Rhinoplasty NJ or nose job NJ. Dr. Kassir is the best rhinoplasty surgeon in NJ. Find rhinoplasty NJ answers and see results from one of the best New Jersey rhinoplasty surgeons.
by Ramtin Kassir, M.D., F.A.C.S.
Do you have any problems breathing through your nose or do you have chronic nose or sinus complaints? Has a prior injury made your nose out of proportion to your other facial features?
Rhinoplasty or nose job surgery, is the surgical procedure that involves changing the shape and size of the nose. Dr. Ramtin Kassir MD performs this procedure for his New Jersey patients that involves reshaping the nasal bones and cartilages to produce a balanced and harmonious nose that blends with the person's facial features.
What is Rhinoplasty?
Rhinoplasty, or cosmetic nasal surgery, improves the shape and size of the nose. The procedure can remove a hump, change the shape of the nasal tip, and straighten the nose. The size and shape of the nostrils can be changed. The goal of rhinoplasty is often to achieve better harmony between the nose and the other facial features. Dr. Kassir is a triple board certified surgeon who has performed thousands of rhinoplasty surgeries for his patients and is considered to be one of the best Rhinoplasty surgeons in New Jersey and NYC.
Rhinoplasty has become one of the most popular facial plastic surgical procedures in recent years as more and more people seek to change the appearance of their noses. Many are unhappy with the nose they were born with while others have had the shape of the nose distorted from an injury. Disorders of nasal breathing and sinusitis often complicate the situation. A range of techniques are used to fully address the desired change in appearance as well as to improve nasal breathing and correct chronic sinus infections. Sinus surgery, if indicated, is done with endoscopes to avoid any visible incisions.
Rhinoplasty may be performed under general or sedation anesthesia on an outpatient basis. Most health insurance plans still provide some coverage for functional nasal surgery and sinus surgery.
Good Candidates For Rhinoplasty
Are you thinking about having a rhinoplasty surgery? Healthy teenagers and adults who wish to have an improvement in their nasal appearance are good candidates for the rhinoplasty procedure. The decision about having the rhinoplasty operation is a very important and personal one. You should first consult with Dr. Kassir at his surgical clinic in the Wayne, NJ, 799 Park Avenue, NYC, or Ridgewood NJ office before deciding on the operation. For most patients that undergo this nose job procedure, the results are life changing. Patients describe an increase in confidence and boost in self-esteem. The ideal NJ and NYC candidates for rhinoplasty are:
Does Insurance Cover Rhinoplasty?
Insurance may cover some of the functional aspects of rhinoplasty. In other words, those procedures that improve breathing:
Different Kinds of Rhinoplasty Procedures:
Dr. Kassir performs many different kinds of rhinoplasty procedures in NJ, including:
Rhinoplasty costs vary by surgeon experience and geography. It can range from $9500 to $15000, depending on what is being done. Revision rhinoplasties are on the higher end. Some insurances cover the functional parts of the surgeries (straightening a crooked septum, opening up sinus pathways, etc).
1. Can you breathe through your nose? Do you have sinus problems? If so, then these should be addressed at the same time as the rhinoplasty. You want a great looking nose that functions well, otherwise it is a waste.
2. How many rhinoplasties does your doctor perform, and how many revision surgeries?
3. It is your face, don’t compromise on quality!
“At 2 weeks 80% of your swelling will be gone, at 2 months 90%.”
Social life Recovery
1. You will wear an external nose splint and tape for 1 week to protect and set the nose during this initial stage of healing. Removing it too early may cause damage and can ruin the surgical work.
2. Your nose will be “noticeably” swollen for 1-2 weeks. By the end of the 2nd week a casual observer won’t be able to notice without careful inspection or knowledge that you had surgery.
3. Bruising resolves in 1-2 weeks, and varies by the patients tendency to bruise. Over the counter Arnica may help reduce bruising.
Swelling in some areas may take several months to a year to “completely” resolve (the majority will be gone 2 months). You will be following up with Dr. Kassir until you have your final nose.
Swelling after rhinoplasty varies depending on the what and how much work was done on the inside of the nose. Our general advice to patients is to expect that 80% of the swelling subsides after 2 weeks, and 90% after 2 months. Healing will be complete by about a year after the procedure. We have patients avoid any type of medications that may thin their blood (aspirin products, garlic, vitamin E, etc), and have them supplement with Vitamin C, arnica and other homeopathics prior to the surgery. It is very important to avoid alcohol before and after the procedure. If necessary we can give steroids to reduce excessive swelling post operatively.
1. Pain: There is very little pain; most patients don’t take their pain medicines
2. Swelling: The worst of the bruising and swelling is seen in the first 48 hours. If warranted we give steroids to expedite this process.
3. Packing: More often than not we don’t pack the nose and patients like this.
4. Bruising: The use of endoscopes and tissue glues minimizes bruising. For prevention we have all patients take vitamin C, arnica, pineapple, and bromelane prior to surgery. NO alcohol – this creates swelling in the nose up to several months after surgery!
5. Splint: We take the splint of after 1 week.
6. Activity: You should not exercise for 2 weeks, and not participate in any contact sports for 6 weeks.
You should inquire about the following when choosing a surgeon:
1. Credentials: Is he a Board Certified Facial & Plastic surgeon? Is he aslo an ENT? How long has he been in practice? First and foremost you need someone who is well trained.
2. Gallery of Work: When you see their before and after gallery does it impress you? There are no guarantees, but the past is a great predictor of the future. You should consider whether the surgeon has experience with your ethnic type.
3. Simulated results: Computer technology allows the surgeon to virtually adjust your nose. This will show you the philosophy that shapes the surgeons style. Pay attention to how your surgeon describes what he would like to do.
3. Reputation: What does their previous/current patients say? Read some reviews and testimonials about the surgeon and their work.
4. Talents: Is your surgeon artistically inclined ? You want a surgeon who can not only manage the technical aspect, but that they will give you the best looking nose possible.
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.
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.
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.
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 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.
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
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 weeks 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).
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.
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.
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.
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.
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.
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.
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.
It is advised that patients avoid heavy exercise for at least a month post-op and particularly avoid contact sports for 6 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.
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.
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.
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.
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-rhinoplasty. 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, dissolvable stitches will dissolve at an average of around 3 weeks post-rhinoplasty.
To prevent swelling post-rhinoplasty, 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-rhinoplasty.
Bruising from rhinoplasty as a general rule will mostly fade away within 2-3 weeks post-rhinoplasty. 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-rhinoplasty.
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-rhinoplasty period, can cause suspicious bumps in the nasal area, but patients are advised not to panic when this occurs.
It is advised that patients refrain from alcohol for at least one week post-rhinoplasty. However, this drinking is to be in moderation, with heavier drinking reserved for at least one month post-rhinoplasty.
Bumps on the nose following rhinoplasty are generally the remnants of swelling and will usually resolve themselves after 3-4 weeks post-rhinoplasty. 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 does indeed. Patients, especially those considering having surgery, must work to stop themselves from obsessive nose-picking which can lead to problems post-rhinoplasty. Obviously, poking yourself in the nose so many times especially post-rhinoplasty 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-rhinoplasty 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-rhinoplasty 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-rhinoplasty 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-rhinoplasty period. The first few weeks post-rhinoplasty 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-rhinoplasty 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-rhinoplasty 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-rhinoplasty 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-rhinoplasty.
Patients can sleep on their sides post-rhinoplasty. 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-rhinoplasty.
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-rhinoplasty 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-rhinoplasty, 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-rhinoplasty, 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-rhinoplasty 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-rhinoplasty, with most of the swelling being gone around 3-4 months post-rhinoplasty. 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-rhinoplasty. Patients should not be concerned if the tip appears swollen for a longer period of time than other areas of the nose post-rhinoplasty.
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-rhinoplasty, 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-rhinoplasty 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.
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-rhinoplasty. 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-rhinoplasty, 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-rhinoplasty, 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-rhinoplasty, 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-rhinoplasty 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-rhinoplasty.
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-rhinoplasty, including septal perforations.
Generally, a week is enough time to fly again post-rhinoplasty (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-rhinoplasty mark. However, the majority of the swelling should be gone within 3-4 months post-rhinoplasty.
Not likely. Taping of the nose post-rhinoplasty 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-rhinoplasty bleeding, should ideally be removed 6-7 days post-rhinoplasty 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-rhinoplasty.
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-rhinoplasty 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-rhinoplasty.
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-rhinoplasty. At 7 days post-rhinoplasty, 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-rhinoplasty, 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-rhinoplasty 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-rhinoplasty, 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-rhinoplasty 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-rhinoplasty 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-rhinoplasty 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-rhinoplasty and more heavy contact sports be postponed until 6-8 weeks post-rhinoplasty. 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-rhinoplasty 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-rhinoplasty, 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-rhinoplasty, 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-rhinoplasty 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-rhinoplasty) 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-rhinoplasty period to match the expectations (hopefully) of the surgeon and the patient.
Saline rinse is generally advisable for the first 2 weeks post-rhinoplasty 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-rhinoplasty.
The full healing period post-rhinoplasty 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-rhinoplasty 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-rhinoplasty 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-rhinoplasty, 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-rhinoplasty 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.
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-rhinoplasty 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.
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-rhinoplasty, 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-rhinoplasty. 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-rhinoplasty 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-rhinoplasty (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-rhinoplasty. 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-rhinoplasty 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-rhinoplasty.
Yes, this should be enough time (7-10 days) to return to work post-rhinoplasty. 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-rhinoplasty 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-rhinoplasty 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-rhinoplasty 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).
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-rhinoplasty.
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.
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-rhinoplasty 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-rhinoplasty, 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-rhinoplasty 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.
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 pride 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.
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.
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 is advised that patients avoid taking NSAIDs like ibuprofen simply because of the risks of bleeding which occur as a result of using them.
Surgeons can reduce the size of the nostrils via an alar base reduction/Weir reduction in which a thin, crescent-shaped patch of skin is removed from the nostril and the hole is stitched. However, it is advised that, before going ahead with this surgery, patients not only choose an experienced surgeon, but also consider whether they truly want to do JUST this surgery. Often, nostril reduction is accompanied by a thinning of the upper nose as well which needs to be done with osteotomies.
Yes this is possible as this is part of the body’s natural healing process. Trauma on the nasal bridge will activate chondrocytes (cartilage progenitor cells) to increase their production, but this is usually very minor.
Depending on the certification of the surgeon, the area in which the surgery is conducted, etc., costs can vary in the neighborhood from $6,000 to $10,000.
