Nose Surgery

Also known as rhinoplasty, nose surgery improves the appearance and proportion of your nose, enhancing facial harmony and self confidence. Surgery of the nose may also correct impaired breathing caused by structural abnormalities in the nose.

Enhancing your appearance with nose surgery

Typical Questions and some facts about these procedures:

• Why Nose Surgery?
  
• Procedural Steps
  
• Important facts about the safety and risks of nose surgery
  
• My recovery
  
• Will the results will be long-lasting?
  
• How much will nose surgery cost?
  
• Terms you should know
  

Why Nose Surgery?

While the shape of your nose is usually the result of heredity, the appearance may have been altered in an injury or during prior surgery.

Also known as rhinoplasty, surgery of the nose improves the appearance and proportion of your nose, enhancing facial harmony and self confidence.

Surgery of the nose may also correct impaired breathing caused by structural abnormalities in the nose.

What can surgery of the nose accomplish?

Rhinoplasty can change:

• Nose size, in relation to the other facial structures
  
• Nose width, at the bridge
  
• Nose profile, with visible humps or depressions on the bridge
  
• Nasal tip, that is large or bulbous, drooping, or too upturned
  
• Nostrils that are large, wide or upturned
  
• Nasal asymmetry and deviation
  

Is it right for me?

Nose surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image. Surgery of the nose is a good option for you if:

• Your facial growth is complete and you are 13 years of age or older
  
• You are physically healthy
  
• You stop smoking
  
• You have specific, but realistic goals in mind for the improvement of your appearance
  

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Procedural Steps: What happens during nose surgery?

Step 1: Anesthesia

Medications are administered for your comfort during the surgical procedure which is done under general anesthesia.

Step 2: The incision

Surgery of the nose is performed either using a closed procedure, where incisions are hidden inside the nose, or an open procedure, where an incision is made across the columella, the narrow strip of tissue that separates the nostrils.

Through these incisions, the soft tissues that cover the nose are gently raised, allowing access to reshape the structure of the nose.

Step 3: Reshaping the nose structure

Surgery of the nose can reduce or augment nasal structures with the use of cartilage grafted from other areas of your body.

Most commonly, pieces of cartilage from the septum, the partition in the middle of the nose, is used for this purpose.

Occasionally a piece of cartilage from the ear and rarely a section of rib cartilage can be used.

Step 4: Correcting a deviated septum

Nose surgery to improve an obstructed airway requires careful evaluation of the nasal structure as it relates to airflow and breathing. Correction of a deviated septum, one of the most common causes of breathing impairment, is achieved by adjusting the nasal structure to produce better alignment.

If the septum itself is deviated, it is now straightened and the projections inside the nose are reduced to improve breathing.

Step 5: Closing the incision

Once the underlying structure of the nose is sculpted to the desired shape, nasal skin and tissue is redraped and incisions are closed. Additional incisions may be placed in the natural creases of the nostrils to alter their size.

Step 6: See the results

Splints and internal tubes will likely support the nose as it begins to heal for approximately one week.

While initial swelling subsides within a few weeks, it may take up to a year for your new nasal contour to fully refine.

During this time you may notice gradual changes in the appearance of your nose as it refines to a more permanent outcome. Swelling may come and go and worsen in the morning during the first year following your nose surgery.

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Important facts about the safety and risks of nose Surgery

The decision to have nose surgery is extremely personal and you’ll have to decide if the benefits will fulfill your goals and if the risks and potential complications are acceptable.

Dr. English will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

The risks include:

• Rupture of small surface vessels of the nose
  
• Infection
  
• Poor wound healing
  
• Anesthesia risks
  
• Bleeding (hematoma)
  
• Nose asymmetry
  
• Cardiac and pulmonary complications can occur in longer surgical procedures and may be associated with the formation of, or increase in, blood clots in the venous system
  
• Change in skin sensation (numbness)
  
• Nasal airway alterations may occur after a rhinoplasty or septoplasty that may interfere with normal passage of air through the nose
  
• Nasal septal perforation (a hole in the nasal septum) may develop but is rare; additional surgical treatment may be necessary to repair the nasal septum but in some cases, it may be impossible to correct this complication
  
• Pain, which may persist
  
• Unfavorable scarring
  
• Skin contour irregularities
  
• Skin discoloration and swelling
  
• Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
  
• Possibility of revisional surgery
  

Be sure to ask questions:

It’s very important to ask Dr. English questions about your nose procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with Dr. English.

When you go home.

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another minor surgery may be necessary to reach the intended aesthetic goal.

Be careful.

Following Dr. English’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. You will be given specific instructions on how to care for yourself.

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My recovery

After your procedure is completed, a splint, internal tubes or packing will likely be placed inside your nose and a splint or bandages placed on the outside to support and protect the new structures during initial healing.

You will be given specific instructions that may include: How to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon.

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Will the results will be long-lasting?

It may take several months for swelling to fully dissipate and up to a year - and sometimes longer - for the outcome of the surgery to fully refine.

Although the results of nose surgery are usually permanent, cartilage may continue to reshape and move tissue that may change the outcome over time.

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How much will nose surgery cost?

Cost is always a consideration in elective surgery. Prices for nose surgeries can vary widely. A surgeon’s cost may vary based on his or her experience as well as geographic office location.

Financing plans are available for qualified patients, so be sure to ask.

Cost may include:

• Surgeon’s fee
  
• Hospital or surgical facility costs
  
• Anesthesia fees
  
• Prescriptions for medication
  
• Medical tests
  

When nose surgery is performed to improve breathing function, this procedure is considered reconstructive and may be covered by insurance. This requires a detailed examination to verify the cause of your breathing impairment and prior authorization from your insurer.

Your satisfaction involves more than a fee.

When choosing a plastic surgeon for nose surgery, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery.

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Terms you should know

• Cartilage: Connective tissue that forms the structure of the nose.
  
• Columella: The narrow strip of tissue that separates the nostrils.
  
• Deviated septum: Cartilage that separates the nostrils is misaligned which may cause partial nasal airway obstruction.
  
• General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
  
• Hematoma: Blood pooling beneath the skin.
  
• Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
  
• Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
  
• Rhinoplasty: Surgery to reshape the nose.
  

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