Rhinoplasty is the surgical correction or improvement of the contour irregularities of the nose. The essential parts of the nose include the bony dorsum (hump), the middle cartilaginous dorsum (part of the nose that helps with breathing) the tip of the nose, and the sides. A rhinoplasty may be considered either functional or cosmetic where correction would involve either a breathing problem or be one to improve the appearance of the nose.

What incisions are used?
A rhinoplasty involves either an open or closed approach. Although a closed approach (where the incisions are confined to the inside of the nose) may limit scarring, there are certain circumstances where and open approach (extending the incision across the bottom of the nose) may be beneficial. However, even if an external rhinoplasty approach may be used, the scar virtually always heals without problems and is rarely even noticeable.

How long does a rhinoplasty last?
A rhinoplasty is intended to last a lifetime, and although patients will continue to age, long lasting results are the norm.

Can other procedures be combined with a rhinoplasty?
The face can actually be divided into thirds with the nose being part of the middle third. Traditional face lifts address the lower two-thirds while the upper third includes the areas of the eyes and forehead. These areas can easily be combined with a rhinoplasty itself and actually help to maintain a uniform appearance.

Are there any specifics points to be aware of?
Reshaping of the nose can reveal immediate results but require a significant period of time to achieve the final results - typically up to one to two years. The results require patience but the end result is worth it. In some cases, the septum of the nose is deviated, which may also require correction - a situation where insurance coverage may be applicable.

What type of anesthesia is used?
A rhinoplasty is usually performed with general anesthesia although local anesthesia with IV sedation is also an option. The procedure usually takes 2-3 hours and patients typically go home the same day.

What can I expect after surgery?
Most patients feel that surgery was less traumatic than they expected and many patients stop taking their narcotic pain medication only a few days after surgery. Sutures are removed in five days and nasal packing (if used) is removed in one to two days. Most of the bruising is resolved at 7-10 days, which is easily covered with make-up.

Follow up is very important and patients are encouraged to return to the office at six weeks, six months and the first and second years after rhinoplasty.

Tell me about credentials - Is there a difference?
Yes, Absolutely! A rhinoplasty is a procedure which, unfortunately, can be performed by any physician - whether adequately trained or not. Most states have very little regulation on this matter. Because of this, non-plastic - or so called "cosmetic" - surgeons can perform a rhinoplasty as well. In addition, some physicians who are legitimately board certified in other specialties, such as dermatology and gynecology, for example are performing "cosmetic" surgery even though they often have never had any formal residency training in the specialty of plastic surgery itself. Weekend courses abound and the patient is often confused as to which doctor to see.

Does Hospital affiliation matter?
Again, yes. Although operating in an office setting is not in and of itself inappropriate, it is always possible that an extended hospital observation or additional care might be needed. Indeed, certain procedures or multiple surgeries are usually best treated within the context of a full hospital facility. In addition, hospitals usually require certain standards (credentialing) such as board certification before a physician can have staff privileges. Unfortunately, there are no legal restrictions in most states that prevent physicians operating out of their offices or non hospital associated free-standing surgery suites; so be sure to ask if your doctor does have admitting privileges at a fully accredited hospital facility. If they don't, their ability to either transfer patients or provide continuity of care is potentially compromised.

Any other helpful hints?
Needless to say, your decision in choosing a plastic surgeon can be a difficult and time consuming task making it even more important that you personally visit with the plastic surgeon that will perform your procedures. Evaluate their results (photos), office, staff, and testimonials and your feelings regarding your overall experience with their practice. You can often ask to speak to other patients who are willing to share their experiences with you.