Changing the Shape of Your Nose: Choosing Rhinoplasty

I fre­quent­ly see patients inter­est­ed in chang­ing the appear­ance of their nose. They may be unhap­py with the size, shape or angle of their nose. They may have a bump or inden­ta­tion that both­ers them, or they do not like the way their nasal tip looks. It may be the nose that they were born with or the appear­ance may be the result of an injury. What­ev­er the rea­son, nasal appear­ance can ulti­mate­ly affect the way we view and feel about ourselves.

Rhino­plas­ty, com­mon­ly known as a ​“nose job,” is a sur­gi­cal pro­ce­dure per­formed to reshape the nose. It is impor­tant to seek out an expe­ri­enced, board cer­ti­fied sur­geon who will not only be focused on the aes­thet­ic result, but who will also be focused on ensur­ing that the nasal air­way is not com­pro­mised dur­ing the reshap­ing process.

As part of your con­sul­ta­tion, I use com­put­er imag­ing soft­ware that allows me to sim­u­late the poten­tial sur­gi­cal changes. It is a great way for you to see how your nasal appear­ance may be altered with surgery; it allows me to have a visu­al under­stand­ing of your desired goal for change while pro­vid­ing you with real­is­tic expec­ta­tions for change. I feel it’s of utmost impor­tance that you have clear and real­is­tic expec­ta­tions. No sur­geon can give you some­one else’s nose; he/​she can only alter your nose. My per­son­al phi­los­o­phy is to pro­vide a nat­ur­al appear­ing nose which is har­mo­nious with one’s face. Although much time is spent address­ing spe­cif­ic changes of the nose, I also take into account how oth­er facial struc­tures may affect the appear­ance of the nose, such as a short chin. The imag­ing soft­ware is very help­ful in iden­ti­fy­ing con­tribut­ing fac­tors such as this, and see­ing dif­fer­ences in chin posi­tion rel­a­tive to the reshaped nose.

Dur­ing your rhino­plas­ty surgery, I will make inci­sions to access the bones and car­ti­lage that sup­port the nose. The inci­sions are pri­mar­i­ly inside the nose where they are invis­i­ble after the surgery, although there is one small exter­nal inci­sion across the skin between the nos­trils. Depend­ing on the goal, some bone and car­ti­lage may be removed, and tis­sue may be added.

I have a back­ground in Oto­laryn­gol­o­gy and I pay par­tic­u­lar­ly close atten­tion to the nasal air­way through­out the pro­ce­dure. Once surgery is com­plet­ed, a small tri­an­gu­lar cast is taped to the bridge of the nose to sup­port the new shape for the first week, and there may be splints inside the nose.

One week after your surgery, the cast, splints and ban­dag­ing around your nose is removed. Your face and eyes may be bruised and feel puffy and the nose will be bruised and swollen for sev­er­al days. It takes approx­i­mate­ly 10 – 14 days for most of the swelling and bruis­ing to improve. Pain med­ica­tion is some­times pre­scribed dur­ing this time. I rec­om­mend­ed keep­ing your head ele­vat­ed and still for the first few days fol­low­ing surgery and your activ­i­ties may also be lim­it­ed for a few weeks. Most patients require about 1 week off from work.

A com­mon ques­tion that I receive is ​“at what age can rhino­plas­ty be per­formed?” Surgery should only be per­formed on a ful­ly grown nose. Com­plete nasal devel­op­ment has usu­al­ly occurred by age 15 or 16 in females and by age 17 or 18 in males. Com­pli­ca­tions may result if surgery is done before this time. I typ­i­cal­ly wait until females are 16 years of age and males are 18 years of age before pro­ceed­ing with this procedure.

As with any surgery, there are also some risks that your sur­geon should review with you so that you can make an informed deci­sion before you decide to pro­ceed. It is also very impor­tant that you feel com­fort­able with the sur­geon per­form­ing your pro­ce­dure. Although tem­po­rary swelling and bruis­ing around the eyes and nose is nor­mal and expect­ed after rhino­plas­ty, oth­er prob­lems may occur and are dis­cussed dur­ing your con­sul­ta­tion. Before mov­ing for­ward with surgery, I will walk you through the surgery process and you will learn about the risks and ben­e­fits of rhino­plas­ty. It is my goal to ensure that you feel com­fort­able and con­fi­dent and that we have an effec­tive patient/​physician partnership.

Mak­ing the deci­sion for rhino­plas­ty should be thought­ful and well-informed. To sched­ule a con­sul­ta­tion for rhino­plas­ty, please call our office at 630−545−7840.