Even months post-rhinoplasty, the nose can still have a good deal of swelling which skews the appearance of the final results of the surgery. My best advice to patients post-rhinoplasty is not to worry too much about the appearance of the nose until at least 8 months post-rhinoplasty.
Unfortunately, the only real proven method to reducing swelling months post-rhinoplasty is simply being patient and allowing the body to heal itself naturally. Patients especially if they have thicker skin (which is known to make the nose seem more swollen) must remain calm and have faith that the surgeon did his/her job correctly.
Afrin should generally only be used when patients are flying, that is, when the changing pressures of take-off and landing increase the risk for nasal issues. Afrin simply decompresses the nasal passages, so patients post-rhinoplasty are better advised to use saline spray to clean their nose, etc.
This flap of skin between the nostrils is called the columella.
Especially during the first few weeks post-rhinoplasty, it is important that patients refrain from wearing glasses because of the pressures which they exert on the nose. At this stage, the nose is still very delicate and, if osteotomies were performed, is still recovering from being broken, so any external pressures may cause irreparable shifts in the bone.
It is unlikely that simply squeezing a nose caused any major form of nasal deformity. However, if the nose is indeed asymmetrical, the patient have a consultation with a board-certified, plastic surgeon to determine what can be done.
It is unlikely that patients who have a rhinoplasty done demonstrate signs of premature aging (crow’s feet, wrinkles, etc.) that can be traced back to the procedure. Often, loss of volume to the face due to weight loss or other more obvious factors like sun exposure or smoking are to blame for signs of aging, in which case the aging can be disguised via fat grafting and other measures.
The alar base reduction is a surgical procedure performed on patients with an excessive wide nasal base and/or excessive nostril flares. In this procedure, thin crescent-shaped wedges are taken out from the nostril and the resulting hole is stitched up, thus reducing the nostril size.
This can absolutely be done and it is known as a tip rhinoplasty. However, patients must keep in mind that it is rare for a patient to have a wide tip but normal-width nasal bones. Often, both are wide which requires osteotomies to fix.
Certainly. Surgeons may often perform turbinate reduction surgery hand-in-hand with rhinoplasty procedures (with the consent of the patient, of course) in an effort to reduce nasal congestion.
This is generally up to the discretion of your surgeon of choice. Patients must be advised that rhinoplasties (a cosmetic procedure) are often not covered by insurance, so it is important to discuss financing plans with your surgeon prior to having the procedure done.
Certain patients may be predisposed to having this deformity post-rhinoplasty because of the way in which the tip cartilages are aligned prior to surgery. Patients may have them angled upward so that, even the removal of some cartilage can cause dents. However, this problem can be fixed with cartilage grafts or even fillers like Restylane or Radiesse.
Typically, external rhinoplasty sutures can be removed after 7 days by the surgeon or will dissolve in that period. However, internal rhinoplasty sutures may take several weeks to dissolve.
Unfortunately, this may be a permanent defect that can only be corrected via the use of fillers. Kenalog and other steroid injections are normally used for thicker skin, but can erroneously be used for thinner skin causing it to become overly delicate (which is what I believed happened here).
This is common as surgeons will often, as part of the post-surgery routine, shock the nasal tissues, causing dead skin to develop that will peel.
Because vitamin E can be a mild blood thinner, it is advised that patients avoid it for two weeks before and after surgery as it exacerbates swelling and increases the risk for hematoma and other post-rhinoplasty complications.
For patients with rhinophyma (excessively large sebaceous glands which cause the nose to appear large), it is important to recognize that the results of a rhinoplasty will not be as dramatic as a rhinoplasty on a patient with thinner skin. However, sebaceous glands can be reduced with a CO2 laser procedure, which can help with the results of the rhinoplasty a little bit.
Although patients will experience mild crusting of blood and mucus post-rhinoplasty, it is rare for it to smell unusually bad unless it is infected. Please consult with your surgeon to evaluate your condition.
There are two main types of stitches that are used in rhinoplasties: dissolving and non-dissolving. Stitches which are placed inside the nose will dissolve over the course of a couple months, while external stitches are non-dissolving and will typically be removed within a week post-rhinoplasty.
Correction of the bulbous tip would be the easier problem and can be solved by thinning the lower lateral cartilages in the tip and stitching them together to create a narrower defined tip. An upturned nose is more difficult and can be corrected in several ways, including the use of grafts or weakening the suspension elements of the nose and repositioning/securing the tip in a more preferable position by suturing the tip cartilages to the skin.
Both methods can be used for rhinoplasty. However, twilight sedation has been shown to produce less post-rhinoplasty nausea. However, in this procedure, patients are not given a endotracheal breathing tube which is up to the patient’s discretion.
Breathing issues can be the result of several factors including a deviated septum, valve collapse or augmented turbinates, which can be corrected via a septoplasty, spreader grafts, and turbinate reduction surgery respectively. Generally, these procedures are considered functional (necessary to correct a defect) and can be billed to the patient’s insurance company.
These symptoms may be attributed to nasal valve collapse which can be corrected via spreader grafts that are harvested from septal cartilage or, in rare cases, ear cartilage.
Taping is simply a measure to safeguard against excessive swelling, and is thus up to the discretion of the surgeon. Patients who do not seem to demonstrate a great deal of swelling may not require surgical tape.
Generally, no. Depending on the width of the nostrils in relation to the rest of the nose, patients may either require a Weir/alar base reduction (if it is just the nostrils that are the issue) or may require a full-on rhinoplasty in which osteotomies are performed in addition to the reduction of the nostrils in order to thin the bridge of the nose as well.
Alar rim grafts are used to reduce the height of the ala and correct nostril shape and thickness.
This is very unusual for surgeons to ask for patients to remove the splints themselves, simply because tugging on the splint and the still-delicate nasal tissue underneath can drastically alter the results of the procedure.
Because of the general numbness and delicateness of the nose post-rhinoplasty, the nasal area is particularly prone to sun damage after the procedure and patients are generally not aware of the problem until it is too late to correct it. It is advised, therefore, that patients stay out of the sun as much as possible in the first 6 weeks post-rhinoplasty.
Because of the risks of infection and complications associated with getting a nose piercing early in the post-rhinoplasty healing process, I would wait at least 6-8 weeks post-rhinoplasty to have this done.
During septoplasties, surgeons will perform purposeful re-breaking of the nose (osteotomies) in an effort to correctly align the nasal bones, so a larger bridge on the nose may be the result of residual swelling from this.
Dorsal humps are usually an accumulation of bone and cartilage which is generally inherited, although trauma to the nose may also cause it (punch to the face, etc.).
Generally, surgeons will look for cartilage grafts in the septal area as a first resort and will only use grafts in the ear when this is not available. However, if ear cartilage is harvested, it is taken from the central depression in the ear called the concha where the incisions are well hidden either from the cymba (the top part of the depression) or the cavum (the lower part of the depression).
Unfortunately, not. However, ear cartilage is usually harvested from the cymba or the cavum (the two central depressions within the ear) where the scars are generally hidden and where removal of cartilage does not significantly affect ear shape.
This is where patients should learn the distinction between healing time and recovery time. The healing time, that is, the full realization of the results of the procedure and the full reduction of swelling and bruising, of a rhinoplasty is about a year. However, patients are generally work-ready within 7-10 days which I would consider the primary concern regarding “recovery time”.
Yes, absolutely. It is safe for patients to begin blowing their nose after about a month post-rhinoplasty, but saline spray can be used prior to this (as long as the splint has been removed).
Non-surgical rhinoplasty which generally consists of the use of fillers to disguise minor defects can be used to correct issues like overly scooped noses (ski slope-style noses), saddle noses (boxer’s noses), pollybeak noses, slightly asymmetrical noses, and others.
Because alar base reduction scars are hidden within the nostril, the recovery time is relatively short compared to other nasal correction procedures. Initial redness may last as long as two weeks, but sutures will be taken out 5 days post-rhinoplasty and the scar will be virtually imperceptible.
Due to the incisions made in the columella area during the surgery, it is normal to experience swelling and tightness in that particular region for up to a year post-rhinoplasty. I wouldn’t personally worry about it.
Generally, nasal bones will be stable enough not to move easily following a month post-rhinoplasty.
Unfortunately, depending on how the bump is situated, this may be a possible reason to have a revision rhinoplasty. This may be a bend in the domal cartilages in the tip that can only be fixed via a revision procedure.
Taping the nose is simply a measure to reduce swelling in the nose post-rhinoplasty and, unfortunately, is not a powerful enough force to help maintain the cartilage and other moved structures in place post-rhinoplasty.
The pros of using grafts are mainly that it acts as additional support for maintaining the results of a rhinoplasty, particularly procedures which elevate the tip, and should not be avoided when they are warranted. By the same time, cartilage grafts should be used judiciously as they might NOT be needed and may actually lead to unevenness in the nose (which is why patients requiring cartilage grafts should go to an experienced surgeon).
In closed rhinoplasties, all incisions are made within the nostrils and thus the scars that form are generally imperceptible unless Weir reductions are also done to reduce nostril size. Open rhinoplasties, however, will also make use of an incision at the columella (the thin strip of skin between the nostrils) which risks more apparent scarring. However, in the hands of an experienced surgeon, even this scar will heal nicely.
Of course! Patients are told to avoid strenuous activity like exercise for 6 weeks or so post-rhinoplasty, but smiling and laughing does not go under this category.
Patients after a rhinoplasty will generally experience a tightness in the nose tip and upper lip area due to post-rhinoplasty swelling and trauma to the nerves in the area, both of which can alter their smile. However, these issues will generally resolve themselves around the 1-2 month benchmark.
If performed by residents at a university hospital, rhinoplasties can be done with minimal cost to the patient. However, given the difficult nature of the procedure and the inherent risks in appearance if the rhinoplasty turns out badly, it may benefit the patient to find a more experienced surgeon in spite of the extra cost. After all, fixing a bad job often incurs more costs than doing it right the first time.
Patients who have these conditions after a rhinoplasty will most likely be in need of a revision rhinoplasty where cartilage grafts are reintroduced to give more support to the tip and fillers are introduced to augment the bridge.
Sometimes, surgeons will simply rotate the tip upwards in order to give the illusion of a smaller nose. However, this does not always work with most patients and instead gives the appearance of a pig-like nose. Unfortunately, long pointy noses can also be corrected with a rhinoplasty procedure in which the septum and the surrounding structures are reduced.
Generally, skin will not need any help contracting and tightening appropriately following a rhinoplasty, so patients with abnormally looser skin are encouraged to wait it out and check for new development. However, steroid injections may help alleviate some of these problems.
