1. What is rhinoplasty?

Surgery of the nose, also known as rhinoplasty, improves the appearance and proportion of the nose, enhancing facial harmony and self confidence. The nose is possibly the most important structure on the face due to its forward position and visibility.


2. At what age can rhinoplasty be performed?

Rhinoplasty patients should have completed their facial growth, so most patients will be 13 years of age or older. There are important growth centers located in the face near the nose; it’s important not to damage these areas before the face is fully developed.


3. What does a typical rhinoplasty consultation entail?

Nasal shaping requires a significant amount of preoperative planning and surgical skill. The alteration of the nasal shape and underlying structure must be handled with the greatest of care. So a preoperative evaluation is important. This evaluation includes examining the nose thoroughly internally and externally and discussing goals and expectations. Any underlying medical problems such as allergies and snoring should be addressed prior to surgery.

Your surgeon will explicitly outline the operative plan and the post-operative. Rhinoplasty is a personal decision, and the final result should take your entire facial structure into account.


4. What should I expect postoperatively?

Immediately following the rhinoplasty, you are likely to feel sore and headachy and experience tenderness in the operative area. Because of the connection between the nose, throat, and stomach, as well as the influence of anesthesia, you may experience nausea, which should gradually subside.

To support the new nasal structures during healing, your doctor will usually place a splint, internal tubes, or gauze packing inside your nose. An external splint, cast, or bandages will protect your nose during the initial healing stages. The doctor will have arranged gauze pads to catch secretions and fluids.

Rhinoplasty is usually an outpatient procedure, but you’ll still need someone to drive you home following the surgery.

You may have some discomfort from the packing and cast on your nose. Some patients feel claustrophobic due to their obstructed nasal airway, and you will need to breathe through your mouth for several days. The packing usually comes out in a day or two, and the splint or cast, if you have one, usually comes off in about a week.

Your doctor will probably advise you to sleep with your head elevated for several days to a week after your surgery to minimize swelling and discomfort. You may experience bruising and swelling for several days after surgery, and your nose may be sensitive for up to two months following your rhinoplasty procedure.


5. What is a "hanging columella?”

The nasal columella is the fleshy section of the external nose that separates the nostrils, also identified as the bottom of the septum. The term hanging columella is used to describe a prominent columella, or one that hangs down between the nostrils. A hanging columella can be corrected with rhinoplasty.


6. Is it possible for someone to be allergic to dissolvable stitches? And if so, what is the reaction like?

Yes, it is possible to be allergic to dissolvable stitches. In fact, this is not an uncommon allergy. The symptoms usually include redness, itchiness, and sometimes pus formation, and symptoms may not show up until three to four weeks after surgery. In some cases, the best response is to remove any remaining suture material and replace it with nylon sutures, removed 10 days following. Your doctor may decide to use tissue glue, although this is uncommon in rhinoplasty procedures.

If the skin around the sutures becomes red, itchy, or irritated, whether the sutures are absorbable or non-dissolving, it may be time to remove the sutures.


7. What is a deviated septum? Are there any new techniques to repair a deviated septum?

There are several ways to fix a deviated septum. The technique used is based upon the severity of the deviation and will be individualized to the patient’s condition.

Why pack” the nose after surgery?

For most patients, packing is more psychologically unpleasant than physically uncomfortable. Usually, rhinoplasty requires packing the nose after surgery to keep the repaired structures in correct alignment and to reduce bleeding and swelling. Some surgeons will place a tube or straw in the packing to allow limited breathing through the nose.


8. Which surgical approach is preferred: Internal (closed) or external (open)?

Either can be effective. Surgery of the nose is performed either using a closed procedure, where incisions are hidden inside the nose, or an open procedure, where an incision is made across the columella, the narrow strip of tissue that separates the nostrils.

The type of approach will depend upon the goals of the procedure and how involved the correction needs to be. The open approach allows direct visualization of the nasal structures and allows a more severe alteration of these structures if needed.


9. What are the steps involved in a rhinoplasty procedure?

Step 1: Local anesthesia with sedation or general anesthesia is administered

Step 2: An incision is made either across the bottom of your nose between your nostrils (an open technique) or in the mucosal lining of your nostrils (a closed technique)

Step 3: The surgeon then may use surgical tools to shave down a hump, remove or rearrange cartilage, or break and rearrange bone to reshape the nose.

Duration: Surgery generally lasts about one-and-a-half hours to two-and-a-half hours.

10. What are the risks associated with rhinoplasty?

As with any plastic surgery, possible risks include infection, anesthesia risks, bleeding, scarring, and pain. Risks more specific to rhinoplasty include nose asymmetry, nasal airway alterations, nasal septal perforation, and the possibility of required revisional surgery.