The very first factor in committing to rhinoplasty is to determine what your needs and desired expectations are. Rhinoplasty is not limited to creating a new size, shape and proportion for your nose. It is often most affective in correcting undesirable bumps and crookedness possibly caused by a broken nose. Assuming you will resemble a specific person is an unrealistic expectation of rhinoplasty. However, striving to improve your own individual appearance is an achievable goal that is an ideal expectation of rhinoplasty. Promising rhinoplasty candidates are individuals whom are considering the surgery in order to improve details of their nose such as: proportioned width from the bridge of the nose to the base, overall size of the nose in proportion to the rest of the face, improved nasal asymmetry, improved nasal profile, straightening of the nose, removal of bumps or bulges in the bridge of the nose, size reconstruction of the nostrils and also tip of the nose adjustments.

The second factor to carefully consider prior to committing to rhinoplasty is the technique that is required to achieve your desired results verses the risks in application of that specific technique. There are typically two techniques used in rhinoplasty as follows:

Open rhinoplasty allows the surgeon a precise detailed view of the internal nasal structure by way of temporary elevation of nasal skin. An incision to the columella, the underside of the nose, is made as well as an added interior incision that temporarily exposes the nasal passage for a significantly detailed view during the procedure. These incisions are repaired once the surgeon is finished performing the surgery and may cause a slight scar. Though open rhinoplasty is the more extensive technique of the two, it is also the most effective in terms of durability and desired results.

Closed rhinoplasty is a technique used for a more simplified procedure that does not require as much nasal reconstruction and does not result in predominately noticeable scaring risks. There is no incision made to Columella in closed rhinoplasty but rather a few incisions to the nostrils interior.

Rhinoplasty risks are usually linked to undisclosed pre-existing medical conditions rather than the actual cosmetic procedure itself. This is why it is highly recommended that you consult with a surgeon in full disclosure prior to proceeding with any cosmetic surgery including rhinoplasty. Slight bruising and swelling is common however more serious risks include infection, adverse reaction to anesthetics used during the procedure, as well as amplified bruising and swelling, and difficulty breathing through the nose.

Consultation with the performing surgeon is a must when considering rhinoplasty cosmetic surgery. During your consult you should be prepared to discuss what your current complaints or discomforts with your nose are, any concerns and questions you may have regarding the procedure, the recovery process and what your expected results are and exactly what they will be.

Your performing surgeon will ask you to disclose any medical conditions as well as your medical history during your consult. Rhinoplasty does require you to be sedated during the surgery. Your surgeon will discuss with you which anesthetic option is recommended and go over them with you in full detail. Dependent on your preference, health condition or complexity of the work you are going to have done, you will have two sedative options. Although IV conscience sedated patients will spend less time in the recovery room, most rhinoplasty candidness prefer the general anesthesia option. Regardless of which sedative you opt for you will be unable to operate a vehicle post operation. Your surgeon will inform you that you must have someone accompany you to and from the operative site. The surgeon will discuss any and all preparation you must be willing to take pre and post-surgery during this consult.

As with any surgery, rhinoplasty does demands some preparation. Preparation for rhinoplasty may not seem very complex but the following requirements are essential to achieving the healthiest and best possible results. Your rhinoplasty surgeon will advise you to take extra precautions in remaining physically healthy prior to your surgery and throughout the healing process proceeding your rhinoplasty. In consult, the surgeon will discuss the importance of a vitamin enriched diet to promote affective accelerated healing and what is important to avoid prior to and during your surgery and healing. A few specifics will be to cease smoking cigarettes two weeks prior to your rhinoplasty date as a precaution to decrease the risk of blood clotting. Your rhinoplasty surgeon will also advise you to cease consumption of any prescription and non-prescription medications that thin the blood. Avoid sun exposure and notify your surgeon of any skin irritations you may acquire prior to your rhinoplasty date. Skin irritation such as redness or dryness due to a cold or the flu may decrease your ability to heal quickly so your surgeon will advise you to notify the office and postpone your procedure if this occurs. The surgeon will advise you to keep the skin clean and clear. Do not apply any creams, lotions or makeup to your face on the day of your rhinoplasty. Preparation instructions will also include that you do not eat or drink anything after 12am the night before your procedure.