Unless the crooked nose interferes with breathing, it is unlikely that insurance will cover for the costs of the procedure. However, this is best answered by your insurance provider directly.
It seems like a logical place to start. ENT doctors are generally familiar with the anatomy/issues of the nose, but facial plastic surgeons are probably the best bet for people looking for a specialist in these fields. Even better would be a surgeon specializing specifically in revision rhinoplasties.
This is generally a matter probably best decided by the patient. However, it is my opinion that true friends and family will support you, regardless of the decisions you make and how they feel about it. I have found that many family members tend to be supportive of the patient’s decision and even those that aren’t will generally not be so outspoken as to openly challenge the decision and try to cancel the surgery.
This may simply be the result of swelling post-rhinoplasty. However, this is best evaluated within 6-12 months post-rhinoplasty.
The surgeon doesn’t necessarily need to be an ENT doctor. Both otolaryngologists and plastic surgeons are perfectly capable of doing rhinoplasties, but patients should take care to check their credentials. If the doctor is board-certified with plenty of experience doing your specific types of surgery and satisfactory before-and-after galleries, you should be in good hands.
Surgeons will generally use these terms interchangeably as they both basically consist of taking out crescent-shaped wedges from the nostrils and stitching the resulting holes (thus creating smaller nostrils). However, the alar base reduction technique is a bit more comprehensive which removes the alar lobule.
Yes, this simple procedure can be done after a rhinoplasty under local anesthesia. However, it is probably best for patients to wait at least 9-12 months before deciding to undergo any revision/additional procedures.
The full results of a rhinoplasty will manifest themselves generally after about 1 year post-rhinoplasty, but patients should generally have an idea about how they should generally look at 6 months (anything afterward is simply refinement of the existing product).
This is very normal as the surgical taping blocks sebaceous glands at the surface, causing oily fluid to build up on the skin. This is perfectly normal and will heal over time.
A hanging columella is treated very simply under local anesthesia in which the surgery basically consists of trimming the columellar cartilage to an appropriate length. It is a very easy procedure that should not cost more than $3000 or so to do.
Depending on the timing post-rhinoplasty, this may be a simple case of residual swelling within the nostrils which can push around structures and block the nasal canal, leading to the two issues which you described.
Columellar struts are generally sutured in between the tip cartilages in an effort to maintain tip shape and support the tip area in order to prevent excessive drooping post-rhinoplasty.
A rhinoplasty is probably the best option for patients looking to decrease the projection of their nose and adjust their tip cartilages in an appropriate manner.
If it has not been a week post-rhinoplasty, I would recommend contacting your surgeon immediately. Splints are generally made to stay on for at least a week post-rhinoplasty.
The most common causes of post-rhinoplasty vomiting are blood dripping into the stomach and complications with general anesthesia. This occurs probably in around 1/10 of most rhinoplasty procedures, but it is important to recognize that these symptoms will only last for about a day or two.
Unfortunately, given the nature of how a rhinoplasty works, it is impossible to simply just fix “one side of the nose” during the procedure because a rhinoplasty is about balancing the nose and maintain harmonious symmetry.
When done by an experienced surgeon, rhinoplasties do not develop scar tissue to the extent where revisions are necessary. Even when scarring does develop, though, cortisone injections can help. Again, the best way to prevent complications is to seek out an experienced surgeon.
Unlike traditional rhinoplasties, the results of an alar base reduction should be almost immediate. There may be redness for the first week or so, but swelling and other issues should not be apparent to the extent of a rhinoplasty.
I would say that patients will generally be presentable a week to ten days following a rhinoplasty.
Surgeons will advise that patients wait at least a year before considering revision rhinoplasties, simply because the results of the initial surgery will only be fully apparent than and any problems that happen as a result of that initial surgery can be detected and corrected with ONE surgery.
Like most rhinoplasty procedures, it will take a full year before all the results of an alarplasty show. In the meantime, it is best for patients to stay out of the sun, avoid smoking and just generally follow the doctor’s instructions.
Generally, the only time where lasers are necessary in a rhinoplasty is for patients with excessively large sebaceous glands that cause the creation of a bulbous tip. Otherwise, lasers are not used in rhinoplasties and may be just another tool for a surgeon to charge exorbitant rates for a rhinoplasty procedure.
Generally, numbness in the tip should begin to improve within 6-12 weeks following the procedure, but may take up to a year to fully resolve itself.
It is my recommendation to have a rhinoplasty done as close to home as possible. While there may be perfectly competent surgeons in Mexico, there is a chance for potential complications and issues in the post-rhinoplasty period which are best addressed by going to the surgeon who performed the procedure in the first place. This may prove difficult if the surgeon is in another country.
This cannot really be answered definitely. Kenalog injections, which are generally spaced out 4-6 weeks apart, are used in select post-rhinoplasty cases where the swelling has not gone down enough. However, these injections must be used judiciously as excessive steroid injections can cause unneeded thinning of the skin.
This unintended consequence of a rhinoplasty, which is normally caused by over-removal of tip cartilage and the resulting upward rotation of the lower edge of the nostril, can be addressed with a columellar tuck which reduces the distance from the base of the nose to the columella (thus allowing the nose to seem normally rotated) and an alar rim graft which weights down the nostrils a bit, thus showing the nostrils less.
These symptoms seem to point towards a broken nose. A CT scan may be necessary and a plastic surgeon should be seen immediately so that the nose can be corrected before it begins to grow in a dysfunctional manner.
I would avoid steroid nasal sprays for at least 4-6 weeks following the rhinoplasty, especially because turbinate reduction and other allergy-related issues may have been corrected during the rhinoplasty.
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.
Nose exercises will do nothing to help the form and function of a nose post-rhinoplasty. In fact, it is probably best for patients to move the nose as little as possible.
The worst swelling after a rhinoplasty occurs at around 2-3 days post-rhinoplasty, after which the swelling gradually subsides after a year or so.
Most surgeons, including myself, would prefer to use the patient’s own cartilage either from the septum or the ear as this has the largest potential for long-lasting results.
Absolutely. This can be accomplished via a smaller-scale procedure than a typical rhinoplasty known as a tip-rhinoplasty. During this procedure, the tip is refined and elevated via the help of cartilage grafts that will lend more support to the tip.
Especially for patients post-rhinoplasty, upturning and swelling of the nose is perfectly normal for at least 6-8 weeks and may persist for up to a year (on a more gradual scale, of course). As I like to tell patients, you don’t really know how well a rhinoplasty turned out until at least 6-8 months in and you don’t see the full extent of the results until at least 1 year post-rhinoplasty.
Generally, rhinoplasties do little for the nasal airways and instead focus on the cartilage and tissue underneath the skin of the nose, meaning that they should have very little impact on the quality and sound of a patient’s voice. Septoplasties, however, normalize the nasal airways and may change the voice slightly, but this is probably best answered by your surgeon via an in-house examination.
Yes, this can certainly be done via the application of cartilage dorsal grafts to weigh the tip down and create the illusion of a longer nose and minor trimming of the columella.
Yes. However, patients must evaluate whether the nose bump is as minor as they believe. Larger nose bumps cannot be simply filed away because it leaves a hole in the nose called an open roof deformity which can lead to a disastrous appearance that can only be resolved with a purposeful breaking of the bone (osteotomy) to push the bones inward and fill that gap.
Many times, the surgical tape applied post-rhinoplasty will trap sebaceous fluid underneath the skin, prompting acne breakouts. In this case, it is necessary for patients to be gentle in their cleaning, using mild exfoliators and asking their surgeon for advice.
It is certainly possible for patients to achieve a button-nose from a rhinoplasty procedure. However, surgeons also have a responsibility to maintain overall facial aesthetics during a rhinoplasty procedure and may not wish to create a nose which does not belong on a particular face. Our goal during a rhinoplasty is to modify the nose and correct for defects, meaning that the nose you will have at the end will still maintain a semblance of the nose that you had.
Depending on the size of the bump, the procedure required to remove it may be as simple as filing away (rasping) the bump or as complicated as actually breaking the nasal bones and repositioning them more inward. Both of these procedures are perfectly safe in the hands of a good surgeon.
Generally, it is advised that patients avoid any strenuous exercise for at least 6-8 weeks post-rhinoplasty simply because of the risk of bleeding caused by increased blood pressure. One episode of nosebleeds is not particularly serious, however, if the patient remains careful.
Yes, natural grafts from the patient’s own cartilage represent the least risk for infection, as opposed to silica, Gor-Tex and other materials.
Generally, calluses which develop after a rhinoplasty will heal naturally and resolve themselves gradually within 1 year post-rhinoplasty as the body reabsorbs the bone and cartilage in the callus. If this does not occur, however, the bump can be rasped (filed) away.
Kenalog injections can be safely administered 4-6 weeks apart as early as one month following the rhinoplasty procedure.
Absolutely not. Surgeons will typically wait for about a week before removing the splint for safety reasons, but delaying it will not impact results at all.
Although most surgeons will use an external splint in order to protect the results of their work, some (although rare) may opt to just use internal packing in order to realign the nasal bones. However, this method does not work as well as an external splint.
Especially in the case of a combined rhinoplasty and septoplasty/turbinate reduction, patients can expect to cough up bloody phlegm in the weeks post-rhinoplasty. However, this should not be an ongoing problem and should correct itself soon afterward.
The most common complaints I hear from East Asian patients is that they have low definition on their nasal bridges and their tips. The nasal bridge issue is often solved with the help of grafts/implants which make the bridge more prominent, while the tip projection is improved with cartilage grafts in a tip-plasty procedure.
Generally, surgeons will prefer to use septal cartilage as a first resort, followed by ear cartilage from the cymba or cavum (top and bottom parts of the central depression within the ear). Rib cartilage is used as a last resort when these two sources are depleted, simply because of the invasiveness of cutting into rib tissue.
Because the surgical tape and cast applied to the skin in the week after rhinoplasty traps sebaceous fluid within the pores of the skin, it is common for patients to experience acne breakouts in this time period. Having a facial prior to the surgery may be the best way to combat this as it cleans out the pores beforehand.
Both silicone and Gore-tex implants are synthetic, with the former being constructed from siloxane molecule chains and the latter being composed of polytetrafluoroethylene. Gore-tex, while tending to shrink over time (unlike silicone, which is stabilized via a capsule), is also stabilized by the surrounding tissue, but tends to be more difficult to remove if infection occurs. I prefer personally to use the patient’s own cartilage as a first resort rather than these synthetic materials.
Serious infections following a rhinoplasty are exceedingly rare. However, when they occur, they are very easily treated like any other infection, with antibiotics and careful monitoring by the surgeon.
