Rhinoplasty can reshape, reduce or augment the nose, remove a hump, narrow nostril width, change the angle between the nose and the mouth, or correct injury, birth defects, or other problems that affect breathing.
Rhinoplasty is usually an outpatient procedure performed under either local or general anesthesia and lasts one to two hours unless more extensive work needs to be done.
Contact lenses can be worn immediately but glasses will have to be taped to your forehead or propped on your cheeks for up to seven weeks.
Also known as "laser peel," laser skin resurfacing removes the uppermost, damaged layers of skin with a carbon dioxide laser beam.
Laser peels can treat wrinkles, sun damage, uneven pigmentation, fine lines around the mouth and the eyes, and facial scars.
A facelift can reduce signs of aging (wrinkles, lines, sagging skin, drooping brow) by removing excess fat, tightening the underlying muscles, and redraping the skin around the neck and face.
Facelifts can be done alone or in conjunction with a forehead lift, eyelid surgery, or nose reshaping.
Most facelift patients are in their 40s-60s, but facelifts can be done successfully on people in their 70s or 80s as well.
Scars are usually hidden by the hair or the natural creases of your face and ears. In addition, they will fade as time passes and should be scarcely visible.
Browlifts can revitalize drooping or lined foreheads by tightening skin and muscles above the eyes, smoothing wrinkles and raising the eyebrows, helping you to look less angry, sad or tired.
Try standing in front of a mirror and placing the palms of your hands to the sides of your eyes above the eyebrows. Then pull the skin back from the eyes, raising the forehead. This is approximately how the procedure will make you look.
The main difference lies in the type of incision made. In a traditional browlift the surgeon makes a coronal (headphone-shaped) incision behind the hairline, stretching between the ears and across the top of the forehead. In a minimally invasive endoscopic browlift the surgeon makes three to five short incisions (less than an inch long) behind the hairline. The endoscope -- a slim instrument with a camera on the end -- is placed in one incision so the surgeon can see beneath the skin, while he or she lifts the skin and adjusts muscles through the other incisions.
By removing excess fat, skin and muscle from the upper and lower eyelids, eyelid surgery can rejuvenate puffy, sagging or tired-looking eyes. It is typically a cosmetic procedure but can also improve vision by lifting droopy eyelids out of the patient's field of vision.
Incisions are made along the eyelids in inconspicuous places (in the creases of the upper lids, and just below the lashes on the lower lids) to minimize scar visibility. If no skin needs to be removed during surgery, the surgeon will likely perform a transconjunctival blepharoplasty, where the incision is made inside the lower eyelid and there are no visible scars.
Contact lenses may not be worn for two weeks. Glasses may be worn immediately.
Patients undergoing nose or neck surgery may consider chin surgery in order to maintain an attractive facial proportion.
Two weeks post-op is still somewhat early to be evaluating the results of the surgery especially given the enormous extent of post-op swelling. However, it is possible that the surgeon may have performed a canthopexy or canthoplasty on the lower eyelid concurrently with the surgery, for which slit-like eyes immediately post-op are normal and will fade over time.
A fat pocket left over from surgery can easily be removed with direct skin excision or even through direct removal.
It is common for people with thin skin to feel the endotine device under their skin, but the device does dissolve over a period of one year. Dimpling may occur during this point, but the endotine device should not be visible.
If a patient is dealing with pain and tightness 1 year post-op, a second opinion is definitely needed. Consult with several surgeons to see what may have gone wrong and whether revision surgery may be needed.
This problem could be attributed to several things, namely an organized blood clot, scar tissue, cyst, retained fat, etc. A full exam is definitely in order to determine the nature of the lump.
Excess fat can usually be trimmed through liposuction, while excess skin must be surgically removed through a face or neck lift. Ulthera can also be used for short-term laxity issues.
Though changes after a facelift vary from patient to patient, some basic results of a standard lift include a better defined jawline, tightening of the skin under the chin, and elimination of muscle banding in front of the neck. As healing progresses, fluid collection and swelling should decrease dramatically and tissue should begin to soften.
A facelift is not done based on age, but rather based on the symptoms of a patient. Generally speaking, skin laxity is the number one issue for which a facelift is necessary, an issue which is rarely present in younger patients (who more often have problems relating to volume loss).
Patients should wait for at least 4-6 months post-op before considering hair growth procedures, as surgery may have “shocked” hair follicles for a long, but temporary, period of time. However, if re-growth does not occur, the best option could be follicular unit grafting.
Full healing does not take place until about 6-12 months, but patients will generally be ready for public events after around 3 weeks. Again, it is important for the sake of the patient that he/she quit smoking and other habits which could inhibit or, at least, prolong healing.
A traditional facelift IS a lower facelift in that it addresses mainly the lower 1/3 of the face and takes care of issues like jowling and sagging of the neck and lower jaw. The term “lower” facelift is used simply to differentiate a facelift from a “mid” facelift which addresses the cheek area and a “brow” lift which addresses the upper third of the face.
Patients are recommended to be in their best nutritional state before surgery, but they must make sure that their weight is fully stable before undergoing elective cosmetic surgery.
In the early stages of surgery, it is easy to dismiss the results of the surgery as “bad”. But, patients must remain calm, especially as bruising and swelling tend to be the greatest at this point. Allowing for time to heal such symptoms is probably the best option for such patients.
Personally, I do not approve of unproven, “gimmick” procedures like facelift acupuncture especially because they offer no elevation of the face.
Patients should remember that a midface lift only alleviates nasolabial folding; it does not treat it completely. Again, for this area and the cheek area, the best option would be fillers and/or fat grafting, perhaps even implants for the cheek.
Generally, muscle weakness, if temporary, takes within 3-6 months to fully recover.
Low brows can generally be treated with neuromodulators like Botox and nasolabial folds with fillers like Juvederm. Yet, partial MACS Lift surgery could also be an option. Consult with your plastic surgeon about your options.
Most patients look presentable after 2 weeks post-op, but healing tends to carry on for a period of many months.
It is perfectly normal for patients to experience lumps and areas of firmness, indicative of early post-op inflammation, in the initial stages of recovery. It will most likely take within 3-6 months for swelling to completely die down, but again patience is key to recovery.
Sculptra is generally used as a deeper volumizer primarily used within the cheeks and the temples and may require multiple treatment sessions for the desired effect. Acid fillers are probably better for under eye filling, as are fat transfer options.
Exploring options with the plastic surgeon may be the best option for patients looking for non-surgical paths of facial rejuvenation. However, there is an abundance of options out there, including fillers, neuromodulators, CO2 laser treatments, soft tissue tighteners, and light based procedures.
Generally, it is important for doctors after a cheek implant to fix it in place with a screw which may require surgical incision. A simpler method of treatment could be to inject fat into the area to hold up the implant in place.
Decadron is a steroid which works on the cellular level to decrease swelling and nausea in the patient. Even patients taking hydrocortisone for adrenal insufficiency are able to take this medication
Valium is an anti-anxiety medication which allows the patient to rest for the immediate post-op period. It is good for patients looking to avoid hematomas which are usually attributed to strenuous activity in this post-op period (rise in heart rate and blood pressure). Consult with your surgeon, however, for long-term use.
Often, patients dealing with neck sagging can have their issues addressed without a facelift procedure. Liposuction and neck skin resection may be all that is needed, but again consult with your plastic surgeon about your option.
It is probably best to have facial surgery when the respiratory system is clear and breathing isn’t affected. If the body is generally stabilized at this point, the facelift should be fine.
Experienced surgeons, again, will attempt to create scars in as inconspicuous of a place as possible, meaning that scarring is often tailored to the priorities of the patient. It is usually based on a number of characteristics including degree of facial aging, skin laxity, hairline, and other unique characteristics.
The PDS is a reabsorbable monofilament suture which is slowly broken down in the body and retains tensile strength for months after a surgery. It is commonly used as a method of fixating repositioned deep tissues.
Unless for extreme reasons, patients at the age of 21 rarely have problems with skin laxity and thus achieve little benefits from a facelift. More often, the issue relates to volume loss which can easily be treated with fillers, fat injections, etc.
Going into a rhinoplasty, a patient must be aware that there is only so much a surgeon can actually do. In other words, we cannot completely reshape a nose into a form which it is not, but we CAN modify its existing structure. A droopy tip, for example, can easily be fixed.
As stated in other similar questions, a surgeon can only work with what he or she has, meaning that we cannot reshape a nose completely into something that is not. However, giving a surgeon pictures of your ideal nose during your consultation is helpful for us to understand what changes you would like to be made (elevated tip, etc.).
Other than a direct blow to the nose, there is little else that can really impact a rhinoplasty six weeks out. No concern is needed.
This is probably a question that is best answered by your personal surgeon. The costs of a rhinoplasty is driven by three main factors: operating room time, the surgeon’s individual fee for the operation, and the anaesthesia/individual equipment used. Many offices will have financing options that make these procedures surprisingly affordable.
The costs of a rhinoplasty is driven by three main factors: operating room time, the surgeon’s individual fee for the operation, and the anaesthesia/individual equipment used. First time rhinoplasties will typically hover around $6,000-$7,000, while revisions may be several thousand higher. However, financing options will probably exist in your surgeon’s office that will make the surgery more affordable.
The final shape of the nose following a rhinoplasty does not truly finalize until after a year following the procedure. When the cast is removed after about a week, swelling will be readily apparent, but this will eventually subside enough within 10-14 days after the procedure for patients to be “restaurant-ready” (recovered enough to go out in public). 75-80% of your results will be mostly apparent after 3-4 weeks.
It can be difficult to tell if a nose is truly broken, other than very obvious signs like a major deviation to one side or severe flattening or depression of the nose. However, if the concern arises after a nasal trauma, patients may have a broken nose if the trauma was followed by a bloody nose. This is an indication of tearing of the periosteum (supplies blood to the nose), which usually occurs when nasal bone fractures.
Swelling is variable from patient to patient depending on factors like age, smoking habits, etc. However, as a general rule, 2-3 weeks is the benchmark for when most of the swelling subsides, at which point the remaining swelling will only be visible to the patient and his/her surgeon. The remaining swelling will gradually dissipate in the next 6-12 months.
As a benchmark, try to avoid anything that increases the risk of excessive bleeding during surgery starting 1-2 weeks prior to surgery. This includes alcohol, herbal supplements, fish oil, and non-steroidal anti-inflammatory medicines like ibuprofen
A tip rhinoplasty, as the name suggests, is only dedicated to the reshaping (usually elevation or depression), rotation, or other modification of the tip. In this procedure, the nasal bones are not tampered with, leading to quicker recovery times. However, this option is usually limited to select patients because, often, rhinoplasties often need to engage the bridge of the nose.
Unfortunately, this is highly unlikely. Non-surgical nasal modifications, by their nature, use fillers to make certain areas bigger in relation to others, so surgery is the only option to reduce nose size.
Recommendations for ideal surgeons for rhinoplasties include board certification in plastic surgery/otolaryngology, specialization in nasal surgeries, and experience in doing your specific type of surgery. I would personally recommend looking at their before and after catalogue to see if their work is satisfactory for your needs.
Unfortunately, there are not any non-surgical options which get as much mileage as an actual rhinoplasty. However, for certain cases, injectable fillers like Restylane can be used to smooth out rough edges (ex. Fill areas around the bump on a bridge to make the bump seem less conspicuous) for lesser cost. These might be helpful for people with overly scooped noses (ski slope noses), noses with small humps, etc (in other words, people who need areas filled, rather than reduced).
First of all, it is important that patients who are serious about achieving a permanent solution to this type of problem lay off cocaine, which is a major vasoconstrictor (narrower of the blood vessels). Vasoconstriction of the nasal membrane blood vessels causes nasal membranes to die, thus leading to the development of holes, etc. Reconstructive nasal surgery may be done with the use of grafts but the chance of success is much lower than typical rhinoplasties.
Two weeks post-op is generally the benchmark to begin exercising again, but ease into your regular exercise regimen and don’t go heavy with the exercise until three weeks post-op. Flying can generally be done a week after the procedure, but it is recommended that patients wait about 10 days to 2 weeks.
Although bruising post-op is generally a consequence of the surgeon’s actions, patients can help reduce bruising by avoiding anti-inflammatory medications like ibuprofen at least 1-2 weeks prior to surgery, applying ice to the surgery site for the first two days after surgery, and keeping their head elevated.
