Richmond’s Nasal and Facial Plastic Surgery Specialists

Pre- and Postoperative Gallery

Improving Form and Function

Each year thousands of people undergo surgery of the nose. Nasal surgery may be performed for cosmetic purposes, or a combination procedure to improve both form and function. It also may alleviate or cure nasal breathing problems, correct deformities from birth or injury, or support an aging, drooping nose.

Patients who are considering nasal surgery for any reason should seek a doctor who is a specialist in nasal airway function, as well as plastic surgery. This will ensure that efficient breathing is as high a priority as appearance.

Facial Proportions

cns-stockThe concept of a beautiful nose is shaped by personal and cultural ideals. Throughout the ages, it has generally been agreed that the height of the nose should be one-third of the height of the face from the bottom of the chin to the hairline. The forehead from the hairline to the nose and the mouth from the nose to the chin should also be equal thirds. The nose should fit into a triangle extending from the top of the nose through the corners of the mouth and the width of the nose at its base should be equal to the width of each eye and equal to the distance of the jaw. From the bottom, the nose should fit into an equilateral triangle. Projection of the nose from the side view is the most difficult feature to quantify. Analysis of fashion models and other leaders in the entertainment industry suggest that a long, straight nose with a well-defined, projecting tip is considered to be beautiful in our society.

The most commonly requested changes are reduction of a nasal hump and correction of nasal asymmetry. Frequently, patients fail to recognize that the nasal hump becomes more apparent because of lack of projection of the associated nasal tip. Computerized morphing techniques can often help illustrate the difference between augmenting the nasal tip and removing the dorsal hump. Computerized facial analysis also helps the patient recognize the effect that the nose has in proportion to other parts of the face, such as the slope of the forehead and the projection of the teeth and chin.

Is Rhinoplasty Surgery Right For You?

Rhinoplasty surgery should only be scheduled after you and your surgeon have both developed a very clear idea of what changes you would like to make upon your nose and whether these changes are realistic. You should feel comfortable that you are performing the rhinoplasty for your own pleasure, and not to satisfy the wishes of someone else. A rhinoplasty is not expected to alleviate personal or professional problems in your life. A rhinoplasty is only a modification of your existing features. It is not possible to recreate an exact template selected from a menu. You must be prepared to accept the discomfort and financial cost of rhinoplasty.

Meeting Your Surgeon

Prior to consulting with a facial plastic surgeon, you should carefully study your nose in the mirror and in photographs. Photographs taken from both sides and from slight angles can often show features of your nose that you do not ordinarily see. You may wish to consult with a trusted friend or family member. It is important also to consider whether you have difficulty breathing out of your nose. Symptoms of nasal obstruction, allergies or sinus disease should be addressed in conjunction with any cosmetic rhinoplasty. An otolaryngologist-head and neck surgeon is trained both in the cosmetic aspects of rhinoplasty and in the management of intranasal obstruction, allergies and sinusitis. An otolaryngologist who is also board-certified in facial plastic and reconstructive surgery has demonstrated additional training, experience and knowledge of the cosmetic aspects of rhinoplasty surgery. Be sure to share any concerns about nasal function or nasal symptoms with your surgeon prior to making a decision.

Preparing for Surgery

Photographs will be taken to document pre and postoperative changes. During the two weeks prior to surgery, you should avoid all tobacco and aspirin or ibuprofen-containing products, as well as any other products that may thin the blood. These include large doses of vitamin E and Ginkgo Biloba. The night before surgery, allow plenty of time to rest and do not eat or drink after midnight. Do not wear makeup or contact lenses on the morning of surgery. Arrange to have at least one week off of work or other responsibilities for your recovery.

The Procedure

During surgery, you will be sedated or completely anesthetized. Your nose will be numb throughout the procedure. Your surgeon will make small incisions inside the nose to obtain access to the cartilages. Sometimes a tiny incision is made directly between the nostrils. This incision is barely detectible six weeks after surgery. The surgeon will make modifications to the bones and cartilages in order to improve the appearance, structure and function of the nose. A splint will be applied to the outside of the nose for 5-7 days. Splints or packing may be necessary inside the nose as well.

Postoperative Instructions

Avoid anything that makes your face turn red-this will increase your risk of bleeding. Do not bend over, lift heavy objects or engage in strenuous athletic activities. Stool softeners are helpful to prevent the constipation that is commonly associated with narcotics. Sexual activity should be avoided for 1-2 weeks. Do not take aspirin, ibuprofen or any other blood thinning products without the permission of your doctor. Do not allow eyeglasses or any other instruments to press directly upon your nose for at least two weeks. Call your surgeon if you should have heavy bleeding, fever, or a sudden increase in pain, swelling or bruising.

Facial Plastic Surgery Postoperative Instructions

Risks and Complications

Rhinoplasty is considered relatively minor surgery and the overall risk in a healthy individual is approximately the same as the risk of using an automobile over the course of a year. Pain is usually controlled with oral medications. A sense of nasal congestion during the postoperative period is usually more annoying than the pain. Bleeding is a moderate nuisance the first day, but quickly tapers off. Dangerous or prolonged bleeding is extremely rare. Crusting or obstruction as a delayed complication following nasal surgery is very rare. Disappointment in the appearance or function of the nose can require revision surgery in as many as 10 percent of patients.

Information provided on this website is for educational purposes only. Medical decisions should only be made after a face-to-face consultation with your surgeon. All benefits and risks of surgery must be discussed in the setting of a face-to-face surgical consultation.

Portions of this content are copyrighted by the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) and used with permission.