While it is difficult to really answer this question on a case-by-case basis, it can be answered generally. The nose and the chin, being along the same midline of the body, are very intimately related and a change in one can impact how the other looks. For instance, patients with a larger nose may look bird-like if their chin is weaker, while patients with a smaller nose may look bottom-heavy if their chin is particularly strong. The overall goal of any facial plastic surgery procedure is to increase overall facial harmony, so ask your surgeon whether a chin implant/reduction would be advisable.
Although people usually do experience some degree of discomfort and mild head/nose pain within the first few days, experiencing these same pains weeks into the post-rhinoplasty period is rather abnormal. This may be an indication of some other pathology.
A graft is tissue (bone, cartilage, fat, other soft tissue) taken from a region of the body and transplanted to another region of the patient’s body or another person’s body for functional purposes. In the case of rhinoplasties, these grafts can either be contour grafts or structural grafts. Contour grafts are used for aesthetic purposes, that is, to smooth and even out structures in the face, correct asymmetry, etc. Structural grafts are used for support purposes, that is, to provide strength to areas like the tip of the nose, etc. In rhinoplasties, cartilage grafts are the main types of grafts used and are taken, in order of preference, from the septum, the bowls of the ear (cymba or the cavum), or the ribs.
To be frank, this really depends on how much contact with the nose will ensue during the kissing. Gentle kissing can be done probably around 3 weeks post-rhinoplasty, but more aggressive kissing where contact to the nose is a concern should probably wait until around 6-8 weeks.
Absolutely, this can be done with a graft. In rhinoplasties, cartilage grafts are the main types of grafts used and are taken, in order of preference, from the septum, the bowls of the ear (cymba or the cavum), or the ribs.
By wide nasal bones, I will assume that you are referring to the bridge of the nose which can be fixed by a controlled osteotomy in which the nose is broken purposefully by surgical instruments and then angled inward to narrow it.
Without an in-house examination, this is difficult to assess. Removal of fullness at the base of the nose may cause the illusion of a longer lip, as can the unhinging of some muscles at the upper lip which control movement.
This should generally not be a major concern. However, patients should evaluate whether enlarged turbinates or deviated septa may cause breathing issues or whether existing sinus issues can be exacerbated by the swelling and other issues following surgery.
Generally speaking, I would prefer to do rhinoplasties on thin skin as opposed to thick skin. Thin skin does make the outline of the bone and the cartilage more apparent underneath, but it is much more manageable than thick skin which tends to hide results and make the change less dramatic (although some prefer that).
Generally, dents from damage to cartilage can be fixed via the introduction of fillers into the region.
Unfortunately, this is not an issue that will resolve by itself. Steroid injections may have weakened the tissue and caused it to collapse, an issue which can only resolved by injecting fillers like Restylane into the area.
Though this is difficult to evaluate without an in-house examination, this could be a spider angioma which can easily be treated with laser treatment.
Normal oil secretion by the skin can be altered because of the trauma to the nose and the cutoff of blood circulation in the area. Post-op, this could result in acne breakouts as oil and other sebaceous fluid becomes trapped in the pores due to the post-op surgical tape.
Generally, when it comes to noses, there is no “magic number”. However, it is generally safe to consider rhinoplasty at ages 15-17 for girls and 16-18 for boys.
Either approach would work, with the open approach having more bruising and a more noticeable scar. However, it is important for patients to consider whether they also need changes in addition to the dorsal hump (e.g. Droopy tip, etc.) which could better be fixed by the open approach.
Given that the rhinoplasty’s main area of attack is on the nose itself, there is no direct adverse effects on the teeth/jaw area from the rhinoplasty. However, I would recommend waiting until the dental correction is done simply because the changes in the jawline and teeth caused by the braces could affect the balance of nose to lips.
It truly depends on the size of the bump. While small bumps can be removed by rasping under local anesthesia, larger bumps, which carry the risk of open-roof deformity if removed by rasping, require osteotomies which are difficult to really perform under local anesthesia. General anesthesia might be more suitable for this reason, and because of the protection offered by the endotracheal tube (can block blood and other fluids from getting into the lungs during surgery).
It is a relatively common occurrence for patients to have broken capillaries in the sclera of the eye (the white of the eye) following a rhinoplasty, a condition known as a subconjunctival hemorrhage. Unfortunately, this bleeding tends to last for up to four weeks. However, if bleeding continues past that period or leaks into the iris (colored part of the eye) or affects vision, let the surgeon know immediately.
Patients are advised to speak with their own surgeons regarding this matter. However, one method which I have seen is to use a disposable glove and fill it with ice at the fingertips, letting the finger parts of the glove rest on either side of the nose and the palm part rest on the forehead.
Unfortunately, yes. Cartilage makes up the framework of the nose in addition to the nasal bones, so with time, slight shifting does occur here and there. Patients with crooked noses will often find that cartilage and nasal bones have a “memory” and tend to grow in ways that were similar to the original deviation, so touch-ups may be necessary.
Unfortunately, this may require a revision rhinoplasty. It seems that there may have been deformities in the columellar cartilages (medial crura) that were not addressed in the rhinoplasty you underwent or a septal deviation. It is best to consult with your surgeon regarding your options at this point.
This may be the result of a suture which has not been removed yet. I would consult with your surgeon to make sure everything is okay.
It is generally difficult for thick skin patients to achieve tip definition that is satisfactory to them. However, cartilage grafts can help add more definition to the nose that can get them closer to where they want to be.
There are several methods by which this can be done. One way is to decrease the height of the nasal bridge. The other is shortening the tip cartilages in order to rotate the tip of the nose upward and create the illusion of a shorter, less projected nose.
Sometimes, grafts can become apparent after a period of a few months post-op. Eventually, they tend to contour themselves out over time, though. However, bring it up to your surgeon to see what he/she has to say.
I would wait at least several months before undergoing another major procedure like rhinoplasty. The rhinoplasty operation itself will operate under general anesthesia and takes about an hour and a half.
This is perfectly normal as it is could be the mucous from the nasal mucosa which is simply runny due to the nasal trauma of the rhinoplasty. However, I would check with your surgeon as clear drainage could be a potential leak in cerebrospinal fluid which could lead to bacterial infections. Check to see if you have headaches while ONLY standing up, as this could be a symptom.
Generally, the same techniques are done regardless of the sex of the patient. However, the goals are different, as ideal male and female noses are obviously different. Males are usually better suited with a more defined bridge, a greater degree of tip projection, less tip rotation (90 to 95 degrees is suitable), and greater width in the middle of the nose. Females can tolerate more tip rotation, subtle dips in the supratip region, etc.
In general, Hispanic patients tend to have thicker (oilier) skin than Caucasian patients, broader faces and wider nostrils/nasal bridges, weaker cartilage, and a greater proportion of nasal humps. With all these considerations, it is important that surgeons understand the aesthetic goals of their Hispanic patients and tailor their surgical goals to their patient’s needs.
Simply for the purpose of reducing swelling, one week of sleeping in an elevated position is probably adequate enough.
Though general work-ready recovery time from a rhinoplasty takes about a week or so, grafting from the rib can cause soreness for at least a couple of weeks and it is best to avoid even light exercise for at least 6 weeks or so.
An open roof deformity occurs when surgeons attempt to rasp (file) away a larger dorsal hump. Think about this situation as taking away the top 1/3 of the roof of a house, where you leave a rectangular hole in the middle. This is essentially what an open roof deformity looks like, and it can be resolved by osteotomies which are controlled fractures of the nasal bones that allow them to be angled inward to cover up the hole.
Surgeons conducting a rhinoplasty often like to use septal cartilage because it is thicker, straighter, and stronger than ear cartilage which is thinner and tends to be used more for revision rhinoplasties.
Unfortunately, trauma to the nose activates osteocytes (bone-producing cells) and chondrocytes (cartilage-producing cells) to add their respective materials to the injury site, thus resulting in a dorsal bump. Sometimes, these areas are subsequently reabsorbed by the body. However, sometimes, they are not and, if this absorption is not apparent even months after the trauma, it is likely to only be solvable via surgical methods.
While smiling may cause a certain degree of discomfort post-rhinoplasty due to edema and other fluid buildup, patients are safe to smile all they want.
Certainly, fillers like Juvaderm and Restylane can definitely help with this. However, if you are looking for a more permanent solution, I would also suggest fat fillers harvested from your own fat deposits.
I would wait at least 6 weeks or so before swimming again simply because of the risk of contact to the nose. As for the sauna, it will tend to be very dry which could bring about a nosebleed, so I would also wait for about 6 weeks here too.
It is true that the lining of the nose swell and thicken in response to allergies and this can block the nasal passages, leading to congestion and other allergy symptoms. A rhinoplasty can help make the air space bigger so that the tissues have to swell more to cause symptoms, BUT this will not help the condition of the allergies.
Yes this should be fine. As long as no workouts are done after surgery and the blood pressure is kept normal, do whatever you want prior to the surgery.
This is most likely your inferior turbinate, a shelf of tissue and bone, which is often cauterized during a rhinoplasty and can swell up post-op.
I would say that, as long as you chose a competent surgeon that is board-certified and has before-and-after galleries to your liking, you should be in good hands. Complications during rhinoplasties are rare and are typically just related to anesthesia, which in most cases just include slight vomiting and/or nausea post-op. If it helps, you are more likely to have a life-threatening issue driving to the hospital for the surgery than the surgery itself.
Blowing the nose prematurely can result in bacteria getting into the internal incision sites. In addition, pushing on the nose during the blowing process may cause shifts in the cartilage and bone which the surgeon worked so hard to avoid. Patients can safely blow their nose 1 week or so post-op.
Due to the trapping of sebaceous fluids in the pores due to the surgical tape, it is common for patients to experience acne breakouts post-op. You should be ready for gentle cleaning at around 1 month post-op, but, if the nose is still sore, wait a couple more weeks beyond that.
This may be fibrous tissue that can take up to a year to fully heal. Consult your plastic surgeon to ask his opinion.
Swelling at the tip can derotate the nose (rotate it upwards). I would not touch the results and wait for the swelling to subside.
This should probably be best addressed by your surgeon, but personally, I believe time is probably the best healer for scars especially if it is soon post-op.
It is doubtful, as it takes a substantial amount of force to actually fracture cartilage or bone tissue. Get it checked out by a plastic surgeon to make sure though.
This could be attributed to nasal vestibulitis which can treated with hydrocortisone cream. However, it may also be necessary to cauterize the areas of bleeding as the nasal lining might be overly thinned.
