Rhinoplasty, also known as a “nose job”, is a very delicate procedure that can re-contour the shape and size of your nose, which can result in an improved overall facial appearance and proportion. Patients often complain of a nasal bump, dislike the size or shape, have asymmetry or a crooked nose, deviated septum, bulbous nasal tip, enlarged nostrils, and/or difficulty breathing. Other patients have undergone some trauma to the nose requiring reconstruction. Rhinoplasty is one of the most complex cosmetic surgical procedures as every millimeter of alteration can have a strong effect. This is where the artistry of plastic surgery is extremely important; not only do we need to create an aesthetically pleasing nose, but also match and contour the nose to the rest of your face. The results can be very rewarding. After surgery, patients comment on the improved proportion and contour of the nose with the rest of the face, straightness with symmetry, and improved ability to breath comfortably along with an improved self-confidence.
Depending on the result you desire, the architecture of the underlying nasal structures can be altered. The vast majority of time, this procedure can be performed in a “closed” fashion with incisions located inside the nostrils, therefore hiding the scars. On very rare occasions, in difficult cases that require more manipulation of the nasal tissue, an “open” approach is performed in that there is an incision at the base of the nose, near the upper lip. This incision is also well hidden in the shadow of the nasal base. The septum is removed if it is deviated or creating difficulty breathing. Often times, the nasal bones are also broken to narrow the bridge in order to create an improved contour with the rest of the face, or to straighten a crooked nose. A splint is placed to protect and maintain the nasal bones in correct alignment until they heal.
During your consultation, Dr. Tsai will present you with all the possible options in detail and work with you to individualize treatment according to your specific goals and expectations to provide you with the best possible result. If you desire other areas of your face rejuvenated, this procedure is often combined with Facelift, Browlift, or Neck lift (Platysmaplasty). There is also a non-invasive option for Skin treatments performed in the adjacent medical spa or at the same time as surgery.
The Rhinoplasty procedure typically takes 2-3 hours to complete. Surgery is performed under general anesthesia (fully asleep) in the adjacent surgicenter. Patients return home the same day as the procedure so transportation will need to be arranged. Your first checkup will be the following day in clinic. Advice is given to sleep at an upright angle in bed for 48-72 hours to decrease swelling and bruising to the face. Ice packs are also recommended for the first 24 hours, on and off. There maybe bruising to the face and eye region but this is normal and will resolve over the next several days. The splint is removed one week after the procedure. Patients usually return to normal daily activities within a few days. Pain is tolerated with prescribed oral pain medication. Exercise is resumed approximately 4 weeks after the procedure.
As with many other delicate procedures, active smoking is a serious contraindication for a facelift. The nicotine creates spasms and constriction of the blood vessels, and after such a fragile surgery, could potentially lead to wound healing problems. However, if smoking and nicotine use is stopped 4 weeks before and continued for 4 weeks after surgery, then this procedure maybe performed safely. Dr. Tsai will review your medical history and help optimize your health before surgery in order to perform the procedure in a safe manner so you obtain the results you desire and deserve.
For more information, photos and videos, please refer to the American Society of Plastic Surgeons website for Rhinoplasty.