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 117
A student in her late teens who was referred by her ENT because of severe nasal obstruction. She was struck with a dodgeball in the nose a year early, and had had significant trouble breathing through her nose ever since. She snored at night and would wake up with a dry mouth in the morning, She is shown 8 weeks after a reconstructive rhinoplasty with correction of her deviated septum and bilateral spreader graft placement. ( like a “breath rite” strip inside the nose). We improved her small dorsal hump and bulbous tip at the same time. The nose appears much straighter and in better balance. The tip definition will typically continue to improve for 3 years after surgery. She is already thrilled with her early result and able to breathe through her nose now.
Rhinoplasty – Patient 116
A 10 year followup on a secondary rhinoplasty. Our patient had initially had a rhinoplasty in California 16 years before and did well until her young infant accidently “head-butted” her in the nose and it collapsed, making it difficult for her to breath. There was a technique called the “Goldman tip” where the cartilages were cut through to give more definition of the tip. Unfortunately, this tends to weaken the nose and was prone to pinching of the tip and collapse, as we have seen here. In my training at the University of Michigan we were taught to strengthen the nose, added grafts were needed and performing “non-destructive” tip rhinoplasty, where the structure of the nose is strengthened and not weakened at the time of surgery. He nose had collapsed inside and she needed an open rhinoplasty with placement of cartilage grafts harvested from the septum to rebuild the lower alar cartilages, as well as to hold open the upper lateral cartilages (like an internal “breath rite” strip) to support the breathing. Although her external appearance has not changed drastically, this corrected the internal collapse of the nose and corrected her breathing difficulties. She stopped by to see us today for another unrelated problem and was kind enough to consent to us using her photos and story.
Rhinoplasty – Patient 115
A woman in her mid 20’s who is bothered by a “hump” of her nose. She is shown before and again, 6 weeks after an open rhinoplasty.
Rhinoplasty – Patient 114
A challenging case of a 17 yo student with a severely deviated nose. An “extracorporeal septoplasty” was performed. This is done in a case where the deviation is so severe that is cannot be corrected properly without completely removing the septum, rebuilding it in the operating room and replacing it in the nose. He is shown before and again, just 6 weeks after his procedure. An open rhinoplasty approach was used with a small incision placed across the columnella. He is thrilled with the natural appearance of his nose after surgery and the improvement in his breathing.
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.
Update: Our patient is now seen 3 years after surgery. The nasal tip has even more definition. Typically the results after a rhinoplasty will continue to improve for 3 years after surgery. We can now expect her to be at her "final" result
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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