Unfortunately, there is very little patients can do to actually prevent scarring. Still, the scars will tend to heal fine if given enough time.
This discoloration may be the result of several factors including unintended UV ray exposure from the sun, broken capillaries (which can be treated with a laser), or poor blood supply to the nasal area (common in patients who have had multiple rhinoplasties).
This is probably best addressed by your surgeon. However, I would advise against nasal irrigation because it creates too much pressure in the nasal region that can lead to disrupted healing of nasal incisions.
Implants, unless they shift and create unpleasant nasal shapes or become infected, are built to last for the remainder of a person’s life
This is very simple as both procedures are often performed concurrently, although the septoplasty will be covered by insurance and the rhinoplasty will most likely not be. However, check if the surgeon has experience with both surgeries and is board-certified.
I would wait at least 3-4 weeks before performing any activity which increases heart rate simply because of the risks of hematoma and bleeding due to increased blood pressure.
It does not fluctuate really, as much as it subsides gradually. Most of the swelling goes down within the first 10 days, with pretty much all of it disappearing within 3 or so months. Full healing should take place after a year or so.
Your own cartilage, particularly septal cartilage (or ear cartilage, if not enough of this is available), is the best choice for implant as it mitigates a lot of the risks of silicone, Gortex and other implants including movement, warping (twisting out of shape), infection, etc.
Other than causing congestion and subsequent increases in swelling and post-nasal drip, this should not have a major impact on the final shape of the nose post-rhinoplasty. Patients should just take care not to rub their nose or put any other pressure on it inadvertently.
I don’t see how this could hurt you. However, it is important for patients to recognize that the goal of surgeons is to match the nose we create to the face and create overall harmony, meaning that a certain celebrity’s nose may not match up with a patient’s face and may not be advisable. However, it does give the surgeons a good idea of what the patient wants and expects.
Decreasing bridge prominence can be accomplished via rasping and potential osteotomies (if the dorsal hump happens to be large). Tip rotation may also help in this case, which can be done via the manipulation of the lower cartilages.
Quite often, this is done by suturing the nasal cartilages in a more narrow fashion and bringing it cartilage grafts from the septum or the ear for additional support. However, the problem which surgeons often have with ethnic noses is that ethnic noses tend to have thicker skin which does not drape nearly as nicely over skin as thinner skin does. Thus, the results may not look quite as apparent.
Probably. The majority of the swelling will probably have subsided by then.
Sometimes, it is possible for a couple nasal bones to shift here and there which is why patients, especially within the first month post-op, should be extra careful not to disturb any areas on the surgical site.
This is doubtful. The typical removal for a rhinoplasty ranges anywhere from 4-6 mm. Some patients may warrant more, but the surgeon should make sure that he/she has a definitive plan of what to do with loose skin and whether the nose still remains proportional to the face.
This is mostly likely to temporary swelling in the back of the nose which is connected to the throat and the ear via the Eustachian tube in the pharynx. This will resolve itself within a week.
Unless the nasal hump is small, it is probably best to having a full-on rhinoplasty simply because of the risk of open roof deformity (shaving off a larger bump leaves a hole that can only be filled with osteotomies that force the nasal bones inward). In addition, removing the nasal bump without having tip work done also makes the nose look unintentionally longer as well.
This can easily be done by trimming the membranous and cartilaginous parts of the columella and suturing the resulting structure in place.
This is unlikely as the glasses only exert very slight pressure.
The ala refers to the lower sides of the nose where the nose joins the cheek and alar flaring refers to an ala that has more curvature than necessary and does not slope gently to meet the cheek. This makes the patient look more angry, as this is a typical evolutionary sign of anger.
Yes, especially in the first few weeks post-op. Saline solution applied via Q-tip is probably the best way to combat this.
In the first 6 weeks post-rhinoplasty, blood supply to the nose is relatively weak and the surrounding nasal structures (cartilage, bone, etc.) are noticeably less strengthened. It is thus best to avoid sun exposure as much as possible. With that being said, minor sunburn is not going to ruin your rhinoplasty. Just be more careful.
Normal airflow through the nose is essential for sinus function (sinuses are air chambers within the facial skeleton). Therefore, a deviated septum or any other obstruction to normal air flow can be corrected with rhinoplasty and this procedure can improve sinus function. However, patients must evaluate whether a blocked airway is actually the cause of their sinus issues, because any other cause will not be fixed via a rhinoplasty.
A supratip dip is a slight dip in the nose right above the large tip of the nose. It is usually preferred on females because it adds a degree of femininity to the nose.
The rigidness of rib cartilage definitely makes it useful for procedures like dorsal augmentation (which is what I image you are looking for) and reshaping, especially in the case of revision rhinoplasties. However, there is a greater degree of discomfort associated here than taking cartilage from the septum or the ear because of the numerous muscle attachment points on rib tissue.
Certainly, as long as the rest of the nose looks proportional. However, this is usually not the case as patients usually need other procedures to make everything look harmonious on the face. The cost for one alone will generally range from $2,000-$4,000.
Often, a short upper lip is related to a droopy tip as the depressor septi muscles impact both. Cutting these muscles and releasing the upper lip can help the tip lift up and thus allows the upper lip to show slightly more.
There are three sites, depending on the type of nose job, which are the most common sites for scar formation. One is the columella, the flap of skin between the nostrils on the underside of the nose, which occurs in the open rhinoplasty procedure. Another is the alar where, if patients chose to have alar reduction surgery to reduce nostril flaring, scars will be present, but relatively undetectable. Finally, the last potential incision site is the dorsum where surgeons MAY place small stab-like incisiosn, although it is more common for these incisions to be on the inner wall of the nose and thus undetectable.
It is important that, when a patient’s surgeon gives him/her the OK to begin cleaning the outside of the nose, they remain gentle. Generally, patients will use sterile solution like alcohol on gauze/cotton.
This sounds like a shifted cartilage graft. It might be best for you to evaluate this with your surgeon.
It is recommended that patients, who are subjected to general anesthesia during a rhinoplasty (at least in my office), have someone drive them home post-op and care for them for the first 24 hours post-op. Patients should try not to drive for at least 3-5 days post-op.
Often, surgeons will attempt to avoid these type of deformities post-op by placing spreader grafts in the nostril. In cases where this occurs, revision rhinoplasty may be required with cartilage grafts taken from the septum or ear as support.
My best advice would be to avoid doing this at least 2 weeks before and 2 weeks after surgery.
Yes, it is necessary because cauterization during the procedure can cause severe burning of the nasal tissue AND because they present a risk for infection because they penetrate underlying soft tissue, not just the epidermis of the skin.
Generally, surgeons will use splints in the first week post-op not only to protect the delicate nasal tissues immediately after the surgery, but also as a reminder for patients to be extra careful in the first few days post-op. Packing has generally gone by the wayside due to discomfort/breathing issues felt by the patient and has given way to internal splints.
This probably can be best solved with the use of cartilage grafts or, as a second resort, injectable fillers.
Taste and smelling will generally be disturbed, particularly if work was done around the septum, for a period of a couple of months to a year. Speaking to an ENT might be the best option for figuring out how to hasten this process.
Try to sneeze through your mouth as much as you can post-op simply because trying to suppress a sneeze through the nose can lead to pressure issues that can alter the results of the rhinoplasty and lead to nosebleeds.
This should not have a major effect on the rhinoplasty procedure. However, patients are advised that in the period of a couple weeks post-op, the nasal bones still aren’t fully solidified and should be treated carefully.
Gently touching the nose will not affect the results. Just make sure not to bump it hard or push very hard as the nasal tissues are still delicate and malleable.
Polly beak deformity, the common name given to supra-tip fullness, can be seen due to excision of dorsum just above the tip and also from poor nasal tip projection, both of which give the impression of an unnatural curve at the tip.
This will most likely be covered by insurance and is usually resolved via turbinate surgery, septoplasty and/or spreader grafts (if the nose is collapsed inward and causes breathing issues).
It really depends on the problem and this matter would be best addressed with an in-house consultation with the surgeon. However, this can be done via osteotomies.
In general, there can be up to 5 post-op visits, the first being at 7 days to remove the nasal splint, the next being at 30 days, then 3 months, then 6 months, then a year (when full results will be more or less apparent).
Over the long-term, these muscles will heal and your smile should come back just fine. However, because cutting the depressor septi prevents the tip from drooping, there will be some loss of sensation in the upper lip area which will cause movement issues in the upper lip (and resulting problems when smiling) for a period of a few weeks.
Patients with this condition may require fascia grafts from behind the hairline on the temple in order to soften the nasal shape. However, this may also be a cartilage issue that can be resolved with a tip rhinoplasty in which the lower cartilages are reshaped to the patient’s liking.
Absolutely not. Oily thick skin may be more difficult to conduct a rhinoplasty on simply because it is less elastic and tends to not drape as tightly around the newly positioned cartilage and bone, thus making the results look less apparent and dramatic. However, no damage can be incurred with this type of skin.
What people often see as the nose “growing” as they become older is a simple drooping of the tip which creates the illusion of elongation.
Theoretically, yes. However, I would be cautious because the sinuses are very open to the external environment and can be breeding grounds for bacteria (thus leading to sinus infections). This can lead to infections in the rhinoplasty surgical site which would just lead to unnecessary complications that can be better avoided by spacing out the two surgeries appropriately.
One of the problems with grafting, although it is relatively rare, is warping, or twisting out of shape. Unfortunately, there is little you can do now other than consult with your surgeon about your best possible options.
Generally, after ages 15-17 for women and 16-18 for men, rhinoplasty can be done. However, patients in high school should consider whether they are ready for any side-effects and complications from the surgery which could occur including swelling, bruising around the eyes, etc. If not, they could consider having it done before college.
Absolutely not. Steroids are simply used to correct tough skin like scar tissue and other abnormalities post-rhinoplasty, but should not be used on normal tissue/skin because of the risk of atrophy that can be disastrous for post-rhinoplasty results.
Good question. The cartilage itself does not swell, but the skin and soft tissue around it does.
It is common for nasal swelling to occur in women during pregnancy, regardless of whether or not they had a rhinoplasty procedure done. This is due to fluid retention.
This pain is likely a result of the endotracheal tube which was placed in your windpipe during the rhinoplasty, a measure of precaution against breathing difficulties under general anesthesia.
I would demonstrate some concern and consult with my surgeon. This could be inflammation due to a suture or graft material.
Unfortunately, not simply due to the painfulness of the procedure without anesthesia and the risks associated with it.
The close-set eyes should not be an issue and the correction of the nasal bridge can be accomplished via an osteotomy that will angle the nasal bones closer together.
