Nose Surgery

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 126
A student in her early 20’s who had nasal obstruction before surgery which caused her to snore at night and wake up with a dry mouth in the morning. She is also bothered by a dorsal “hump” and a drooping appearance of the tip of her nose. She was diagnosed with vestibular stenosis or collapse of the internal nasal valve. This can be improved temporarily with Breath-Rite” strips but can be improved surgically with the placement of “spreader grafts”. This is a strip of cartilage in the shape of a match stick that is placed between the top of the septum and the upper lateral cartilages to prevent collapse when a patient inhales through the nose. She is shown before and again, 5 ½ weeks after an open rhinoplasty with placement of spreader grafts. Her breathing is normal now and she loves the early improvement in the shape of the nose. The nose will typically continue to develop more refinement over the next 3 years a s swelling slowly resolves.
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Rhinoplasty – Patient 125
A 13 1/2 year follow-up on a woman who was bothered by the appearance of her nose. This was before computer simulation and I have sketched out the changes that we wanted to make in a side view. She had deviation of the septum a marked collapse of the internal nasal valve ( a Breath rite strip is used to temporarily improve this sometimes). She is shown before and again, 13 1/2 years after an open rhinoplasty with bilateral spreader graft placement as well as placement of a columnellar support strut from the septum to stabilize her nasal tip. Her nose is no longer blocked and she loves the natural appearance of her nose after surgery. The dorsum is straight and the tip is refined in appearance.
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Rhinoplasty – Patient 124
A woman in her mid 40’s who is bothered by drooping of the nasal tip and a dorsal hump. The tip is also bulbous in appearance. She snores and wakes up with a dry mouth in the morning. On exam she has a positive “Cottle” maneuver bilaterally demonstrated collapse at the internal nasal valve ( the area that is improved with “breath rite strips”) as well as septal deviation. She is shown before and again, 2 ½ years after an open rhinoplasty with septoplasty and correction of the vestibular stenosis with bilateral spreader graft placement. Her nasal obstruction has resolved, and she is pleased with the natural appearing improvement of her nose.
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Rhinoplasty/Restylane – Patient 123
A woman in her late 40’s who was bothered by a “bump” on her left mid nose. She first noticed this after being struck by a ball in the nose a few years before. On examination she has very thin skin and has a prominent cartilage bump under the skin. A surgical rhinoplasty is an option to reshape the cartilages and add a strip of fascia from her scalp under the skin to add more thickness and help to camouflage this area. I recommended that she might try a “non surgical rhinoplasty” first with the use of Restylane injected under the skin to camouflage the area. This was done in a few minutes in the office with a topical anesthetic. She is shown 2 weeks after and has a significant improvement with ½ cc of Restylane. Although this is not permanent, it typically lasts for a year or longer in this area and is easy to repeat. She is pleased with her improvement. The nose looks straighter, and the “bump” is no longer as noticeable. The side view shows an improvement in the dorsum.
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Rhinoplasty – Patient 122
A 20 yo woman who does not like her nasal profile.  She also has severe nasal obstruction and before her surgery would snore at night and wake up with a dry mouth in the morning.  She had a positive Cottle maneuver bilaterally which is a test for collapse of the nose at the internal nasal valve.  She also has significant deviation of the septum.  She is shown before and again, just 6 weeks after an open aesthetic rhinoplasty combined with a septoplasty and bilateral spreader graft placement.  Although it has been just 6 weeks since her surgery, her nasal obstruction has resolved.  And she is thrilled with her new nose and no longer tries to hide her profile.  The nasal tip should continue to gain in refinement over the next 3 years as the swelling in the nasal tip continues to decrease.
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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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