All About Rhinoplasty: Surgery, Cost,
Recovery, and More

Rhinoplasty is an operation meant to improve the shape and size of the nose; putting it in harmony with the rest of the face, and balancing other features. It is a surgical resculpting of the nose, accomplished by careful contouring of the bone and cartilage to give the nose more aesthetic appeal.

This procedure can also correct breathing problems caused by deformities or sinus disorders. Most incisions in “seamless rhinoplasty” are hidden inside the nose. Rhinoplasty is performed under sedation with local anesthesia.

The surgery takes from 1 – 2 hours. Seamless rhinoplasty reduces discomfort since no plates, tubes, or painful packagings are used. In most cases, change in appearance can be immediately realized.

A Quick History Lesson

Surprisingly, plastic surgery dates back to ancient Egypt, around 3000 B.C. It has also been practiced in India since 800 B.C. Out of necessity physicians found themselves repairing the faces of soldiers wounded in battle.

Rhinoplasty seems first to have been discussed as an aesthetic objective during the middle to late Renaissance. By the middle 1800s doctors in Europe and America began to experiment with different cosmetic surgical procedures in order to enhance the shape, appearance, and functionality of the nose.

The first intranasal rhinoplasty was performed by John Orland Roe in 1887. Later, the surgery was transformed into a medical art form by Jacques Joseph (born Jakob Lewin Joseph) in 1898. His goal was to help people when the shape and size of their nose caused them social embarrassment.

Rhinoplasty took a giant leap forward during one of the most tragic times of the early Twentieth Century, during World War I. In order to provide wounded troops a greater quality of life, surgeons were forced by circumstances to make major technological advances in reconstructive procedures in a short amount of time. Along with these advances came improvements in anesthesia and antiseptic techniques, in turn bringing about major safety advances in rhinoplasty.

Present Day

Present day, rhinoplasty is one of the most popular of all plastic surgery procedures. In a survey of member surgeons in 2005, the American Academy of Cosmetic Surgery (AACS) reported that out of 63,030 invasive cosmetic surgeries, 39.8% were rhinoplasties.

The exact number of women who underwent rhinoplasty was 7,030, outnumbering men by nearly 2 to 1. According to the American Society of Aesthetic Plastic Surgery (ASAPS) rhinoplasty ranked 4th in top surgical procedures in 2004, with 116, 187 procedures performed.

Realistic Expectations

There are many positive aspects to rhinoplasty. The procedure can reduce or increase the size of the nose, change the shape of the tip or the nasal bridge, or straighten the nose. It can be used to narrow the opening of the nostrils, change the angle between the nose and the upper lip, correct a birth defect or injury; or relieve certain breathing problems.

What rhinoplasty cannot do is make someone a better person, take away emotional problems, attract the perfect mate, or transform someone’s life by changing their appearance. It can, however, transform their face and improve their appearance, giving a well-balanced patient greater confidence.

Am I a Good Candidate?

Those who consider rhinoplasty should generally have a positive self-image. However, they may find their nose too large, have a prominent bump, or feel that their nostrils are too wide or too narrow. Changing the shape and size of the nose can effectively enhance the face, bringing out the beauty of other prominent features, such as attractive eyes or a lovely mouth.

Is rhinoplasty right for you? It just may be. If you are in good overall health, and have realistic expectations, you most likely are a good candidate. If you are considering having rhinoplasty surgery, be certain to carefully research plastic surgeons in your area. Choose wisely by gathering information from your family physician, medical universities, family, friends, and persons who have had successful rhinoplasty procedures. Also research the Internet and other resources.

Check with medical societies to find out if any of the surgeons you are considering have complaints lodged against them, or if they have a criminal record. Be careful and take your time while making a selection. This procedure will alter the appearance of your nose and affect your whole face; you want to be certain that the fate of your appearance will be placed in skilled hands.

Planning Your Surgery

Once you have selected a surgeon, meet with him or her for a consultation. Discuss your expectations and any secondary medical conditions that might exclude you from having the procedure.

The doctor will want to know your medical history. Certain pre-existing conditions may rule you out as a candidate. You are at increased risk of complications if you have diabetes, poor circulation, heart, lung or liver disease, have a family history of blood clots, take certain medications, or if you smoke. Be sure to tell your surgeon if you've had any previous nose surgery or an injury to your nose, even if it was many years ago.

Your entire face will be examined and considered when planning the procedure. For instance, a weak chin may create the illusion that your nose is larger than it really is. Some patients choose to have chin augmentation along with rhinoplasty. The physician will discuss such things with you.

Skin type, ethnic background, and age are also important factors to discuss with your surgeon prior to surgery. Age can also be a factor. Many surgeons will not operate on teenagers until they've completed their growth spurt. This is around 14 or 15 for girls, and somewhat older for boys.

According to Dr. Sanjay Grover of Newport Beach, California, the procedure will be limited by the internal and external structures of the nose. “A certain nose cannot be created, but it can be helpful to bring pictures of noses that you like.”

After examining your nose and your preferences for desired size and contour, the surgeon will be able to give you a realistic idea of what improvements can be made. When the doctor understands your expectations, he or she will be better able to determine whether or not your goals are realistic.

Weighing the Cost

Rhinoplasty is an expensive operation. Costs range anywhere from $3,000 - $12,000, depending upon region or country, doctor’s credentials, and patient’s needs.

The good news is that rhinoplasty is one of the few plastic surgeries that are sometimes covered by medical insurance, especially if the procedure corrects a breathing problem, birth defect, or is needed for reconstruction due to injury.

Check with your insurance company; be certain to obtain proper pre-authorization for your surgery. This usually requires a “predetermination letter” provided by the surgeon. To find out if your medical policy will cover rhinoplasty, contact your insurance representative. Ask exactly what your policy covers: Surgery? Anesthesia? Corrective surgery, if necessary? Hospital costs? Will surgery increase my premium, or will future coverage be affected because of the surgery?”

The Surgery Itself

Rhinoplasty is one of the most common, yet most difficult and precise plastic surgery procedures there is. The surgeon will perform it mostly by feel. There are two main techniques used: closed rhinoplasty, and open rhinoplasty.

Closed rhinoplasty involves incisions confined to the inside of the nose. Swelling is minimal, and recovery time fastest. The down side is a lack of visibility for the surgeon, who may not be able to achieve the exact changes that you want.

Open rhinoplasty literally opens the nose, giving the surgeon greater visibility. Swelling and bruising last longer, but the surgeon is able to bring about a more satisfying, precise result.

Recovery

Full recovery after rhinoplasty can take from 6 weeks to 6 months. Recovering from swelling and bruising usually takes 1 - 6 weeks for closed surgery, 1 - 5 months for open surgery.

While numbness can last for several weeks, you can usually return to work in about 3 weeks. Be sure and wear sun block for several months; it is also recommended for long-term use. Keep your head elevated when you sleep.

During recovery your nose may be asymmetrical (irregular or lopsided), crooked, swollen, bruised, numb, and painful. You will need to wear a splint and possibly ice packs for 2 to 6 days. Pain medication and sleeping pills can manage your pain and sleep issues.

The New You

Take time to ensure that your nose heals properly. You can help the healing process and help insure surgery success by following all post-operative orders faithfully. If you have any questions, contact the surgeon.

Eat light and go easy on yourself. Before long you will begin to see the final results. But smaller changes may continue to occur over the next 6 - 12 months. Remember, time and healing is on your side. So go ahead and enjoy the new you!