It is recommended that patients not worry about the results of a rhinoplasty until about 3-4 months post-op, at which point the majority of the swelling which may skew the appearance of the results will subside. Check again at this point and consult with your surgeon if you are still unhappy.
Male noses generally have straight bridges without deviation/curvature, thicker skin at the tip, and are generally a bit larger than female noses.
Nasal growth typically ends in a patient’s 20s, but other changes may be responsible for making the nose seem larger. Acne outbreaks and rubbing the nose due to allergies may thicken the nasal skin and changes in the underlying nasal bones and cartilage may cause drooping of the tip.
This is a variable benchmark that depends on the physical maturity of the patient’s nose (operating on a still-developing nose can impede nasal growth), the emotional maturity of the patient, etc. But, generally speaking, after 15-17 for women and 16-18 for men is the ideal.
This product may temporarily press up your nasal tissue, but it won’t lead to any permanent changes.
Yes, this can be done. It is rare, but grafts can be applied to the tip area to help with deviation, especially one that is caused by nasal trauma (punch to the face, etc.). Fillers may also help if you are for non-surgical solutions.
No, not at all. Nasal tissue has very little fat, so weight gain or loss will not impact the results of a rhinoplasty.
Nowadays, when the packing used for rhinoplasties is less than it used to be, the removal of splints should not cause any major discomfort for the patient.
The ala base (the middle part of the nose) can definitely be corrected in a rhinoplasty without any impact on the nostrils.
Given that stitches will generally dissolve within 5-7 days post-op, there shouldn’t be any problem with accidentally pulling out a stitch. No concern is necessary, but be careful not to remove more.
While slight scarring is common for rhinoplasty procedures, unsightly scarring in the sites of external incisions, etc. is relatively rare and may warrant aggressive treatments like kenalog (steroid) injections. However, a consultation may be needed for this.
Nasal vestibulitis (the development of scar/scab tissue in the nostrils) is a common occurrence post-op, especially for patients with a history of seasonal allergies. It is suggested that patients with this condition see their doctors, who may suggest applying OTC hydrocortisone with a Q-tip to site of scar development (this will generally fix the problem within a week).
A rhinoplasty can absolutely help correct a bulbous nose. However, it is important that patients when considering this procedure find a board-certified plastic surgeon whose before-and-after pictures online are to their liking.
Patients who experience an upturn in the tip of their nose post-op most likely had a surgeon who overcorrected the original condition. However, this is not a concern as the tip should come down within 2-3 weeks after surgery. It is also possible that the upturn may be caused by swelling which is perfectly normal post-op and should come down within the same period of time.
Closed rhinoplasty, which does not involve incisions on the columella (the bottom part of the nose), can absolutely be used to correct a small hump in the nose. However, there is really no significant difference between an open and closed rhinoplasty other than the incisions on the columella in the open version of the procedure.
Bulbous noses are most often corrected via an open rhinoplasty where the soft tissues of the nose are elevated to expose the lower lateral cartilage underneath and narrowing them.
Generally, hard bumps on the nose post-op are the results of swelling due to the instruments used in osteotomies (controlled breaks in the nose made to correct the nasal deformities). Patients should consult with their surgeons upon seeing these bumps, just in case they are the results of other issues, but should generally not be concerned.
Hot liquid and spicy foods dilate blood vessels and increase the risk of bleeding post-op, so it is best to avoid these types of food for about 24-48 hours post-op. After this, the swelling will begin to subside gradually and diet will become less of a concern.
Nasal growth generally stops after a patient reaches his/her 20s. However, acne outbreaks and rubbing the nose due to allergies may thicken the nasal skin and changes in the underlying nasal bones and cartilage may cause drooping of the tip. In this case, rhinoplasty will help with the appearance of a patient’s nose.
It is recommended that patients sleep with head elevated post-op in order to reduce discomfort and swelling. It is also advised that patients avoid sleeping on their side because this may lead to movements that could potentially squeeze the nasal area, but this is generally not a concern because the cast will mostly hold everything in place.
As surgeons will tell you, the REAL post-op look after a rhinoplasty does not actually form until about a year after the surgery is completed. Minor swelling, particularly in the tip, may exist until then, but it should not be a concern to the patient.
Although it is advised that patients fix a broken nose before the body’s natural healing process takes full form, a broken nose can be “reset” through a fracture-reduction rhinoplasty, but it will require re-breaking of the nose through an osteotomy and resetting of the nasal bones.
Ringing in the ears could be attributed to residual blood from the surgery resting on the eardrum, but further consultation with an ENT may be necessary.
If the nose was displaced during the trauma, a fracture-reduction rhinoplasty may be necessary. However, depending on how soon the corrections take place, the treatment may require re-breaking of the nose through an osteotomy and resetting of the nasal bones. Consult your surgeon about this before proceeding.
A tip rhinoplasty is, in most cases, the best course of action for a bulbous nose because it can reduce the tip area without changing the nasal bones. However, it is important for the patient to realize that true results will not materialize until about a year or two after the procedure is completed, so patience is a major key here.
Most surgeons will recommend that patients utilize saline solution and apply it to problem areas via Q-tip, and then use another Q-tip to then absorb the remaining crusted blood loosened by the first Q-tip.
Patients worried about having more natural results after a surgery can expect the features of the face, after 2 weeks of initial tightness, to soften within the next couple of weeks, yielding more natural results.
It is possible for a hit to the nose to cause the development of a small dorsal hump due to the slight separation of the upper lateral cartilages from the bone which can occur. This can be corrected via cartilage grafting. However, it is important to also recognize that trauma to the nose may just create swelling that may look like a dorsal hump, so it is important to ice the area in question and evaluate.
A nasty smell inside the nose following surgery may just be the result of dried, crusted blood development or extraneous mucous which infiltrated the area, both of which are perfectly normal post-op conditions that can be corrected with saline spray. However, a consultation with a surgeon may be advised in order to evaluate for a possible infection.
This is an excellent question because it addresses a great misconception in the plastic surgery world. Bad surgeons exist in any area, even in Hollywood, so do not use price alone to evaluate a surgeon’s competency prior to scheduling a surgery with them. Recommendations for ideal surgeons for rhinoplasties include board certification in plastic surgery/otolaryngology, specialization in nasal surgeries, and experience in doing your specific type of surgery. I would personally recommend looking at their before and after catalogue to see if their work is satisfactory for your needs.
In general, facelift cost vary depending on location, surgeon’s skill, facility and anesthesia fees, overhead costs, and other factors.
Many gimmicks like these work to simply temporarily compress nasal tissues, but do not lead to any substantial changes. There is no substitution for professional work when it comes to optimizing nasal structure.
Steroid injections about a year or so post-op can definitely help with any residual swelling and can soften up the tissue in problem areas, but have your surgeon complete these procedures.
As stated in other queries, the true results of a rhinoplasty do not materialize fully until after a year post-op. Residual swelling particularly in the tip is extremely common among rhinoplasty patients, so no concern is necessary if this condition persists.
MACS Lift is a surgery which works well for some patients and not so well for others. Patients in the latter category, because of the rather limited nature of the MACS Lift, may need to undergo secondary facelift or mini-lift surgery to achieve optimum results.
It is generally recommended that, unless done by the hands of a surgeon, patients avoid massaging the nasal area post-op. This is because the subtle pressures of the hand may create shifts in the nasal structure that could cause major problems later on
Again, the costs of a rhinoplasty surgery will vary depending on a number of factors including geographic area, qualifications of the surgeon, equipment used, etc. However, a general ballpark for this type of surgery may entail somewhere between $5000 and $10,000. I would advise patients to place less priority on cost and more on the qualifications of the surgeon, because corrective surgery is often much more expensive than first-time procedures.
Nicotine in cigarettes is a powerful vasoconstrictor (causes narrowing of the blood vessels) and must thus be avoided in order to speed up the healing process post-op. It is recommended that patients wait at least 4 weeks or so post-op to resume smoking again, but not doing so is even better.
Generally speaking, the deviation of a septum is usually a functional problem and is often covered under insurance because it can improve the patient’s breathing. However, any changes to the nose would most likely be seen as “cosmetic” rather than functional changes and will most likely not be covered under this plan. These procedures are often performed hand-in-hand, though, so it is best to evaluate any financing plans with your surgeon of choice
Nostril flares can be corrected with procedures like the alarplasty/alar base reduction in which the nostrils are narrowed and an alar base resection is performed with the help of a crescent-shaped wedge removal in the nostril wall. However, this procedure is rather difficult as it entails extreme precision in order to reduce the likelihood of asymmetrical nostril development.
Generally, deviation of the septum and enlarged turbinates are not associated with pain unless combined with a sinus infection. Consulting with your surgeon is probably the best course of action, but the solution may simply be dryness of the nasal canal.
A month after such a procedure, it is common for swelling to occur heavily and residual numbness is also found frequently. Consult with your doctor if there are still any concerns.
It is advised that patients avoid heavy exercise for at least a month post-op and particularly avoid contact sports for 6-8 weeks post-op, mostly to avoid the risks of bleeding and the complications which follow from that.
Personally, I am more partial to avoiding man-made materials during rhinoplasty which can often pop out post-op and, in the case of Gore-Tex, have a high probability of infection. I prefer to use septal cartilage from the patient’s nose or, if that is not available, from the patient’s ear because the body is accustomed to it.
Hardness and swelling 9 months post-op is usually indicative of a maturing scar. However, it could also be attributed to fat necrosis or a small, unresolved hematoma.
Generally speaking, rhinoplasty is considered a cosmetic procedure and will likely NOT be covered under insurance regulations.
This is a problem that is better addressed on a case by case basis, but generally, I would say that patients who experience swelling after a nasal injury will find that most of their problems will be solved with some ice. However, it is best to go to a qualified surgeon for evaluation in order to check for nasal fractures.
Surgical fillers have been FDA approved for use on the face for wrinkles, but surgeons have been using them for a long time for nasal injections (off-label use, of course). I am not aware of any particular diseases which result from the use of fillers, but there have been reports of patients who are unhappy in the long-term with the use of fillers and would rather have rhinoplasties done to correct the original problem.
It is perfectly normal for swelling to be apparent for up to a year post-op, so residual swelling particularly on the tip area several months post-op is perfectly normal and should not be a concern. Your surgeon did not do “anything wrong”.
Deviated septa are a primary motivation for patients getting rhinoplasties. Such procedures often involved the creation of osteotomies (purposeful breaking of the nose in order to align the septa properly) and subsequent adjusting of the surrounding cartilage and nasal tissue. Sometimes, cartilage grafts may be required from the patient’s ear, but this is up to the surgeon’s discretion.
Try all you want, but, unfortunately, facial exercises have not been proven to have any effect on improving facial asymmetry.
It is recommended that, if patients have contact lenses, that they utilize those rather than glasses for at least 4 weeks post-op. However, if glasses are the only vision correcting tool available, they can be worn over the splint. When the splint is removed, however, patients are recommended to tape their glasses to their forehead or acquire a common pharmacy device which allows the glasses to rest on the cheeks.
Generally, patients will be aware if a nasal fracture has occurred immediately after a trauma. In most cases, bumps on the nose following trauma are a result of soft tissue damage particularly in the periosteum (where the nasal blood supply is housed) and will degrade eventually.
Most facelifts frequently used today, whether they be SMAS, deep-plane, or even mini facelift, have at least some interaction with the SMAS layer beneath the skin. Tightening of the muscle layers underneath the skin usually always happens with any of these procedures.
In most cases, the post-op result of an upturned nose where the tip is over-elevated is the result of an overaggressive approach by the surgeon. However, patients should generally not be concerned as the tip will most likely begin to descend into place as the year after the surgery progresses. If improvement does not occur, non-surgical options can be used by your surgeon like fillers or surgical options can be utilized including a derotation of the tip, etc.
Surgeons generally advise their patients to count on ¾ of the swelling post-op to dissipate within 3-4 weeks post-op and then for the rest of the swelling to disappear within the course of a year post-op.
Nasal dorsal humps can be reduced through rhinoplasty. However, one major risk, particularly if the surgeon is not well experienced, is the appearance of nasal bones through the skin (check for well-experienced, qualified surgeons to avoid this). Other than that, the other risks are pretty standard for rhinoplasty and can be mitigated in the hands of a qualified, experienced surgeon.
