What is rhinoplasty?
Rhinoplasty is an outpatient surgical procedure designed to alter the size and/or shape of the nose. Generally this involves altering the underlying bony and cartilaginous framework of the nose. Rhinoplasty is often done to improve the physical appearance, breathing quality, or both.
What kind of specific concerns can be addressed?
Some of the most common issues addressed with rhinoplasty include:
- Dorsal hump
- Large nose
- Bulbous tip
- Crooked nose
- A widened nose
- A pinched/collapsible nose
- Droopy tip
- Upturned tip
What are the different types of rhinoplasty?
Rhinoplasty procedures can be either open or endonasal. In endonasal, or closed rhinoplasty, there are no visible incisions. All work is done on the inside of the nose. Because of this, there is generally less swelling and slightly quicker recovery. Open rhinoplasty involves a small incision through the columella and incisions on the inside of the nose. This provides much better access and visualization of the whole nose. Consequently, a greater variety of maneuvers can be performed. Dr. Harbison performs both endonasal and open rhinoplasties regularly. The choice of approach depends on many factors including any prior nasal surgery, patient’s nasal anatomy, and the desired changes, among others.
Am I a good candidate for rhinoplasty?
It is best to wait on rhinoplasty until the facial skeleton has matured sufficiently, generally around age 16. Patients should be in good enough health to undergo a general anesthetic, and able to come off blood-thinning medications (if currently taking) for 2 weeks. Ideally the patient should be able to take adequate time to recover and avoid heavy activity during the healing process.
What kind of results can I expect?
Rhinoplasty is a diverse procedure, and each surgery is individualized for that patient. It is important to remember that facial proportions, skin thickness, and current nasal anatomy must all be considered to create an ideal result. 3D photography and surgery simulation with photomorphology can be a useful communication tool between the patient and surgeon to discuss goals of surgery. Additionally, before and after photos can give real life examples of the types of changes that can be accomplished.
What is recovery like?
It is important to remember that everyone’s recovery is different, and depends on many factors. Most patients will spend the first couple of days after surgery taking it easy, and using pain medication as needed. Generally there will be a small nasal cast, a few skin sutures (if open approach used), and possibly intranasal splints. These will be removed 5-6 days after the surgery. At that point, there will be some residual swelling and minor bruising, but pain and discomfort have significantly improved and many patients are back to work after 1 week.
When will I notice results?
Some results will be noticed as soon as the external cast and sutures are removed, but it is important to remember that there will still be a degree of swelling present at this point. There are some changes, particularly in the nasal tip, that can take several months (or longer) to develop. This is often because it can take this long for the nasal skin to accommodate the underlying cartilage changes.
Will insurance cover rhinoplasty?
Generally rhinoplasty for aesthetic improvement is not covered by insurance. In select cases that are a result of nasal trauma or significant airway obstruction (not due to other causes), insurance companies may cover the procedure.
Understanding Nasal Anatomy:
- Radix – The root of the nose
- Rhinion – The area where the nasal bones and cartilage meet; very common area for bumps to develop
- Supratip break
Common rhinoplasty terms explained
- Projection – Distance the nose protrudes from the face
Ideal projection must be balanced with height of nose, upper lip, and rest of the face
- Rotation – Angle the nasal tip forms with the upper lip
The ideal angle for women is 95-105 degrees
The ideal angel for men is 90-95 degrees
- Columellar show – Amount of visible columella on profile(side) view.
Ideal amount 2-4 mm