Around two weeks in is a good benchmark for when you can begin sleeping on your side post-op. However, some surgeons may even recommend as soon as 7-10 days.
Depending on the time frame, I would wait until a year post-op to begin considering revision surgery. However, further support in the tip may be necessary via a strut graft.
The time frame for using Kenalog and other steroid injections as a way of combating swelling and eliminating scar tissue post-op varies from surgeon to surgeon, with some recommending it right after surgery and others advocating the use of it months after. They are generally spaced 4-6 weeks apart, however.
Absolutely, and this is usually done with an open rhinoplasty. The base of the nose is narrowed and support is brought in via septal or ear cartilage to make the tip sturdier.
As I have said before, there are good surgeons and bad surgeons everywhere and people may benefit from saving costs via surgical tourism. However, if patients wish to go abroad to have surgery done, I would advise them to be wary only because any complications that may arise in the post-op period may be best addressed by the surgeon who did the procedure in the first place.
It certainly does not hurt to get it done, especially because it may reveal aspects of a person’s health to a surgeon which may impact the surgery itself and the post-op process. Blood tests can help determine if a person has a clotting issue, for instance, or has other potential complication-causing problems. Personally, in my office, I will often have patients obtain blood work before rhinoplasties.
Unfortunately, scars cannot be permanently removed in the way that patients would like to see. However, they can be mitigated via cortisone injections and, long-term (after the healing process is complete), via laser resurfacing and dermabrasion treatments.
A typical “Asian” nose can indeed be crafted via a shaving down of the bridge, especially the radix (the top part of the bridge), and conducting osteotomies to realign the nasal bones in an appropriate manner.
Honestly, unless the concha bullosa (which is an air-filled space that may block sinus openings) present problems that could lead to diseases like sinusitis, it is often considered unnecessary to take care of concurrently with a rhinoplasty. However, if it IS symptomatic, then it can be taken care of at the same time as your rhinoplasty procedure.
Certainly. Ethnic noses (in which this is often the case) can be made more feminine via reduction of the nostrils and the bridge of the nose as well as alar reduction surgery (to reduce nasal flare).
This term can be broken down into two parts: sept- and turbino-. It is a procedure which corrects a deviated septum (sept-) and corrects for enlarged turbinates (turbino-), both of which can obstruct nasal airways. Correction of these two issues is often determined as functionally necessary and will usually be covered by insurance.
A drooping columella can be addressed by removing a small section of skin and cartilage from the area and then simply patching up the area.
Alcohol in moderation should not a problem at around 3 weeks post-op.
Actually, it is best for patients to correct the original deviation within a week or so following the trauma because the nose (which tends to have a sort of “memory”) will want to naturally realign itself via the growth of cartilage and bone. Surgeons can easily help this process along its way by performing a septoplasty and correcting the deviation, and then letting the body heal itself.
This depends on how her nose works with your existing facial features and how similar your noses are. It is always good to bring in pictures to your surgeon’s office to get him/her a sense of what you want your final result to be. However, patients must realize that celebrity noses do not necessarily look good on every face and that the surgeon can only modify existing noses, not create new ones.
Though it is usually the tip which experiences numbness during rhinoplasty, the numbness can also extend to the upper lip due to the nerves which are cut and stretched during the procedure and need to grow back. This may take months to heal, maybe even a year or so, but do not worry: It will resolve itself eventually.
Yes this can definitely be done. However, patients must consider whether tip work may be necessary to make all details of the nose proportional to each other.
The type of nose which you get post-rhinoplasty depends on your surgeon’s skill and what you bring to the table (existing nose, genes, etc.). The goal of surgeons is to modify an existing nose and correct for any defects which bother/inconvenience a patient, not substitute one nose for another. Giving your surgeon pictures of what your ideal nose, although not always possible to recreate exactly on the face of a patient, will give him/her a good idea of what you want.
Surgeons will typically space out Kenalog injections between 4-6 weeks apart. Swelling subsides gradually up the 6-8 week post-op mark.
Patients days into the post-op process may see white bumps that are representative of sutures that have not fully dissolved/healed yet.
A pollybeak deformity (the name given to supra-tip fullness in a patient) can be corrected often by removing some septal cartilage and reinforcing the tip of the nose —- which tends to drop —- via the placement of a cartilage graft. Steroid injections may also help as the deformity may be the result of excess scar tissue.
Patients can sleep on the ear in question within a week or two after the cartilage is harvested, but it may continue to be mildly painful for around 3-4 months, after which it heals completely.
Patients can conceivably begin playing contact sports at a period of 6-8 weeks, with most surgeons suggesting waiting until the first 8 weeks simply because of the risk of bumping/breaking the nose in contact sports like football or soccer.
Because during the surgery lidocaine mixed with epinephrine is injected into the surgical sites to constrict the blood vessels, there should be relatively little bleeding post-op. Oozing is typical on the first day if osteotomies are performed, but this is usually absorbed by nasal packing/drip pads.
Unfortunately, this is highly unlikely. Surgical fillers can be used in certain limited cases, like to augment the nasal dorsum or to add more mass to a tip, but this is exceedingly rare and most patients are probably better off with a rhinoplasty procedure.
A natural ski-slope nose may be best addressed by inducing less projection of the tip (deprojection) and perhaps placing some septal or ear cartilage along the patient’s supratip area to introduce fullness into the area.
If this question is for someone who has not had rhinoplasty surgery, this is typical, as cartilage sections in the nose can slide past one another.
Patients should generally not concern themselves with the technique of open or closed rhinoplasty as much as the skill of the surgeon, as the results of both are very much comparable in many cases.
Although this may still be residual swelling, it is most likely hard bone tissue which unfortunately must be fixed via a revision rhinoplasty. Talk to your surgeon about your best options at this point.
Although the results generally will not differ between silicone and cartilage, I prefer to use cartilage simply because there is less risk of inappropriate movement of the tissue and infection.
Yes this can certainly be done. Cartilage is often harvested from the septum, the ear, or the rib (in order of preference) in order to lengthen the nose and to give the tip more definition.
Unfortunately, this is highly unlikely. Insurance will likely pay for any functional defects like a deviated septum or enlarged turbinates which result in breathing difficulties, but any cosmetic changes will likely have to be paid out-of-pocket.
Some cheaper options to dealing with a dorsal hump could be to wear larger-frame glasses which take attention away from the bridge, use non-surgical fillers like Restylane to heighten areas around the bump and make it less noticeable, etc.
Probably not, as nasal growth tends to stop soon after puberty (15-17 for girls, 16-18 for boys). This may be the sign of a callus formation, or the buildup of cartilage and bone.
This is somewhat unusual, as most patients favor a straight, less bumpy nose. However, patients can have this issue corrected via cartilage addition to the area or even injectable fillers.
Depending on the patient, this may be best addressed by trimming a portion of the columella to decrease the columellar show and adding cartilage in order to weight down the tip and rotate the tip downwards.
Patients with this condition should contact their surgeon immediately. While it may just be localized bruising, this may also be a sign of unhealthy pressure from a cartilage graft in the skin or decreased blood flow to the area that could result in necrosis of the tissue.
No, there has not been enough scientific studies to establish any sort of link between smoking marijuana and discomfort/pain following anesthesia. But, why risk it?
Yes it can. However, alar base reduction is not suitable for ALL Asian noses as nostril rims which meet the upper lip at a straight right angle may be very difficult to fix with alar base reduction while still looking natural. This is a question probably best answered by your plastic surgeon.
A septoplasty is a procedure which modifies the nasal septum (the wall in the center of the nose) and usually helps with deviation of the septum in order to correct breathing.
A turbinectomy is a procedure which reduces the size of the nasal turbinates which are curved bony structures on the nose which contain mucous membranes. Enlarged turbinates may block nasal airways and so can be removed (bilateral means removal on both sides of the nose).
In reality, Flonase via its active ingredient fluticasone is expected to reduce swelling, but can cause the opposite reaction in 1/100 or so of its patients. However, I would advise against using any unnecessary sprays and perhaps just sticking with saline. Consult with your surgeon about this, though.
Firm swelling is common in the weeks post-op mostly in the peritip region, especially if cartilage grafts were used.
Absolutely. This can be achieved with the use of cartilage grafts that will support the tip of the nose.
The reason why patients are often told that rhinoplasties take up to a year or so to fully heal is due to the healing of scar tissue and cartilage grafts which are often used during the procedure to give more support to the tip of the nose. However, if rib cartilage was used, then this may remain noticeably more firm than the rest of the cartilage in the nose (which is why rib cartilage is used as a last resort).
At one year post-op, patients should generally be close to their final results or should be there already. Patients with thick skin may take a little longer to fully heal and reveal their final shape, however.
Middle vault collapse, the medical condition responsible for the inverted V-deformity, is equally likely in both the open and closed forms of the rhinoplasty procedure. However, this can be avoided prior to surgery with the use of spreader grafts in the middle portion of the nose.
This will vary within the $3,000-$5,000 range.
Theoretically, a patient can have a rhinoplasty as soon as 3 months afterwards. However, they must consider whether they will have the time or energy for a cosmetic procedure at this time. In addition, as the narcotics used during the rhinoplasty procedure may pass into breast milk, it is important for mothers to pump and store breast milk in anticipation for the procedure.
The surgeon and the girl’s parents must consider this question and evaluate whether the patient is physically and emotionally ready for the procedure. However, at 16 years old, a female patient would be within the “safe zone” of having a rhinoplasty done.
Unfortunately, while surgeons would be open to helping you, it is important that you find a way to pay them for their service. I would recommend that patients achieve a degree of financial stability prior to scheduling surgery, especially since revision procedures may be needed.
Absolutely not, unless it presents a significant medical issue during the surgery (which is unlikely). In fact, the bifid tip can even be fixed during the procedure by suturing the lower tip cartilages closer together and then filling in the resulting dip in the nose with filler or cartilage.
Frankly, there is not a great deal to differentiate between the tip-plasty and the full rhinoplasty in terms of invasiveness, recovery and complication risks. Both carry very minimal risk, most of which is in the anesthesia component of the surgery.
Because there isn’t a great deal of muscle pulling on the nasal bone, unlike other bones in the body where fractures might occur, nasal bones can be left alone to heal perfectly fine and surgery is not necessary unless it results in some sort of functional or cosmetic deformity (deviated septum, etc.). The cast is removed after 7 days and patients are told to avoid strenuous exercise for about 6-8 weeks because blood pressure increases can make nosebleeds more likely.
This is probably best addressed by having an evaluation with your surgeon. He/she will likely take a culture of any drainage which may occur and prescribe antibiotics to fight the infection. Do not try to treat it on your own.
