What You Need to Know About Rhinoplasty (Nose Surgery)

If you’re considering undergoing rhinoplasty, or nose reshaping, surgery you may have a ton of questions about surgical options and what to expect before and after surgery. Read below for some basic information about nasal surgery and answers to some of these questions.

What is a rhinoplasty?

A rhinoplasty, also known as a ”nose job,” is a surgery that alters the outer shape of your nose. Typically during the surgery the surgeon will also perform a septoplasty which is a procedure that straightens the inner wall that separates the right side of your nose from the left. Thus, a rhinoplasty can achieve two main goals: altering the outer shape of your nose and helping you breathe better through your nose.

Who can undergo a rhinoplasty?

Except in specific cases with extenuating circumstances, rhinoplasties are typically not performed on patients under the age of about 15 or 16. The reason for this is twofold:

1. At this age, the nose and face have finished growing and thus the surgery shouldn’t cause any issues with further growth and
2. Patients should be old enough to have thought seriously about the consequences of undergoing surgery that will alter their looks. Beyond that, rhinoplasties are suitable for patients that earnestly want to improve the appearance of their nose. It is important to remember that this is an elective surgery and should not be pursued by patients with medical problems that make undergoing anesthesia unduly risky.

What types of rhinoplasty are available?

This is a bit of a loaded question. It completely depends on how one chooses to categorize it. But one useful way of breaking down the types of rhinoplasty is the following:

1. Open Rhinoplasty: An open rhinoplasty involves a small incision across what is called the columella. This technique allows for complete visualization of the underlying nasal cartilage and bone and thus may be the preferred technique for noses that need major alterations or in revision cases.
2. Closed Rhinoplasty: A closed rhinoplasty avoids the columellar incision, and thus avoids the risk (albeit low risk) of scarring on the skin. However, there is much more limited visualization of the underlying structures and thus this technique is more appropriate in cases that require minimal alterations. There is also significant discrepancy in surgeon preference based on what a certain surgeon feels like he or she can achieve with a certain technique.
3. Liquid Rhinoplasty: Finally, the “Liquid Rhinoplasty” is a hot new term. This is a truly non-invasive method of using injectable fillers (such as Juvederm® or Restylane®) in the nose to make more subtle contour changes. This technique has the benefit of having essentially no downtime but also is extremely limited in what it can achieve.

What should I expect prior to having a rhinoplasty?

I like to think of there being three main steps prior to undergoing a rhinoplasty:

1. Patient contemplation: Patients should never undergo any surgery without a considerable amount of thought and contemplation. This is especially true for rhinoplasty. Changing the look of your nose can do wonders for a patient’s self-esteem and improve the overall aesthetics of their face tremendously. But altering one’s appearance is a serious undertaking and should not be taken lightly by patient or surgeon.
2. Consultation with Facial Plastic Surgeon: Consultation with your plastic surgeon is obviously critical. It is important for there to be mutual trust in this doctor-patient relationship. Furthermore, it is of utmost importance that you discuss your goals explicitly and thoroughly with your surgeon. They in turn must demonstrate understanding toward you and be honest about whether your goals are achievable in their hands. One universal step in this process is taking uniform pictures of your face and most surgeons will then use computer software to morph your nose to give you an idea of what might be achievable during surgery.
3. Pre-op counseling: After deciding you would like a rhinoplasty and then meeting with your surgeon and coming up with an agreed upon plan, you will meet with a doctor or nurse practitioner to go over all your other medical conditions to make sure all potential issues can be discussed and avoided as much as possible.Each of these steps is absolutely critical and it would be careless to try to emphasize one over the other.

What should I expect after having a rhinoplasty?

Recovering from a rhinoplasty requires patience. Typically there will be an external cast on your nose as well as packing in your nose. The packing is uncomfortable but is typically removed on postop day 1. The external cast typically is removed in about 1 week. Bruising around your eyes and cheeks is normal. Finally the nose will be very swollen. While this swelling improves tremendously over the first 1-2 weeks, some degree of swelling can persist for up to a year. Thus, you cannot make any judgements about your result for at least 6 months and in some cases up to a year.

Final Thoughts

 A rhinoplasty is a serious surgery to undergo as a patient and to undertake as a surgeon. But in the appropriate patient it can be a life-changing surgery. If you think you might like to pursue a rhinoplasty, our Patient Consultants and facial plastic surgeons at the Quatela Center would love to talk to you, to provide you with the best and most up-to-date information, and the skill, compassion, experience, and care to achieve your goals. We’re here to provide a positive experience than can change your life. Please call (585) 244-1000 to speak to a Patient Consultant for more information and to schedule your appointment.

Dr. Vito Quatela is a double board certified facial plastic surgeon who is one of the pioneers of modern rhinoplasty. He has performed over 2,500 rhinoplasty procedures and has dedicated most of his 30 years of experience perfecting his technique to achieve uncompromising results. This time has afforded him the opportunity to mature his surgical expertise to achieve patient satisfaction very reliably. During his career he has also become an educator on rhinoplasty and has taught several generations of surgeons how to be proficient in this challenging operation.

Dr. Heather Lee trained under Dr. Quatela for her fellowship in Facial Plastic and Reconstructive Surgery and joined the surgeons at the Lindsay House in 2017. Her expertise and focus in aesthetic and functional procedures as well as her dedication to compassionate care for her patients allows her to continue the Lindsay House philosophy of creating uplifting experiences that change people’s lives.