Rhinoplasty, commonly referred to as a “nose job,” is surgery to change the shape of your nose by modifying the bone or cartilage. Rhinoplasty is one of the most common types of plastic surgery.
Reasons for Rhinoplasty
People get rhinoplasty to repair their nose after an injury, to correct breathing problems or a birth defect, or because they’re unhappy with the appearance of their nose.
Possible changes that your surgeon can make to your nose through rhinoplasty include:
- a change in size
- a change in angle
- straightening of the bridge
- reshaping of the tip
- narrowing of the nostrils
If your rhinoplasty is being done to improve your appearance rather than your health, you should wait until your nasal bone is fully grown. For girls, this is about age 15. Boys might still be growing until they’re a bit older. However, if you’re getting surgery because of a breathing impairment, rhinoplasty can be performed at a younger age.
Talk with your surgeon about whether rhinoplasty is appropriate for you and what it can achieve. When planning rhinoplasty, your surgeon will consider your other facial features, the skin on your nose and what you would like to change. If you're a candidate for surgery, your surgeon will develop a customized plan for you.
You must first meet with your surgeon to discuss whether you’re a good candidate for rhinoplasty. You’ll talk about why you want the surgery and what you hope to accomplish by having it.
Your surgeon will examine your medical history and ask you about any current medications and medical conditions. If you have hemophilia, a disorder that causes excessive bleeding, your surgeon will likely recommend against any elective surgery.
Your surgeon will perform a physical exam, looking closely at the skin on the inside and outside of your nose to determine what kind of changes can be made. Your surgeon might order blood tests or other lab tests.
Your surgeon will also consider whether any additional surgery should be done at the same time. For example, some people also get a chin augmentation, a procedure to better define your chin, at the same time as rhinoplasty.
This consultation also includes photographing your nose from various angles. These shots will be used for assessing the long-term results of surgery and may be referred to during the surgery.
You should avoid painkillers containing ibuprofen or aspirin for two weeks before and two weeks after your surgery. These medications slow down the blood-clotting process and can make you bleed more. Let your surgeon know what medications and supplements you’re taking, so they can advise you about whether or not to continue them.
Smokers have more difficulty healing from rhinoplasty, as cigarettes slow the recovery process. Nicotine constricts your blood vessels, resulting in less oxygen and blood getting to healing tissues. Quitting smoking before and after surgery can help the healing process.
What are the steps of a rhinoplasty procedure?
Step 1 – Anesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation or general anesthesia. Your doctor will recommend the best choice for you.
Step 2 – The incision
Rhinoplasty 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.
Through these incisions, the skin that covers the nasal bones and cartilages is gently raised, allowing access to reshape the structure of the nose.
Step 3 – Reshaping the nose structure
An overly large nose may be reduced by removing bone or cartilage. Sometimes surgery of the nose may require the addition of cartilage grafts.
Most commonly, cartilage from the septum, the partition in the middle of the nose, is used for this purpose. Occasionally cartilage from the ear or rarely a section of rib cartilage can be used.
Step 4 – Correcting a deviated septum
If the septum is deviated, it can be straightened and the projections inside the nose reduced to improve breathing.
Step 5 – Closing the incision
Once the underlying structure of the nose is sculpted to the desired shape, nasal skin and tissue is redraped and incisions are closed.
Additional incisions may be placed in the natural creases of the nostrils to alter their size.
Step 6 – See the results
For a few days, splints and gauze packing may support the nose as it begins to heal. Get more information about rhinoplasty results.
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