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Nose Surgery

 

What is nose surgery?

While the shape of your nose is usually the result of heredity, the appearance may have been altered in an injury or during prior surgery. Nose surgery, commonly referred to as rhinoplasty, improves the appearance and proportion of your nose and may correct impaired breathing.

Rhinoplasty can change:

  • Nose size, in relation to the other facial structures
  • Nose width, at the bridge
  • Nose profile, with visible humps or depressions on the bridge
  • Nasal tip, that is large or bulbous, drooping, or too upturned
  • Nostrils that are large, wide or upturned
  • Nasal asymmetry and deviation

Is nose surgery right for me?

Nose surgery is a highly individualized procedure, and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image. Surgery of the nose is a good option for you if:

  • Your facial growth is complete and you are 13 years of age or older
  • You are physically healthy
  • You are a non-smoker
  • You have specific, but realistic goals in mind for the improvement of your appearance

What happens during nose surgery?

Anesthetic medications are administered for your comfort during the surgical procedures. The choices include intravenous sedation and general anesthesia. 

Once the anesthesia is provided, your surgeon will begin the incision. Surgery of the nose is performed either using a closed procedure, where incisions are hidden inside the nose, or an open procedure, where an incision is made across the columella, the narrow strip of tissue that separates the nostrils. Through these incisions, the soft tissues that cover the nose are gently raised, allowing access to reshape the structure of the nose.

Surgery of the nose can reduce or augment nasal structures with the use of cartilage grafted from other areas of your body. Most commonly, pieces of cartilage from the septum, the partition in the middle of the nose, is used for this purpose. Occasionally a piece of cartilage from the ear and rarely a section of rib cartilage can be used.
If the septum is deviated, it is now straightened and the projections inside the nose are reduced to improve breathing.

Once the underlying structure of the nose is sculpted to the desired shape, nasal skin and tissue is redraped and incisions are closed. Additional incisions may be placed in the natural creases of the nostrils to alter their size.

Splints and internal tubes will likely support the nose as it begins to heal for approximately one week.

While initial swelling subsides within a few weeks, it may take up to a year for your new nasal contour to fully refine.

During this time you may notice gradual changes in the appearance of your nose as it refines to a more permanent outcome. Swelling may come and go and worsen in the morning during the first year following our nose surgery.

Nose surgery to improve an obstructed airway requires careful evaluation of the nasal structure as it relates to airflow and breathing. Correction of a deviated septum, one of the most common causes of breathing impairment, is achieved by adjusting the nasal structure to produce better alignment.

What is nose surgery recovery like?

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

After your procedure is completed, a splint, internal tubes or packing will likely be placed inside your nose and a splint or bandages placed on the outside to support and protect the new structures during initial healing.

You will be given specific instructions that may include how to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health and when to follow up with your plastic surgeon.

It may take several months for swelling to fully dissipate and up to a year – and sometimes longer – for the outcome of the surgery to fully refine.

Although the results of nose surgery are usually permanent, cartilage may continue to reshape and move tissue that may change the outcome over time.

What are the risks of nose surgery?

When nose surgery is performed by a qualified plastic surgeon, complications are infrequent and usually minor. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

The risks include:

  • Rupture of small surface vessels of the nose
  • Infection
  • Poor wound healing
  • Anesthesia risks
  • Bleeding (hematoma)
  • Nose asymmetry
  • Cardiac and pulmonary complications can occur in longer surgical procedures and may be associated with the formation of, or increase in, blood clots in the venous system
  • Change in skin sensation (numbness)
  • Nasal airway alterations may occur after a rhinoplasty or septoplasty that may interfere with normal passage of air through the nose
  • Nasal septal perforation (a hole in the nasal septum) may develop but is rare; additional surgical treatment may be necessary to repair the nasal septum but in some cases, it may be impossible to correct this complication
  • Pain, which may persist
  • Unfavorable scarring
  • Skin contour irregularities
  • Skin discoloration and swelling
  • Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
  • Possibility of revisional surgery