Rhinoplasty and reconstructive nasal surgery

Rhinoplasty (Nose Job)
Nose deformities can either be inherited, result from trauma, or result from prior surgery. Our surgeons have vast experience in the correction of nasal deformities. Surgeries are typically same day-surgeries, but vary widely in their complexity and in the amount of time involved to complete the surgery. Insurance will usually cover recent nasal fractures, and will sometimes cover external nasal deformities that cause nasal blockage.

Our philosophy is that a nose must look “natural” after surgery. An operated appearance is to be avoided (just ask certain celebrities). It is important to remember that there is no such thing as a perfect nose after surgery. There will be minor irregularities or crookedness. These are usually hard to see, and may only be felt. If there is a small deformity that is troublesome, this is usually fixed 6-9 months after the first surgery.

Surgery on the nose can correct major deformities, or can correct subtle problems that detract from the overall appearance of the face.

Setting a Broken Nose
Broken noses with crooked nasal bones can often be set right in the office after numbing the nose, and this is not a particularly painful procedure. It must be done within two weeks of the injury, before the bones begin to set in their new position. If more than two weeks have passed since the injury, we usually have to wait at least six months to let the bones completely set in their new position, and then perform a formal Rhinoplasty.

Nose Surgery Techniques
Small nasal humps or minor fullness in the tip can be performed in what is called a “closed” Rhinoplasty. All skin incisions are done inside the nostrils, leaving no visible scars. A splint is worn for about a week afterwards. If the septum (the inside part that divides the two halves of the nose) needs straightening, this is usually done at the same time, and the internal splints usually stay in for a week.

More challenging nose surgeries (and most revision nose surgeries) are done with an “open” technique. A small zig-zag cut is made between the two nostrils, and is joined to cuts inside the nostrils that allow the skin of the nose to be lifted up. The cartilage and bone of the nose is nicely exposed, allowing us to make major changes in the tip, the sides and the top of the nose. Noses can be made smaller or larger, narrowed or straightened. Tips can be made more refined or prominent, raised or lowered. If more fullness is needed, your own cartilage can usually be harvested from your nasal septum, your ear, or even from a rib. Collapsed noses can be corrected using similar techniques.

What to Expect Following a Broken Nose
If it is necessary to break the nasal bones to straighten the nose or reduce the size, you can expect to have black eyes for 1-2 weeks. The swelling in the nose and face starts to go down after about three days. Most people “lie low” for a week or so. Pain killers usually are necessary for the first week. Some people go back to work after one week when the bruising has turned a yellowish color and is fading. Others take two weeks off of work. The nose itself, particularly the tip may remain swollen for several months. It may take a full year before the nose completely settles down, but most of the healing takes place in the first two months.