Easier breathing will generally come 10-14 days post-op and will continue to improve for 6-8 weeks afterwards.
It is not unusual to feel migrating tightness post-mini facelift. Normal post-operative scars will feel their tightest at around 6-12 weeks post-op, but can be easily treated with massage and hydrocortisone cream.
While weight loss or gain may affect the appearance of the nose in relation to other structures (as the face gets thinner, the nose takes up a greater proportion of the face and thus looks “bigger”), the nose itself has little fat within it and is not actually affected in terms of size by changes in overall fat for the patient.
Many patients feel the Kenalog working within the first two weeks of injection, but may even feel it as soon as 1-2 days post-injection. Often, surgeons will follow up the initial injection with another one 2-4 weeks after the first one.
Generally, as long as the nose blowing is not too strenuous, patients can generally blow their nose one week post-op. Until then, it is recommended that patients use saline to break up any chunks which may accumulate in the nose and then use a Q-tip to extract them.
It is unlikely that, especially after a year since the pregnancy was completed, bulbous noses which developed in those nine months will return to normal. At that point, any corrections will have to come from rhinoplasty.
It is important that patients keep in mind the fragility of the nose following the rhinoplasty, especially considering the osteotomies (purposeful breaks in the nose) which were likely created during the procedure. Thus, keeping the nose protected is a top priority. By bumping their nose, patients risk septal hematoma (accumulation of blood in the nasal septa) which must be treated in the ER.
Generally speaking, it is unlikely for people around a potential patient to pay attention to the nose unless there is a defect there, instead focusing mainly on the cheeks, lips and eyes. With that said, rhinoplasties do not alter nasal structure in a way that substitutes one nose for another, but rather modify the existing nasal structure to conform with the patient’s needs (elevation of the tip, slimming of the nostrils, etc.).
Generally, dissolvable stitches will dissolve at an average of around 3 weeks post-op. However, stitches come in many types, meaning that some will take a week or so and others around 4 weeks.
To prevent excessive swelling post-op, patients are advised not to drink alcohol or smoke or engage in behaviors which will result in altered blood flow to the surgical area. They are also advised to sleep with their head elevated and keep ice on the surgical area for the first 2 days post-op.
Bruising from rhinoplasty as a general rule will mostly fade away within 2-3 weeks post-op. In the majority of cases, however, it will disappear even sooner (within 1-2 weeks).
The cutting and stretching of nerves around the tip and the upper lip/teeth during a rhinoplasty will definitely cause a general numbing of the area, particularly if the surgery in question was a revision rhinoplasty where extensive cutting of scar tissue occurred. However, these symptoms are very temporary and will probably dissipate within 2-3 weeks post-op.
Dorsal hump removal is generally a component of rhinoplasty and thus the costs of it will be very much in line with that of a typical rhinoplasty. As stated before, geographic area, equipment used, and other factors deeply impact the cost of these procedures, but an average rhinoplasty will run somewhere in the area of $5,000 to $10,000.
During a rhinoplasty, the trimming of cartilage in the nose often entails the subsequent trimming of bone tissue in the nose with the use of osteotomies (purposeful breaking of the nasal bones). Unevenness during this process, which will eventually work itself out in the post-op period, can cause suspicious bumps in the nasal area, but patients are advised not to panic when this occurs.
Most often, the optimal correction procedure for a crooked nose particularly after trauma is open rhinoplasty where the nasal fracture is reduced, potentially with cartilage graftings to even out the area surrounding the break.
It is advised that patients refrain from alcohol for at least one week post-op. However, this drinking is to be in moderation, with more heavy drinking reserved for at least one month post-op.
Bumps on the nose following rhinoplasty are generally the remnants of swelling and will usually resolve themselves after 3-4 weeks post-op. Harder bumps may also be evidence of calluses forming in the healing bone which will eventually dissipate as the healing process occurs. Either way, patients should not concern themselves when this occurs.
It is definitely not uncommon for patients who experience nasal fractures to experience headaches. It is best for these patients to go to a well-qualified surgeon to plan their best course of action.
Many surgeons may be able to correct this problem with an alar cinching procedure that prevents side-to-side movement of the nostril during smiling. However, these procedures should be done very judiciously as over-thinning of the skin can lead to the development of an overly skinny nose (a la Michael Jackson).
As you probably learned in your middle school health classes, puberty is a time of great changes for the body and, as such, it is also a time of great changes for your nose. Before nasal growth stops permanently in one’s 20s, it progresses extensively in the teenage years and features which stood out before on the nasal area will stand out further (bumps will grow, etc.).
It is important for patients when considering a tip rhinoplasty to consider the name of the procedure carefully. A “tip” rhinoplasty restricts itself essentially to its namesake, the tip of the nose, not the bridge or any other area. Therefore, it is a procedure which is limited to a specific set of patients with tip-related deformities only. Often, patients who desire a thinner nose will need to have a full rhinoplasty done so that the tip does not look disproportionately thin.
It does indeed. Patients, especially those considering having surgery, must work to stop themselves from obsessive nose-picking which can lead to problems post-op. Obviously, poking yourself in the nose so many times especially post-op will lead to changes in nasal structure.
The main factor which distinguishes the open and closed rhinoplasty procedures is the presence of an incision in the columella, the skin between the nostrils on the underside of the nose (the open form has the incision, while the closed form does not). This incision is rather conspicuous and patients will often opt for the closed form which makes incisions inside the nose, thus leading to no visible scars.
The short-term swelling post-op which is almost universal for rhinoplasty patients often lead to a restriction of the airflow in the nose, thus leading to breathing problems. These problems are often exacerbated by the development of mucous and crusted, dried blood deposits during the recovery. Unless these problems persist long-term, that is, several months after the surgery occurs, the patient should not be concerned.
Especially during puberty, there will be a great deal of growth and changes in the nasal area. Parents should refrain about worrying about a child’s nose until well into their teenage years.
In terms of swelling, a majority of the recovery time in a full rhinoplasty is restricted to the tip anyway, so the dissipation of swelling in both cases will eventually go for about a year. However, the bruising caused by the tip procedure is definitely much less extensive and will subside within 2-4 weeks.
Constantly touching the nose may lead to minimal changes in nose thickness, stretching of the nostrils, etc, but not to any noticeable extent.
Whistling in the nose post-op is generally caused by a small opening, usually a minor septal perforation (hole in the septum of the nose). This may have been caused by the harvesting of septal cartilage and should be evaluated by your doctor.
As stated in another query, rhinoplasties are strictly cosmetic procedures and are usually not covered by insurance. However, septoplasties (often performed concurrently with rhinoplasties) are functional surgeries which can be used to correct breathing defects and are thus usually covered by insurance providers.
Asymmetrical nostrils may be the result of an uneven septum which can easily be corrected with a rhinoplasty procedure. However, in the case that they are not, rhinoplasties can correct them still, but the procedure is much more difficult and involves the cutting away of skin from the nostril area.
This is absolutely normal. Patients will often find that the swelling which was kept down by the cast returns with a vengeance when the cast is removed. However, they should not be concerned as the healing process over the next three weeks post-op will cause this swelling to die down.
As other surgeons will tell you, there are rare cases when patients will remove the nasal splint and, in a majority of those cases, the results of the surgery are permanently altered. Splints are used to hold the nasal skin in place over the cartilage and bones which were modified, so removal of them must be done carefully. Patients will often remove them incorrectly, pulling at the skin and causing irreparable damage to the results.
Many ethnic patients, particularly African-Americans, have thickened nasal tips as a result of excess fibro-fatty tissue. During a rhinoplasty, this tissue is removed and cartilage is harvested from the ear, etc. to shape the tip.
Of course, given the increased overhead costs in big cities like Los Angeles and New York, costs for procedures in these areas will cost more than they will in other parts of the country. As such, a rhinoplasty in these areas will generally hover in the $8000-$10,000 area.
Unfortunately, non-surgical methods do not take away anything from a nasal hump but rather camouflage it. Fillers are applied to the area around the hump to make it less conspicuous, but because humps are mostly cartilage, they can only be reduced via rhinoplasty procedures.
As I tell my patients, it is key that they remain patient in the post-op period. The first few weeks post-op will be accompanied by a great deal of swelling and bruising that will skew the appearance of the surgical results and make them look significantly worse than they actually are. It is best to wait at least 6-8 weeks to evaluate for asymmetry.
It is best for patients to avoid any form of strenuous activity, including sex, for at least 3 weeks post-op in order to reduce the risks of cut down on swelling and mitigate the risks of hematoma and post-operative bleeding.
Ideally, patients will only require one rhinoplasty within their lifetime. Subtle changes will occur over time: the tip of the nose will begin to descend gradually, because the new nose ages with the rest of the body. However, such changes are subtle and will not require additional surgeries.
This is probably left best to the discretion of your surgeon, as it depends on the bump’s size. Smaller bumps may not require surgery and may be easily camouflaged with the use of fillers like Restylane. However, larger humps will require a full rhinoplasty with osteotomies (breaking of the bone in a purposeful way).
Rhinoplasties come in two main forms: open and closed, with the only difference being that closed rhinoplasties are done via incisions on the inside of the nose (that is, not visible) and open rhinoplasties having more apparent incisions especially on the columella area (the skin between your two nostrils). The incision on the columella in the open rhinoplasty is the only one that has the potential to be apparent, but even these should heal beautifully over time.
Without surgery, there is no option of reducing nostril size. This procedure consists of taking skin from the inside of the nostril via removal of a crescent-shaped wedge. However, it is recommended that patients wait at least a year post-rhinoplasty to have other changes made on the nose.
Unfortunately, there are no easy fixes for tip elevation like exercises or massages and the only option which is known to surgeons today to correct droopy tips is a full rhinoplasty which will help elevate the cartilage within the nose and reposition the muscle (depressor septi) which is responsible for the drooping.
Because of the trauma which your nose undergoes during a rhinoplasty procedure (the coagulation of blood, elevation of cartilage and other internal structures), the nose is much noticeably weaker post-op and is more prone to burns and discoloration from UV rays. It is recommended that patients wait at least 4 weeks, potentially even 6, before wearing sunglasses.
During a surgery such as this, a top priority among surgeons is the patient’s comfort and safety. Thus, we suit the anesthesia to your needs and wants. Patients can choose from local anesthesia (patient is fully awake and the area is numbed), local sedation (patient is given local anesthetic plus a sedative so that he or she falls asleep during surgery), or general anesthesia (patient is fully sedated and given a breathing tube). Patients with health problems may be recommended for the first two options as general anesthesia puts more strain on the heart and the lungs.
Often, post-op patients will notice small bumps here and there which they will interpret as a surgery gone bad. Most likely, however, especially several months after, it is residual swelling which will eventually dissipate over the course of a year after the surgery is done. Harder bumps may be signs of a possible callus, which is less common, but also disappears over time.
Not at all. The procedure of a rhinoplasty often entails osteotomies if necessary, that is, the purposeful breaking of the nasal bones to ensure their correct repositioning. Therefore, there is no additional cost and the “pain” is no more than a traditional rhinoplasty, which is basically none at all.
Patients will often find that residual swelling is pronounced particularly in the tip. This is generally a pretty heavy surgical site during the rhinoplasty procedure and will be subject to the greatest proportion of the swelling. Regardless, patients need not worry as residual swelling gradually dissipates over the course of a year.
Particularly during septo-rhinoplasties, muscle fibers in the base of the nose and in the upper lip are slightly separated to allow for proper healing of the tip of the nose. Thus, the smile will be a little skewed as the upper lip may not properly elevate. However, this should return to normal within the first few weeks post-op.
Patients can sleep on their sides post-op. However, it is suggested that they maintain extra caution to not bump their nose on the bed frame or a pillow. It might be advisable to sleep with extra pillows under your head to help with this and to counter swelling which will occur in the few days post-op.
It is recommended that patients wait at least 4-6 weeks before going out into environments with high sun exposure. However, even then, it is advised that patients avoid direct sunlight contact with their surgery site and wear plenty of sunscreen, as the trauma undergone by the nose during rhinoplasty causes it to be much weaker and number and thus prone to burns and discolorations from UV rays.
In general, a rhinoplasty for a deviated septum will cost somewhere in the neighborhood of $8,000-$10,000. However, this can vary widely depending on factors like geographic area, anesthesia used, etc.