During your consult your surgeon will also discuss your recovery procedure in detail. Completion of your rhinoplasty can take anywhere from 2 to 4 hours, possibly longer depending on your reaction to the sedative you chose. Full recovery that reveals the true form and shape of your final results from rhinoplasty can vary dependent on the patient as well as the complexity of the surgery. Some candidates report the true and final rhinoplasty results did not surface visually until up to a year after the procedure. These rhinoplasty recipients reported continuous change of shape or size throughout their recovery.

Immediately following the aesthetic surgery the surgeon will tape down and cast the bridge of your nose as well as the tip. This is to help drain any fluid and to assist in diminishing excessive swelling. The cast however, is removed within the first 1 to 2 weeks. The most significant change in the appearance of your rhinoplasty results will surface within two to twelve weeks. Candidates have also reported temporary side effects during recovery such as facial stiffness, slight facial muscle strain or feeling of paralysis resulting in difficulty with facial expression. Once the swelling from the rhinoplasty subsides these side effects vanish as well.

Finally, another determining factor regarding your commitment to rhinoplasty is cost. The cost of rhinoplasty varies from candidate to candidate. This is because the surgeon will base your estimate on your specific desired requests such as the sedative you chose and the areas of your nose you wish to have corrected. The estimated cost is also reflective of the technique required to achieve these results as well as whether or not the rhinoplasty is covered by your insurance carrier. In most cases rhinoplasty is not covered by insurance companies unless it is necessary for proper nasal functionality. During your consultation with Beverly Hills plastic surgeon, Dr. Warren Lent, you will receive a cost estimate that includes sedative options, surgeon fees and facility fees.

Rhinoplasty is not for everyone, yet for candidates whom have suffered with a dysfunctional nasal passage or poor self-esteem and self-confidence due to nasal imperfection, rhinoplasty has the ability to affectively improve not only your appearance but also your quality of life.

Today, a flawless, smooth and sturdy framework can be achieved. When a patient with ultra thin nasal skin opts for rhinoplasty several methods can be used to achieve a perfectly flawless look. One method is to thicken the skin with injections. Subcutaneous blanket graphs are often used. These graphs are fashioned using living dermas. The graphs do require that there be a healthy cutaneous blood supply. Thin skin is also prone to spider veins which can readily be remedied through the use of vascular laser treatments.

A consideration when opting for rhinoplasty are the results you wish to achieve. If you are looking only for improvement in looks, then you will probably be satisfied with the results. Keeping your expectations realistic are quite important. If you have a reasonably attractive nose, your result will be modestly improved. For patients with more severe deformities, rhinoplasty can dramatically transform one’s looks.

A word to the wise is to avoid multiple surgeries. The first surgery in rhinoplasty is almost always the best outcome. Further surgeries may further complicate matters especially for the ultra thin skinned patient. If you
can achieve the look you want from the very first surgery you would be wise to stop there. The one most important decision you will be making is choosing the right surgeon. A few tips to follow to assure a successful choice are imperative. First make sure they are bored certified and have a valid medical license. Check their malpractice history. Use a surgeon who has a specialty regarding procedures and outcomes. Don’t be afraid to get references. Word of mouth, internet endorsements, surgical portfolio and being in good academic standing are must for you to research. Last but not least is to make sure your doctor takes the time to sit and consult with you. Agree on a plan of action and look at past work and photos of previous patients.

Breathing Disturbances

Head and neck surgery can have serious consequences. For example, Joan Rivers “stopped breathing during a surgery on her throat” (Zupkus, 2014, pgh. 1). Getting surgery on one’s nose can cause a major complication with regard to breathing.

Infections

Infections like MERS are common in hospitals. It might be good to take extra precautions against spreading germs if getting the procedure done in a hospital. The doctors should make sure the operating room area is a sterile environment, which goes without saying.

Postoperative Deformities

It is possible that during this type of surgery, the flesh of the nose itself does not heal properly. This can cause postoperative deformities. Hopefully they are not serious. One can never be too careful.

Be aware that the risks of complication in getting nose surgery include having breathing disturbances, infections, and possibly even postoperative deformities.

References

Rettinger, G. (2007). Risks and complications in rhinoplasty. GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery, 6, Doc08.

Zupkus, L. (2014). Joan Rivers hospitalized following throat surgery, reportedly in stable condition. Retrieved 22 July 2015 at http://www.huffingtonpost.com/2014/08/28/joan-rivers-hospitalized_n_5730092.html.

Rhinoplasty surgeons are different. Ensure that your plastic surgeon is ideal for your nose. They should have more than five years’ experience in the nose job field. An ideal surgeon is one that can perform advanced techniques such as open rhinoplasty. You could perform an extensive background research on your surgeon’s credentials. Ideally, your surgeon has to be certified either by the board of plastic surgery or otolaryngology.

