Rhinoplasty

If you are considering rhinoplasty, you will find information and topics related to nose surgery procedures on our website, as well as how it's done, what to expect from it and if you are a good candidate.

Rhinoplasty History

The concept of rhinoplasty has been around for centuries.

Rhinoplasty is one of the oldest cosmetic surgeries for which written evidence exists. Writing around 500 B.C., the Indian Ayurvedic physician Sushruta (sometimes referred to as the father of plastic surgery) described nasal reconstructive surgery in detail. He and his disciples used their techniques to repair the noses of soldiers whose faces had been marred in battle. They also rebuilt the noses of thieves who had all or part of their noses cut off as punishment. Interestingly, some of the techniques recorded by Sushruta 2.5 millennia ago are used today, particularly the technique of using a flap of grafted skin from the forehead to aid in the reconstruction process. This technique has allowed surgeons to create a new nose for patient recipients of the procedure, even today.

Modern rhinoplasty traces its roots back to two men in the 1800s: Johann Dieffenbach and Jacque Joseph. They performed nose reduction surgeries using incisions outside of the nose. These surgeries differed because they were performed on relatively normal noses for aesthetic purposes, and not to rebuild and repair noses that had been destroyed or removed. These surgeries were purely cosmetic surgeries.

The first rhinoplasty using incisions within the nose (intranasal rhinoplasty) was performed by American John Orlando Roe in 1887. He placed the incisions inside the nose, which offered a number of benefits. This procedure hides the scars inside the nose, where they would be invisible to casual observers. This method (typically called "closed rhinoplasty") was the primary way to perform rhinoplasty surgery, until the 1970s.

In 1973 Dr. Wilfred S. Goodman wrote an article that changed the direction of the surgery titled, "External Approach to Rhinoplasty." His published work described in detail the "open rhinoplasty" technique, which directed surgeons to place incisions inside the nose and also to make a small incision on the underside of the nose (the columella), allowing access to the underlying cartilage and bone much easier. The writings and refining work of Dr. Jack Anderson also helped to make open rhinoplasty a more popular and mainstream procedure.

Even as open rhinoplasty became more common, it was typically not used for follow up, secondary rhinoplasty until the late 1980s, when doctors began to see the merits of using this technique for revisionary purposes.

Over time, a number of refinements have improved rhinoplasty. Today, noses can be surgically altered with more precision and safety than ever. Surgeons can reduce the size of the nose, improve features, change the shape and use implanted materials to enlarge parts of the nose.

As modifications in rhinoplasty techniques and technology have advanced, the procedure has become more popular than ever, and not reserved for the rich and famous. This increase in popularity has crossed economic, demographic and racial boundaries, as well. In the past, rhinoplasty was performed according to an idea of beauty based on American Caucasian aesthetics. However, surgeons have expanded their approaches to offer "ethnic rhinoplasty" to Hispanics, Asians and African Americans. Now, the patient's nose is improved in a way that fits naturally with the patient's face and respects their ethnic heritage.

According to the American Society for Aesthetic Plastic Surgery, rhinoplasty has consistently ranked among the top 10 most popular cosmetic surgeries in America for the last 10 years. In 2009, more than 133,000 rhinoplasty surgeries were performed. Of these, approximately one-fourth was performed on men, and three-fourths on women. Among men, rhinoplasty is the second most popular cosmetic surgery; among women it is eighth. It is the most commonly requested cosmetic surgery among patients 18 and under.

Functional and Reconstructive Rhinoplasty

Functional rhinoplasty aims at restoring normal breathing function by restoring the normal passage of air through the nasal passages.

In conjunction with this surgery, a septoplasty (straightening the partition between the two nasal cavities) might be performed as well. If irregular breathing is caused by the swollen bony plates in the nasal passages, a turbinectomy or a turbinate reduction can also be performed to clear passages and restore normal nasal breathing.

Reconstructive rhinoplasty aims at restoring the appearance and normal function of the nose. This surgery is performed often after trauma has deformed the nose, such as accidents, autoimmune disorders, previous unsuccessful surgery, cancer and intra-nasal drug abuse. A reconstructive rhinoplasty can also treat congenital abnormalities.

About The Rhinoplasty Procedure

Rhinoplasty surgery is generally an outpatient procedure that can be performed in a hospital, ambulatory surgical facility or an in-office surgical suite.

It requires local anesthesia with IV sedation or general anesthesia. An overnight stay in the hospital or a special recovery facility might be recommended, and you can request either option if it will make you feel more comfortable.

To determine the approach to your rhinoplasty, your surgeon should carefully evaluate your overall facial appearance, proportion and structure, while taking your medical history, ethnicity and personal goals into account. The possibilities of this procedure are exciting, and they include:

• Eliminating bumps and irregularities on the bridge of the nose
• Lowering a high bridge or raising a low bridge
• Narrowing a wide bridge
• Turning a tip up or down
• Reducing or enlarging a nasal tip
• Changing the size and position of nostrils

It is a myth that the nose must be broken during rhinoplasty. A broken nose happens in accidental trauma. In nose surgery, the smallest instruments are used to cut and shape structures of the nose, including the bone.

Rhinoplasty is performed as an open or a closed procedure, depending on structural changes required to refine features or fix a problem, depending upon your surgeon's expertise and preferences. In a closed procedure, incisions are hidden within the nose. An open procedure requires an additional incision across the narrow strip of tissue that separates the nostrils. This incision site will heal and scarring will diminish during the healing process.