In general, full healing (that is, full dissipation of the swelling from the procedure) will take up to a year to heal properly. However, the bruising and swelling which results varies widely depending on if osteotomies were performed, the type of rhinoplasty performed, etc. The majority of the swelling, however, in most cases will resolve itself within 4 months and the nose will generally be presentable to the public without significant issues within 1-2 months.
Any crooked nose (that is, where there is septum deviation), regardless of whether it was caused by injury or by genetics, can be fixed with a traditional rhinoplasty procedure. However, patients should consult with a surgeon and see whether fillers or other non-surgical options could also work for them.
Unless you are a member of certain African tribes who dilate his/her nostrils with nose rings that apply CONSTANT, heavy pressure, it is unlikely that touching the nose and blowing it every now and then will permanently affect nostril width to an appreciable degree.
In most cases, small lumps and bumps post-op are simply the result of residual swelling from surgeries which tends to dissipate over the course of a year. Sometimes, they could be from residual shavings of cartilage which will also be reabsorbed by the body.
After a period of a few weeks post-op, patients can begin to clean their nose gently with saline or a hydrogen peroxide/water mixture. However, it is crucial that they remain gentle while doing so, applying a slight rotational, rather than a pushing, motion.
As I addressed in another query, it is recommended that patients wait until their nose is fully developed before choosing to go ahead with rhinoplasty. Timing for a rhinoplasty after ages 15-17 for women and 16-18 for men is the ideal.
It often scares patients to think that their nasal bones will be broken during rhinoplasty procedures. However, they should be aware that the breaking is not at all similar to a typical nose break caused by a punch to the nose, but is rather more precise and done with instruments. Also, rhinoplasty procedures take place under anesthesia, so the only pain which will be felt is afterwards (and it is a mild pain, similar to a headache following a broken nose).
Other than staying protected from sun exposure for at least 4-6 weeks post-op, there is little that a patient can do to prevent scar buildup as it is a product of the body’s natural healing process and varies widely from patient to patient. Fortunately, heavy scarring is rare following a rhinoplasty and, in the extreme cases where they do occur, steroid injections have been shown to reduce or even completely mitigate their appearance.
Not at all. Again, swelling is a perfectly normal part of the post-rhinoplasty healing process and will take up to a year to fully dissipate (especially in the tip and nostril area). Therefore, most imperfections seen post-op are merely the result of swelling and will also disappear.
Typically, numbness following rhinoplasty is a common symptom and resolves itself within 8-12 weeks following surgery. However, it may take as long as a year or two before symptoms resolve themselves completely. Patients will know when the nerves regenerate because they are usually accompanied by itching and brief, shock-like sensations
Again, as I answered with many of my patients, swelling especially in the tip and nostril area following a rhinoplasty will resolve itself almost completely after a year post-op, with most of the swelling being gone around 3-4 months post-op. It is key that patients remain calm and wait out the results.
It depends on the procedure. In our offices, we generally like to use general anesthesia to protect the patient’s airways, but tip rhinoplasties (which only work on the very bottom of the nose and do not involve the breaking of nasal bones) can be done under local anesthesia.
Although some surgeons will recommend using fillers for indentations in the nose, these fillers offer only a temporary fix to a more permanent problem and have been shown to cause other problems like redness of the skin. Often, what patients are dealing with in these types of indentations are separation of cartilages in the nose which can only be corrected with rhinoplasty procedures.
These medications are typically used for anti-swelling purposes and are best used in the week prior to and after the rhinoplasty. If patients do not see any results after this period, the swelling which they believe they might see may be the result of thicker skin (genetic).
It is difficult to say without seeing a patient whether they are in need of a rhinoplasty procedure or not. However, a small, up-turned nose is one which requires a great deal of precision and is best handled by an experienced surgeon. Be careful when choosing your surgeon to find one that is board-certified and has had experience with these types of procedures before.
Due to the repositioning of cartilage which occurs extensively in the tip of the nose during rhinoplasty, the tip is one of the most prone areas to swelling post-op. Patients should not be concerned if the tip appears swollen for a longer period of time than other areas of the nose post-op.
Absolutely not. Because rhinoplasties often require osteotomies anyway, I would recommend that patients, if they do have a broken nose that they wish to have repaired, come after 5-7 days but no later than 2 weeks post-injury. At the 2 week mark, the bones will have already begun to heal and it may be more difficult for surgeons to correct the original defect.
It has been shown that repetitive stretching and pulling of the skin can cause irregularities, but this only occurs with constant pressure. Nostril asymmetry is more often caused by an irregularly shifted nasal midline that can be repaired surgically.
This problem is probably best addressed by an examination in a qualified surgeon’s office. However, pure speculation indicates that this may be an issue of the nasal conchae or caused by septal deviation, both of which require surgical solutions.
Of course, every surgery carries with an inherent risk. However, as long as the patient in question is healthy and gives us a full run-down of anything (allergies, etc.) which could cause problems, the risk of them driving to my office to do the rhinoplasty has more inherent risks than the rhinoplasty itself.
Absolutely. Septoplasty and rhinoplasty procedures are often performed hand-in-hand because they work in essentially the same neighborhood. If the surgeon you are planning on working with is qualified and experienced, I would definitely check in to investing in one complete procedure because it carries less recovery and surgical time.
A hard tip following rhinoplasty is most likely caused by residual swelling or scar tissue which may have formed, as well as cartilage grafts which may have been used during a patient’s rhinoplasty procedure. As I mentioned in previous queries, the tip of the nose undergoes the greatest proportion of the swelling post-op, so healing takes a while in this area.
The best tip for achieving a natural rhinoplasty look is first to find an experienced surgeon that is board-certified in plastic surgery AND specializes in these types of procedures. The second tip is to not set your expectations unrealistically high. Very often, patients will come in demanding a “Kim Kardashian nose” or something like that when it is impossible for me as a surgeon to make it look natural. What rhinoplasties do is essentially modify an existing nose to correct defects, not substitute one nose for another. Our goal as surgeons is to simply enhance the nose you already have.
The purpose of the splint post-op is to protect the nose and also ensure a decrease in post-procedure swelling. However, even if the splint is crooked, the surgical tape underneath it is probably applied correctly. Consult with your surgeon about this, though.
The most common side effects of a rhinoplasty are relatively mild and include bruising and swelling which dissipates within weeks to months following the procedure. Some much rarer risks include bleeding (which is more of an issue for patients with a history of using blood thinners and NSAIDS), scarring which can be corrected with steroid injections, and potential infections which can be mitigated in the hands of an experienced surgeon.
This is merely for the purpose of reducing swelling.
Often, patients with indentations in the nose are dealing with irregularities in the underlying lower lateral cartilage tissue, problems which can only be addressed via a full rhinoplasty procedure. Fillers have shown to be ineffective in these scenarios and only provide temporary relief for the issue at hand.
Smoking any substance like marijuana will cause pulmonary irritation that will cause a longer healing process. I would recommend waiting at least 3-4 weeks before doing anything of the sort.
Generally, at this point, the facial structure should have healed nicely after Sculptra treatment. Therefore, having a facelift should not be a problem, especially considering that Sculptra is often done concurrently with a facelift.
The tip can often be corrected via repositioning of the depressor septi muscles as well as repositioning of the cartilage at the tip already and cartilage grafts.
It is rare for patients to experience this sort of symptom post-op. This may be a sign of an infection and must be looked at immediately by your surgeon.
It is recommended that patients, when sneezing or coughing post-op, use their mouth as much as possible in order to relieve unneeded pressure from the nose. Especially during the first week, take care not to blow your nose if not necessary.
Of course, after the surgery, the nose ages just like the rest of the body and drooping does occur. However, this only occurs at a gradual rate and is unlikely to look unnatural. For patients concerned with the possibility of an upturned nose following surgery, it is important to recognize that there will be significant swelling in the columella region (the bottom part of the nose where the incision was made) that will cause upward rotation of the nose, but this will dissipate over time.
Many gimmicks like these work to simply temporarily compress nasal tissues, but do not lead to any substantial changes. There is no substitution for professional work when it comes to optimizing nasal structure.
A wide, flat nose is typically among certain ethnic communities, particularly those of East Asian or African-American ancestry. Cartilage grafts from the septum or the ear will often help adjusting the nose in order to give it more “height” and protrusion and this can be done during a rhinoplasty.
This is a very unusual symptom, not at all common. I would recommend seeing a board-certified surgeon immediately to check what the issue might be. It may be the sign of a re-broken nose.
Nasal rinses can start to be used one week post-op, but patients must remain gentle with them.
Patients with a bulbous nose (wide) can easily have this defect correct via rhinoplasty. However, they should also take care to consider additional revisions in the bridge of the nose to ensure that the corrections made at the tip will not look disproportionate.
It is unlikely that after 6 weeks post-op, any minor hit to the nose caused irreparable problems in the nose’s structure.
Often, the question which patients must come to terms with during these times is actually which vitamins to AVOID. Vitamin E is known to cause unnecessary post-op bleeding and should be avoided in the week after surgery. Certain vitamins can help, including Vitamin A and Vitamin C, as well as certain herbs like Bromelin and Arnica which can reduce swelling.
It is completely normal for swelling, particularly in the tip of the nose, to still be present up to a year post-op.
Yes absolutely. It is possible for this procedure to be done without touching the tip or the bridge of the nose because the incision is made as a crescent shape on the inner wall of the nostril. However, it is rare for patients to expect a reduction in nostril area without reducing anything else, especially the tip.
Because cocaine acts as a powerful vasoconstrictor, it decreases blood supply to nasal tissues and thus inhibits the healing process and even causes these tissues to be necrotic and die. I would highly advise AGAINST using it simply because of hearing cases where patients run into an array of issues post-op, including septal perforations
Generally, a week is enough time to fly again post-op (2 weeks for turbinate or septal surgery). Spraying the nose with Afrin ½ hour before take-off and landing will likely help.
It is important for patients to recognize that, as surgeons, our goal is to modify an existing nose and correct defects during rhinoplasties, rather than substitute one nose for another. If the surgeon you chose was competent, the rhinoplasty should enhance your overall appearance and give your face a degree of greater harmony.
Generally speaking, in the case of a competent, experienced surgeon, middle vault collapse of the nose is exceedingly rare. This is usually caused by scar contracture and shrinking of the skin that could affect the middle of the nose and the tip. However, this can be avoided by strengthening the nasal structure with cartilage grafts.
Most, if not all, of the swelling will disappear by the one-year post-op mark. However, the majority of the swelling should be gone within 3-4 months post-op.
Not likely. Taping of the nose post-op is more a measure of reducing swelling rather than maintaining the shape of the nose.
Not fixing a broken/deviated nose immediately does not necessarily make it impossible to correct the original defect, but it definitely makes it more difficult. Nasal fractures are best treated within 10-14 days of the original injury before the nasal bones begin to reset in the newly established manner.
If done under local anesthesia, this procedure will typically run within the $2000-$3000 dollar range. However, this cost can vary depending on geographic area, the patient’s choice of anesthesia, etc.
Unfortunately, changing the shape of your nose requires movement and repositioning of the underlying skeleton and cartilaginous structure. Fillers and other non-surgical tools will typically only camouflage defects like a dorsal hump, etc by filling it areas around the defects.
The cast, which is kept on to reduce swelling and post-op bleeding, should ideally be removed 6-7 days post-op by an experienced surgeon.
Any activity which increases blood pressure (even light exercise) can present a problem in terms of swelling. I often recommend to my patients that they refrain from running until at least 3 weeks post-op.
Though the figure varies widely, a typical tip rhinoplasty will run in the range of $6,000-$8,000. However, do not let cost guide you and seek a board-certified surgeon who specializes in these procedures because having to spend for a revision surgery is more expensive than just doing it right the first time.
Patients can resume light exercise after 3 weeks post-op and then build up to strenuous exercise over the next couple of weeks after. However, I often recommend that they stop if they detect additional pressure in the nasal area. Increased blood flow to the area could increase the amount of potential scar tissue that forms post-op.
Not usually. One must remember that the nasal splint goes OVER the surgical tape underneath, and both of these measures are used to reduce swelling post-op. At 7 days post-op, the nasal bones and cartilage are usually stable enough to not require the splint anymore.
Unfortunately, other than the tips which your surgeon probably gave you (avoiding blood thinners like aspirin, not smoking, etc.), there is little else that you can really do to reduce bruising as it is part of the body’s natural healing process.
