What is Nose Surgery?
Nose surgery, also known as Rhinoplasty, in Boston and Worcester, Massachusetts, is a procedure that improves the proportion and harmony of the face through correcting the size and/or shape of the nose. This procedure can also be done to correct medical issues, such as impaired breathing due to structural defects like a deviated septum.
Am I a good candidate for nose surgery?
Ideal candidates for nose surgery are physically healthy men and women whose nose is completely done growing, and individuals that have realistic goals for the surgery. Individuals who smoke may not be ideal candidates for any surgical procedure.
Rhinoplasty – Patient 113
A woman in her late 40’s who is bothered by her nose being too “wide”. The trick here is to reduce the width of the nose and the tip, but not overly lower the dorsum of the nose, as is usual in a typical rhinoplasty. She is shown before and again, 22 months after an open rhinoplasty. After a small reduction in the nasal hump with a power burr, medial osteotomies were performed to narrow the nose as well as percutaneous lateral osteotomies. A non-destructive tip rhinoplasty was performed at the same time to correct the “boxiness” of the tip. We can expect the tip to continue to appear even more refined over the next year as swelling continues to diminish. She is already thrilled with the new appearance of her nose. It is narrower and proportional, and the minor dorsal hump is corrected but not overly lowered.
Rhinoplasty – Patient 112
A 17 year old who is bothered by a dorsal “hump”. On exam he also has some deviation of the nose. He is shown before and again, 6 weeks after an open septorhinoplasty. Bilateral spreader grafts were placed to prevent an “inverted V” deformity which is more likely when lowering a large dorsal hump. A portion of the septum was used as a strut to support the tip, which is left just higher than the nasal dorsum to give a “tip break”. He is already pleased with the appearance of his nose. He will develop more refinement as swelling typically diminishes over the next 3 years.
Rhinoplasty – Patient 111
A man in his mid 20’s who is bothered by a “ hump” on his nose as well as difficulty breathing. He also has a severe deviation of his nose and septum. He is shown before and again,
6 weeks after open rhinoplasty with septoplasty and spreader graft placement. His contour is quite good at 6 weeks, but he will continue to see a subtle improvement over the next 3 years as swelling continues to slowly resolve.
Rhinoplasty – Patient 110
A professional in her mid 30's who is bothered by a crooked nose, dorsal hump, difficulty breathing. On examination she was noted to have significant deviation of the septum as well as vestibular stenosis. Vestibular stenosis is the collapse of the nose when someone breathes in that takes place at the "nasal valve" area and is often temporarily improved with "Breath rite" strips. She was also noted on exam to have a "weak chin". The chin falls behind an imaginary line that touches the upper and lower lips. She is shown before and again,4 months after an open rhinoplasty with correction of the vestibular stenosis by placing "spreader grafts", a match stick shaped piece of the septal cartilage. She also had a medium chin implant placed. She is thrilled with her early improvement, and no longer has obstruction of her breathing. Her husband notes that she no longer snores at night. The nasal tip will continue to gain refinement over the next 2 1/2 years. The slight pinkness of her nose is a sunburn from the weekend.
Our patient is now shown 16 months after surgery. The nose appears even more refined as the swelling in the nasal tip diminishes. We can typically expect the nose to improve for the first 3 years after surgery. She is thrilled with the natural appearance of her surgery. Friends and relatives know that she looks better but are not sure why. We have moved her closer to the aesthetic ideal, and people can tell that she looks better, but assume that she has gotten a new hair style.
Rhinoplasty – Patient 109
A young woman in her mid to late teens who was troubled by a small dorsal hump and a drooping nasal tip. She is shown before and again, 6 months after an open rhinoplasty. The nasal tip will continue to gain in definition and refinement over the next 2 1/2 years as the typical swelling after surgery continues to diminish. She is already thrilled with the improvement of her nose after surgery, and notes that her breathing is improved as well. Her case is a challenge because of the weakness of the tissues around the tip. A "columnellar strut" fashioned from septal cartilage as well as special suturing of the tip allowed us to improve the projection and give her a slight "tip break" with the tip sitting higher than the dorsum after surgery.
She is seen again 17 months after surgery. The nose typically continues to improve in appearance for 3 years after a rhinoplasty, as swelling in the tip slowly goes away. Although her nose looked good shortly after her surgery, we can see continued "refinement' in the appearance of her nose as the structure created at the time of surgery is slowly revealed.
What are my options for nose surgery?
There are two main techniques used for rhinoplasty today: the open procedure and the closed procedure. A closed procedure involves hidden incisions made inside the nose, while an open procedure entails an incision outside of the nose, or along the slim strip of tissue that separates the nostrils, called the columella.
Depending on the patient’s goals for the outcome of the surgery, bone or cartilage can be removed to reduce the size of the nose, while cartilage grafts may also be required.
What should I expect during recovery?
Typically, it takes about 10 to 14 days for most of the swelling and bruising to heal following nose surgery, and a nasal splint is often placed for the first week. Bruising under the eyes and brief nausea from anesthesia are normal side effects. Patients are advised to avoid straining, bending and lifting, as well as wearing eye glasses immediately after the procedure.
In most cases, patients return to work within two weeks, once the bruising has depleted. However, more strenuous activities should be avoided for about six weeks. Although the results are immediate after surgery, the overall contour continues to improve for two to three years. As with any invasive procedure, there are risks involved with nose surgery. Ruptures of small surface vessels on the nose, infections, and poor wound healing are all complications that can arise.
How long will results last?
Rhinoplasty results are permanent. However, rhinoplasty revision surgery is also an option.
“Dr. Hall and his staff are great. They are friendly and made me feel comfortable. Dr. Hall is very knowledgeable and put me at ease regarding my surgery.”
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