While viewing the simulated results of your nose job, the surgeon has to show you before and after results of previously done rhinoplasty surgeries. By viewing this result, you can tell whether the surgeon is experienced or not. A bad nose job could not only make you look bad but could also affect your health since the surgery involves contact of the blood vessels. A wrong nose operation could even cause death. Ensure that your plastic surgeon is experienced before performing rhinoplasties.

Why is symmetry and proportionality important?

From the beginning of human history people always deemed certain individuals more beautiful than others. In recent years more and more research has centered on the idea of beauty and why some people are perceived to be more beautiful than others. Scientists discovered that in the vast majority of communities, symmetry, balanced facial features and a proportionate face play an immensely important part in what is viewed as beautiful. When considering any cosmetic procedure, and in particular cosmetic rhinoplasty surgery, patients often hope to achieve a more symmetrical nose, a prominent feature that work best with the proportions of their face.

Aesthetic factors in cosmetic rhinoplasty

The nose is one of the most prominent and defining characteristics of the human face. It is difficult not to notice a person’s nose as it is so centrally located on the face and because almost all communication happens with our mouths and eyes so attention is always focused on our facial features.

In some cases a disproportionate nose can upset the entire symmetry of the face ruining the overall harmony of our looks. One of the great advantages of Beverly Hills rhinoplasty is that it is able to restore this symmetry and often very minor tweaks can result in a profound improvement to the patient’s looks. In most cases it is possible to change the size of the nose, adjust the location and size of the tip and change the height and width of the nasal bridge. Other patients have noses that lean off center adding to unwanted asymmetry of the face while some patients suffer from humps on their noses. All of these problems can be addressed by a plastic surgeon carrying out rhinoplasty surgery.

The importance of pre-surgery consultation

While some patients have a very clear idea of what they would like to achieve by undergoing cosmetic surgery, it is important to remember that your plastic surgeon has performed numerous procedures and can advise as to the best course of action. Balance and proportionality is the foremost goal in any cosmetic surgery procedure and your surgeon can help to achieve the most harmonious results.

Beverly Hills Plastic surgeon Dr. Warren Lent will provide you with a full consultation prior to undergoing your plastic surgery. As a fully board certified plastic surgeon he is able to provide plastic surgery patients with the best possible options prior to undergoing any procedures.

Revision rhinoplasty is a plastic surgical procedure which aims to improve upon the results achieved in a previous plastic surgery. Most often patients decide on revision rhinoplasty when their previous plastic surgery left them dissatisfied with the appearance or functionality of their nose. Aesthetic problems that can trouble patients include asymmetry, a wide nose tip, a still present hump on the nose, or too low a bridge. However, in some cases the functionality of the nose is also a concern for instance when patients suffer from breathing problems, collapse of the nasal valve or an unresolved deviated septum.

Beverly Hills plastic surgeon Dr. Warren Lent is certified by the American Board of Plastic Surgery and able to consult on all forms of rhinoplasty.

What are the reasons for revision rhinoplasty?

Every plastic surgery solution should be preceded by an informative consultation with the plastic surgeon where the patient and doctor can talk about the problem areas and the plastic surgeon can present a realistic outcome of the proposed surgery. Unfortunately, in some cases the patient’s expectations can be too high or the surgeon can fail to inform the rhinoplasty patient about the realities of the procedure. In other cases, such Beverly Hills plastic surgeon Dr. Warren Lent, all information is shared and the patient is well prepared and psychologically adjusted but external circumstances mean that more than one procedure is necessary.

The difference between rhinoplasty and revision rhinoplasty

Revision rhinoplasty is widely thought of as one of the most delicate and complex plastic surgery procedures. After a consultation with the plastic surgeon about the problem areas that need tackling and the formation of a realistic procedure plan, the plastic surgery itself is very similar to rhinoplasty. However, it is important to note that with each rhinoplasty surgery more scar tissue is formed which makes it difficult to accurately foretell the exact outcome of the revision surgery. It is also important to keep in mind that revision rhinoplasty often means more time in the operating theater as the sculpting and reshaping of the nose has to be more meticulous and detailed.

A consultation with Beverly Hills plastic surgeon Dr. Warren Lent will ensure that all issues associated with rhinoplasty are addressed long before the actual plastic surgery.