Harder bumps on a nose subject to trauma are usually an indication of a callus formation (deposition of bone and cartilage in an area). Without an actual examination, it is hard to tell what the bump could be, but the possibilities include a cartilage-dominated callus or even small fluid accumulations (edemas).
Because thick skin is generally more elastic and less pliable, it tends not to drape as gracefully over the newly aligned cartilage and bone in a rhinoplasty. That being said, however, notable results still can be achieved with ethnic rhinoplasty via the use of cartilage grafts to give the underlying framework of the nose under the skin more definition that will be apparent even under thick skin.
While pulling out stitches by accident does not always cause pain, it is probably best for patients to speak with their surgeon if they suspect that a stitch was pulled out. Removing one stitch accidentally will not necessarily cause any damage, but evaluation will not hurt.
Injection, or non-surgical, rhinoplasty is not a true rhinoplasty in the sense that the underlying cartilage and nasal bones under the skin are not manipulated in any way and the changes are thus more subtle. Instead, during these procedures (which generally last around 10-20 minutes), temporary injectable fillers like Restylane or Juvaderm are placed in the skin to add fullness into areas and influence nasal contouring.
Chances are the surgeon who built your tip add a cartilage graft. To return to the preoperative stage, the graft can be easily removed.
This correction can be accomplished very easily under local anesthesia. Here, the tip of the nose is rotated upwards and held in place via sutures and the columella is trimmed slightly.
Yes, this can be done. Bilateral spreader grafts can help to widen the upper nose and shaping sutures can be used to help rotate the tip cartilages away from the midline of the nose, thus creating the illusion of a wider nose.
What may be interpreted as nasal growth past the age of 20 or so (when nasal growth actually stops) is rotation of the tip of the nose downwards due to gravity and aging. This can be corrected via a tip-plasty in which the depressor septi muscles which cause nasal drooping are partially released and the tip is lifted, sometimes via a cartilage strut.
Patients who find a knot forming on the nostril, thus making one of the nostrils look more rounded than the other, may have a bossa of the nasal tip which is a collapse of the lower lateral cartilages upon themselves. This can easily be corrected via revision surgery.
Rhinoplasties can indeed be performed even if the patient can has asymmetrical facial features. However, it is best for these patients to seek out experienced, board-certified surgeons who have a good sense of how to perform these types of procedures.
The reason patients are advised to wait at least 4-6 weeks before undertaking strenuous activity like weightlifting is because of the increased risk of nosebleeds resulting from heightened blood pressure. Patients can experiment at this point to a degree: try weightlifting moderately once and see if swelling has increased (if so, stop and try again in a week or so).
After a rhinoplasty, the nose behaves just like any part of the body in that it follows a natural aging process. Tip drooping is a significant part of the aging of the nose and even applies to noses that have undergone rhinoplasties. Consider this: Rhinoplasties turn back time in terms of nasal aging, but they do not freeze it.
Cartilage reabsorption in a graft is not ideal as this cartilage was placed in an effort to support the area in which it was placed. Some reabsorption does take place following a year post-op, but not significantly enough where it would cause issues.
It depends where the swelling is. In some patients, there is swelling in the supratip region which weighs down the nose and causes it to droop. The subsiding of the swelling will thus cause the nose to correct itself and rotate upward.
The reason surgeons will rasp a nasal dorsum is that they wish to correct small dorsal humps that do not require osteotomies to fix. It is analogous to sanding a surface or filing nails in order to create an even, smooth surface.
The only risk associated with tampon use during a rhinoplasty procedure is toxic shock syndrome, which is only an issue if you foresee not being able to change a tampon on a regular basis. Tampons themselves should not interfere with the anesthesia in any way.
As long as you don’t force either, both of these minor exercises of the nose should not do any permanent damage to the results.
This is probably best evaluated by a surgeon’s examination. However, sometimes, rhinoplasty may not be necessary as injectable fillers can disguise the bump in question.
Rasping is considered a rhinoplasty procedure and thus may cost anywhere in the neighborhood of around $3,000-$6,000, depending on the anesthesia used.
Patients can shower after the splint is removed one week post-op. However, they are advised not to apply too much pressure while cleaning the nose.
With most alar base reductions, the swelling usually resolves completely within about a month post-op.
At times, it can. Other than the issue of not draping over the cartilage and bone post-rhinoplasty, thick skin also presents other complications including subdermal fibrosis, increased risk of scar tissue, and fluid retention. However, this question is difficult to provide a general answer to and is probably best answered via an in-house examination if a patient with thick skin wishes to have rhinoplasty surgery.
This can be done, especially if the broken nose is corrected within a week of the original trauma. However, if the broken nose is on a child, sedation or general anesthesia may be more appropriate given the painfulness of the needles.
This is best evaluated, after approval by your surgeon, by applying pressure on one side of the swelling for about 1 minute or 2 and examining how deep of an indentation this created. If the indentation was deep, then it is most likely swelling. If this is the case, then lymphatic drainage may be the issue in which case massage of the area may help. If the indentation created was shallow, then it may be bone tissue in which a revision rhinoplasty is needed at least 6 months after the original procedure.
Unfortunately, no. This is probably another market gimmick designed to dupe less-informed customers.
A revision rhinoplasty refers to a rhinoplasty procedure which is used to correct the results of a previous rhinoplasty which had a negative impact on the patient, functionally and cosmetically. Unfortunately, given the high degree of difficulty inherent in a rhinoplasty procedure, it tends to have a relatively high rate of revision (8-10% of cases require revision). As a result, patients should be careful in choosing their surgeon and make sure they have all the proper qualifications and experience to do the surgery.
Generally, a typical rhinoplasty will involve cutting of sensory nerves within the skin, thus causing a decreased response to touch within the area for a period of several months. This is particularly apparent at the tip of the nose which undergoes the highest proportion of trauma during this procedure. Motor nerves, however, in particular the facial nerves which control the mouth and nose, should not be impacted during the surgery.
It depends on the depth of the scars. Fraxel and other laser treatments can provide relief for patients with more shallow scars, but deeper scars may require re-excision of the scar and dermabrasion of the skin.
It could be. Many surgeons who make a columellar incision will find that whatever side the incision is made on will tend to swell more than the other side. However, if the columella appears to have shifted, it may require the resectioning of septal cartilage.
Especially if an osteotomy was performed, this is a perfectly normal symptom of a rhinoplasty. Patients are advised not to concern themselves if something like this were to happen.
Generally, in rhinoplasty surgeries, form and function come hand in hand; that is, creating an aesthetically pleasing, well-balanced nose will generally result in a nose where breathing and other functions are brought up to speed as well. Certainly, badly performed rhinoplasties can alter breathing, but the trick to avoid this is to find a surgeon who is qualified and has the proper credentials.
This refers to the breathing tubes used in conjunction with nasal packing (which, used alone, tends to be very stuffy). Nasal packing following a rhinoplasty is a procedure that has very much gone by the wayside. Regardless, breathing in the first few weeks or so post-rhinoplasty will be a pain because of mucous buildup.
Especially in patients with thicker skin, supratip fullness may be an indication of impending scar tissue which can be resolved with Kenalog injections. However, have this evaluated by your plastic surgeon as it also could be cartilage or bone buildup that leads to a pollybeak deformity (which can only be corrected with revision rhinoplasty).
If the cartilage graft was taken from the rib, this is a perfectly normal symptom as rib cartilage tends to be sturdier compared to septal or ear cartilage. Also, depending on the timeline post-op, this may be a normal part of the healing process and may resolve itself over time.
This may simply be a symptom of the swelling which could cause your nose to look bunched up and shorter. However, if this appearance issue does not resolve itself after about a year, it may be the result of an over-shortening of the septum in which case revision rhinoplasty is needed.
At around 4 weeks out or so, patients can resume light to moderate activity like yoga as long as it is not strenuous and they pay attention to any swelling which may occur (and stop activity immediately once this is noticed).
Sounds like a marketing gimmick. I would avoid it if possible.
Over time, the tissue of the nose (skin, etc.) will begin to thin gradually. However, this does not alter the general width of the nose, that is, the features molded by the cartilaginous and bony framework, so the nose does not get thinner in this respect.
This may be the result of swelling and fluid retention (edema) and may be best resolved via filler injections or even a blepharoplasty. A more thorough examination is needed to determine what to do in your particular case.
No, the bones do not swell. The tissues around them, like the skin and other softer tissues, do though.
Patients may experience the growth of a dorsal hump after trauma to an area which can prompt bone-producing cells (osteocytes) and cartilage-producing cells (chondrocytes) to build up that area. However, formation of a dorsal hump (if this is not the case) can often be due to genetics.
If patients do not experience any unusual discharges or pain, it is doubtful that simple, grayish-clear discharge is the result of an infection. It is probably more likely that it is sinusitis. Consult with your physician to make sure, however.
I would generally recommend filling out these areas via the transfer of septal or ear cartilage.
It is not a risky procedure and can be done via the use of the patient’s own cartilage and/or fillers/implants. However, it is important for patients to make sure that their entire nose remains in balance and is also proportionate to the rest of the face.
I would advise against it because of one of the ingredients in Zyrtec-D known as pseudoephedrine which is a stimulant that can increase blood pressure and heart rate, thus creating a slightly increased risk of bleeding during and post-surgery. Contacting your surgeon and the anesthesia department of the hospital where you will be having this procedure done is the best option here.
This is probably best answered by an examination with your surgeon. Nasal bones could easily be rasped via a limited incision, but ask what your surgeon thinks about this operation and whether it is feasible.
Yes, congestion can last as long as two months post-op and can be combated via the use of saline spray, at the discretion of your surgeon.
Correction of a broken nose involves a procedure known as open reduction which involves the creation of osteotomies (controlled fractures) to realign the septum of the nose. In some patients, spreader grafts might be necessary to ensure that the nose does not collapse during or after surgery.
Derotation of the tip via the release of ligaments in the nose and addition of cartilage grafts to weight down the nose can indeed help here.
If patients require ONLY work on the tip, then yes, the cost of rhinoplasty can be reduced and a tip-plasty can be performed. However, it is rare for patients to just require this procedure as reduction of the tip often requires reduction of the nasal bridge and other areas of the nose in order to keep the proportions of all the facial structures in check.
There is no real universal answer for this as it varies from surgeon to surgeon. Often, surgeons will like having blood work because it may reveal potentially complication-causing conditions that patients will either not disclose or forget to reveal prior to the procedure. Again, this is a question best answered by your surgeon.
