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RHINOPLASTY

RHINOPLASTY

Rhinoplasty is a surgery that changes the shape and look of the nose. The nose is made of bone, cartilage, and skin. The upper part of the nose is bone, and the lower part is cartilage. Rhinoplasty can change the bone, cartilage, or skin on the nose. Depending on your needs, it could be a combination of one, two, or all three. Patients consider rhinoplasty for multiple reasons. It could be entirely cosmetic, necessary for health and breathing reasons, or a combination of both.

Candidates for Rhinoplasty

Candidates for the surgery depend on the needs and desires of the patient. Patients who are interested in rhinoplasty for cosmetic reasons need to have realistic expectations. Because rhinoplasty is permanent, patients should be confident that they are ready for rhinoplasty. Potential patients also need to be in good health.

For patients who are looking into rhinoplasty for medical reasons, the surgery may be able to correct specific issues. If you have difficulty breathing, an injury to your nose area, or a congenital disability, the operation may be right for you.

Depending on your needs, the surgery can correct any issues. Below are the following improvements that your doctor can achieve through the surgery:

  • Change the sloping angle of your nose.
  • Correct defects at the point from the tip of the nose to the upper lip area.
  • Narrow or widen the width of your nose.
  • Increase or reduce the size or length of your nose.
  • Correct bumps and other issues at the bridge of the nose.
  • Change the shape or size of your nostrils.
  • Enlarge or reduce nasal passages.
  • Change your nose profile.
  • Correct broad, bulbous, drooping, or a too upturned nose.
  • Correct an asymmetrical or deviated nose.

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Rhinoplasty Consultation

Rhinoplasty is one of the most complex surgical procedures performed today. Because the surgery takes the utmost skill, the consultation is highly essential. Letting your doctor know your expectations is essential. A surgeon cannot guarantee results, but they can manage your expectations. A patient cannot select a particular nose they want and have the outcome match ideally. This is due to limiting factors such as skin and bone thickness, nostril size, and general facial configuration. This is why it is crucial to find a doctor that you trust. Finding someone who has proven results with before and after photos and excellent patient reviews are necessary. The consultation should feel comfortable and free from pressure. A right surgeon will tell you whether they can help you achieve your desired results or not. Together with your doctor, you can both decide on the most beneficial procedure based on your expectations and individual nasal anatomy.

Types of Rhinoplasty

The surgery is both reconstructive and cosmetic, as various surgical techniques are used to improve the function and appearance of the nose. Depending on your individual needs and the decisions made at the consultation, there are various types of rhinoplasty.

Primary

This refers to procedures on that nose that have not had any prior surgeries or trauma. This surgery aims to resize, reshape, or reposition the tip, profile, or nostrils. This surgery can fix common problems, including small humps, reshaping a bulbous tip, changing the angle between your nose and mouth, and changing the shape of your nostrils.

Revision

This is also referred to as secondary rhinoplasty and corrects issues from a previous operation. This is more difficult as there is less cartilage to work with, and there may be scarring or tightened tissue. This surgery can help with the appearance and function of your nose.

Functional

This is performed for health reasons. It is meant to help relieve nasal obstruction. This is often caused by a deviated septum and may result in breathing problems. The corrective surgery called septoplasty can help with these issues and provide a more balanced appearance as well.

Reconstructive

This is done to repair any deformities caused by injury, congenital disabilities, or aging. It can also be used to remove external skin tumors or internal nasal tumors. This surgery requires extra precision and should only be performed by an experienced surgeon. Aesthetic reshaping can also be done during reconstructive surgery.

Tip

The nasal tip is the furthest point on your nose from your face. It is considered a significant factor in the appearance of the nose. This surgery can modify the tip and give your nose more definition by adding or removing cartilage. This surgery can often achieve results that are subtle yet beautiful.

Ethnic

Plastic surgery is no longer tailored only to meet Caucasian standards. African American, Asian American, and Latino patients can now undergo procedures to change the appearance of their nose while maintaining their ethnic identity.

Rhinoplasty Surgery

Step 1: Anesthesia
You may be given a mild sedative or valium to calm any nerves you have on the day of surgery. Depending on the extent of your surgery, you will either be given intravenous sedation or general anesthesia. Your doctor will go over what’s best for you at the consultation so you will be prepared on the day of surgery.