Absolutely. A bulbous tip, as this is called, can easily be reduced by a tip rhinoplasty (tip-plasty) which focuses specifically on the bottom point of your nasal structure and gives it a more natural contour.
Unless the manipulation occurred within the first few days post-op, there is little to worry about for patients who did this. Temporary swelling may occur, but this is nothing to worry about. However, I would recommend against squeezing them in the future because it could cause bacterial infection.
As I tell many of my patients, the key to success in the post-op period following the rhinoplasty can be encompassed in one word: Relax. Very often, the residual swelling from the surgery, which tends to mostly resolve itself within 3-4 months with some swelling remaining up to 1 year post-op, can make the results of the surgery look much worse than they actually are. Patients are advised to keep this in mind and remain calm.
It is important for patients to recognize that we as surgeons cannot substitute one nose for another, but can only modify an existing nose and correct it for defects. Therefore, not everything, even in the hands of the best surgeon, can end up with the exact look of a celebrity because the underlying basic structure is too different. Also, even if a perfect recreation of a particular celebrity’s nose is done, it may not work well in relation to a patient’s other facial features.
No, while massaging may temporarily cause minor changes in nasal structure via compression of nasal tissue, these changes are by no means permanent or effective.
Although improved methods of post-op care have generally made nasal packing after a rhinoplasty relatively obsolete, many surgeons today still use nasal packing as a way of preventing excess post-op bleeding. However, it is usually not needed except in rare cases where other methods to stop bleeding have not helped.
It is highly recommended that patients looking to go abroad to have surgeries done take a second look at this idea and perhaps err on the side of caution and choose a surgeon closer to home. While there may be wonderful doctors abroad, it is important that, should something go wrong in the post-op phase, the surgeon who treated you also be able to evaluate you.
Generally, it is normal for patients to experience asymmetrical swelling, that is, one side of the nose healing faster than the other. I would not worry too much, but take care to see your surgeon as this may be the result of simple fluid accumulation (edema) which will heal itself over time.
Highly unlikely. Cartilage is very elastic and bounces back to its original shape, even after repeated pressure.
I would not recommend removing the scabs directly as it could lead to infection. Patients who wish to breathe better can apply saline or a water/hydrogen peroxide mix in order to relieve the crusting, but gentleness is key.
Generally, surgeries which work to improve the quality of life (in this case, the goal is improving breathing) tend to be accepted readily by insurance. However, if the septum is not deviated and breathing is not an issue, the surgery will only be counted as an aesthetic/cosmetic one and will NOT be covered by insurance.
It is advised that light exercise be postponed until 3 weeks post-op and more heavy contact sports be postponed until 6-8 weeks post-op. For diving specifically, due to the risk of potential nose bleeding (and the problems with wildlife that might ensue), I would recommend waiting at least 8 weeks for the nose to fully heal.
In the hands of a well-experienced, competent surgeon, rhinoplasty carries with it only the typical risks of any major surgery. With that said, in these circumstances, you are more likely to have an accident on your way TO the surgery than to have complications during the surgery itself. However, it is the patient’s responsibility to find a surgeon who is board-certified in plastic surgery and has experience with these procedures.
Yes this can be done with an alarplasty in which a crescent-shaped wedge of skin is taken out from the nostril via an incision inside the nostril tissue and the resulting hole is closed up to reduce nostril size. However, this is a rather difficult procedure with great potential for asymmetrical results, so work with a surgeon who is very competent and has a history with these procedures.
This can only be answered on a case-by-case basis. If the excess cartilage in question is around the tip, a tip-plasty can be performed without osteotomies. However, extra wideness on the bridge of the nose or any areas other than the tip will most likely require a careful breaking of the nose which only an osteotomy can provide.
Often, creases in these areas are caused by repeated motions of the muscles, much in the same way that laugh lines or crow’s feet developed. Mild solutions like Botox or Dysport may provide relief.
Some bleeding is generally expected post-op within the first few days, but bleeding in which the dressing is soaked or blood is emerging from the pharynx (throat) is rare. For this, consultation with a qualified ENT surgeon might be necessary. If the bleeding in question is years post-op, it is more likely caused by dryness in the nose, as are most nosebleeds.
Correction of a nasal septum deviation during rhinoplasties will definitely cause a change in the voice, the extent of which can vary, due to change in airflow and the subsequent effects it has. However, unless the septum is being manipulated, it is unlikely that other types of rhinoplasty would affect the voice in a noticeable manner.
During puberty, there is an explosion of growth particularly in the nose and midface areas, meaning that any noticeable features which existed before generally become more noticeable. However, by ages 15-17 for women and 16-18 for men, the growth should stabilize, at which point septoplasties and rhinoplasties can be performed.
Rhinoplasties can definitely be performed on patients with thick skin. However, there may be some limitations. Rhinoplasties work by lifting up the skin, adjusting the underlying muscle and cartilage, and then re-draping the skin. However, the skin needs to be tight in the last step which may be difficult to do for patients with more elastic, thick skin, so extra thinning of the underlying tissue might be needed.
For most patients, nose growth will stop when they reach their 20s. However, rhinoplasties can be performed at ages 15-17 for women and 16-18 for men because growth is a gradual process and the nasal area can adapt and age with the rest of the body.
During puberty, certain areas of the body tend to expand more than others, these areas including the nose. Bumps may form at this time, but cannot be removed except via rhinoplasty at the appropriate age (15-17 for women and 16-18 for men).
This step is taken to counter and minimize the inevitable swelling which occurs and to counteract the pressures caused by minimal forces to the nose (ex. Eyeglasses).
Unfortunately, given the early nature of these traumas post-op, it may be necessary to visit your surgeon for an evaluation.
Excellent question. Some things to ask your surgeon before you allow him to operate in order to determine whether he/she is worth your time could include:
What board certifications do you have?
How many rhinoplasty surgeries have you performed, especially within the last year?
May I see before and after pictures of your work, particularly with my type of surgery?
How much will this surgery cost? And how many revisions have you had to do on your work and what does that cost?
What sort of anesthesia do you use for my type of procedure?
Which hospital are you affiliated with?
If you have to ask the question, I would say you answered it yourself. Any poking or prodding of a surgery site, especially within the early weeks of the post-op period, will inevitably cause undesired results.
Not necessarily. While a deviated septum could create a crooked nose, problems in the alignment of the underlying cartilage (upper lateral, specifically) or bone may also play a part in creating a misshapen bridge. It is recommended that patients be professionally evaluated in a surgeon’s office.
Patients with this condition may benefit from a Weir excision in which skin from the inside of the nostril is removed and the hole is tightened to prevent excess spreading during smiling. However, even non-surgical options like Botox could help with this problem by relaxing the muscles that spread the nostrils.
Not necessarily. I would not recommend trying to remove it yourself, but would rather opt to go to the surgeon for professional removal in order to prevent infection.
Because of the inherent difficult in keeping the splint dry when there is makeup next to it, it is recommended that patients wait until the splint is removed (1 week post-op) before applying makeup.
Due to the contraction of scar tissue as well as the reduction of residual swelling, the nose does indeed decrease in size over the course of the post-op period to match the expectations (hopefully) of the surgeon and the patient.
Saline rinse is generally advisable for the first 2 weeks post-op simply to clear crusting blood and excess mucus deposits within the inner wall of the nostril. However, it is best to follow your surgeon’s recommendations regarding nasal cleaning post-op.
The full healing period post-op takes up to a full year, when all the swelling will eventually dissipate. However, patients will generally recover from surgery within the first few days post-op and will be ready for work within a week. After three weeks, you can even return to light exercise.
The recommendation is that patients wait at least 10-14 days post-op to resume drinking coffee and wine, as the former can raise blood pressure (presents risk of increases in swelling) and the latter may also present problems with swelling.
This condition can be fixed by manipulating the upper lateral cartilages and performing a septoplasty which will inevitably require an osteotomy. However, upper lateral cartilages may need to be bolstered via a cartilage graft from the septum or the ear. It is best to consult your surgeon for the best course of action.
Theoretically, yes. However, this is a relatively temporary fix and also makes the lower nose look much wider and misshapen. In cases where the bridge is seen as too wide, a full rhinoplasty may be required, complete with osteotomies (which break the bone in a purposeful manner).
This is a condition called vasomotor rhinitis which can be resolved with sprays like ipatroprium bromide or atropine. Consultation might be necessary, however, to make sure it is not part of a more serious issue.
In some cases, rhinoplasty patients will experience a permanent decrease in breathing due to factors like smaller nostrils, formation of scar tissue on the inside wall of the nostril, etc. Generally, though, breathing difficulties should subside within 2-3 months post-op, but may dissipate as soon as 2-3 weeks.
It is difficult to answer this question, primarily because it is unclear where the cartilage deposits are. In the simplest case, a tip rhinoplasty can be performed via small incisions through which the excess cartilage will be shaved. However, there may be more complicated procedures which need to be performed.
This is probably best evaluated by your surgeon. However, for a rough method of evaluation, you can feel the difference between thick skin and cartilage by feeling your cheek and then feeling your ear. Thick noses can contain a mixture of both, however.
This is an extremely common occurrence and it is advised that patients refrain from panicking. Instead, just maintain a low-sodium diet and keep the head elevated in order to reduce swelling, as always.
Unnatural thickening of the nose, other than from swelling, may be caused by the buildup of scar tissue underneath the skin, particularly if the patient has had multiple rhinoplasties. This can be solved by cortisone or Kenalog injections.
This can be corrected via an incision within the nose that will free up the tip and allow it to drop down naturally. Additional reinforcements may be needed in the form of cartilage grafts at the base of the septum. Trimming the cartilage near the tip of the nose may also provide the loss of support and thus the derotation which is desired.
Although strategies for nasal beautification are not as effective or long-term as a full rhinoplasty, they can be good short-term fixes. The main alternative to surgery is the use of fillers like Restylane or Radiesse which camouflage defects by filling in areas around the site of defect. But, these must be used judiciously because, otherwise, the patient risks having too much filling in areas where it is not necessary.
A hard bump forming on the nose is an indication of a minor bone callus which will eventually resolve itself within six months. In some cases, a minor revision may be required to shave it off if it is not resolved by that point.
Numbness following a rhinoplasty is not uncommon, but a consultation with the surgeon is probably necessary just in case. Speculation would seem to indicate that the numbness in the tip of the nose is caused by the resection of the depressor septi muscle, the symptoms of which will probably dissipate after three months. The numbness in the upper lip is most likely the symptoms of nerve aggravation which will also resolve itself as time goes on.
This is a relatively common complaint due to the disruption of nerves which occurs when work is done on the septum. As it happens, the palate and the septum share some nerves which are disrupted during the surgery. The subsequent regeneration of the nerves comes with dull throbbing and pain which will resolve itself
Surgeons disagree over massage simply because of the underlying issue of whether pressure from the massage could alter the structure of the nose which was determined during the surgery. Some will claim, however, that it reduces swelling. There is not enough proof to really support either side, so it is more of a practice which passes from mentor to student.
A typical rhinoplasty will take around 2 hours to perform.
Unfortunately, it is not that easy. Single finger pressure cannot induce bone resorption.
An osteotomy (controlled breaking of the nasal bone) is not performed in all rhinoplasties, but rather is only performed in cases where the upper portion of the nose needs narrowing. This occurs when a dorsal hump is shaved down, when there is septum deviation correction, and when a wide nose needs to be generally narrowed.
Dorsal humps are a primary motivation for many patients to get rhinoplasties. Depending on the size of the bump, it may be able to be shaved down without much hassle, but may require an osteotomy (controlled fracture of the nasal bone).
Though I would rather patients quit smoking entirely after surgery, I would wait at least 4 weeks post-op to begin again. Cigarettes contain nicotine and carbon monoxide, the first of which is a vasoconstrictor and causes tissue death in the surgical area by limiting blood flow and the second of which decreases the blood’s oxygen capacity and also causes tissue death.
Sometimes, dorsal humps can be disguised via the use of fillers around the hump so that it does not stand out as much as it did. However, this method generally increases the overall size of the nose and thus only works well for those with smaller noses. Those with larger noses will unfortunately require a much larger operation like a rhinoplasty where osteotomies are performed.
In the first couple of weeks post-op especially, uneven swelling and bruising is common. Because the full cycle of healing does not end up at least a year post-op, with most of it subsiding by 3-4 months, patients need not worry about asymmetrical swelling.
