(Plastic Surgery of the Nose)
DefinitionRhinoplasty is a surgical procedure to reshape the nose.
Reasons for ProcedureRhinoplasty may be done to:
- Change or improve appearance
- Improve breathing
- Correct an injury or birth deformity
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Possible ComplicationsProblems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Poor healing of the skin
- Unsatisfactory cosmetic result or scarring
- Increased risk of nosebleeds
- Reaction to anesthetic
- Puncture of septum or collapse of nose bridge—rare
- Age—recommended age is after teen growth spurts and before middle age
- Prior nose surgery
- Prior trauma to the nose
- Medical problems
What to Expect
Prior to ProcedureYou may be asked to provide a picture of the nose shape you desire. You may also be given a book to look through to choose a nose shape. Computer software may be used to simulate desired results.Your doctor will likely do the following:
- Blood tests
- Urine tests
- X-rays of the facial bones
- Electrocardiogram (EKG) or chest x-ray may be also required
- Take pictures of your nose before the procedure
- Arrange for a ride to and from the procedure.
- If you are having general anesthesia, do not eat or drink anything for at least 8 hours before the procedure.
AnesthesiaYou may have general or local anesthesia. You will be asleep with general anesthesia. Local anesthesia will numb the area. In this case, you may also be given a sedative to help you relax. The type of anesthesia used will depend on your procedure and general health.
Description of the ProcedureThere are three main components of the procedure:Lifting the Skin of the Nose from the Bone and CartilageThe nose will be injected with a numbing medication and epinephrine. The epinephrine will prevent excessive bleeding. An incision will be made either inside the nostril or outside the nostril, across the ridge between the nostrils. The skin will then be lifted off the cartilage of the nose.Remodeling Bone and CartilageDepending on the desired outcome, some nasal bone may be removed, or fractured and reset to a new shape. Cartilage may also be trimmed. Other techniques involve placement of tissue grafts of bone, cartilage, or mucosa from the patient, a donor, or a synthetic graft. They will be used to help remodel the shape of the nose. For example, the tip of the nose may be narrowed or raised, or the slope of the nose may be reduced or increased. The shape or size of the nostrils may also be changed.Redraping Skin Over the New BaseWhen the procedure is finished, the incisions will be closed. The skin will be redraped over the new bone structure. The skin will be tightly taped to keep it in place. A protective metal splint will then be applied on the outside of the nose. It will help to maintain the positioning during healing. Either soft plastic splints or gauze packing coated with petroleum jelly will be used as nasal packs. They may also be inserted into the nostrils as support during healing.
How Long Will It Take?About 2-4 hours
How Much Will It Hurt?Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Average Hospital StayYou will most likely go home on the same day.
Post-procedure CareTo help ensure a smooth recovery:
- For the first few days after surgery, rest in bed with your head elevated to reduce swelling.
- Apply ice packs to your nose during the first 2 days. This will help to relieve discomfort.
- Take prescription or over-the-counter pain medications as directed by your doctor.
- Do not blow your nose at all during the first week. Do not blow your nose forcefully for one month.
- Protect your nose from any injury for 8 weeks. Do not wear glasses. Be careful when washing your face.
- Ask your doctor about when it is safe to shower or bathe.
- Avoid vigorous exercise for at least 3 weeks. Avoid contact sports for 6 months.
Call Your DoctorAfter you leave the hospital, contact your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Persistent elevated temperature
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
- Pain that you cannot control with the medications you have been given
- Cough, shortness of breath, chest pain, or severe nausea or vomiting
- Any new symptoms
American Academy of Facial Plastic and Reconstructive Surgery
American Society of Plastic Surgeons
Canadian Society of Plastic Surgeons
Nasal surgery. American Academy of Facial Plastic and Reconstructive Surgery. Facial Plastic Surgery website. Available at: http://www.aafprs.org/patient/procedures/rhinoplasty.html. Accessed August 26, 2013.
Nose surgery: rhinoplasty. American Society of Plastic Surgeons website. Available at: http://www.plasticsurgery.org/cosmetic-procedures/nose-surgery-.html. Accessed August 26, 2013.
- Reviewer: Michael Woods, MD
- Review Date: 08/2014
- Update Date: 09/30/2013