Rhinoplasty Or Nose Job

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• QWhat should I expect following my rhinoplasty surgery?

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  A Dr. Arthur W. Perry, MD , Plastic Surgery, answered

  After rhinoplasty, you will wake up from surgery with a splint on your nose and possibly with packing inside your nose. The packing is eliminated when possible, since it is the most uncomfortable aspect of the procedure. You will have stitches in the various incisions in your nose. A drip pad, a piece of gauze held in place with a dressing that drapes around your ears, catches the oozing blood after surgery. At home you will change the drip pad often the first night; by the next day, the oozing stops.
  
  You'll see your surgeon a day or two after surgery and have your nose cleaned. The bruising and swelling around your eyes, forehead, and lips will remind you of the 1988 Newsweek photo of Geraldo Rivera after his television show guest smashed a chair over his nose. Your swelling will subside in a few days. The splint and sutures are removed a week after surgery. At that time, your nose will still be quite swollen. Brave people go back to work after the splint is off; others wait two weeks, until the swelling settles down and any residual bruising can be covered by makeup.
  
  Now comes the hard part -- waiting. Unlike a breast augmentation where you wake up from surgery with C cups, your final nose will not make its appearance for many months, if not years. While the swelling decreases over the months following surgery, the internal scarring increases over the first three months, and then takes the next nine months to settle down. Even though we say that the nose is done a year following surgery, in actuality subtle changes occur for years and even decades afterward.

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• QWhy is a nose job a difficult surgery?

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  A Dr. Stuart A. Linder, MD , Plastic Surgery, answered

  Rhinoplasty surgery is quite complicated because the anatomy doesn't allow for error in the operating room. Only board certified plastic surgeons and otolaryngologist should perform rhinoplasty surgery. The approach can be either open or closed (through small incision in the nostril). Making a perfect nose requires skill with manipulation of bone, cartilage, and skin. This makes it one of the most challenging surgeries we plastic surgeons perform.
• QWhat does a nose job involve?

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  A Dr. Stuart A. Linder, MD , Plastic Surgery, answered

  A nose job is also referred to as a rhinoplasty. The components of each individual patient's surgery depends on the corrections necessary. Common manipulations include narrowing of the dorsum ( infracture of the nasal bone), tip elevation (anterior cartilage trimming and repositioning), and correction of breathing (septoplasty, turbinectomy). Rhinoplasty surgery should be performed by board certified plastic surgeons and facial plastic surgeons (otolaryngologist). 
• QWhat should I know about ethnic rhinoplasty?

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  A Dr. Jeremy P. Warner, MD , Plastic Surgery, answered on behalf of NorthShore University HealthSystem

  The term "ethnic" rhinoplasty refers to modern techniques of tailoring a patient's nose to fit his or her face and not just routinely "westernizing" a nose. In other words, there is not one nose to fit everyone's face. A rhinoplasty should look natural and blend into the rest of the face. It should not look "done", what I like to refer to as the "red-carpet" look, as many celebrities have nose jobs that are obvious and overdone. While every nose is unique, there are some cultural similarities in the way noses look. With the trend being toward more natural surgical results, ethnic rhinoplasty can be performed which alters the shape of the nose without making it look out of place. This usually involves maintaining some degree of "strength" along the dorsum in order to avoid a "surgical" look. 
• QHow long does it take to recover from a rhinoplasty?

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  A Dr. Stuart A. Linder, MD , Plastic Surgery, answered

  The recovery from rhinoplasty surgery depends on the extent of dissection and nasal bony involvement. We learn in our training as board certified plastic surgeons Not to revise a nose for up to 1 year after the initial surgery. Directly after the surgery a nasal splint may be used, and nasal packing as well. Persistent swelling may occur up to 3 weeks. Bruising under the orbital areas are frequent after nasal bony work with infracturing to narrow the bridge. Edema and swelling may persist for the first couple of weeks as well. 

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• QHow is a rhinoplasty done?

