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/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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Rhinoplasty – Patient 121
A woman in her early 20’s who was interested in chin augmentation and rhinoplasty. She did not like the overall shape of her nose and the dorsal hump, and also feels that her chin is too small for her face. She also had a history of nasal obstruction and would snore at night and wake up with a dry mouth in the morning. She is shown before and again, 6 weeks after an open rhinoplasty with straightening of her septum and placement of spreader grafts to correct collapse of the internal nasal valve. She had a solid silicone anatomic chin implant placed through an incision under the chin at the same time. Her nasal obstruction is improved, and she is thrilled with her natural appearing improvement. The nose looks better already at the 6 week mark but will typically continue to improve in the tip area over the next 3 years as swelling gradually resolves.
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Rhinoplasty – Patient 120
An early ( 6 week) result on a woman in her late 30’s who was bothered by the appearance of her nose as well as by difficulty breathing. She had a severely deviated septum as well as obstruction of the “internal valve” of the nose ( the kind of obstruction that is improved with BreathRite strips) Because of this obstruction she would snore at night and wake up with a dry mouth in the morning. She also felt that her nose was too large for her face and was crooked. She is shown before and again, 6 weeks after an open rhinoplasty with septoplasty and bilateral spreader graft placement. Her chin is slightly “weak” and her facial balance could be improved further with a chin implant but she elected not to have this done at this time. The postoperative photos show that the nose is much straighter in appearance and the tip has more refinement. The tip shape will typically continue to improve over the next 3 years as the swelling slowly resolves. She is already thrilled with her early result, and her breathing is dramatically better.   Update: Our patient is seen again at 6 months after her surgery. The nose continues to gain in definition and refinement as the swelling after surgery continues to diminish. This will typically continue for about 3 years after surgery.
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Rhinoplasty – Patient 119
following a nasal fracture playing basketball in high school. Although his fracture was apparently reduced at the time he had almost complete obstruction of both sides of his nose, with his nasal septum collapsed like a accordion. He is shown before and again, 6 weeks after an extracorporeal septoplasty/open rhinoplasty. In a case like this the septum is removed completely, straightened on the surgical table and attached to a pds plate ( a dissolvable plastic like material) to stabilized it and then placed back into the nose. Spreader grafts were placed at the same time. He is shown 6 weeks after surgery and not only is he able to breath normally again, but his nose is much straighter. Update: Our patient is now seen 8 months after his surgery. His nasal obstruction has resolved and his nose has maintained its shape after his extracorporeal septal reconstruction
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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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