Nose Plastic Surgery

Rhinoplasty (RIE-no-plas-tee) is surgery that changes the shape of the nose. The motivation for rhinoplasty may be to change the appearance of the nose, improve breathing or both.

The upper portion of the structure of the nose is bone, and the lower portion is cartilage. Rhinoplasty can change bone, cartilage, skin or all three. Talk with your surgeon about whether rhinoplasty is appropriate for you and what it can achieve.

When planning rhinoplasty, your surgeon will consider your other facial features, the skin on your nose and what you would like to change. If you're a candidate for surgery, your surgeon will develop a customized plan for you.

Sometimes part or all of a rhinoplasty is covered by insurance.

Why it's done

Rhinoplasty can change the size, shape or proportions of your nose. It may be done to repair deformities from an injury, correct a birth defect or improve some breathing difficulties.

Risks

As with any major surgery, rhinoplasty carries risks such as:

• Bleeding
• Infection
• An adverse reaction to the anesthesia

Other possible risks specific to rhinoplasty include but are not limited to:

• Difficulty breathing through your nose
• Permanent numbness in and around your nose
• The possibility of an uneven-looking nose
• Pain, discoloration or swelling that may persist
• Scarring
• A hole in the septum (septal perforation)
• A need for additional surgery

Talk to your doctor about how these risks apply to you.

How you prepare

Before scheduling rhinoplasty, you must meet with your surgeon to discuss important factors that determine whether the surgery is likely to work well for you. This meeting generally includes:

• Your medical history. The most important question your doctor will ask you is about your motivation for surgery and your goals. Your doctor will also ask questions about your medical history — including a history of nasal obstruction, surgeries and any medications you take. If you have a bleeding disorder, such as hemophilia, you may not be a candidate for rhinoplasty.

• A physical exam. Your doctor will conduct a complete physical examination, including any laboratory tests, such as blood tests. He or she also will examine your facial features and the inside and outside of your nose.

  The physical exam helps your doctor determine what changes need to be made and how your physical features, such as the thickness of your skin or the strength of the cartilage at the end of your nose, may affect your results. The physical exam is also critical for determining the impact of rhinoplasty on your breathing.

• Photographs. Someone from your doctor's office will take photographs of your nose from different angles. Your surgeon may use computer software to manipulate the photos to show you what kinds of results are possible. Your doctor will use these photos for before-and-after assessments, reference during surgery and long-term reviews. Most importantly, the photos permit a specific discussion about the goals of surgery.

• A discussion of your expectations. You and your doctor should talk about your motivations and expectations. He or she will explain what rhinoplasty can and can't do for you and what your results might be. It's normal to feel a little self-conscious discussing your appearance, but it's very important that you're open with your surgeon about your desires and goals for surgery.

  If you have a small chin, your surgeon may speak with you about performing a surgery to augment your chin. This is because a small chin will create the illusion of a larger nose. It's not required to have chin surgery in those circumstances, but it may better balance the facial profile.

Once the surgery is scheduled, you'll need to arrange for someone to drive you home if you're having an outpatient surgery.

For the first few days after anesthesia, you may have memory lapses, slowed reaction time and impaired judgment. So arrange for a family member or friend to stay with you a night or two to help with personal care tasks as you recover from surgery.