Frequently Asked Questions Before Nose Surgery or Rhinoplasty
The fee for nose surgery can be located in the
cosmetic surgery prices. Please call my office
for an accurate price quote or make an appointment for a personal consultation
to discuss your specific concerns. My suggested quotes include professional
fees, anesthesia fees, operating room costs, house calls, before care
and after care. They do not include hospitalization costs, prescriptions,
home nursing care, preoperative history and physical examination, laboratory
costs, or pathology fees. If you compare prices, make sure that you
consider all these costs. In addition, nose surgery usually requires
some time off work for a safe recovery. I require complete payment two
weeks in advance of all cosmetic surgery.
Some people have a nose shape that is not flattering to their face
due to many reasons including facial development, nose injury, or birth
defects. Nose surgery reshapes the underlying cartilage and bone to
give a more natural balanced appearance.
It is normal for the nose not to be the same on both sides. Rhinoplasty
can reduce these differences but not eliminate them. It will be necessary
for you to adjust to some nose asymmetry after your surgery.
Scars are part of all surgery. It is important to understand where
nose surgery scars will be placed. Closed nose surgery scars are placed
inside the nose. Open nose surgery scars are inside the nose and across
the columella (skin between the nostrils). If the nostril needs to be
narrowed, an external scar is necessary at the base of the lateral nostril.
These can easily be covered with makeup.
During nose surgery, it is frequently necessary to narrow the nasal
bones. These bones are cut with a special instrument and moved inward
to narrow the nose. During this part of the surgery a small (matchstick
sized) uncut piece of bone is broken.
Closed nose surgery is the traditional way of doing the surgery where
all the incisions are placed inside the nose. This technique is effective
for many patients. However, when second surgery is necessary or when
extensive cartilage grafts are necessary, open nose surgery is beneficial.
Open nose surgery requires scars that are inside the nose and a small
scar across the columella (skin between the nostrils).
There are risks with any surgery. Infection, excessive bleeding, abnormal
scarring, poor healing, slow healing, skin loss, changes in skin sensation,
muscle or nerve injury, although uncommon, can occur with any surgery.
Fortunately, most problems that result from such complications are correctable
with additional surgery. Difficulty breathing and persistent external
deformity can also occur. Finally, although very rare, loss of smell
and cerebrospinal fluid leaks have been reported with nose surgery.
You must understand your risk of complications completely before you
choose to have a nose surgery.
Internal swelling after nose surgery does temporarily interfere with
breathing. Most often this resolves in six weeks. Rarely this can persist
and require further surgery. If you have difficulty breathing before
surgery, it is important to consider internal (septum) surgery at the
same time as external surgery.
Rarely, changes in airflow after surgery can interfere with the sense
of smell.
There are always risks with nose surgery. When severe complications
are combined with inexperienced surgeons, poor results can occur. I
believe that nose surgery can be done safely with a high degree of patient
satisfaction. Serious problems are usually related to infection and/or
medical problems. Most poor results can be improved with additional
surgery.
Everyone in America wants the latest in medical care. This is not always
the best medical care. At times media presentations will leave out critical
information about potential complications, quality of result, and FDA
regulation. I am open minded when it comes to new technology but I would
rather not use my patients to try out the newest techniques. Recent
advances in nose surgery include open nose surgery techniques. This
technique allows precise correction of deformities that require complex
cartilage grafting.
How old do I have to be
to have this surgery?
Nose and face development can continue into the teens. When surgery
is done before this time, there is a chance the surgery will have to
be repeated or it will not look natural. In addition, it may be emotionally
difficult to adjust to the surgery during teen years. I generally suggest
that surgery be postponed until eighteen years of age. However, exceptions
can be made for teenagers who have severe nose deformities that are
a result of birth defects (cleft lip, dermoid cyst).
Should I stop smoking?
For general health reasons, I recommend that all my patients stop smoking.
It is clear that smoking increases your risk for developing all sorts
of cancers. Breathing problems like emphysema and circulatory problems
including heart attacks are also linked to smoking. Smoking can increase
the risk of coughing after your surgery that can lead to unwanted bleeding.
Smoking also reduces blood flow that can result in skin loss during
the healing period. Both of these problems can ruin the results of your
nose surgery and lead to revision surgery. It is always best to stop
smoking.
There are other choices when it comes to nose surgery. These include
forehead lift, laser resurfacing, acceptance of a deformity, and changes
in makeup style. Always understand all your options before having nose
surgery.
Cosmetic surgeries can be combined to yield dramatic and complimentary
results. For safety reasons, I recommend the length of surgery be limited
to six hours and no more than two areas of the body be treated at the
same time. Nose surgery is frequently combined with facial rejuvenation
surgery (facelift, forehead lift, and laser resurfacing), facial liposuction,
facial implants, and buccal fat pad excision. It is interesting to note
that breast enlargement surgery
is frequently combined with nose surgery.
This is a question that can only be answered after a personal consultation.
Rhinoplasty is suggested to patients
with unacceptable external nasal appearance. This may represent a dorsal
hump, drooping of the tip, excessive projection, or bulbous tip. I feel
strongly that nose surgery should not be done if high blood pressure
(hypertension) is not well controlled or if you suffer from nose pain.
There are other things to consider as well including psychiatric conditions,
life stress, medical illness, obesity, and motivation. You should be
a healthy nonsmoker, within twenty pounds of your ideal weight. Major
life stresses (i.e. grieving a death and divorce) must be absent in
your life. The ideal candidate is motivated by internal desires to look
better.
Each time nose surgery is done,
scar tissue is deposited, and the cartilages are weakened. For this
reason, I recommend that nose surgery only be done two or three times
at prescribed intervals.
For more questions and answers see our general frequently asked questions
about cosmetic surgery.
For more questions and answers about rhinoplasty or nose surgery:
During Nose Surgery
After Rhinoplasty
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