Background:

Aesthetic (cosmetic) surgery of the nose, also called rhinoplasty, can improve the shape, size and general appearance of the nose. The goal is a natural look that achieves a harmonious balance with the patient’s other facial features. Plastic surgeons usually recommend that patients wait until they are at least 14 or 15 before undergoing rhinoplasty. Assuming good health, there is no upper age limit. Rhinoplasty is sometimes performed in conjunction with a facelift or other rejuvenative surgery to correct aging changes of the nose such as a drooping tip.

Technique:

Alterations may be made to increase or decrease the nasal bridge, reduce the size or width of the nose, narrow the nostrils, change the angle between the nose and the upper lip, or reshape the tip. Often incisions will be placed inside the nose, where they will not be visible. Sometimes, a very short incision is made across the vertical strip of tissue that separates the nostrils, called the columella. This technique is called an "open rhinoplasty." Through whatever small incisions are made, work is done on the cartilage and bone that form the framework of the nose. Sometimes, the position of certain bones may need to be altered slightly in order to make the nose look narrower and straighter. If the nose needs to be built up in certain areas, this can be done using nasal cartilage, or perhaps bone or cartilage from another site.

Benefits:

• High patient satisfaction when expectations are realistic.


• Significant complications from rhinoplasty are infrequent.


• Results are permanent, except for changes associated with the aging process.


• Incisions are usually inconspicuous.


• Patients may be able to return to work a week to ten days after surgery. Most normal activities including exercise can usually be resumed within three weeks.

Other Considerations:

• Every surgery carries some risk. Potential complications include bleeding, infections and reactions to anesthesia. Numbness of the skin is usually temporary. Noticeable swelling may last for several weeks. Minor residual swelling may continue for many months. Bruising around the eyes and cheeks is most apparent during the first three days following surgery.


• Occasionally additional surgery may be necessary. Since the healing process is gradual, the patient should expect to wait up to one year to see the final results.


• Patients must avoid exposing their reshaped nose to direct sunlight, and must be conscientious about using sun block.