Rhinoplasty

Rhinoplasty surgery changes the size, shape, and structure of your nose. Commonly called a nose job, this popular facial plastic surgery procedure can reduce a prominent bump, narrow a wide tip, straighten a crooked bridge, fix asymmetry, or make your nose more proportional to the rest of your facial features.

What is a Rhinoplasty?

Rhinoplasty, the clinical term for nose surgery, can change your nose, removing imperfections or simply making it more proportional with the rest of the face. 

Rhinoplasty is one of the original cosmetic surgeries, first performed in the United States in 1887. The surgery involves making incisions to access the underlying bone and cartilage. Depending on the patient’s goals, Dr. Larrabee may remove some bone and cartilage, or tissue may be added. Once he has altered the underlying structure of the nose, the skin and tissue are re-draped over the new structure. 

Nose surgery is a delicate procedure, and Dr. Larrabee takes great pride in his ability to give his patients the nose they feel confident, comfortable and happy with. This procedure can really change a patient’s self-image.

Who is a good candidate for rhinoplasty?

When a patient comes to the Larrabee Center exploring the possibility of nose surgery, there are usually three areas of dissatisfaction: cosmetic issues, injury repair, or to improve function.

Cosmetic — If a person feels her nose is too bulbous or there’s a bump on the bridge, it can be a real issue. Here are common aesthetic reasons patients seek to make some changes:

  • There is a prominent bump on the bridge.
  • The nose droops downward.
  • The nostrils are overly flared.
  • The nose isn’t proportional with the rest of the face.
  • The nose is too big or too small.
  • The nose has a bulbous tip.
  • The nose is too wide or flat.
  • The nose is crooked from a prior injury.

Injury — People often injure their nose, but don’t always opt to correct it. Things like touch football games or even simply bumping into an unseen wall in a dark room can alter the look and the function. Dr. Larrabee can correct both the appearance and the function.

Function — Some people are born with nasal passages that are too narrow. Restricted airflow can lead to snoring and even sleep apnea. Mouth breathing is typically due to congenital issues with the inner nose. Rhinoplasty can open constricted airways and vastly improve breathing function.

What are the risks with rhinoplasty?

There are the general risks that accompany any surgery: anesthesia reaction, infection, bleeding, poor wound healing, scarring, and changes in skin sensation. Specific to this procedure, the patient may have difficulty breathing, skin discoloration and continued swelling, possible perforation of the nasal septum, or unsatisfactory final results. With the extensive experience and board-certified credentials of Dr. Larrabee any of these complications are exceedingly rare. But if further changes are needed, revision surgery may be necessary.

How do I prepare for nose surgery?

As with any surgery, you’ll need to stop taking any blood thinners, anti-inflammatories, aspirin, and most supplements for one week prior to your surgery with Dr. Larrabee. These can all lead to increased bleeding, which shows itself with more extensive bruising during your recovery. If you smoke, you’ll need to stop for at least two weeks prior to and following your surgery because smoking constricts the blood vessels, and this can dramatically impede healing with this procedure. 

Your real preparation should be for two facets of nose surgery: getting used to how to wear your eyeglasses and sleeping. You can’t have the weight of your frames sitting on your healing nose, so they will need to be taped above your nose. It’s good to practice this a bit before your surgery, especially if you wear glasses full time. You’ll also need to plan your sleeping arrangements, as you’ll need to sleep on your back for at least two weeks.

What is the procedure for Rhinoplasty?

For nose surgery, Dr. Larrabee uses two methods: closed or open surgery. During your consultation, Dr. Larrabee will discuss which method he believes fits your needs, but this will be a joint decision.

In open rhinoplasty, an incision is made across the columella, the sliver of tissue between your nostrils. The soft tissue is then lifted upward and off the bone and cartilage. The open method completely exposes the underlying structure, making more dramatic modifications possible. Once the bone or cartilage has been reshaped, the soft tissue is then brought back down. 

In closed rhinoplasty, Dr. Larrabee makes all the necessary incisions inside the nose. Obviously, this leaves no visible scarring, but it also can limit the extent of reshaping that can be done. If the patient seeks to build up an area of the nose, Dr. Larrabee can take cartilage or other material from the septum, the ears, a rib, or synthetic implants can be used. When the patient seeks to shrink the size of the nose, the nasal bones must be broken.

What will my recovery be like after rhinoplasty?

When your surgery is complete, Dr. Larrabee will have packed your nose and placed a splint over the outside. This splint will stay in place for about one week. We’ll provide a cold compress to help minimize swelling, but there will be swelling and bruising. This is inevitable with the degree of tissue trauma involved in rhinoplasty. For the first week, it will be necessary to keep your head elevated as much as possible, even when sleeping. Of course, you can’t sleep on your stomach. Sleeping on your side isn’t a good idea, either, as it’s too easy to change your position enough to place pressure on your nose. The area around your eyes and nose will be bruised and swollen usually for 10-14 days.

You’ll need to avoid any clothing you pull over your head to minimize the possibility of bumping your healing nose. If you wear glasses, they will need to be taped to your forehead for up to seven weeks to keep any pressure off your nose. Any strenuous exercise or heavy lifting that increases blood flow to the face needs to be strictly avoided for several weeks. Dr. Larrabee will discuss your restrictions at length with you, giving you a timeframe to return to your typical exercise and activity routines.

When can I expect to see the full results of my rhinoplasty?

Patience is a virtue when recovering from nose surgery. Swelling can linger and can return later in the day and at night for weeks. It can take up to six months for a patient to fully realize their new nose, although this schedule varies dramatically with individual patient’s healing rates. But your patience will be rewarded — rhinoplasty is a very satisfying procedure, as patients who have always had issues with features of their nose feel as if their whole facial appearance has improved with their new nose.

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