It is difficult for me to call this for myself. It is more of a decision for the patients, that is, “Who is the best surgeon for you?” When evaluating surgeons, patients need to make certain that their surgeon of choice is board-certified, specialized in their desired type of procedure and has experience doing these surgeries, has satisfactory before-and-after photos, etc.
There is a small proportion of fat in the nose within the lateral alar sections, but this is nowhere near where surgeons typically operate. The nostrils, the bridge, and other typical surgical sites for rhinoplasty are generally bone and cartilage, meaning that weight gain or loss does not have a major impact on the results of a rhinoplasty.
The reason why surgeons will almost always apply a splint in the first week post-op is because of the delicacy of the nose in this period. Small forces, even a slight hit with a towel, can have large impacts simply because the cartilage underneath the skin has been shifted, so patients are advised to be careful.
Most surgeons will have some of imaging software that allows patients, during consultations, to see EXACTLY what the doctor plans on doing and also lets them do a before-and-after side-by-side comparison of the results. I have found that this very comforting for patients and highly advise patients to see a surgeon who has this software.
It is certainly possible for these arrangements to be made. However, one must remember that rhinoplasty is one of the most difficult procedures in the plastic surgery world and is ideally conducted by a doctor with a great deal of experience and the proper credentials in order to ensure a good result.
In general, both types of surgeons should theoretically be qualified to conduct this procedure. Therefore, the choice really comes down to who the surgeon will be, rather than their practice. Make sure to obtain a surgeon who is board-certified, specializes in your procedure, has good before-and-after results, etc.
Generally, the tip is composed of a great deal of cartilage and thus may be prone to fracture. These types of injuries are generally only treatable with a rhinoplasty procedure.
This is generally best taken care of with a rhinoplasty in which medial and lateral osteotomies are performed to lessen the lateral width of the nose and the nasal bones are turned more inward. In cases where patients have a sunken upper-third of the nose, cartilage grafts may also be required.
Patients can reduce swelling by asking surgeons to apply surgical tape to the area and also practicing good habits such as reducing alcohol/smoking habits, reducing sodium in the diet, and (if swelling is persistent after several months) engaging in light exercise.
It is difficult to determine the cost of reducing a hump because patients will have different requirements. Small humps will require smaller procedures, but typically, the cost to reduce a hump is synonymous with the cost of a rhinoplasty which will cost in the neighborhood of $8000-$10,000.
Bulbous tips can be reduced via a tip rhinoplasty in which the nasal bones are not tampered with and the tip cartilages are simply manipulated. However, an in-house consultation with a patient’s surgeon might be necessary to evaluate this for sure.
It is rare for stitches to find their way into the inner nose, but it sometimes happens. In cases like these, patients should NOT pull out the stitch by themselves, but rather have it removed by their surgeon.
This depends on the patient’s circumstances, that is, what size the bump is. Smaller bumps can usually be shaved off with a rasp tool, but shaving off larger bumps in this manner can lead to an open roof deformity on the nose which can only be corrected during the procedure via an osteotomy in a rhinoplasty. Here, the nasal bones are carefully fractured and pushed inward to close up the hole created by the hump reduction.
It is rare for patients to die of complications directly associated with rhinoplasty, simply because the nose is not exactly crucial for survival. If deaths do occur, and this is EXTREMELY rare, it will occur due to complications with anesthesia or because of prior health concerns which are not disclosed to the surgeon. Make sure, during your consultation, to tell your surgeon everything and also look into general anesthesia in which a breathing tube is inserted to ensure proper ventilation.
The tip/columella area is a primary surgical site during a rhinoplasty and will take longer to heal in terms of swelling than other areas of the nose. The swelling will tend to gradually dissipate over the course of a year, but should be generally resolved within 6 months.
As stated in other questions, the columella area is a primary incision site during the surgery and undergoes more trauma than other portions of the nose in the procedure. Lymph flow may be disrupted in this area causing fluid buildup (edema), but this will resolve itself over time.
Definitely. X-rays only show fractures in hard tissues such as bones and not soft connective tissue, like cartilage. Evaluation by a surgeon is probably the best avenue to determine whether cartilage is indeed fractured.
It depends on the nose which the surgeon is starting with. This type of technique is ideal for patients who have the combination of a droopy tip and a long nose. However, if the tip is normally rotated, there is no need to mess with it and the issue would be better resolved by shortening the septum and bringing the inferior tissues upward. Consultation with a surgeon is probably the best way to determine a patient’s course of action here.
It is certainly possible for nasal trauma to fracture cartilage and cause deviation of nasal tissues without actually breaking the bone. In this case, separation of the cartilages in the nose may be necessary for evaluation and cartilage grafts will be introduced to supplement weaken structures.
In the case of reduction rhinoplasty, it is important for patients to keep their expectations realistic. The nose must be modified in a way that maintain the patient’s natural look and keeps it proportional to the surrounding facial structures. In addition, thick skin may also be more difficult to handle as it is more elastic. Consulting a surgeon is necessary to answer further questions.
This really depends on the surgeon’s schedule, the patient’s schedule, and the need to obtain medical clearances.
An L-implant shapes the columella area (bottom of the nose) and the dorsum area, while the I-implant only shapes the dorsum area. Patients may want to reconsider getting these silicone implants, however, and may want to instead opt for natural cartilage from the septum or the ear.
In some cases, surgeons will offer discount rates to do both at the same time, but patients should be wary of surgeons who are offering TOO much of a discount. As the old saying goes, “If it’s too good to be true, it probably is”. This surgeon may not be properly certified. In any case, though, septoplasties are generally covered by insurance so costs can be lowered in this manner.
It may be best for patients to evaluate with their surgeon if they detect unusual smells. This may be the sign of a residual suture which needs to be removed, but could also be indicative of an infection.
The best way to evaluate thickness is probably by pinching individual portions of the nose from top to bottom and examining how thickness increases going in this direction. Thick skin is generally relevant in the tip and tends to be rather oily. If the patient easily manipulate the skin over the tip, it is thinner.
Generally, the nose will tend to age with the rest of the body following rhinoplasty. Open rhinoplasties which support the nasal tissues with cartilage grafts will tend to hold up better, but they too will not stop the aging process completely.
Steroid injections, though present for a little while after they are introduced to the body, only provide a temporary preview of the final result of the procedure before being absorbed by the body.
A major complaint which patients have with nasal packing (gauze which pushes the skin against the septum for better healing) is that they feel congested and are forced to breathe through their mouths. For this reason, nasal packing with tubes are introduced to help the patient breathe through the nose and feel less congested.
This is highly inadvisable as patients often do not know the precise motions which are required to set the nose in a perfectly straight manner. It is recommended that patients with a deviated nose go to a professional to have it fixed.
If the flat bridge is from fractures, then osteotomies can be done to narrow a wide nose. If congenital then osteotomies may not be enough and dorsal onlay grafts may be necessary.
Steroid injections are introduced in patients to prevent the buildup of scar tissue that can actually deform the tip. However, while helpful, it can also cause atrophy of surrounding tissues and overthinning of the skin if not used judiciously.
It is acceptable for patients to go back in the pool after a month or so post-op, but take care not to bump your nose on anything. I would, however, postpone swimming in the ocean to 8 weeks because of the risks of a bleeding nose and the subsequent problems which could occur with sharks and other wildlife.
This is an indication of blood trapped in the lower rim of the eye, which will eventually dissipate after a period of 6 months or so.
This may be something that is best evaluated by your surgeon, but the likely cause of this is poor lymphatic drainage and scar tissue which may have accumulated.
Generally, these stitches should not last longer than a week or two (absorbable). Evaluate with your surgeon to have them removed.
This is up to the discretion of the surgeon. However, some methods can include reducing of the septum, upward rotation of the tip (in the case of longer noses with droopy tips), and modification/elevation of the tip cartilages.
The inflammation caused by rhinoplasty tends to cause excess mucous production that will last for a month or so post-op. Patients need not worry if this occurs.
Technically it can be. However, patients must realize that scar tissue tends to thin over time and surgery with the intention of removing it may cause the formation of new scar tissue and steroid injections may also present complications.
It is important for patients to recognize that surgeons have a responsibility to modify the nose in a way that makes it look natural in relation to the rest of the surrounding facial features. Thus, while surgeons can reduce a nose via manipulation of the underlying cartilage and shortening of the septum, it must look aesthetically pleasing.
This is best evaluated by a surgeon. However, if temporary pressure via the hand can help in reducing it for a short period of time, it is probably swelling which will subside.
As long as the patient is healthy enough to have both procedures at the same time and the surgeon of choice is qualified to do both procedures, there does not seem to be a problem with doing them together. However, care must be taken to avoid infection and this is done by choosing a well-qualified surgeon.
Loss of smell immediately post-op is usually temporary due to the blockage of nasal passageways from swelling. However, it may be advisable to wait and, if things do not improve, to visit an otolaryngologist for a smell test to check for damage to the olfactory nerve.
It is a general consensus among surgeons that they prefer cartilage over man-made implants simply because there is less risk of infections and other complications.
Normally, it consists of both and is best reduced through surgery.
Generally, most surgeons will use a spreader graft or even an onlay graft (which strengthens the cartilage more than a spreader graft, but does not really lift or support it) for open rhinoplasties, rather than closed ones. Collapsing nasal valve may be better served with an onlay graft in order to bolster the cartilage wall.
Yes this is fine. I would recommend carrying Afrin spray and applying it 30 minutes prior to takeoff and landing to mitigate the risk of nosebleeds.
I would recommend waiting 6-8 weeks simply because of the risk which a bump to the nose can have on the results of a rhinoplasty.
Completely. It is normal for residual blood and tissue to remain within the nose, especially if the patient does not blow their nose post-op (which they shouldn’t), and mix with the mucous produced there.
It is probably best to wait 4-5 weeks or so before beginning “Insanity-type” cardio workouts simply because of the risk of increasing blood pressure and inducing nosebleeds.
At this point, it is still normal to have some swelling from the rhinoplasty still present in the tip. However, unless a graft was placed in that area, it should have at least a small degree of give. If not, evaluate with your surgeon your best course of action.
Swelling in the tip, the hardest-hit area in terms of trauma, tends to persist for about a year and can distort the appearance of results. Please be patient in evaluating your results.
Chances are this is the result of the splint which is admittedly somewhat irritating and does not allow much oxygen flow to the skin. Itching is good, however, and indicates the absence of infection.
Because rhinoplasties often entail the narrowing of the bridge of the nose, it is normal for a minority of patients to experience sensitivity and discomfort for a period of weeks. No concern is needed.
Generally speaking, patients should take care not to exert any pressure on surgical areas post-op. If the crusting bothers patients that much, they may be better served with saline spray.
It is unlikely that heavier glasses will necessarily deform nasal bones, especially in a nose which has not undergone rhinoplasty. Patients can try going to lighter frames and see what occurs, however, if they are curious as to what could happen.
Generally, alarplasty scars though pretty much permanent are extremely well hidden along the alar/nasal intersection and will generally fade over time.
This can be done via a rhinoplasty which will generally hover in the cost neighborhood of about $8,000-$10,000.
Generally speaking, the major difference between these two procedures is the presence of a endotracheal breathing tube in the general anesthesia route which helps secure the patient’s airway. In twilight sedation, the patient breathes on his/her own. Either practice is generally safe.
In reality, thick skin is more difficult to manage and drape over a newly created cartilage foundation than thin skin because it is more elastic and willing to stretch. Therefore, reduction rhinoplasty is considerably more difficult under these circumstances because, while skin does contract, thick skin does so far less.
While it is rare for these cases to occur, they do occur once in about a thousand times. Generally though, if the patient bolsters their immune system with antibiotics, it will go a lot way to preventing infections.
Absolutely not. There is no telling what the anesthesia or the medications needed prior to and post-op will do for the baby.
Sure. Gentle cleaning of the area with a Q-tip and a mixture of hydrogen peroxide and water OR saline solution can do wonders with loosening up the crusts that inevitably form post-op.
Yes, this should be enough time (7-10 days) to return to work post-op. However, patients must realize that bruising and swelling will still be apparent in this period of time. Therefore, if appearance is important, taking a couple more days off may be advisable.