Unfortunately, no. Cartilage, while being highly elastic and bendable, is not necessarily easily movable (at least in a permanent fashion). Deviated septums can only be corrected with a septoplasty.
Messing up one suture will probably not do a significant amount of damage. However, consult with your surgeon just in case.
Because surgeons often use lidocaine mixed with epinephrine in surgical areas to constrict blood vessels, blood loss is typically minimal during these types of procedures. Some blood may escape into the throat and into the stomach, which can cause vomiting and nausea. However, a gauze pack is usually placed in the back of the throat to catch the majority of the blood.
I would advise against it. During this time, the skin has just been redraped over the newly aligned tissue and is not properly attached yet. Therefore, any action which may involve pulling or prodding the skin could cause issues. Skin care questions are best addressed by the surgeon who conducted the operation.
Generally, I would advise patients to pick the surgeon, not the procedure, as the surgeon’s individual skill is probably the biggest factor as to whether a patient achieves the results he/she wants. However, if you insist on a straightforward answer to the question, I would probably recommend open rhinoplasty for tip work only because it allows for the surgeons to have a greater view of the work they are doing in that area.
Though this is probably best addressed by your surgeon, bleeding within the nasal wall post-op may just be the result of aggravation of a suture. This is best addressed by consulting what to do with the surgeon and NOT touching the aggravated site anymore.
The standard answer for this is generally about 2 weeks, but consult with your surgeon and ask his/her opinion since different surgeons will handle this issue differently.
If work was performed on the septum (septoplasty, harvesting of cartilage from the septum), there is a chance that this may be the result of a septal perforation. However, it is best not to jump to conclusions as it may also just be a large mass of crusted blood and mucus in the nose (especially if it is early in the post-op period). This is best addressed by examination by the surgeon.
Both of these procedures were likely performed to correct a breathing defect. If by empty nose syndrome (which is not a real condition) you mean that the turbinates have been fully removed, this is not likely unless your surgeon went hyper-aggressive on the turbinate removal —- which is not medically advised at all. I would not worry about this.
Actually, skin is not removed during a rhinoplasty. When performing these surgeries, more skin is undermined than necessary for the area of surgery, so that it can redrape over the skin more evenly. In general, noses during rhinoplasties are not undermined enough where excess skin is a major concern.
Unfortunately, this is not a realistic procedure for the results you want. Steroid injections are used strictly in post-op conditions to reduce swelling, not as a method of primary treatment as they do not reduce cartilage in the nose.
Unfortunately, nostril over-spreading during smiling or even while resting is not something which is fixed by a typical rhinoplasty. Although post-op swelling may contribute to this, patients who are dissatisfied with their nostrils post-rhinoplasty may want to consider alar base reduction.
Technically, it can be. However, particularly if osteotomies are performed, the sound of breaking bones and the general discomfort of injecting local anesthesia may cause anxiety and discomfort for the patient, so general anesthesia is usually the best option.
This is unlikely. In general, grafts are used as a way of supporting changes which are made to the nose, meaning that those changes would still likely be present in some way after the graft is removed. Also, the formation of scar tissue and the thinning of the skin around the graft will also contribute to a difference in pre-graft and post-graft noses.
This is nothing to worry about. After a year post-op, the nose is more or less fully healed. Therefore, the swelling which occurs when cigarette smoke is in the air is probably more of a sign of inflammation or slight allergy due to the irritation of cigarette smoke. Minute swelling can also be caused by alcohol which is a vasodilator that causes the nose to become thicker (“drinker’s nose”).
I would suggest not getting it pierced. Because of its importance in breathing and the possibility of cartilage reabsorption after surgery (which can potentially undo the results of the procedure), the septum is best not touched post-op.
Tip refinement is, to put it in general terms, the re-contouring and re-shaping of the nose tip for better appearance. This usually involves the addition/removal of cartilage from the tip and the suturing of the results, in addition to the use of cartilage grafts for people with thick skin to heighten the nasal tip.
Just because a surgeon seems to apply the same type of nose job to his/her patients does not necessarily mean he/she is a bad surgeon. A rhinoplasty, being one of the most difficult procedures in plastic surgery in terms of importance and general skill required, is a highly individual operation that depends on the surgeon’s sense of aesthetics, the patient’s facial structure, etc. That being said, you should not be able to look at a nose and immediately tell who performed the rhinoplasty. The question to ask yourself when choosing a surgeon is whether you are satisfied with his/her before-and-after rhinoplasty gallery, whether they are qualified/board-certified, etc.
Though it is difficult to say for sure without an in-house consultation, this may be a sign of potential irregularities in the cartilage and bone where osteotomies were performed but the bones did not come together quite as nicely as your surgeon may have hoped. This problem can usually be fixed with fillers or cartilage grafts.
Yes, this seems to indicate that the nose is infected, perhaps by the presence of a residual suture, but consultation with your surgeon will probably be necessary to know for sure. The nose should not be painful this far post-op.
Generally, it is normal for these types of humps to be present over the first several months post-op. However, if the bump is still present after several months post-op, it may be reduced via a rasping procedure that will only require local anesthesia and a few minutes in your surgeon’s office.
This may be a question best answered by your surgeon, but a hole which does not go all the way through the septum does not constitute a septal perforation.
A pollybeak deformity generally requires a revision rhinoplasty in which there is a reduction of cartilage in the supratip region and potential cartilage grafts to support the tip.
Although it may seem like the weight of the cartilage in the columella may help “pull the nostrils back” in terms of flaring, this is not true. In the hands of a good surgeon, a hanging columella can be easily corrected without changing the other aspects of the nose, including width of the nasal bridge/tip.
Redness on the nose surface post-rhinoplasty, especially in the first weeks post-op, are generally the result of irritation of the skin by the nasal tape. However, consultation with the surgery may be necessary if patients feel that irritation of the skin is not the issue.
Although rhinoplasty can lead to a narrowing of the nose in general, it should not lead to excessive breathing difficulties. Problems breathing well post-op can be the result of a range of issues including septal perforation, nasal valve collapse, and others, so consultation with an ENT surgeon is probably your best bet.
Post-op cleaning procedures are best addressed by the surgeon who performed the procedure. However, patients who have significant amounts of dried blood on the inside of the nose should have most of this debris removed by the surgeon, and then use saline nasal spray at home to maintain a clean nose.
It is unlikely that this is scar tissue. More likely, this is caused by the thinning of the skin with aging that makes the results of the rhinoplasty more apparent years after the procedure has been performed.
Generally, patients should not experience excessive pain and tenderness post-rhinoplasty and should check for redness, swelling or discharge at the surgical site (could be signs of infection).
Depending on the degree of modification to the nose and the procedures performed, patients will generally be work-ready within 6 days to 2 weeks post-op. However, 2 weeks is usually the max, unless patients will be doing a heavy amount of exercise in which case, they are recommended to wait 4-6 weeks.
I would advise against massaging the nose after this procedure simply because of the effect it could have on the movement of bones and cartilage in the surgical site.
Keloid scarring post-rhinoplasty is so exceedingly rare that I usually advise patients to not even worry about it.
I generally prefer using general anesthesia during the operation simply because it allows for protection of the breathing airway via endotracheal tubing, minimizes the danger of the patient moving around surgery, etc. However, some surgeons will opt for twilight sedation if they trust their anesthesiologist enough.
Although it can be difficult to perform a rhinoplasty on African-American patients simply because of the tendency for surgeons to modify the nose to Caucasian standards (make it overly thin, etc). There are surgeons who have plenty of experience in ethnic rhinoplasties such as this, so African-American patients are better off consulting with these surgeons.
Patients must realize that the rhinoplasty procedure, even if done by the most skilled surgeon, does cause a great deal of trauma to the nose. Scarring is simply one method the body uses to heal the wounds caused by this operation.
Generally, in the hands of a good surgeon, cartilage which is harvested from the septum will NOT require replacement as the surgeon will leave a large piece of cartilage there to maintain support of the nasal tip. If more cartilage needs to be harvested for grafting, it will be taken from the ear and the rib.
Because of the close relationship between the nose and the upper lip, changes in the nose caused by a rhinoplasty CAN influence how the lip looks. For instance, heightening of a drooping nasal tip and removal of a hanging columella can make the upper lip longer. However, there is no direct change in the structure of the lip during this procedure.
Gore-Tex has a good track record and, for that reason, is still highly used in nasal as well as cardiovascular surgery. However, I generally prefer using my patient’s own tissue for nasal augmentation.
On the contrary, we recommend Arnica in our office in the week prior to and after the rhinoplasty surgery as a way to reduce bruising and swelling post-op.
Every surgeon does something different when it comes to post-rhinoplasty nasal care. Personally, I do not use nasal packing. This is a question best answered by your surgeon as he/she will know what materials your packs were made of.
This could have a range of causes, from the endotracheal tube used during surgery, post-nasal drip, or even strep throat. Check with your surgeon about this.
Thinning of the skin is one common problem with silicone implants, which is why I am often hesitant to use them. It is best to have the implant removed before it begins to extrude.
Generally I would remain cautious about this, because traditional upper lip lifts can leave a scar that presents problems when combined with a rhinoplasty.
In general, surgeons are wary of using silicone in the nose because of the issues it can cause in terms of scarring and thinning of the skin. Other fillers can be used like Restylane and Juvaderm which have better track records, but nasal asymmetry may be better addressed with a rhinoplasty surgery.
Although this is a rather uncommon request when it comes to rhinoplasties, it can certainly be accomplished via rasping or even an osteotomy to flatten the bridge of the nose. However, given that most people would prefer a thinner nose, I would suggest consulting with your surgeon before having any procedures done.
Unfortunately, a cartilage graft is just about the only thing that can add cartilage to a depleted area.
Alar batten grafts are generally used for functional purposes, as a way of reinforcing the alae during breathing so that the walls of the nostrils do not collapse during inhalation. They are not used to widen the alar base or to increase nostril flare.
The collapse of the nasal valves will not directly lead to sinus infections, but their effect on airflow to the sinuses can indirectly lead to sinusitis.
Generally, problems with smelling post-op are the result of swelling in the nose and should resolve gradually within a year post-op.
Patients may experience paresthesias post-rhinoplasty, which is a zapping sensation that occurs when sensory nerves begin to regrow in a trauma-affected area. However, twitching is unusual and should be addressed via consultation with the surgeon.
This is a common complication with nasal implants, and the best course of action would probably be to have the nasal implant removed before it impedes blood flow, extrudes through the skin, etc.
Likely not. This is probably just residual swelling. Give it time to heal.
Uusally, splints are removed 1 week after surgery.
Dr. Ramtin Kassir © 2017
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