Face

Rhinoplasty

When people feel self-conscious about the appearance of their nose, it can severely impact the way that they feel about themselves. Most patients want a nose that blends in with, rather than draws attention away from, surrounding features. Rhinoplasty permanently alters the size and shape of the nose to enhance the appearance.

Rhinoplasty procedures can include alterations in the nasal dorsum, where a large hump can be reduced and/or a wide nasal base can be made narrower and more delicate.

Tip rhinoplasty procedures employ cartilage removal and cartilage alterations with stitches to refine a bulbous or boxy tip, or reduce projection of an overly large nose.  Wide, flaring nostrils can be made smaller with alar base procedures.

A patient with a crooked nose may undergo rhinoplasty to help straighten the nose to improve their appearance.

Nasal airway obstruction can also be addressed with surgery on the septum to straighten a deviation. Some patients may have excessively large turbinates (internal nasal structures that help humidify the air we breathe), which can be reduced.

The rhinoplasty patient may present with one of these issues, a combination of several, or even all of them.  Extensive evaluation by an experienced plastic surgeon is necessary to develop a detailed operative plan to achieve the best possible results from rhinoplasty surgery.

Your Initial Consultation

At your initial rhinoplasty consultation at my Dallas practice, I will review with you all of your concerns about your nose.  With a mirror, I will show you what areas can be improved and what areas I feel may not show significant improvement.  I may discuss the relationship of your nose to your chin and whether any enhancement of your chin with an implant or other surgery is recommended.  I will assess your nasal airway for signs of obstruction, which could be improved with nasal septal surgery or turbinate surgery.

I will also review with you your medical history and current medications.  If you have high blood pressure, this must be well controlled with medication prior to considering rhinoplasty surgery.

If a patient decides to undergo surgery, pre-operative photographs are taken. The cost of surgery will also be discussed, and the full payment is due to my office before surgery. If more time is required to assure the best possible result, you may be billed additionally by the surgical facility. Surgical fees include the cost of surgery and all post-operative follow-up care and visits. If there is an airway obstruction component that may be partially covered by your insurance, my staff is experienced with contacting your insurance company to assist you.

Your Rhinoplasty Procedure

Rhinoplasty procedures are usually performed under general anesthesia.  This is done for your safety during the operation.  This nose is then infiltrated with local anesthetic containing ephinephrine and packed with gauze soaked in vaso-contricting medicine to minimize bleeding.

I usually perform open rhinoplasty procedures where an incision is made in the columella (the skin between your nostrils) and then up inside your nostrils.  The nasal skin is then elevated off of and exposing your nasal cartilage and bones.  Alterations are then made to the underlying nasal skeleton to improve the appearance of your nose and address any nasal airway issues.  In some cases, the nostrils are made smaller with skin alterations.  Your incisions will be closed with a combination of absorbable suture and removable sutures.

The complete procedure will usually require from two to three hours in the operating room, depending on the extent of surgery.  You will usually be discharged home after your surgery in the surgical facility.

After Your Rhinoplasty

Your nose will feel swollen and areas will feel numb.  These sensations are normal and will resolve with time.  You will experience nasal airway congestion and obstruction usually resolving within five to seven days after surgery.

Bruising after surgery will settle around the lower eyes and should resolve within two weeks of surgery.  The majority of swelling should resolve within three to six weeks after surgery.  Small amounts of residual swelling will take up to four to six months completely resolve; however, this swelling will only be noticeable to you and not to anyone who looks at you.

Limitations, Risks and Possible Complications

How happy you are with the results depends on how effectively you communicate to me what specific areas concern you, how well I communicate to you what improvements a specific procedure can yield and how realistic you are about your expectations.  Plastic surgery is a combination of art and science.  Above all other plastic surgery patients, the rhinoplasty patient needs to anticipate improvement, rather than perfection after surgery.

Any change in your appearance affects your perceptions and self-image.  It is very common for my Dallas rhinoplasty patients to go through a period of adjustment and have feelings of doubt or low mood during this time.  These feelings usually last for up to three weeks after surgery and are rapidly replaced by positive feelings as the healing process progresses and you adjust to your improved appearance.

Over or under correction of deformities is always possible in cosmetic surgery.  This tends to be more commonly seen in rhinoplasty surgery, which is definitely a surgery of millimeters. A small, but meaningful percentage of rhinoplasty patients may require secondary surgeries to address residual or post operative deformities.

In a small percentage of patients, excessive nasal bleeding may occur after surgery.  This can usually be controlled with Afrin; rarely, additional intervention may be necessary to control nasal bleeding.

Infection is extremely rare after rhinoplasty surgery, but is possible.

Rarely, over resection of nasal cartilage may result in nasal skeleton collapse, which can require secondary surgery to restore the nose to a normal appearance.

Conclusion

For patients who feel self-conscious about the appearance of their nose, a rhinoplasty procedure can significantly improve their confidence levels. Rhinoplasty permanently alters the size and shape of the nose to enhance its appearance and make it blend in better with the facial features.

If you have any questions regarding your decision about rhinoplasty surgery, please do not hesitate to contact my Dallas office for further information.

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