Dissolving sutures are used internally, and either dissolving or removable sutures are used to close external incisions. You will wake up after rhinoplasty with a splint covering your nose, and small tubes might be placed in your nose for a short time to prevent draining fluid from being swallowed. It's also possible that you may have packing to support the nose internally as the nose heals. No matter how cumbersome or uncomfortable, you shouldn't remove any splints or packing without your surgeon's permission.

The Rhinoplasty Procedure

Rhinoplasty techniques and approaches depend on the surgeon and the patient's case. Although the procedure varies, it has some universal characteristics that make it safer, better and more precise.

Find a rhinoplasty surgeon near you

Finding a rhinoplasty surgeon in your area is easy; click on the Surgeon Locator to find a list of surgeons near you. Visit their websites and read their credentials. RhinoplastyGuide.com offers a national directory of specialists.

Rhinoplasty Types

There are many rhinoplasty techniques and options available: closed and open, primary and secondary, as well as a host of new approaches described on our comprehensive guide.

Rhinoplasty Fees

The fees and costs for rhinoplasty surgery will vary depending on the surgeon, your area of residence, the type and extent of your rhinoplasty procedure, as well as other factors. The most accurate way to know the fees associated with rhinoplasty is to set up a consultation with a surgeon. He or she will evaluate your case, let you know if you are a good candidate and give you an estimate for your surgery based on your situation.

The surgeon's office will talk with you about financing options if you are not able to pay the fee in one lump sum. Click here to read more about costs associated with rhinoplasty surgery.

Rhinoplasty Recovery and Results

While you research your procedure, learn what to expect after rhinoplasty, including the length of recovery time, special care requirements and medications you might need to take. Learn about what long-term results you can expect, how to manage your expectations and what additional treatments or care might be necessary to maintain your results.

Rhinoplasty Risks

Rhinoplasty is a common procedure and the outcomes are typically very successful, but like any medical procedure, it has risks. Before deciding on rhinoplasty, educate yourself about the procedure so you can make an informed decision. Weigh the benefits versus the risks and potential side effects, with the help of a one-on-one consultation with a plastic surgeon. You can minimize your chances of complication, both serious and benign, by selecting a skilled and experienced rhinoplasty surgeon, and by following his or her instructions.

Common Risks

The most common risks associated with rhinoplasty are bruising and swelling, which are present to varying degrees in every patient. Somewhat more serious are blood clots, infections, adhesions or scars that form across the nasal cavity. These scars can stretch across the entire nostril, but this outcome is very rare. The procedure can cause nasal obstructions and make it difficult for the patient to breathe normally through the nose. Patients should contact the surgeon to be seen in this case to be evaluated and have any obstructions removed.

Less Common Risks

During rhinoplasty, a hole can be made inadvertently in the septum, the wall that separates the nostrils. This hole, which is called a septal perforation, can cause: chronic nosebleeds, crusting and difficulty breathing. It can also cause a strange whistling noise when breathing through the nose.

If the rhinoplasty surgeon removes too much of the underlying bone or cartilage of the nose, this can cause an unusual appearance. In these cases, the nasal skin is left without support and loses its shape, resulting in a deformity known as a "polly beak." When the septum is left without proper support and a deformity occurs, the bridge of the nose sinks, creating a "saddle nose."

During some rhinoplasty surgeries, the tip of the nose is rotated upward. While this can improve one's appearance when performed in moderation, if the rotation is overdone, it can make the nostrils overly prominent and visible, producing a somewhat pig-like appearance. On the other hand, if too much of the cartilage at the tip of the nose is cut away, this can cause the tip of the nose to have a strangely pinched appearance.

In addition to these aesthetic risks, there is the possibility for nasal numbness if certain cuts are not made properly. Numbness can linger for months and, in some cases, be permanent.

The final outcome of a rhinoplasty cannot always be foreseen before or during the operation. Over time, the cartilage and soft tissue might change shape, and sometimes the nasal bones become dislodged. To minimize this risk, patients should adequately protect their noses and faces while they heal and recover. Any trauma or pressure while the nose is healing can have adverse effects on the eventual appearance of the nose.

Benefits of rhinoplasty

There is a reason why rhinoplasty procedures are so popular: They can have a large and powerful impact on a person's life. They can alleviate breathing problems, improve one's appearance, boost a person's confidence and help them to achieve an overall better quality of life. All of this can be achieved with only minor downtime after rhinoplasty is performed.

Choosing a Rhinoplasty Surgeon

Our goal with RhinoplastyGuide.com is to help you with your decision-making process. We have compiled information, videos and before-and-after pictures to help you to understand the procedure. We have compiled a list of surgeons that you can search to find rhinoplasty surgeons in your area.

Patients should ask questions like, "Is rhinoplasty right for me?" "Would I make a good rhinoplasty candidate?" "What results can I expect?" "How can I find a good rhinoplasty surgeon?" "How much will my surgery cost, and how long will it take me to recover?"

Check if the surgeon is board certified in plastic and cosmetic surgery and has rhinoplasty training. Research the facility where the rhinoplasty will take place. View the surgeon's before-and-after photos and ask for testimonials.

Learn About Rhinoplasty

RhinoplastyGuide.com has helped many prospective rhinoplasty patients like you to learn about the latest trends, procedures and developments in rhinoplasty. If you take a look at the different sections of our site, you will come away with a very good understanding of rhinoplasty.

Find out what rhinoplasty techniques are most popular, how much they cost, what might happen during your surgery, receive answers to numerous frequently asked questions, and much more. View pictures and videos of people who have undergone this surgery, and see for yourself what they looked like before and after their surgeries.