Your facial appearance creates the first impression, and the size, shape, and symmetry of your nose play a significant role in the appeal of your face. Modern plastic surgery makes it possible, in talented hands, to create a more balanced, harmonious facial appearance by changing the shape, size or contour of the nose.
Rhinoplasty - commonly referred to as a “nose job” - is one of the most frequently performed facial surgeries. About half a million rhinoplasty surgeries are performed every year in the USA. In addition to the procedure being performed for aesthetic improvement, a nose job may also be performed to resolve breathing problems associated with a deviated septum, birth defect, or trauma. Since the nose is an organ that gives form to the face as well as provides function by breathing, the ideal nose of the 21st century should function as well as it looks.
By reshaping the nasal structures, including bone, cartilage, and skin, rhinoplasty can help achieve one or more of the following:
Straighten a crooked nose
Smooth a prominent bump in the bridge of the nose
Reduce the length of an over-protruding nasal tip
Refine the size of a bulbous nasal tip
Narrow a nose that is too wide for the face
Reduce the size of a nose that is too large
Restore symmetry to the nose following injury
Correct breathing problems by opening up blocked nasal passages
How it works
Rhinoplasty is highly individualized, and the exact techniques Dr. Romita will use during a procedure will look a little different each time, depending on a patient’s anatomy and desired changes. There are generally two types of Rhinoplasty procedural approaches:
For an “open” rhinoplasty, a small incision is made under the nasal tip, between the nostrils. This approach allows the cosmetic surgeon more complete access to the nasal structures, where he or she can then sculpt the nose into the desired shape. Because of this increased access, cosmetic surgeons will typically use the open rhinoplasty approach for patients requiring more extensive reshaping. The resulting scars are well-hidden in the natural contours of the nose so they are as inconspicuous as possible.
For a “closed” rhinoplasty, incisions are made inside the nostril. This approach is most commonly used for patients who need more minor adjustments to the nasal structures to achieve their desired improvements. The advantage of closed rhinoplasty is that there is no visible scarring after surgery; however, this approach may not be suitable for more extensive rhinoplasty procedures.
How long will it take?
Most Rhinoplasty procedures are performed under general anesthesia and require one to two hours. If other procedures will be performed at the same time, it can take several hours. After closing the incisions and addressing any issues with the nasal wall, or septum, patients will be sent to the recovery room and can home 45 minutes to two hours after surgery.
You will need to stop eating and drinking fluids for a specific period of time the evening prior to your nose job, most often midnight. In some cases, defined by your physician, you may need to take certain medications with a small sip of water.
For the least possible chance for infection, shower with an anti-microbial soap the evening before your nose job surgery. This removes and discourages the growth of bacteria on the surface of your skin. Try not to cause too much irritation of the face, specifically the nose, while scrubbing. Repeat this process the morning before the procedure.
In advance of your procedure, your surgeon will ask you to:
Stop smoking at least six weeks before undergoing surgery to promote better healing
Avoid taking aspirin, certain anti-inflammatory drugs, and some herbal medications that can cause increased bleeding
Regardless of the type of surgery to be performed, hydration is very important before and after surgery for safe recovery.
After the surgery, you may be asked to wear a nasal splint over your nose for support. The splint will protect your nose while you sleep and shield it from accidental bumps. You may also have a small triangular bandage beneath the tip of your nose. Nasal packing may also be placed inside your nose for additional support; it acts as an internal splint to hold everything in place and to keep the airway clean and free of crusts.
Expect some swelling and bruising and possibly some discomfort. Your face will be puffy, and the areas around your nose and eyes will be bruised and swollen after surgery. Dr. Romita may recommend cold compresses to help minimize the swelling and reduce pain. You may need to keep your head elevated and relatively still for the first few days after surgery. Patients may be prescribed a pain medication to deal with any pain experienced.
Limit diet to light, bland foods for the first few days following the procedure. If you don’t experience any difficulties, you can move onto heavier, tastier foods. Avoid foods and spices that have been known to cause you sneezing or other reactions.
Dr. Romita will also provide detailed instructions about the normal symptoms you will experience and any potential signs of complications. It is important to realize that the amount of time it takes for recovery varies greatly among individuals. You will need to wait for up to three or six weeks before you can engage in exercise or athletics. Don’t bend or exert yourself physically until cleared by your physician. Though the stitches will be tiny, they still have the potential to break when you exert yourself.
The nose will continue to heal for the next month. In some cases of extensive reconstruction, the nose may require several months to attain the look desired. Don’t expect to be red-carpet ready for several weeks. The tip of the nose could take upwards of a year to two years to fully set. The time will pass quickly, and a few months of healing is nothing when compared to a lifetime of feeling embarrassed or unhappy and suffering a lack of self-confidence.
Results following Rhinoplasty surgery can be quite dramatic for patients, even if the changes made were subtle.
A natural, pleasing aesthetic outcome is always the goal. It is important for patients to understand that having rhinoplasty surgery will alter the look and overall shape of the face. It is also important to understand that while the majority of results are just what our patients were hoping for, there is no such thing as perfection when it comes to cosmetic nose surgery. Having realistic expectations upfront is important during the pre and post-surgical process. Patients will see a noticeable difference in their profile as well as how they appear facing forward.
The smaller, softer, shapelier looking nose that is generally the result of a rhinoplasty surgery often have a very positive impact on our patients' self-confidence.
Before & After
Click photo to enlarge