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Rhinoplasty

Q – What is a rhinoplasty?

Rhinoplasty is a term given to the surgical procedure intended to improve the shape, size, and function of the nose. A complete procedure will address every aspect of its appearance. This typically involves reducing a hump, straightening the nose, making the nose smaller, improving the definition and symmetry of the tip, and raising the tip into a more pleasing position. Other details can also be addressed, including narrowing the nostrils or nasal base and supporting a nose that has lost its structure.

A rhinoplasty may also be performed to improve breathing. This is usually done at the same time that the outside appearance is improved. Techniques that help breathing include septoplasty, or straightening the structure inside the nasal airway, placing supporting grafts that open the nasal valves, and improving the support of flaccid nostrils. This portion of a rhinoplasty is usually covered by insurance.

Q-What are the different types of rhinoplasty?

In general there are two types or surgical approaches to a rhinoplasty. The first is the endonasal technique. This is the classic technique where incisions are placed completely inside the nose. Although this is an excellent option for patients with a minimal deformity or a simple cosmetic concern, it is limited by the amount of exposure the surgeon can achieve. The more common technique is an external technique that utilizes a small incision placed between the nostrils. This provides the surgeon with excellent exposure allowing for the precise placement of grafts and detailed refinement of the nasal tip. The small incision is placed in such a way that it is virtually imperceptible even a few weeks after the procedure. During your consultation, each of these methods will be discussed in detail and the best option for you will be decided.

Q-Will insurance cover the cost of a rhinoplasty?

Although all insurance companies are different, most will provide coverage for patients who have a functional breathing problem or a severe nasal deformity resulting from trauma or medical condition. Insurance companies will not cover a rhinoplasty performed for cosmetic purposes.

Many patients with breathing problems also elect to undergo a cosmetic procedure at the same time. By doing so, insurance will assist in paying for that portion of the procedure, operating room costs and anesthesia fees that is associated with correction of the function of the nose.

Q-At what age should I consider a rhinoplasty?

Younger patients can consider surgery after they have reached puberty and the nose has completed growth. This is usually around the age of15 in girls and 16 in boys. Otherwise, a rhinoplasty can be performed at any age in adults.

Q-How long does the procedure take?

The typical length of time required to perform a rhinoplasty averages about 2 hrs. This depends on the severity of the deformity and the surgical technique chosen. Revision surgery generally requires a longer operating time.

Q-What is a primary rhinoplasty?

A primary rhinoplasty is performed on patients who have never had nose surgery before. The nose will not have scar tissue or complex abnormalities seen in revision rhinoplasty patients.

Q-What is a revision rhinoplasty?

Revision rhinoplasty is performed on patients who have already had a rhinoplasty by another surgeon. The revision surgery is performed to correct a problem that was not addressed during the previous surgery or for those who have developed scarring or breathing difficulties.

Q-What will happen during a consultation for rhinoplasty?

During your consultation, Dr. Wheeler will discuss in detail your expectations regarding the procedure. A complete medical history and nasal examination will be performed. You will also have your pictures taken and digital computer imaging will be done. This will allow you to see the results in your appearance after changing the shape of the nose and improve communication between you and Dr. Wheeler regarding your cosmetic goals.

Q-Where does the rhinoplasty procedure take place?

Rhinoplasty may take place in an outpatient surgical center, or a hospital.

Q-What type of anesthesia is usually used for rhinoplasty?

The type of anesthesia commonly used is either local anesthesia with sedation or general anesthesia.

Q-How much pain is associated with this procedure?

Sharp pain is uncommon after the procedure. The patient should expect a dull ache during the first few days. This can be controlled with a light prescription pain medication that can be quickly replaced by over-the-counter medications.

Q-Will I have packing in my nose after the rhinoplasty?

Dr. Wheeler does not routinely pack the nose after nasal procedures. He uses a technique that prevents bleeding without the use of packs.

Q-What is the recovery like after rhinoplasty?

After your procedure, a splint will be applied to the nose. You will also have a small drip pad under the nose to catch drainage that will occur. On the first day after surgery, you will be seen in the office and the drip pad will be removed. You will be asked to apply cold compresses to the nose and face over the next several days. The nasal splint will be removed after 7 days. After this point you may continue to have swelling that will gradually subside with time.

Q-How much time will I need to take off from work?

Patients may wish to take one week off from work, although some may wish to return sooner with the nasal splint in place.

Q-When can I begin to exercise after my rhinoplasty procedure?

Patients may be able to return to light exercise after one week. Full strenuous activity or exercise should be avoided until 2-3 weeks.

Q-What are the risks or complications of rhinoplasty surgery?

Complications after surgery are rare but may include bleeding, infection, and incomplete correction of the nose. There are risks associated with having anesthesia that will be discussed by your anesthesiologist at the time of the surgery. There is also the potential that you may require additional surgery or a second procedure.

Q-What should I look for in a surgeon to perform my rhinoplasty?

Rhinoplasty is one of the most difficult and complex cosmetic procedures to perform. It requires a level of skill and attention to detail that are only achieved after extensive training specifically in nasal surgery. It is of the utmost importance that you do your homework and carefully choose the surgeon to perform your procedure. Your surgeon should have a background in Otolaryngology, Head and Neck Surgery. Unlike any other specialty, surgeons board certified by the American Academy of Otolaryngology have undergone years of training in the surgical treatment of diseases of the nose, both inside and out. Their surgical training is exclusive to the face, head and neck, which encompass some of the most difficult anatomy in the human body.

In addition, he or she must also have fellowship level training in cosmetic surgery certified by the American Board of Facial Plastic and Reconstructive Surgery. A facial plastic surgery fellowship goes one step beyond the traditional residency training to give that person experience in state of the art procedures in cosmetic surgery. This level of training usually puts them at the forefront of the specialty and makes them leaders of the field of facial plastic surgery.