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  A Dr. John F. Burnett, MD , Plastic Surgery, answered on behalf of Saint Agnes Medical Center

  The way a rhinoplasty is done depends on the problems the person sees with the nose. There are many things that have to be looked at before the surgery. Generally, the areas focused on are:

  • the bridge of the nose—width, height, bump
  • the tip of the nose and how the cartilage is shaping the tip
  • the base of the nose, how wide it is and how much projection the tip has 

  The other difficult thing is how to project what the nose will look like after surgery. There are specialized computer programs that can help predict that but it’s just an estimate. The best predictor is having the surgery done by a plastic surgeon who has done a large number of rhinoplasties. The surgeon will be better able to predict the outcome based on his or her experience.
  
  Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified healthcare provider.

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• QWho is a good candidate for a cosmetic rhinoplasty?

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  A Dr. John F. Burnett, MD , Plastic Surgery, answered on behalf of Saint Agnes Medical Center

  People who are candidates for rhinoplasty are unhappy with the appearance of their nose. If they have a good discussion with a plastic surgeon and they describe the problems they see with their nose and listen to the surgeon’s recommendations, then they can make the decision whether they want the surgery and if they want to do it with that surgeon.
  
  Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified healthcare provider.

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• QShould my teenager have a nose job?

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  A Dr. Stuart A. Linder, MD , Plastic Surgery, answered

  Normally rhinoplasty surgery or a nose job should not be performed before age 14-16. It is vital that the nasal cartilages and bony vault be fully developed prior to elective nasal surgery. Rhinoplasty, when performed by a board certified otolaryngologist or plastic surgeon can greatly enhance the patient's self esteem and breathing. Rhinoplasty surgery can be performed for several reasons on a teenager. Cosmetic reasons may include a large dorsal hump, tip droop, wide nasal base, or nasal shift. Functional reasons may include septal deviation, nasal bone fracture, turbinate hypertrophy. 
• QHow effective is a rhinoplasty?

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  A Dr. Homayoun N. Sasson, MD , Plastic & Reconstructive Surgery, answered on behalf of Castle Connolly Top Doctors

  The effectiveness of rhinoplasty largely depends on the following factors:

  • degree of the deformities
  • the person’s genetic background
  • skin type
  • age
  • facial proportions
  • desired and realistic expectations
  • postoperative compliance
  • surgeon’s skills and expertise
  • preparation of the person for an outcome that cannot always and entirely be predicted and guaranteed

  In a carefully selected and well-prepared scenario, the combination of proper indications and timing for this procedure, adequate preoperative and postoperative preparation and support and managing realistic expectations combined with good technical skills usually result in a very satisfying and effective outcome. In most cases, it can dramatically improve a person’s face and outlook and self-confidence and help propel him or her towards careers and/or social circumstances which might've been otherwise difficult or impossible to achieve.

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• QWhat is rhinoplasty?

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  A Dr. Homayoun N. Sasson, MD , Plastic & Reconstructive Surgery, answered on behalf of Castle Connolly Top Doctors

  Rhinoplasty is surgery to address deformities of the nose. Rhinoplasty is the Greek terminology denoting a change or enhancement of the nose, at times associated with improving nasal breathing and function, simultaneously. Its main goal is to restore better proportion of nasal dimensions to the rest of the face, be it as a result of congenital deformities such as cleft lip and nose, trauma, infection and/or cancer, to name a few. It frequently addresses disproportionalities of nasal dorsal hump, wide or narrow nose including the tip, nostrils, nasal height, asymmetries and other numerous types of nasal deformities. At times, it may, inadvertently or by design, help improve or restore breathing as a result of deviated septum or previous surgeries or injuries to the nose. It is performed in two ways, "open" and "closed" or scar-less rhinoplasty, each having its pros and cons and depends on the skills and preference of the surgeon and the problem at hand. When performed properly and conservatively, it can significantly improve the person's appearance and self-confidence and even help alter the person’s life.

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