Surgery
Rhinoplasty, or surgery to reshape the nose, is one of the most commonly performed plastic surgeries. Rhinoplasty can reduce or increase the size of your nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip. It may also correct a birth defect or injury, or help relieve some breathing problems.
Considering rhinoplasty? This information will give you an understanding of the procedure: When it can help, how it's performed, and what results you can expect. It may not answer all of your questions as much depends on the individual patient and the concerns or conditions they present with. Dr. Antell can provide condition-specific advice and expectations for individual patients in a private consultation.
The best candidates for Nasal Plastic Surgery
Rhinoplasty can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal. Before you decide to have surgery, consider your expectations and discuss them with your surgeon.
The best candidates for rhinoplasty are patients looking for improvement, but not necessarily perfection, in the way they look. If you're physically healthy, psychologically stable, and realistic in your expectations, you are likely a good candidate for rhinoplasty. Rhinoplasty can be performed to meet aesthetic goals or for reconstructive purposes; to correct birth defects or breathing problems.
Age may also be a consideration. Many surgeons prefer not to operate on teens until after they've completed their growth spurt, at around 14 or 15 for girls and a bit later for boys. Facial and nasal development should be mostly complete. It's important to consider teenagers' social and emotional adjustment, too, and to make sure it's what they, not their parents, want.
What Are The Risks?
When rhinoplasty is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including infection, nosebleed, or a reaction to the anesthesia. You can reduce your risks by closely following your surgeon's instructions both before and after surgery.
After surgery, small burst blood vessels may appear as tiny red spots on the skin's surface; these are usually minor but may be long-lasting. As for scarring, when rhinoplasty is performed from inside the nose, there is no visible scarring at all, and when an "open" technique is used, or when the procedure calls for the narrowing of flared nostrils, the small scars at the base of the nose are usually not visible.
Planning your Nasal Surgery
Good communication between you and your surgeon is essential. In your initial consultation, Dr. Antell will ask what you'd like your nose to look like (photos are great), evaluate the structure of your nose and face, and discuss the possibilities with you. He or she will also explain the factors that can influence the procedure and the results. These factors include the structure of your nasal bones and cartilage, the shape of your face, the thickness of your skin, your age, and your expectations.
Your surgeon will also explain the techniques and anesthesia he or she will use, the type of facility where the surgery will be performed, the risks and costs involved, and any options you may have. Most insurance policies don't cover purely cosmetic surgery; however, if the procedure is performed for reconstructive purposes, to correct a breathing problem or a marked deformity, the procedure may be covered.
Be sure to tell your surgeon if you've had any previous nose surgery or an injury to your nose, even if it was many years ago. You should also inform your surgeon if you have any allergies or breathing difficulties, if you're taking any medications, vitamins, or recreational drugs, and if you smoke. Don't hesitate to ask your doctor any questions you may have, especially those regarding your expectations and concerns about the results.
Closed vs. Open Rhinoplasty
Preparing for your Nasal Surgery
Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications, and washing your face. Carefully following these instructions will help your surgery go more smoothly. While you're making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.
Where your Nasal Surgery will be performed
Rhinoplasty may be performed in a surgeon's office-based facility, an outpatient surgery center, or a hospital. It's usually done on an outpatient basis, for cost containment and convenience. Complex procedures may require a short inpatient stay. Dr. Antell performs the majority of his cosmetic surgeries in his accredited, state-of-the-art surgical facility in New York.
Types of anesthesia for Nasal Plastic Surgery
Rhinoplasty can be performed under local or general anesthesia, depending on the extent of the procedure and on what you and your surgeon prefer. With local anesthesia, you'll usually be lightly sedated, and your nose and the surrounding area will be numbed; you'll be awake during the surgery, but relaxed and insensitive to pain. With general anesthesia, you'll sleep through the operation.
How to get started?
Dr. Darrick E. Antell and his staff will be happy to discuss Nasal Surgery (Rhinoplasty) with you. Please call for a private consultation or schedule an appointment online at our office.
The Nasal Plastic Surgery
Rhinoplasty usually takes an hour or two, though complicated procedures may take longer. During surgery, the skin of the nose is separated from its supporting framework of bone and cartilage, which is then sculpted to the desired shape. The nature of the sculpting will depend on your problem and your surgeon's preferred technique. Finally, the skin is re-draped over the new framework.
Many plastic surgeons perform rhinoplasty from within the nose, making their incisions inside the nostrils. Others prefer an "open" procedure, especially in more complicated cases; making a small incision across the columella, the vertical strip of tissue separating the nostrils. When the surgery is complete, a splint will be applied to help your nose maintain its new shape. Nasal packs or soft plastic splints also may be placed in your nostrils to stabilize the septum, the dividing wall between the air passages.
After your Nasal Surgery
After surgery, particularly during the first 24 hours, your face will feel puffy, your nose will ache and you may have a dull headache. You can mitigate discomfort with pain medication prescribed by your surgeon. Plan on staying in bed with your head elevated for the first day.
You'll notice that the swelling and bruising around your eyes will increase at first, reaching a peak after 2 - 3 days. Applying cold compresses will reduce this swelling and make you feel a bit better. In any case, you'll feel a lot better than you look. Most of the swelling and bruising should disappear within two weeks or so. (Some subtle swelling-unnoticeable to anyone but you and your surgeon-will remain for several months.)
A little bleeding is common during the first few days following surgery, and you may continue to feel some stuffiness for several weeks. You should not blow your nose for a week or so, while the tissues heal. If you have nasal packing, it will be removed after a few days and you'll feel still more comfortable. By the end of one or occasionally two weeks, all dressings, splints, and stitches should be removed.
Getting back to normal after Nasal Surgery
Most rhinoplasty patients are up and about within 2 days, and able to return to school or sedentary work within 7 - 10 days of surgery. It will be several weeks, however, before you're entirely up to speed.
Your surgeon will give you more specific guidelines for gradually resuming your normal activities. They're likely to include these suggestions: Avoid strenuous activity (jogging, swimming, bending, sexual relations, any activity that increases your blood pressure) for two to three weeks. Avoid hitting or rubbing your nose and excessive sun exposure for eight weeks. Be gentle when washing your face and hair or using cosmetics.
You can wear contact lenses as soon as you feel like it, but glasses should be avoided. Once the splint is off, glasses would have to be taped to your forehead or propped on your cheeks for another six to seven weeks, until your nose is completely healed.
Your surgeon will schedule frequent follow-up visits in the months after surgery, to check on the progress of your healing. If you have any unusual symptoms between visits, or any questions about what you can and can't do, don't hesitate to contact our office.
Your new look after Nasal Surgery
In the days following surgery, when your face is bruised and swollen, it's easy to forget that you will be looking better. Rest assured that this stage will pass.
Day by day, your nose will begin to look better and your spirits will improve. Within 1 - 2 weeks, you'll no longer look as if you've just had surgery. Still, healing is a slow and gradual process. Some subtle swelling may be present for months, especially in the tip. The final results of rhinoplasty may not be apparent for a year or more.
