Maybe you have a bump, a wide nose, a bulbous tip, or a crooked nose that has made you feel self-conscious all your life. Or perhaps you have had an injury that now impacts your breathing, despite being healed for some time. Whatever the nose-related issue, rhinoplasty helps hundreds of thousands of patients every year regain confidence in their appearance through the re-sculpting of nasal cartilage and bone.
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Rhinoplasty is a surgical procedure that changes the size and shape of your nose. Commonly called a nose job, it is not the same procedure as a septoplasty, which is the surgical correction of a deviated septum. However, both procedures can be performed at the same time and under the same anesthetic.
There are two types of rhinoplasty, open and closed. The difference is in where the surgical incisions are made. Both of these techniques are highly effective, and the decision to use one or the other depends upon the shape of the patient’s nose and the desired results. In general, a closed rhinoplasty is slightly less invasive because all of the incisions are made inside the nose, and it does not require an incision on the columella, the underside of the nose. But even with an open rhinoplasty, the incision is usually barely noticeable after it has healed.
The vast majority of our rhinoplasty patients are dissatisfied with the way their nose looks and are looking to change its appearance. We also see several patients each year who have structural abnormalities or previous injuries, resulting in breathing difficulties that can be corrected through a rhinoplasty. Unfortunately, some have had rhinoplasty in the past and are unhappy with either the appearance or function of their new nose; we are also happy to provide a consultation for these patients. In addition to the reasons above, you are likely a great rhinoplasty candidate if you have any of the following:
Rhinoplasty is also routinely and safely performed on teenagers. Young people often realize at a young age that they do not like the way their nose looks and would like to have it reshaped. To ensure a successful procedure and results, female candidates must be a minimum of 14 years of age, and males should be at least 16-17 years of age.
A closed rhinoplasty is our preferred method, as it does not leave any external scarring. Dr. Rice makes all of the incisions for a closed procedure on the inside of the nose. These internal entry points still allow access to the areas of the nose that need refinement and can be highly effective at addressing a majority of cosmetic concerns. We also love this method because we prefer not to leave any visible scars, no matter how small, whenever we are able. Our guiding philosophy is to help you achieve your goals in the least invasive way possible. With that said, because the closed technique is less invasive, there can be slightly less access to the nose, which means some issues are better corrected with an open rhinoplasty procedure.
Open rhinoplasty is used for procedures that require more exposure for the necessary corrections or procedures that are more extensive. The open rhinoplasty method allows full access to the entire nasal structure. This access is acquired by making an incision between the nostrils (across the columella), allowing direct visualization of both sides of the nose, enabling us to re-shape the structure by altering the nasal cartilage. This will leave a small scar that will be virtually unnoticeable after it heals.
Regardless of the method, tissues will be modified and/or grafted, cartilage will be altered, and your desired results will be achieved. Once the maneuvers are made to accomplish the desired result, the incisions are closed with dissolving sutures inside and fine silk sutures at the columella. Last, a thermoplastic splint is placed over the nose to protect and support its new shape.
A rhinoplasty usually requires 3-4 weeks of recovery. During the first three days of recovery, you may experience bruising around the eyes, swelling, discomfort, and minor bleeding. We will prescribe medication to help with any pain. Additionally, during the first few days of recovery, we recommend sleeping with your head elevated on several pillows and utilizing cold packs around the nose to help reduce swelling. It is important to be cautious and protective of the nose as it heals.
When it comes to exercise, patients may resume light walking 1-2 days after surgery. We actually encourage walking shortly after surgery as it can help with the recovery from anesthesia and improve circulation in the lower legs, which can prevent blood clot formation. We recommend not lifting anything heavier than ten pounds for at least one week after surgery. When it comes to weight lifting, strenuous sports, and sports that involve balls that may hit the nose, we advise our patients to wait six weeks before returning to these activities so that the nasal bones can fully heal.
Most of our patients return to non-physical work within 10-14 days after their surgeries. Additional post-rhinoplasty recommendations include:
You can expect your rhinoplasty results to be both dramatic and permanent. It may, however, take some time for your full results to be revealed. You will notice a change immediately, but it may take your nose a full year to heal and settle into its new shape due to the effects of swelling and bruising. Because it can take time for your final results to appear, we encourage patients to wait patiently for healing to take hold. We are confident that once your swelling subsides and your nose is completely healed, you will absolutely love your new look!
Rhinoplasty offers dramatic results on its own, but it can also be combined with other procedures such as septoplasty (correction of a deviated septum), chin or cheek augmentation, facelift, browlift, or eyelift.
What is the difference between rhinoplasty and a liquid nose job? One is surgical, and the other is not! A liquid nose job is performed using injectable hyaluronic acid (HA) dermal filler such as Juvéderm Voluma or Restylane to smooth and shape the nose. This kind of correction has its limitations, first and foremost in that it is temporary in nature. Filler is naturally absorbed by the body in 6-18 months, depending on the patient, so this is a great way to try out a new profile if you’re unsure about a more permanent change. Liquid nose jobs are great for smoothing out a bump or adding volume or symmetry to one’s nasal tip, and they come with no downtime. But filler can’t make your nose smaller. So if you’re looking to reduce the shape of your nose or correct functional issues, a rhinoplasty is the way to go.
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Dr. Rice received his medical degree from Loma Linda University in Southern California where he also completed an internship in general surgery and specialty surgical training in Otolaryngology—head and neck surgery. Dr. Rice went on to complete advanced training in Facial Plastic and Reconstructive Surgery at the Institute of Facial Plastic Surgery. He is double board-certified…
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