The terms “open rhinoplasty” and “closed rhinoplasty” may at first appear to be confusing patients but in fact they only refer to two different surgical approaches to reshaping the tip of the nose. When performing open rhinoplasty the plastic surgeon makes an incision along the soft tissue separating the two nostrils (the columella) allowing the surgeon to access the inner bone structure and cartilage of the nose. A closed rhinoplasty does not involve an incision along the columella, all incision are internal.

Advantages to Open Rhinoplasty

The most important advantage of open rhinoplasty is better visibility for the plastic surgeon. Once the trans-columellar incision is performed the nasal skin can be lifted up over the nose exposing the underlying structure of the nasal tip. The plastic surgeon can easily see where adjustments to the bone and cartridge have to be made. In addition, when performing an open rhinoplasty the nasal cartridge distortion is minimized which results in more precision and control from the surgeon.

Some plastic surgeons opt for closed rhinoplasty especially with patients whose nasal anatomy is more straight-forward and who do not require a drastic plastic surgical approach. However, it is important to remember that patients suffering from more complex problems such as twisted noses, cleft-lip deformity or problems following a previous rhinoplasty have a much better chance at success when opting for open rhinoplasty. The greater versatility, control and visibility allowed to the plastic surgeon during the procedure offsets the disadvantage of a possible minor scar after surgery.

Common Misconceptions about Open Rhinoplasty

One of the most common concerns with patients considering undergoing open rhinoplasty is whether they will be left with unseemly scars. However, it is important to know that the columellar incision is performed in a stair step shape which means that it is almost imperceptible after it heals. In addition, the incision is placed on the inside and narrowest portion of the colunella skin so that from the front and side views it is very unlikely that the scar will be visible.

Another concern is that open rhinoplasty is more invasive and can damage the cartilage. This is a complete misconception – when lifting the nasal skin over the tip the cartilage remains undisturbed allowing the plastic surgeon to make any necessary changes more precisely and with less trauma to the underlying structure.

The most important advantage of an open rhinoplasty is the greatly improved precision afforded to the plastic surgeon, making the final result better, while simultaneously reducing the long-term risks typically associated with a rhinoplasty.

To find out which form of nose plastic surgery is most suitable for you book a consultation with American Board of Plastic Surgery certified Beverly Hills plastic surgeon Dr. Warren Lent.

Septoplasty is a plastic surgery solution to correct and straighten the nasal septum, or in other words the partition dividing the two nasal cavities. In a perfectly functioning nose this partition runs down the middle of the nose, dividing the two nasal cavities equally. When the septum leans to one side or the other, also called a “deviated septum”, one of the cavities becomes smaller making breathing harder. Patients suffering from a deviated septum often suffer from breathing difficulties, snoring and sleep apnea.

Other Causes of Nasal Obstruction

An additional factor your surgeon may consider is the condition of the Turbinates. The Turbinates are normal structures inside the nose that warm and moisten air as it passes thru the nasal airway. The Turbinates can often become enlarged, or “hypertrophy”, which can cause or contribute to obstruction of normal airflow.

Also, many people who have experienced trauma, or previous nasal surgery can have weakening of the structural support of the nose. This can lead to inward collapse of the nose as one takes a breath, which can also be an important cause of nasal airway obstruction.

The restrictive airflow can be corrected by undergoing functional rhinoplasty restoring the balance between the two nasal cavities. Often septoplasty or functional rhinoplasty is performed together with cosmetic rhinoplasty improving both the appearance and the functionality of the patient’s nose at the same time.

Septoplasty: step by step

Septoplasty procedures can be performed both under local and general anesthesia depending on what the surgeon and patient decide prior to surgery. The surgeon reaches the septum through the nostrils so typically the patient is left with no visible scar after the procedure. After making a small incision in the lining of the septum the surgeon can reach the cartilage to readjust it to the center and trim if necessary.

The entire procedure takes around 60-90 minutes and in most cases the patient can go home straight after surgery. It can take up to a year for cartilage to completely settle into its new form but most patients feel significantly recovered after only a few weeks. During the first few weeks of the recovery period is it advised to avoid high intensity exercise. Functional rhinoplasty patients are also advised to keep their head elevated during sleep after surgery to minimize swelling.

Turbinate surgery: step by step

A procedure may be necessary on the Turbinates should they be a contributing factor to nasal airway obstruction. This may require that the one or both of the Turbinates may need to be shrunk, trimmed, or moved out of the way to help increase the airflow. This is often done in combination with a septoplasty.

