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What you need to know if you are considering rhinoplasty

By Judy Latta

Can a “nose job” boost your social standing? A new study published in the Journal of the American Med­ical Association suggests that people who have undergone a successful rhinoplasty, commonly known as a nose job, are perceived by casual observers to be more attractive, successful and healthy than they were prior to the surgery.

The researchers from Johns Hopkins Medical School concluded that patients likely experience improved social interactions, and possibly a competitive advantage in professional situations, related to the positive effects of having a nose job. Thus, it is no surprise that rhinoplasty is one of the most common facial plastic surgery procedures performed in the United States for both men and women seeking to improve their facial appearance.

 

WHAT IS RHINOPLASTY?

Rhinoplasty is plastic surgery that involves adjustment of the bones and cartilage that give shape to the nose for correcting and reconstructing the form, restoring the function, and aesthetically enhancing the nose. According to the American Society of Plastic Surgeons (ASPS), rhinoplasty can treat the following issues:

  • Nose size in relation to facial balance
  • Nose width at the bridge or in the size and position of the nostrils
  • Nose profile with visible humps or depressions on the bridge
  • Nasal tip that is enlarged or bulbous, drooping, upturned or hooked
  • Nostrils that are large, wide or upturned
  • Nasal asymmetry

 

COSMETIC RHINOPLASTY

Most people who undergo rhinoplasty do so for cosmetic reasons. “Some are unhappy with the nose with which they were born or the way aging has changed their nose,” reports the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). “For others, an injury may have distorted the nose.” A rhinoplasty surgeon can sculpt the cartilage to minimize or re-form the tip or bridge of the nose; adjust the bones to change the underlying structure to reduce length, width and/or overall shape; add cartilage, fat, fillers or tissue grafts to build up a nose that is too small or oddly formed; or sculpt the nasal tissue to change the nose’s slope and angle.

The most common reason people get a nose job is to eliminate a bump on the bridge of the nose. Since cosmetic surgery is considered elective, it is often not covered by insurance.

 

MEDICAL RHINOPLASTY

In addition to aesthetic purposes, rhinoplasty can also be beneficial for improving the function of a nasal passage with an obstructed airway that is distorted by injury or illness, or was deformed at birth. The most common medical nose problem, a deviated septum, occurs when the cartilage that separates your nostrils is out of position. This can cause breathing problems, nosebleeds, and pain.

An adjustment to improve an obstructed nasal airway can be made by adding or removing bone or cartilage, grafting tissue, or implanting synthetic material that changes the shape of the nose to align the nasal passage. Septoplasty is the surgical procedure that adjusts the inside of the nasal septum to improve airflow through the nose. Rhinoplasty usually is also required to fix the structure of the nose, as septoplasty alone typically will not correct the entire problem. Since this procedure has a medical purpose and is considered reconstructive, whether performed alone or in conjunction with cosmetic rhinoplasty, it may be covered in part or completely by insurance.

 

THE SURGICAL PROCEDURE

Rhinoplasty is generally an outpatient procedure and can be performed in an accredited hospital or other surgical facility. It generally takes at least an hour to complete, and according to the ASPS, there are several basic steps to the procedure.

First, since it is a surgical process, intravenous sedation or general or local anesthesia is administered to keep the patient comfortable. An incision is made either inside the nasal cavity or across the columella, the narrow strip of tissue that separates the nostrils, to allow the surgeon access to the bone and cartilage.

Next the surgeon reshapes, reduces, augments or rearranges the underlying form and structure of the nose, and if the septum is deviated it is straightened, and projections inside the nose are reduced to clear the airway and improve breathing. Once the underlying structure of the nose is sculpted to the desired shape, the nose tissue is arranged smoothly over the new structure, the incisions are sealed. The restructured nose is supported by a splint, packing material and bandages to help maintain the new shape until the nose is healed and the swelling subsides. The splint protects the nose from getting bumped and guards it while the patient sleeps.

Immediately following rhinoplasty, there will typically be swelling, bruising, nasal congestion and possibly puffy, black eyes. Blood and mucus discharge from the nose is not unusual. Ice and bed rest can be helpful for alleviating these symptoms. Most people say that the pain from rhinoplasty is not intense, but the recovery is somewhat uncomfortable as it tends to be difficult to breathe through the nose and sleep in the immediate aftermath of the surgery. It usually takes about two weeks for the swelling and bruising to improve enough for patients to return to non-strenuous activities and about a month to return to vigorous activity and exercise. Glasses should not be worn until the swelling and tenderness of the bridge of the nose subside. There is typically very little, if any, scarring from rhinoplasty because the incisions are made either inside or under the nose. Minor swelling may persist for up to a year but will probably not be noticeable to others. Significant complications from rhinoplasty are rare.

 

HOW TO GET STARTED

Interested in having your nose surgically altered? Talk to a board-certified surgeon to see if rhinoplasty would be right for helping you to achieve your aesthetic and medical goals. Keep in mind that rhinoplasty is a highly complex procedure that demands a specially trained cosmetic surgeon. The American Board of Cosmetic Surgery (ABCS) recommends that those interested in rhinoplasty “choose a surgeon who has extensive experience in facial cosmetic surgery and performs rhinoplasty as a significant portion of his or her practice.” Visit americanboardcosmeticsurgery.org to find a board-certified cosmetic surgeon in your area.


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