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Rhinoplasty: Definition

Rhinoplasty, commonly known as a nose job, is a surgical procedure that reshapes or resizes the nose for either aesthetic or medical purposes. Understanding the intricacies of this operation sets the stage for an informed decision.

Open Rhinoplasty: Involves an external incision at the base of the nose, providing the surgeon with maximum visibility. It's often used for complex cases requiring extensive alterations.

Closed Rhinoplasty: All incisions are inside the nostrils, leaving no external scars. This approach offers limited visibility and is usually for simpler cases.

Tip Plasty: Focuses exclusively on reshaping the nasal tip, often for subtle enhancements. It can be performed using either open or closed techniques.

Revision Rhinoplasty: Done to correct or refine a previous rhinoplasty, this procedure is often more complicated due to scar tissue and altered anatomy.

Septorhinoplasty: Combines a septoplasty (to correct a deviated septum) and a rhinoplasty (for cosmetic alterations) in a single operation.

Filler Rhinoplasty: Uses injectable fillers for minor adjustments and is non-surgical. The results are temporary, usually lasting only a few months.

Ethnic Rhinoplasty: Tailored to meet the aesthetic preferences and anatomical structures of different ethnic groups, ensuring culturally sensitive outcomes.

Functional Rhinoplasty: Performed for medical reasons, usually to alleviate breathing difficulties or to repair structural abnormalities from birth or trauma.

Adolescent Rhinoplasty: Aimed at younger patients, this type requires careful evaluation to ensure emotional and physical readiness for surgery.

Surgical Materials: Various materials like silicone implants, cartilage grafts from the patient, or biological tissue substitutes can be used in the procedure, each with its advantages and drawbacks.

Understanding the various types of rhinoplasty will guide you in conversations with healthcare providers and help you make an educated decision about the most appropriate procedure for your needs.

What to Expect?

Before the surgeon even touches a scalpel, a comprehensive pre-surgical consultation is crucial for both the patient and the medical team.

Initial Assessment: The surgeon conducts a thorough examination of your nose and face. This usually includes photographic documentation for surgical planning and simulations.

Medical History: A detailed medical history is imperative. Information about allergies, previous surgeries, and current medications can impact both the procedure and the recovery.

Surgical Objectives: Patients have the opportunity to discuss their aesthetic or medical objectives. Clear communication aids in setting realistic expectations.

Simulations: Advanced software allows for a virtual preview of the expected outcomes. They are not 100% accurate and should be considered as approximate visualizations.

Pre-Op Tests: Blood tests, ECGs, and sometimes MRIs are conducted to ascertain fitness for anesthesia and surgery.

Risk Disclosure: Surgeons are obligated to disclose potential risks and complications. Fully understanding these risks aids informed consent.

Surgical Plan: A step-by-step procedural plan is formulated, detailing techniques to be used, anesthesia type, and estimated operation time.

Financials: The total cost, including surgeon's fees, facility charges, and post-op care, is disclosed upfront. Payment plans and insurance applicability are also discussed.

Pre-Op Preparations: Guidelines on what to avoid before surgery, like certain medications or alcohol, are provided. Sometimes, prescriptions for post-surgical medications are given in advance.

Psychological Assessment: Some surgeons require a psychological evaluation to ensure the patient's emotional readiness and realistic outlook on the surgery's outcome.

A well-executed pre-surgical consultation sets the tone for a successful rhinoplasty experience. It minimizes risks and ensures that the patient is fully informed and prepared for the surgical journey ahead.

The Surgery

Understanding the workflow of the surgery can alleviate apprehensions. Each rhinoplasty procedure follows a structured plan.

Anesthesia: The patient is administered either local anesthesia with sedation or general anesthesia, based on the surgical plan.

Incisions: Open or closed rhinoplasty dictates where incisions are made. In the open method, an external cut on the columella is made. For the closed technique, incisions are inside the nostrils.

Reshaping: Excess bone and cartilage are removed or reshaped to achieve the desired nose structure. Grafts may be used for augmentation.

Adjustments: Deviated septum, if present, can be corrected at this stage. Tip modifications or nostril resizing might also be performed.

