Nose Surgery (Rhinoplasty) Cosmetic Surgery

Rhinoplasty (Nose Reshaping Surgery)

Rhinoplasty is a nose-reshaping surgery that can correct deformities or make subtle aesthetic changes for cosmetic purposes. This article explains the procedure and the various Rhinoplasty techniques.

The development of Rhinoplasty occurred primarily as a plastic surgery technique to restore a proportional nose shape, or to correct for constricted breathing, whether after injury or due to a birth defect. In addition to these corrective procedures, surgeons now use cosmetic plastic surgery to perform subtle aesthetic changes to nose size and shape.

The Rhinoplasty Procedure

Primary Rhinoplasty is a nose-reshaping plastic surgery that can be performed under local anesthesia (you are awake) or under general anesthesia (you are asleep). Cosmetic nose surgery is often performed in a doctor's outpatient surgical suite. Rhinoplasty normally requires one to three hours in surgery, depending on how much nose reshaping to be done. Two types of primary Rhinoplasty include "open" versus "closed."

Open Rhinoplasty

Open Rhinoplasty surgery allows the surgeon the least restricted access to the cartilage and bone of the nose but is also more likely to cause scarring. The incision across the columella makes it possible for the doctor to lift the skin off the tip of the nose and shape the cartilage very precisely. When healed, the incision leaves a very small, almost unnoticeable scar on the underside of the nose. Despite this drawback, some surgeons feel that the open nose job procedure is the best option in many cases.

Closed Rhinoplasty

The closed Rhinoplasty procedure offers all of the traditional nose job benefits without the risk of external scarring. Incisions in this operation are made inside the nostril, where they will be completely invisible after healing. While it may not offer quite as much freedom to the surgeon, the closed Rhinoplasty surgery still allows plenty of reshaping possibilities. Bone and cartilage can be removed or, in some instances, taken from another part of the patient’s body and added in for better shape or support. In other instances, the surgeon may decide that an artificial implant is the best way to give the patient the nose appearance he or she desires.

Open and closed Rhinoplasty both usually entail general sedation, though some doctors may recommend only local anesthetic. The only difference is the extra cut for open surgery which does not significantly alter the recovery process after the open surgery since the skin heals faster than the bone and cartilage underneath. In the end, then, the decision between these nose surgeries comes down to a question of whether the surgeon will have enough access without the cut and whether getting that access will be worth the tiny scar it will leave.

Secondary Rhinoplasty is performed to correct problems that persist or develop after a previous Rhinoplasty. Although the problems may be minor and easily corrected, often the problems are major, which makes the secondary Rhinoplasty more difficult, requiring more expertise than the primary surgery.

The goals of secondary Rhinoplasty are to reconstruct the nasal framework so that the nose appears natural, functions properly, and is in balance with the other facial features. To accomplish this, it is necessary to reconstruct and reshape the supporting framework of cartilage and bone through an open approach, using cartilage grafts obtained from either the ear or a rib. With the proper techniques, significant improvement and sometimes dramatic results can be achieved.

Because of the complexity, a secondary Rhinoplasty can take two to three times as long as a primary Rhinoplasty and can cost twice as much, depending on the number of grafts used to reshape the nasal framework. Most secondary rhinoplasties are performed with general anesthesia at outpatient surgery facilities or hospitals.