Rhinoplasty, or Nose Surgery

Reshaping the nose is one of the most rewarding operations in cosmetic surgery. The procedure can be tremendously gratifying for both the surgeon and the patient. The surgeon can practice surgical techniques that verge on artistry; the patient may find the entire aesthetic of his or her face beautifully modified.

While the Barbra Streisands and John Barrymores of this world have profited from their famous profiles, it’s wonderful that someone who is less accepting of his nose’s appearance has an option to safely alter it. The person who requests a rhinoplasty is usually unhappy with the shape or size of the nose, and may also desire to change the tip, nasal bumps, size of the nostrils, or to correct a deformity or breathing problem.

At the initial consultation about nose surgery, I request the patient bring some pictures of noses to the appointment. Using the visuals, I can get some idea of the patient’s goals and expectations, and we can discuss the possible outcome of the surgery.

I perform nose surgery on patients of all ages, but the majority are in their late teens through their thirties. Many teenagers are unhappy about their appearance, feel awkward, and are striving to find perfection. I don’t recommend performing this procedure until a teenager reaches the ages of seventeen or eighteen, when growth spurts have concluded. From an emotional standpoint, surgery at an early age makes the transition to a new appearance easier to handle; every year we live with our noses, it gets harder to think of changing our appearance. Therefore, if you are considering a change, the sooner in life, the better.

THE PROCEDURE

The procedure can be performed with the patient under local anesthesia with IV sedation, or under general anesthesia. The operation takes anywhere from two to four hours, depending on the complexity of the procedure.

The night before your operation, you should not eat or drink after midnight. Plan to arrive at the hospital or surgery center about two hours prior to your procedure, since you may be asked to give blood for laboratory analysis or complete any extra paperwork. Prior to your rhinoplasty, your physician will take “before” photos of your nose to refer to them during the surgery. Technically, rhinoplasty is one of the most difficult procedures for a surgeon to perform. It requires extra training and a lot of concentration and thought on the part of the surgeon. Therefore, a thorough consultation with the patient, including these photos plus any the patient brings to the initial consultation, will aid the surgeon in achieving the desired goals.

Once you are in the operating room, either the surgeon or anesthesiologist will administer sedation, depending on the type of anesthesia you have requested. Before any incision is made, the nose is anesthetized with local anesthesia (either lidocaine or marcaine with epinephrine). In addition, most surgeons use a combination of cocaine and/or epinephrine. This helps to shrink the mucous membranes as well as control bleeding.