Rhinoplasty, or nose job, is a facial plastic surgical procedure designed to enhance the cosmetic or aesthetic appearance of the nose, and to restore or reconstruct the functional integrity of the nasal airway. Sometimes patients can have nasal deformity from birth or dating back to their childhood, while other times patients have a known history of trauma that led to nasal obstruction or crookedness that needs correction. Whatever the reason for having a misshapen nose or impeded airflow, your rhinoplasty surgeon should be skilled in both the cosmetic and functional (breathing) aspects of this complex cosmetic surgery.

The Technique

Rhinoplasty, whether using a scarless (endonasal, closed) or external (open) technique, is performed under sedation or general anesthesia, which requires an operating room. This is an outpatient surgery and patients go home the same day after awakening from the surgery. The scarless or endonasal technique can be performed with all incisions placed within the nose. If an external approach is required to get the most satisfactory outcome for an individual, then a small incision is hidden on undersurface of the nose. Each patient will be examined individually to determine which approach is most appropriate.

The Recovery

The following morning after surgery, our Oklahoma City facial plastic surgeon, Dr. Scott Shadfar, will instruct patients how to care for the nose after their surgery. Patients will be expected to clean the inside of the nose where the incisions are located. If an external approach is used, sutures on the outside of the nose are removed on day 7 following the surgery, otherwise all the sutures on the inside will dissolve on their own. This step is not necessary for the scarless rhinoplasty. During the first week following nasal surgery a patient can expect some swelling and congestion. Patients will have a splint and tape on the outside of their nose for one week. Sometimes bruising can be seen around the top of the nose and below the eyes. If this occurs it usually is resolved by the end of the week at the time of the splint and tape removal.

Patients usually have minimal downtime of 1-2 weeks before returning to work, and we ask those patients traveling from out of town to stay for routine checks during this time period.

Rhinoplasty Frequently Asked Questions (FAQs)

Who is a good candidate for rhinoplasty?

Good candidates for rhinoplasty generally include women and men who are bothered by one or more of the following concerns:

  • A noticeable hump on the nasal bridge
  • A misaligned and/or distorted nasal bridge
  • A disproportionately large and/or downward-turned nasal tip
  • Unevenly sized and/or misshapen nostrils
  • A deviated septum restricting proper airflow

In addition to these issues, good candidates for rhinoplasty need to have realistic expectations for the outcome of surgery. This is not to say patients will not achieve the results they desire, but more so that the goal of rhinoplasty is to improve the appearance (and/or function) of the individual’s nose—not to create a nose that looks identical to someone else’s.

Which parts of the nose can rhinoplasty address?

Depending on each patient’s specific needs and desires, the rhinoplasty procedure can be individually tailored to refine and/or enhance the nostrils, nasal bridge, nasal tip, nasal hump, and septum. More specifically, the nostrils can be resized and reshaped; the nasal bridge can be straightened, made bigger/smaller, or broadened/narrowed; the nasal tip can be raised/lowered and increased/decreased in size; the nasal hump can be trimmed or shaved down; and the septum can be repaired or realigned.

What is the difference between open and closed rhinoplasty?

Open rhinoplasty is performed using a tiny incision hidden in the columella (the junction between the left and right nostrils on the undersurface of the nose). In contrast, closed (endonasal or scarless) rhinoplasty involves the use of small incisions made inside the nose. Both techniques can yield exceptional results for the right patients, and the most effective method will be determined based on the individual’s unique needs and goals.

Is rhinoplasty performed differently for women and men?

In general, the fundamental technique used to perform rhinoplasty for women and men does not differ. However, there are certain nasal characteristics unique to females and males that are generally taken into account when planning and conducting surgery. For example, the nasal bridge for most females tends to be thinner and less prominent than that of most males. Additionally, the nasal tip of the female nose is often turned slightly upwards whereas the majority of male noses are less elevated, usually creating a 90–95 degree angle between the upper lip and nose. In the end, rhinoplasty is an individualized treatment, and regardless of what is thought of as the aesthetic ideal for men and women, the procedure can be customized to meet the specific needs and goals of the patient.

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