Improving Structural Support of the Nose: step by step

When the structural support of the nose is weak or absent, the surgeon may need to rebuild these structures to prevent collapse of the nasal skin during inspiration. This is a done by repairing or adding cartilage and bone to the precise location where support is lacking. This can be a complex procedure and is usually done via an open rhinoplasty by surgeons familiar with the most up to date techniques.

The risks of Functional Rhinoplasty

Unfortunately there is no guarantee that functional rhinoplasty patients will not encounter nasal obstruction problems in the future and they might need to undergo a second surgery. Other risks include scarring, perforation of the septum and bleeding.

Rhinoplasty is a plastic surgical procedure that allows a plastic surgeon to reshape and correct the functionality and appearance of the patient’s nose. Nose plastic surgeries can reduce the size of the nose, change its angle or shape, smooth out bumps and alter the tip of the nose and a number of other corrections. It’s all about getting the proportions right.

Who Needs Rhinoplasty?

In some cases nose plastic surgery is necessary to improve the patient’s breathing by correcting or eliminating structural problems. Nose surgery is also recommended after injuries or traumas that leave the nose broken or in need of reconstruction. The surgery often involves removal of bone or cartridge but sometimes tissue is added to the nose (this can be from another part of the body or a synthetic material).

Rhinoplasty is one of the most widely performed plastic surgeries in the world with more than half a million nose plastic surgeries performed every year. As the nose is one of the most prominent and central features of the human face altering its appearance can result in truly dramatic transformations and can achieve an overall more balanced, symmetrical look.

Nose Surgery – Step by Step

As with all surgical procedures all nose surgeries are preceded by an in-depth medical consultation where the patient has a chance to talk to the plastic surgeon about his or her wishes and possible problems concerning the appearance or functionality of the nose. It is good to keep in mind that while an idea of the “perfect nose” can be a good starting point, it is the plastic surgeon’s job to present the patient with what is a realistic outcome for the planned procedure.

As a double certified Beverly Hills plastic surgeon, Dr. Warren Lent can provide patients will all the information they need before undergoing nose plastic surgery.

It is possible to perform rhinoplasty under both general and local anesthesia but patients should keep in mind that if they opt for the lower risk local anesthetic they will hear all the noises produced by the plastic surgery.

At the start of the surgery small incisions are placed inside the nose and when necessary on the outside as well. These incisions are very well camouflaged. The plastic surgeon then proceeds to remove excess bone or cartilage or where needed add extra tissue. The size and shape of the nose is altered and various parts of the nose can be remolded (such as the tip or the bridge of the nose). It is also possible to change the angles of the nose in relation to the forehead or the lips by altering the underlying support structure. The goal is always to make the various parts blend in a way that is harmonious and well proportioned.
Work inside the nose can be done, at the same time, to improve breathing through the nose. Attention is placed on straightening the wall that divides the nose, called the septum. Additionally, other enlarged structures such as the turbinates, the natural tissue inside the nose that warms and moistens air, can be reduced when they cause blockage.
After all the internal changes have been made the skin is re-draped over the newly formed nose and the incisions are closed. Usually a small splint is placed on the nose to help maintain its shape and to help reduce any future swelling.

The length of rhinoplasty plastic surgery procedures varies greatly depending on how complicated and extensive the surgery is. Some procedures can take as little at 45 minutes while others require several hours in the operating theatre. Following the surgery most patients are able to go home on the same day but in some cases they are advised to stay one night in the clinic. The recovery period for rhinoplasty patients is relatively long. Immediately after the procedure the patient will experience some pain and discomfort but this subsides significantly after one week when the cast is removed. After a further couple of weeks the swelling goes down considerably and after two to three months only the patient will be able to detect any swelling. The final result of the rhinoplasty can take up to a year to take shape.

Possible Risks and Complications

The possible risks and complications, as with any plastic surgery procedure, will very much depend on the extent and type of the “nose job” performed. In a reduction rhinoplasty, where bone or cartridge is filed away, some patients may experience reduction or loss in sense of smell. Scarring within the nose can also effect sense of smell and give a feeling of a blocked nose. Infections can also occur and patients should be aware of any separate risks surrounding anesthesia. Finally, but very importantly, some patients can feel that the final result of the plastic surgery does not match their expectations. This predominantly occurs shortly after surgery when the final shape of the nose is not yet apparent and the swelling surrounding the area distorts the angles of the nose.

For further information about nose plastic surgery arrange an appointment with Beverly Hills plastic surgeon Dr. Warren Lent.