Rhinoplasty

placeholder-imgThe decision to undergo rhinoplasty surgery, also known as “nose job” or “nose reshaping” surgery, is an extremely personal one. Rhinoplasty is one of the most technically challenging facial procedures and requires a thorough knowledge of nasal aesthetics and anatomy, significant training and experience, and a meticulous attention to detail. Our patients at Richmond Aesthetic Surgery can rest assured that they are receiving specialized care from experienced surgeons who strive to achieve their patients’ individual goals. Rhinoplasty can be used to address aesthetic and/or functional concerns, helping people to feel more confident in their looks as well as improve their breathing. If you are concerned that your nose is asymmetrical or disproportionate to your other facial features or if you suffer from breathing impediments, a rhinoplasty can clear obstructed airways in the nose, easing the flow of air through the sinuses, increase facial harmony, and boost self-esteem.

A rhinoplasty is the surgical correction of the nose to achieve aesthetic and functional improvements. Some of the benefits of rhinoplasty are listed below.

Functional improvements of rhinoplasty can include:

  • Correcting a crooked or deviated septum
  • Adjusting the size and shape of the nostrils to improve airflow
  • Widening internal airways of the nose

Aesthetic improvements of rhinoplasty can include:

  • Adjusting the size and shape of the nose to be in sync with the patient’s other facial features
  • Augmenting the tip of the nose
  • Reducing the prominence of the nose’s ridge
  • Raising the bridge of the nose for a smoother slope
  • Adjusting the size of the nostrils

These improvements are attained by making a series of incisions within the nose to expose the underlying nasal anatomy. There are two categories of rhinoplasty techniques: open and closed.

Open Rhinoplasty

Open-Rhinoplasty-300x226The “open rhinoplasty” involves making a small external incision along the columella of the nose (the part between the nostrils). This external incision then connects to incisions within the nose. The soft tissues of the nose are then carefully freed from the underlying cartilage support of the nose, providing direct access to these important structures. At this point, the bony and cartilage support of the nose can be carefully reshaped under direct visualization to improve nasal function and aesthetics. Humps due to the prominence of bone and cartilage can be reduced incrementally. Any deviations of buckling of the septum can also be corrected. This approach provides clear exposure of the cartilages that determine the shape of the nasal tip. As a result, careful refinement of these cartilages can be performed very effectively. The open approach provides the surgeon with maximal exposure of nasal anatomy and allows for very precise correction of aesthetic and functional deformities. The technique is useful in correction of nasal deformities due to previous fracture, and noses that have significant deviations of the nasal septum.

Closed Rhinoplasty

Closed-Rhinoplasty-300x225The “closed” technique involves using intranasal incisions exclusively to expose the structures of the nose. The technique is useful in correcting more isolated and/or minor deformities of the nose, and in removing isolated septal deviations. While the technique involves fewer incisions and may have less postoperative swelling, it does not offer the same amount of direct exposure and precise control of nasal anatomy.

In either techniques, functional and aesthetic refinements often require the use of cartilage grafts to improve the internal support of the nasal framework. Benefits of cartilage grafts include:

  • Support of the internal nasal airway, thereby improving airflow and relieving obstruction
  • Correction of septal deviation and straightening of the nasal dorsum (the visible surface of the nose)
  • Improving tip shape and projection

Cartilage grafts are typically harvested from the nasal septum or the ear. In rare cases in which septal cartilage is unavailable due to previous operation or injury, grafts can be harvested from as segment of rib cartilage.

Rhinoplasty Consultation

Nose_and_Chin_Combo_-_Animation_-_web_rd256Ideal candidates for rhinoplasty surgery include healthy men and women over the age of 17 who wish to address functional or aesthetic issues with their nose. The first step in achieving a successful rhinoplasty procedure is your initial consultation. During your initial consultation, you will meet your surgeon, and you will discuss your specific concerns and goals for a rhinoplasty. You will undergo a thorough history and physical exam, paying particular attention to your nasal anatomy and function. Based on your initial concerns, our surgeons will develop a comprehensive specific surgical plan that will best achieve your anticipated outcome. Using VECTRA 3D Imaging technology, you will be able to see a visual prediction of their results to help you make a well-informed decision about your health. The VECTRA analysis is also a way to convey to our surgeons the vision that you have for your results.

After the consultation, if you are determined to be a good candidate for rhinoplasty, Dr. Zemmel will provide detailed pre-operative instructions in preparation for your surgery. Dr. Zemmel believes that a successful rhinoplasty depends on clear communication of realistic expectations of surgery with each patient.

Your Rhinoplasty Procedure

All rhinoplasty surgeries are performed by Richmond Aesthetic Surgery’s board-certified plastic surgeons at either St. Francis Hospital’s Ambulatory Surgical Center or the Ambulatory Surgery Center at Henrico Doctors’ Hospital – Forest Campus. During this outpatient procedure, patients receive general anesthesia to maximize safety during surgery and minimize discomfort. If additional cartilage is needed to help reshape the nose, this cartilage is harvested from either inside the middle of the nose or from the back of the ear. A rhinoplasty typically takes 2-3 hours to perform, depending on the goals of the individual patient.

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Your Rhinoplasty Recovery

Most of our patients do not experience significant discomfort following their rhinoplasty procedure, and any discomfort is usually resolved with prescription pain medication. Dressings, nasal splints, or external nasal casts are used to protect the nose and expedite healing, depending upon the rhinoplasty technique used for your individual procedure. While some patients may feel a slight numbness in the tip of the nose immediately after surgery, this tends to dissipate after a few months.

During the first days of recovery, you should elevate your head and apply a cold pack to help reduce any swelling. After a few days, you will return to our Richmond office and one of our plastic surgeons will remove your dressings and/or splints. Most patients are able to return to work within 1 week of surgery. While at this time you will likely be able to see changes in the appearance of your new nose, the final results will be fully visible 6-12 months after the procedure.

Turn back the hands of time and renew your youthful appearance.

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