Step 2: Incisions and Reshaping
There are two types of procedures, an open and closed process. Depending on your needs, your doctor will advise which is best for you.

Closed Procedure

Small incisions are made inside your nose to reach the bone and cartilage. Some bone and cartilage may be removed. It also may be rearranged to achieve the shape you want. The skin over your nose is left untouched and shrinks to the new form.

The closed procedure is beneficial because there is no visible scarring. However, this technique is not for everyone. This technique works better for patients that are looking for minor changes, such as removing small bumps on the bridge of their nose.

Open Procedure

An incision is made across the narrow strip of tissue that separates your nostrils. The soft tissues that cover your nose are gently raised, allowing the doctor to access and reshape the structure of your nose.

The open procedure is better for those that need more extensive work performed. While there is scarring, taking proper care of the scar will lighten it, and it will eventually be unnoticeable.

In rare cases, if your nasal bone and/or cartilage structure has been damaged or compromised, an implant can be used to reconstruct the nose and nasal passage. Synthetic materials can lead to long-term complications, so cartilage from a patient’s ear, rib, or septum are more appropriate materials for reconstructive surgery.

To keep your features in proportion, it may be necessary to make your nostrils smaller. This is done by making cuts into the skin of your nostrils. This will leave beautiful scars on each side of your nostrils. If you have to have augmentation surgery, you may need a graft of extra bone or cartilage to build up your nose. Cartilage is usually taken from the septum (the area of skin between your nostrils) for this purpose.

Step 3: Closing the Incision
Once the underlying parts of the nose are sculpted to the desired shape, your nasal skin and tissue are re-draped, and the cuts are closed with dissolvable stitches. You may also have small plastic splints inserted inside your nose to prevent scar tissue from forming. This will also help support your nose as it begins to heal.

Step 4: The Results
Initial swelling will subside within a few weeks. You may notice gradual changes in the appearance of your nose as it refines to a more permanent outcome.

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Rhinoplasty Surgery Recovery

Rhinoplasty recovery times are very much an individual process and it is very important for you to follow all the instructions given to you by Dr. Moelleken before and after your rhinoplasty procedure to minimize the risks.

Some tips for a speedy recovery from your nose surgery include:

  • Keep your head up as much as possible to reduce the risk of too much bleeding.
  • Do not take a hot bath or drink alcohol at least two weeks after surgery.
  • Do not use any nasal sprays or decongestants, no matter how stuffy you feel.
  • Sleep in a propped up position to help relieve congestion.
  • You will need to breathe through your mouth for the first few days, which can lead to dry lips. Use a lip balm on your lips to soothe any chapping.
  • Do not blow your nose for at least one week after your surgery. If you need to sneeze, cough it out instead of holding it in.
  • Check your temperature on a regular basis as a high temperature may indicate an infection.
  • The vast majority of nose surgeries are outpatient procedures, which means you will go home on the same day as your surgery. After you have sufficiently recovered, you will be released to someone you previously arranged with to drive you home. Once you are home, you should plan on relaxing as much as possible because that will help you recover more quickly. Again, you should arrange for someone to help care for you at least the first 24 hours after your nasal surgery. You may become nauseous following your surgery and this is common and usually not problematic. During many nose jobs, the patient may swallow a small amount of blood and this can make you feel ill.

Concerns about Nose Job Recovery

The first time you look in the mirror after your surgery, you may be surprised but do not worry. Bruising and swelling around your nose are common and these will fade with time. If you are concerned about bruising, Dr. Moelleken may recommend anti-bruise creams. You should keep your nose out of the sun for the first few weeks, as your nose will be particularly sensitive. If you do venture into the sun, always wear sunscreen as this will help to keep the sunlight from changing the pigmentation of your scars.

Week 1 Recovery

Within the first week or so, the cast, splints, or packing will typically be removed from the nose. When these are removed, make sure that you are very careful with your nose. You cannot always estimate the aesthetic outcome of rhinoplasty because after the surgery, nasal bones may dislodge and cartilage and soft tissue shape may change over time. It is extremely important that you do not suffer any type of trauma on your nose after surgery, since any applied pressure may affect the final outcome of rhinoplasty. Be cautious because your nose is very weak and it needs the chance to fully heal.