Suturing: Once reshaping is complete, sutures are used to close the incisions. In an open procedure, stitches on the columella may be visible temporarily.

Monitoring: The patient is moved to a post-operative recovery room for vital signs monitoring until the anesthesia wears off.

Initial Recovery: Most patients are discharged on the same day unless complications arise. Facial puffiness and mild pain are common but manageable.

Splints: Internal and sometimes external splints are placed to support the newly shaped nose and to aid healing.

Review: A post-operative appointment is usually scheduled within a week for an initial assessment and suture removal if necessary.

Data Gathering: The surgical team often takes post-op photographs and documents findings for future reference and for comparison with pre-op simulations.

Foreknowledge of the surgical steps can help demystify the rhinoplasty process, making it a less daunting experience. This clarity is invaluable for both psychological ease and active participation in your care.

Post-Op Care

Effective post-operative care is as vital as the surgery itself for achieving optimal results.

Immediate Care: Post-surgery, expect facial swelling, bruising, and discomfort. Ice packs and over-the-counter analgesics are often advised.

Medications: Antibiotics and antihistamines may be prescribed to prevent infection and alleviate symptoms, respectively.

Wound Care: A set protocol for cleaning and caring for surgical wounds is provided. Deviation from these guidelines can risk infection or poor scarring.

Activity Levels: Light walking is encouraged, but strenuous activity is avoided for at least two weeks post-surgery.

Nutrition: A well-balanced diet rich in vitamins aids quicker recovery. Avoid spicy foods and alcohol that can exacerbate swelling.

Follow-up Visits: Regular appointments for wound inspection and progress monitoring are scheduled. Non-dissolvable sutures, if used, are typically removed within a week.

Long-term Care: While the immediate post-op period lasts a couple of weeks, full recovery can take up to a year. Regular follow-ups may continue for several months.

Expectation Management: The healing process has ups and downs. Emotional preparedness for this rollercoaster is essential for overall well-being.

Photographic Documentation: Post-op photographs are periodically taken for record-keeping and to objectively measure progress against initial simulations and expectations.

Scar Management: Topical treatments and sometimes laser therapy are used for minimizing scars. Silicone-based gels are often effective.

Proactive engagement in post-operative care accelerates recovery and improves outcomes. Knowledge of what to expect post-surgery empowers the patient to be an active participant in their own healing journey.

Non-Surgical Options

For individuals hesitant about going under the knife, there are less invasive alternatives that offer notable results.

Fillers: Injectable fillers like hyaluronic acid can change nose shape temporarily, usually lasting six months to a year. They're good for minor adjustments but can't reduce nose size.

Thread Lift: Threads are inserted into the skin to pull up sagging tissue. While not permanent, it offers an alternative to change the nose's contour.

Botox: Botulinum toxin can subtly alter the nose by relaxing specific muscles. It's commonly used to reduce a "bunny nose" effect when smiling.

Rhinomodulation: Combining both fillers and Botox, this treatment adjusts both the nose's shape and its dynamic movements.

Ultrasound: High-frequency ultrasound can stimulate collagen production, leading to tighter skin. It's a long-term commitment with gradual results.

Liquid Rhinoplasty: This is a nuanced form of filler treatment, where the liquid can be used more liberally to make larger changes.

Septoplasty: For functional issues like a deviated septum, septoplasty can improve airflow without altering external appearance.

Risks: While these are less invasive, they come with their own set of complications like infection or an allergic reaction. Always consult an experienced practitioner.

Cost: Generally cheaper than surgical options, these treatments nonetheless require ongoing maintenance, adding to long-term costs.

Effectiveness: The longevity and effectiveness of these treatments are less compared to rhinoplasty but may suffice for those wary of surgery.

Understanding the range of non-surgical alternatives empowers individuals to make more informed decisions tailored to their comfort levels and aesthetic goals. While they may not offer permanent results, these methods provide a low-risk entry point into aesthetic adjustments.


  • Rhinoplasty Los Angeles
    A Los Angeles board certified plastic surgeon specializing in rhinoplasty (nose job), including closed (scarless/endonasal) rhinoplasty and open rhinoplasty, as well as cosmetic plastic surgery of the body and face. His practice is located in Glendale, California.