The main reason why people regret their rhinoplasties is generally because they are dissatisfied with their surgeon’s performance. In order to prevent this from happening, it is suggested that patients thoroughly research their surgeon prior to going ahead with surgery and make sure that their expectations are realistic and align with the plans of their surgeon. Communication is key to this step.
It is important for patients to recognize that, sometimes, a nose can be reduced to the point where it is simply not natural-looking in relation to the rest of a patient’s facial features. We as surgeons have a responsibility to not only fulfill a patient’s needs, but to stay realistic. Think of this way. We do not substitute one nose for another, but rather modify existing noses and correct defects. We maintain your original nose but tweak it, rather than giving you a new one.
There are generally two types of crooked noses: one which starts normal but is made crooked by trauma and another which is naturally crooked. The first is resolved with correction of the septal deviation and alignment of the nasal bones, while the second may require additional steps like support via cartilage grafts.
Generally, during puberty, there is an explosion of growth in the nasal and jaw areas (disproportionately so compared to the rest of the body). When this happens, slight imperfections may be accentuated --- similar to how enlarging a photo can reveal hidden flaws. As such, it is normal for slight bumps to turn into larger dorsal humps, etc.
Yes definitely, because the nasal splint serves to compress the surgical area and reduce swelling. However, nasal taping can help ease the amount to which swelling occurs.
An infection post-op can have many causes, including an infected implant, introduction of a foreign body, etc. When an infection occurs, patients are advised to look for the cause by having any mucus or discharge cultured and to take the antibiotics which are recommended by their surgeons.
The nose can be made to appear longer via downward rotation of the tip or the introduction of extension cartilage grafts. However, this is a much more complicated procedure than shortening of the nose and so must be done by an especially well-experienced surgeon.
Generally speaking, this procedure involves the use of cartilage grafts to strengthen the cartilage on the inner nasal wall and to widen the openings. Collapse of the internal nasal valve requires a spreader graft, which is more intensive. Collapse of the external nasal valve may be alleviated with a smaller graft.
This procedure is generally less common than using rhinoplasty to narrow the nostrils and typically uses cartilage grafts from the tip of the nose or the ear. Consultation with a surgeon is best, however, to determine a patient’s particular course of action.
Especially if cartilage grafts were introduced, it is normal for stiffness to remain post-op for up to a year due to the trauma which the tip of the nose in particular undergoes during the procedure.
Bromelain may help with bruising and swelling, but both of these medications should be taken one week prior to and following surgery. In addition, make sure when sleeping or lying down to keep your head elevated above the heart.
Generally, the nasal packing (gauze which would line the inner nostrils) which doctors would often use post-op has been replaced with internal splints that prevent the formation of scars and septal hematoma. This is also supplemented by an external splint which puts more pressure on the skin and guides it into place on top of the underlying cartilage and muscle tissue.
This is especially common due to the blockage of sebaceous glands on the skin by the tape. Common acne regimens should be fine to help alleviate this.
Depending on what patients define as a wide nose, there are several procedures which can be done to alleviate this problem. Osteotomies can be done to narrow the upper nose, cartilage can be removed from the middle, alar base reductions can be done to reduce nostril width (which is usually the common problem), etc. A more thorough examination is necessary to determine exactly what should be done though.
Nasal flaring, depending on the severity of the problem can definitely be fixed with solutions like Botox (for small-scale procedures) or with larger-scale operations like a Weir’s reduction or an alarplasty.
Generally no, other than during the initial period when there will probably be some nasal congestion that occurs (but this should clear up). The biggest concern in terms of vocal sound will be from the intubation needed to keep breathing up during general anesthesia application.
Alarplasty scars tend to stay well hidden, but may take a while (several months) before becoming fully camouflaged. Once the swelling and bruising is resolved, the smile will develop normally after six weeks.
Generally, nasal growth should cease when a patient is in his/her mid-20s. Continuous growth afterwards may be attributed to rhinophyma which is excessive growth of sebaceous glands around the lower third of the nose, but may also be just the general loss of elasticity in the skin that causes the nose to droop.
This can usually be done with a nasal speculum in a surgeon’s office which can distinguishes healthy septum tissue (pink color) from inflamed septum tissue (red color).
In most cases, patients are expected to make a full recovery following a rhinoplasty, so it is probable that patients experiencing smiling difficulties will find their concerns alleviated. Patients may find that the separation of the muscle fibers between the base of the nose and the upper lip during certain procedures like septorhinoplasties may reduce smiling capabilities, but these issues will eventually resolve themselves.
Unlike cigarette smoke, marijuana smoke presents no dangers of nicotine, a potent vasoconstrictor which has the ability to cause necrosis of nasal tissue. However, it does have carbon monoxide which limits oxygen to the surgical site and may lead to tissue death there. In addition, the coughing induced by marijuana can lead to internal bleeding post-op.
The best way to sleep after surgery is on one’s back with the head elevated above the heart to reduce swelling.
From my sources, it seems that rhinoplasties in Dubai cost exorbitant amounts of money, far more than those in the USA. While rhinoplasties in the States may cost between 8-10k, I have heard cases of double or even triple the price in Dubai.
Unfortunately, due to the thick nasal skin associated with an average African-American nose, it is very unlikely that even the most skilled surgeons can complete this transformation without risking the nose being unnatural looking. The nostrils and the tip can be narrowed and the nasal bridge can be augmented, but not to the extent that many will desire.
Unfortunately, no. A rhinoplasty procedure makes the nose weaker in the days post-op and the repeated blows to the facial area and the nose from boxing risks destroying or even making worse the results of each rhinoplasty.
Especially during the first several weeks post-op, swelling in the nasal area and crusting of blood and mucus will cause congestion of the nasal airway and thus inhibit breathing. This swelling will begin to subside, however, and will improve after 2 weeks.
Cartilage shifting post-op can be disguised with the use of fillers, but a more permanent solution would be to introduce cartilage grafts.
This is definitely possible as trauma to a bone-dense area induces the deposition of calcium in that area in the body’s effort to strengthen that particular site of injury.
In my experience, it is usually best for support to be introduced into the nasal region via natural cartilage grafts from the ear or the septum. It is not clear whether the Medpor nasal implant will work for a particular patient, but the best chance of success involves grafts from the body.
Unfortunately, the amount of fat in the nose is not substantial enough nor is it confined to the right areas (it is mostly in the tip of the nose) to have it drawn out in the effort to correct a wide nose. Narrowing the nose often consists of narrowing the nasal bones themselves via osteotomies.
It is generally a good habit to wait at least 6 weeks prior to beginning vigorous exercise.
Especially in thicker-skinned individuals, this could very easily be caused by the maturation of scar tissue which can contract and thus pulls the nostril sides downward, giving the appearance of a bulbous nose. Unfortunately, the only alleviation for this condition comes in the form of a revision rhinoplasty. Steroid injections would help initially when the scar was beginning to form.
As long as the nose was not vigorously poked or prodded during the crying, there is no reason for it to impact your final result.
During the first couple of weeks post-rhinoplasty, it is probably best to advise against moving or disrupting the nasal structure in any way. It would be best for patients to ask surgeons for their recommendations in these cases.
Yes, given the freshness of the trauma endured by the nose during rhinoplasty, it is perfectly normal for patients to experience bleeding and oozing. Patients should contact their surgeon and ask about the protocol for cleaning the nose, as it varies from surgeon to surgeon.
At long periods of time post-rhinoplasty (a year or so), bumps on the inner wall of the nose will most likely be scar tissue which can alleviated with the help of steroid injections or a simple excision under local anesthesia. However, short-term bumps may be sutures that need to be taken out or swelling that will dissipate by themselves.
This is probably best answered by the surgeon who performed the surgeon, but as long as there was no ripping of the tape off, there should not be a problem.
No, not at all. Anytime after ages 15-17 for women and 16-18 for men is perfectly reasonable to have a rhinoplasty. However, the key is finding a board-certified surgeon specializing in nasal procedures that has before-and-after work to your liking. Please do your homework in figuring out who is best for you and do not let price guide you.
This procedure can certainly be beneficial for those undergoing rhinoplasty because it helps clear the airways, not to mention that due to its functionality (necessity), it is generally covered by insurance.
This symptom probably resulted from the breathing tube used during the application of general anesthesia and salt water can help, as can throat lozenges.
Both of these techniques are used in cases where there are dorsal humps. Rasping is used when there is a small dorsal hump and is what patients often refer to as a “shaving” of the dorsal hump. However, in cases where there are large dorsal humps, shaving away the dorsal hump will result in a very flat nose with a larger hole (called an open roof deformity). The solution to this are medial and lateral osteotomies which realign the nasal pyramid and close up the hole in order to produce a more aesthetically pleasing appearance.
If this question is posed within a year post-rhinoplasty, both the bulbousness of the nose and the upturned appearance of the tip are probably both due to post-rhinoplasty swelling. These will all be resolved gradually within a year post-rhinoplasty.
Congestion usually clears up within 6-8 weeks of a rhinoplasty and tends to get better gradually.
Patients should generally stop smoking within 2-4 weeks before surgery, again because of the effect which nicotine has on constricting needed blood vessels.
This depends on what exactly the patient’s needs are. If the only concern is wide nostrils, then an alarplasty or a Weir reduction is ideal. However, neither of these procedures addresses questions about the tip of the nose or the bridge which are often problem areas for patients requiring a nose job.
If patients are trying to have a baby, it is advised that they wait at least 6-8 weeks before pursuing any vigorous activity like sex simply because of the risk of bumping the nose and also increasing blood pressure and triggering nose bleeds.
For patients without a great deal of swelling, a bump on the nose may unfortunately be permanent and may need to be fixed via fillers.
Generally, it is best for the patient to be as healthy as possible prior to an elective surgery like this. Many surgeons will not risk a bacterial infection during a rhinoplasty as there is a possibility for complications.
Skin breaking out may be part of the healing process, but proper skin care may be in order. Check with your surgeon to find your options.
Yes, this can certainly be done via the extraction of cartilage from the tip of the nose and placement of this cartilage onto the bridge.
It may seem like a better idea to have different specialist treat different aspects of the face, but patients must remember that surgeons can often specialize in several different things, meaning that different procedures can be done all at once. Again, consultation is probably key, so see which surgeons you feel comfortable with.
Unfortunately, as the facelift is a cosmetic procedure, it is very unlikely that it will be paid for by the insurance company
Patients should not expect massive improvement after 5 days post-op. By this point, swelling, hardness, and lumpiness will all be present in full force. Check back in 6 months or so if you want to find true improvement.
Immediately after surgery, I would recommend seeing patients the first two days post-op. After that, I would recommend seeing them at least one a week for as long as they feel it is necessary.
Though the cheekbone itself is not moved during a MACS lift, underlying tissue can be elevated.
It is important for post-op patients to make the distinction between a hypertrophic scar and a keloid scar. A hypertrophic scar is a thickened scar which stays within the boundaries of the original incision whereas a keloid scar spreads out from the incision and have a mushroom-like appearance. Patients who have demonstrated keloid scarring should most likely see their surgeons.
The next best thing to a facelift would probably be a mini facelift which offers small-scale improvement to jowling and other “facelift”-related symptoms. However, non-surgical options like fillers or fat grafting do exist which, depending on the patient, can provide better results.
Patients must first make the distinction between hypertrophic scars and keloids. If keloid formation is truly a problem, surgery should not be undertaken.
A golf-ball sized lump present after the procedure is likely a hematoma. Drainage of this area is probably the best way to avoid facial contour damage.
These symptoms tend to resolve themselves over time, but, if persistent, can definitely be treated with Botox treatments. However, patients should be wary that a possible side effect of this treatment could be weakness at the site of injection.
Even after a couple of months post-op, it is normal to experience symptoms like hardness and tender skin. Over the first six to twelve months, most skin irregularities heal just fine, so patients are encouraged to remain calm.
Patients experiencing recurring tightness may find solace in lymphatic massage, but it is also important for these patients to first check that the cause of the tightness is normal healing, rather than infection or something more serious.
Contrary to popular belief, having a full body massage is not only OK after surgery, but is probably encouraged. A full body massage can be easily done 4-6 weeks post-op to help dealing with swelling and other lingering problems.
Patients who have had hematomas from surgery are likely going to experience tightness and facial swelling as a result. Generally, as time goes on, facial swelling decreases and the sensation of tightness will diminish.
For younger patients, there is still a great deal of time to improve the look of the skin without surgical means. Eating healthy, exercising, and avoiding smoking and overexposure to the sun are all things which can be done to avoid further collagen-related damage in the skin.