Week 2 Recovery

After approximately one week, you should be able to return to work and resume your ordinary activities. However, you should avoid any heavy lifting and you should wait approximately six weeks before you return to regular exercise. Your levels of bruising and swelling will gradually subside over the course of the next weeks and your appearance will continue to improve. At approximately six months, your results are at their best and they will be, for all intents and purposes, permanent. With increased age, your nose will continue to change, just as the rest of your body however, you should be able to enjoy the results of your nose surgery for many years to come. Nose surgery gives patients permanent results and performed correctly, patients are extremely happy with their new nose.

Rhinoplasty Risks

If you choose a highly-skilled, well-trained, experienced cosmetic surgeon for your rhinoplasty such as Dr. Moelleken, complications are infrequent and what complications do arise are usually minor. Following his advice will help to minimize any risks making your rhinoplasty procedure generally safe. In order to make an informed decision however, you need to be aware of the possible side effects and the risks associated with this procedure.

Side Effects of Rhinoplasty Surgery

  • Soreness, swelling, and bruising, particularly around your eyes.
  • Stiffness and numbness, particularly at the nose tip.
  • Inability to breathe through your nose, which should ease as the swelling subsides.
  • Scarring – When rhinoplasty is performed from inside your nose, the scars won’t be visible, but you may be able to feel them for a while after surgery. The open nose surgery procedure may give you a small scar on the underside of the nose. Though you should have little or no scarring on your nose, you will have permanent scars if you have bone taken from your rib or hip.
  • Red spots on your skin’s surface, which is caused by, burst, small blood vessels.
  • Chest or nose infection, treatable with antibiotics.
  • Nose bleed either shortly after your operation or after one week.
  • Temporary loss or reduction in sensitivity to smell.
  • Changes in the shape of your nose as scar tissue matures.
  • Damage to the septum.

You should contact Dr. Moelleken immediately if you develop any of the following symptoms:

  • Persistent bleeding that does not stop within 10 to 15 minutes
  • Difficulty or inability to drink or swallow normally
  • High temperature
  • Increased pain

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Recovery

Most surgeries are performed in outpatient clinics. This means you’ll be able to go home the same day. Once you are home, focus on relaxing and resting so you can get your body back to normal quickly. Recovery is entirely dependent on the individual and the type of surgery that was performed. The most critical factor in quick recovery is following your doctor’s post-surgery requirements. Below are some tips to increase the recovery process and get back to normal as soon as possible.

  • Keep your head up as much as possible, including when you sleep.
  • Breath through your mouth for the first few days (use lip balm for dry lips).
  • No nasal sprays or decongestants.
  • Do not blow your nose for at least one week after surgery. If you need to sneeze, cough it out.
  • No hot baths for at least two weeks after surgery.
  • Avoid the sun for the first few weeks and use SPF if you go outside.
  • Check your temperature regularly.
  • Contact your doctor if there are any concerns.

After your surgery, you’ll notice a lot of bruising and swelling. This is entirely normal, and it will subside within a few weeks. During the first week, the cast, splints, and packing will typically be removed. Once removed, you’ll need to be careful with your nose as it is still actively healing. This week is crucial for healing as your nose is still fragile. During the second week, you will most likely be able to return to your normal activities. For the first six weeks, you’ll want to avoid exercising or lifting heavy objects. Your results will be at their peak at the six-month mark. The results should last a lifetime as long as there are no subsequent injuries.

Call us today to schedule your
appointment in Beverly Hills or Santa Barbara.

Rhinoplasty Beverly Hills & Santa Barbara

Dr. Brent Moelleken is a double board-certified plastic surgeon In Beverly Hills. He is one of the most highly skilled surgeons in the country and has received his training at Harvard, Yale, and UCLA. Due to his commitment to patient outcomes, he has been selected as one of Vogue Magazine’s “Top 10 Plastic Surgeons in America.” Contact Dr. Moelleken today for a consultation.

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BEVERLY HILLS
120 S Spalding Dr #110 Beverly Hills, CA 90212 | (310) 273-1001
SANTA BARBARA
601 E Arrellaga St #103 Santa Barbara, CA 93103 | (805) 898-9299

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