Patients dealing with extensive white scarring behind the ears following surgery usually have excess tension in the skin of this region and thus have a poor blood supply in this area. The scar must be excised and the skin adjusted to reduce the tension in the area.
Generally, swelling within the first few weeks of surgery, though seeming like a lot, will not stretch the skin to any appreciable degree. The results of the facelift will largely remain intact.
It is important for patients to seek out an adequate surgeon with plenty of experience in facial surgery. I would recommend a surgeon who is accustomed to doing around 1-2 facelifts a week for about 10+ years.
Swelling which arrives and then disappears 18 months after a facelift is not indicative of a typical hematoma, but is more likely the result of a parotid leak. I would recommend a full exam with the surgeon followed by the application of Botox and antisialagogues to the area.
This procedure has been around for a decade and is somewhat recent in terms of facial rejuvenation surgery. For this reason, it has not been proven to work as effectively as a facelift procedure and is continuously hounded by many doctors as a “fad”.
Unfortunately, any nerve damage sustained over 18 months is likely to be permanent. The best solution would be to have Botox placed on the other side to even out the distortions.
The Lazerlift procedure is marked by its use of a Cynosure laser-tipped cannula which is used to undermine facial tissue and achieve skin tightening. The results of this are not nearly as invasive or effective as a facelift, but nerve damage may still be a risk.
After 3 years, many patients do experience recurring skin laxity following a facelift. Again, the extent of the loosening depends on many factors including sun exposure, smoking, genetics, etc.
A saggy cheek and nasal region is usually not caused by typical aging and patients who have this symptom over the long-term may have problems with the tissue structure in the face. If this is true, facelifts are not the answer, but consultation with the plastic surgeon could provide several options for these patients.
Patients who are experiencing muscle spasms, but still retain feeling in the area around which the spasm is occurring, should likely not worry as this is usually indicative of minor nerve irritation. Again, consultation with the plastic surgeon may be necessary, but usually this is not a serious problem.
Generally speaking, the Acculift procedure, in the grand scheme of things, does very little for patients who are serious about facelift surgery, particularly those in their later years. Residual neck bands and poor facial definition are just some of the post-op complications which can occur.
The buccal fat pad is located in an area superior to the fat around the jowls and thus will have very little impact on jowling if suspended. The true method to treating jowls consists of an SMAS Lift possibly combined with fat resection.
Patients are advised to reach a stable weight prior to their facelift. That way, they do not have to worry about volume loss and botched results after the procedure is done.
Facelifts and fillers tend to work hand-in-hand very well. Though many people would opt to have facelift procedures done BEFORE fillers are added, doing the reverse is perfectly acceptable.
Patients worried about affecting the results of the facelift with excessive movement of the face (smiling, talking, etc.) should not be so concerned. Again, the elevated tissues modified in the facelift are fixed in place with sutures and/or Endotine devices and will be released in time.
Generally, even though tightness is somewhat abnormal at this point, everyone heals at their own pace and some patients take longer than others. Gradual improvement can definitely be expected in the next month. Consult with your surgeon if symptoms continue to persist over a year.
Patients looking to have a revision neck lift following a platysmaplasty may have lost significant elasticity in the first procedure, but can still have the neck lift done in a relatively short period of time.
Patients at the age of 32 are well below the normal age of a facelift. Many other options exist, some of which are not nearly as invasive, like fillers, Botox, fat grafting, photofacial, laser treatments, etc. Either way, a facelift is usually out of the question.
Inability to pucker post-facelift is usually caused by swelling and will most likely recover before long.
Damage to the buccal branches of the facial nerve is generally not a cause for major concern as cross innervation generally allows for full recovery. However, improvement should be seen after 2 weeks. Consult with the plastic surgeon or a neurologist to check for permanent damage.
Dilute steroid solutions should not cause either.
Unfortunately, patients who are unsatisfied with their jowling post-MACS Lift have fallen victim to a common problem in facelift surgery. The MACS Lift, while being effective for some, is totally ineffective for those who want penetration into the deeper tissues, for which there is no cure but the SMAS Facelift.
Though there are some minor side effects for facelift procedures, some of which include tightness, swelling, numbness, etc., any other major health problems acquired by the patient post-op are unlikely caused by the surgery.
It is normal for patients to feel tightness more sharply on one side of the face than the other, yet massage and time usually helps even things out.
At this point, after a year or so following surgery, any damage to the sensory nerves around the ear and neck and the facial nerve is going to be difficult to try and undo. Botox may help with the temporary concerns of droopiness.
Patients dealing with post-op fat under the chin may be dealing with excess fat (easily reduced with lipocontouring techniques) or residual scar tissue (could be treated with cortisone or other steroid injections). Hyperpigmentation can be addressed with laser resurfacing techniques.
Sunscreen in the post-op days, when the skin loses its normal ability to respond to sun exposure and damage, is especially important. Patients should stay out of the sun for about 3 weeks, after which sunscreen can be applied (I recommend a zinc-based sunscreen for minimal chemical absorption).
Generally, when making an incision during a facelift, experienced surgeons will attempt to perform them where they are least noticeable. Some, for example, may prefer the horizontal occipital hairline incision(horizontal cut behind ear) which allows for the most substantial pull on the neck portion of the facelift, but others may find that too noticeable. Again, it is all a matter of anatomy and of the patient’s priorities.
Over the long term, there is virtually no way to ensure the constant maintenance of dermal toughness. However, in the short term, patients could look into the options of ultherapy and/or laser resurfacing treatments.
Chances are patients who experience prolonged bruising post-op are dealing with hemosiderin deposits which can only be resolved with time. Additional options like laser therapy can only be explored after about 1.5 years or so.
Patients should generally use 2 weeks as a benchmark for when results should START to normalize. Again, there is still a great deal of swelling at this point and results are expected to look “strange”. Following up with the surgeon is the ideal route for now.
There remains an important difference between a facelift and a liposuction in terms of procedure. A liposuction is merely the removal of fat in the chin (submental area) and in the neck since facial fat is good for maintaining youth. A facelift, however, is much more involved and consists of removing fat above and below the platysma, tightening neck muscles, etc.
Skin Only facelifts, as common in the 80s, are still performed. However, surgeons have discovered that the best results for a facelift often come when tissues underlying the skin are adjusted along with the skin. Otherwise, there is a chance for that characteristic windswept look of botched facelift surgeries.
The mini facelift, as the name suggests, is a rather minor procedure which addresses sagging along the lower face and jaw line and is more used for slightly aging people who do not have neck laxity problems. The midface lift targets the cheek areas and, to a limited extent, the nasolabial folds.
Unfortunately, little can be done surgically, other than static or dynamic slings/muscle grafts, to repair long-term nerve damage. Patients can attempt to strengthen weak muscles through nerve stimulation and therapy, and asymmetry could be disguised with the use of fillers or Botox.
Loose skin around the mouth area, especially for younger patients, is usually best addressed with the use of fillers or fat grafting.
A good step in finding a capable surgeon is to examine before-and-after photos of the surgeon’s work in order to understand whether they provide natural, but youthful, results or even interview some of the surgeon’s former patients to hear their insight.
Irritated or elevated scar tissue can be easily taken care of with cortisone injections, but other than that, very little can be done
Transition lines can often be dealt with quite effectively with a variety of options including surgical revision (major or minor), Juvederm fillers, or subcision of scar lines (in order to smooth out the bands by relieving adherence to the deeper tissues).
For facial atrophy, the best option is usually fat grafting which provides a correction of the soft tissue contour problem and an improvement in the quality of the overlying skin.
Again, it is not unheard of for 37 year old patients to undergo facelifts when they truly need them. However, much better options usually exist for them in terms of addressing volume loss; these include fillers, fat grafting etc.
Facelift scars typically would be in front of your ear extending below your earlobe and around to the crease behind your ear.
Generally, after a face and neck lift, one would expect any jowling before surgery to be gone. However, it all depends on the extensiveness of the facelift and whether the deeper SMAS tissues responsible for jowling were addressed at all. Again, though, patients must remain patient even months after the procedure before they start making judgment calls.
Depending on the relative pigmentation of the skin, ablative or non-ablative laser resurfacing techniques may be in order if the patient wishes to correct small depressions (pores) on the skin. For larger depressions, fat injections or fillers may also be effective.
Due to post-surgery tightness and local edema (not to mention swelling), facial movement is always impaired after surgery. However, as these issues begin to resolve themselves out, the range of facial movement tends to increase and weakness usually recovers smoothly. Again, though, it is best to consult with your plastic surgeon or even a neurologist if any concerns are there.
Though swelling is to be expected, it is unusual to maintain it for a long period of time after the surgery. Patients at this point may be dealing with edema which could be treated with lymphatic drain massage, but again consultation is probably necessary.
It is difficult to believe that Fraxel treatment prior to surgery would do anything to contribute to the facelift. I would personally recommend having the procedure done concurrently with the surgery or several weeks post-op in order to hide any possible scars which may develop.
Weeks after surgery, it is not unusual to see post-operative bleeding on certain scars. Patients, if this occurs, should take care when cleaning the area and make sure to consult with their surgeon (or even send him/her photos) about the bleeding just to make sure everything is fine.
For superficial wrinkles on the face post-op (since facelifts actually do little to address wrinkling), laser resurfacing is definitely a good option.
Numbness following a facelift is generally to be expected in the lateral cheek and neck area, yet weakness with smiling and other lower facial muscle-oriented movement may indicate facial or trigeminal nerve injury. It is important for patients to keep close contact with their surgeons in order to be prepared for such a situation.
After 5 weeks post-liposuction, it is not unusual for patients to have a lumpy chin area and normal results can generally be expected, given time. However, it is important to check for any fluid collection in the area for which a consultation may be necessary.
It is common for sutures to be placed in this location because it allows for trimming of neck tissue to be easily hidden within the hairline.
A mini facelift, as suggested by the name, is less invasive than a full facelift and relies mainly on lifting the jowl area and providing minimal tightening of the skin. A full facelift, however, goes deeper affecting the SMAS layer under the skin, repositioning facial contours, tightening the neck muscles, etc.
Patients before performing a fat grafting procedure should attempt to keep their weight as stable as possible prior to and after the surgery in order to keep the results stable. In addition, the grafted fat should come from a stable part of the body.
A mini facelift is a procedure in which incisions are placed around the ears and the skin is pulled up to these incisions and trimmed at the suture line. A midface lift, however, is usually performed through an extended lower eyelid incision, a preauricular (in front of ear) incision or a combination of both.
Scars can be easily excised causing any lower pole on the ear to move into a better position. After this is done, soft tissue can be activated to fill the defect.
Losing fat in the face after a facelift, especially for leaner patients, may cause the appearance of hollowness in the face which can easily be solved with fat transfer or filler treatments. Generally, however, as long as the weight loss is not dramatic (25 pounds or so), the patient should have little difficulty.
In general, fat grafting is a technique used for effectively addressing volume loss and is usually best combined with a facelift for maximum results. In general, I would recommend that patients trying to choose between these two options see their surgeon and decide for themselves.
The timing of a facelift does not depend on age, but rather on the physical state of the face itself. If the cheeks have begun to droop, the jowls have appeared, and the neck has developed loose skin with lack of structure, then a facelift may be needed for such a patient. Again, however, there are many varieties of facelifts and patients should research which one is right for them.
Generally, the rule is that, in post-op recovery, you are going to look worse before you look better. Fear and anxiety over facial appearance is perfectly normal in the weeks post-op and will likely subside as the face begins to heal. The key is patience.
Generally, for nasolabial folds, a facelift, especially the marketed ones, is not the way to go. Fat injections or fillers may be a more effective method of treatment.
Redness and irritation around sutures post-op is normal as the body sees the suture as a potential agent of infection and attempts to expel it from the body. Inflammatory cells are called and attempt to break down the stitch. It is probably best to consult your surgeon about these problems.
The best treatment for chin definition would probably be the lower facelift which improves sagging jowls and removes excess skin from the lower areas, repositioning tissues along the way. Areas from the mouth, neck, and ears remain relatively unaffected.
Dr. Ramtin Kassir © 2017
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Disclaimer: This site only provides information about cosmetic surgery and this information is not meant to be taken as medical advice. For more information about plastic surgery, contact Dr. Kassir.