What is a
A rhinoplasty (also referred to as a “nose job”) is a surgical procedure that is typically performed for cosmetic and functional purposes. The purpose of this surgery is to rebuild the nose for a more attractive appearance and bring a balanced uniformity to the rest of the face. Rhinoplasty is among the most delicate and elaborate facial surgeries to execute but the results are always remarkable.
When considering the possibility of having rhinoplasty surgery, the patient has two options: an open rhinoplasty or a closed rhinoplasty.
The procedure for an open rhinoplasty requires an incision made in the columella of the septum, the fleshy tissue that is located between the nostrils. Choosing an open rhinoplasty allows for increased precision and accuracy during the procedure and provides for easier access to the latent cartilage and bone structure. An open rhinoplasty is often the procedure of choice for rhinoplasty surgeries that need to be revised in some fashion. Some of our patients have shown concern for scarring from an open rhinoplasty but the incision being made is very small. The residual scarring is minimal and will diminish with time.
First and foremost, there are no incisions made outside of the nose. Dr. Ardesh strategically places every incision necessary for the surgery inside of the nostrils. This is why a closed rhinoplasty is also known as an endonasal rhinoplasty. This version of the procedure is not as invasive nor does it leave any visible scarring. The result is a nose job that has a reduced potential for swelling after surgery.
Open Rhinoplasty vs. Closed Rhinoplasty – Which is Right for You?
There are distinct advantages and certain drawbacks to each type of rhinoplasty. In order to help you decide which is best for your particular situation, let's review the following comparison to better educate you on rhinoplasty surgery before you schedule a consultation. Once you have an opportunity to discuss your concerns, Dr. Ardesh will recommend an effective course of action to address your needs.
Advantages of an Open Rhinoplasty
Open rhinoplasty surgery is more common than the alternative because the interior framework of the nose is fully exposed during the procedure. This allows for a greater capability to modify and revise the shape of the nose, so the results you want are easier to achieve. Post-op stabilization of the nose is made easier as well and this can assist in the healing process.
Drawbacks of an Open Rhinoplasty
Everything related to the procedure is made potentially longer and more severe with an open rhinoplasty. The surgery itself is typically longer and requires more invasive actions to perform the work with efficacy. As a result, the recovery process can also become more protracted. There is a risk of an increased level of bruising and swelling around the surgery site.
Advantages of a Closed Rhinoplasty
The primary reasons why a closed rhinoplasty is the best choice for some of our patients are a shorter surgery period, less potential for scarring, very little bruising and swelling after the procedure, and no scarring. Recovery time is also shorter compared to an open rhinoplasty.
Drawbacks of a Closed Rhinoplasty
The procedure is a bit more challenging due to limited visibility and, therefore, some level of restrictions on the capability for revising nose shape to meet your expectations. In addition, the incisions that are made during this form of the procedure can make it tougher to stabilize the nose after surgery.
Reasons for Getting a Rhinoplasty
Patients who come to see Dr. Ardesh for a rhinoplasty will do so for two main reasons. The work is performed to address a medical concern or this is cosmetic surgery to make the patient feel more confident in the way he or she looks in the mirror.
These are just some of the issues that Dr. Ardesh can address with an open or closed rhinoplasty:
- Eliminate a bump or curve on the nose
- Enlarge or decrease the size of the nose
- Enlarge or decrease the size of the nostrils
- Straighten the bridge of the nose
- Adjust the shape and size of nasal passages for easier breathing
- Modify the contour or shape of the tip of the nose
- Reset or revise the shape of the nose due to injury
Dr. Ardesh can perform these and other types of rhinoplasty surgery to alter your nose for health or cosmetic reasons. If you are unsatisfied with your current facial appearance or you are dealing with an urgent medical matter that requires reconstructive surgery, call Dr. Ardesh today to schedule a consultation for a rhinoplasty.
How Long Does Rhinoplasty Surgery Take?
The time it takes to perform rhinoplasty surgery is not the same for each and every patient. There are various factors that come into play when trying to determine how long a rhinoplasty might have you under anesthesia inside of an operating room.
Experience of the Rhinoplasty Surgeon
A doctor who possesses advanced skill and prowess in performing these types of surgeries will do the work far more efficiently and effectively than someone who lacks an expert level of experience. Dr. Ardesh is a double board-certified facial plastic surgery specialist with more than eleven years of experience performing rhinoplasty surgery.
Primary or Revision
If this is the first rhinoplasty you are having done, then it will take less time than if you are coming in for revision surgery. Fixing a previous rhinoplasty takes longer due to the specific nature of correcting an earlier procedure.
If a rhinoplasty is being performed for medical reasons or to improve functionality of breathing, the procedure could take longer. When this surgery is performed to address concerns related to breathing or allergies, these are factors that must be taken into account to ensure the success of the procedure.
Although the use of an anesthetic is common with rhinoplasty operations, the length of time necessary for completing the procedure can be affected by how much anesthesia is required to keep the patient unconscious during surgery. Factors to consider include how long it takes for the anesthetic to take hold and how much time is needed for the patient to wake up after the operation is finished. Longer surgery times may require more anesthesia which can make it harder to wake up without feeling groggy.
Certain types of rhinoplasty surgeries incorporate the grafting of cartilage in the nose to achieve the desired result. The reason may be due to missing or damaged cartilage that needs to be replaced and the time it will take to complete your rhinoplasty could also be affected by the amount of cartilage necessary for the procedure. Extra cartilage must first be harvested from one of the locations that are commonly utilized for this purpose. Most surgeons will use cartilage that has been taken from the nasal septum, the back of the ear, or in extreme instances, the ribs. The particular needs of the patient and the work being done during the rhinoplasty will often dictate the area that works best for cartilage harvesting. The harvesting process, though not very lengthy, can add extra time to the procedure.
Open Rhinoplasty or Closed Rhinoplasty
Finally, the type of rhinoplasty procedure you select can also have a bearing on how long it will take. An open rhinoplasty typically takes a bit longer because the exterior incision that is made at the columella of the septum needs to be closed once the procedure is finished. The incision and the suturing can add extra time to the surgery period.
How Long is the Recovery Process for a Rhinoplasty?
Similar to the question above as to the length of time the procedure will take, the healing process also relies on certain critical factors that are unique to the individual. Everyone heals differently and not every rhinoplasty is the same. So the healing process may be longer for some and quicker for others.
However, Dr. Ardesh recommends that every patient takes the same precautions after surgery to ensure proper healing, ward off any possible infections, keep swelling and bruising to a minimum and manage any mild pain or discomfort that might arise in the days after the operation.
After the Appointment
The most important thing every patient must keep in mind after returning home on the day of surgery is to simply rest. Do not expect to return to your normal activities directly after a rhinoplasty. That will take some time. But for the remainder of the day and the evening after surgery, plan on doing nothing else but rest. Dr. Ardesh may prescribe some pain medications to manage any post-op pain or discomfort though most patients don't require anything stronger than some over the counter acetaminophen or ibuprofen to relieve any discomfort.
Swelling and Bruising
Although a closed rhinoplasty will often come with less swelling and bruising, you can expect to have some level of each with both types of this procedure. A swollen, bruised appearance around the nose and eyes will typically last for about a week. Due to the swelling, you may feel as if your nose is congested or stuffed up. This is normal and will begin to subside as the swelling starts to go down.
What Not to Do After Rhinoplasty
The precautions you take in the immediate days and weeks after your rhinoplasty surgery can have a significant effect on the results of the procedure. Dr. Ardesh will go over all of his post-op guidelines and restrictions to help you better prepare for the recovery process, but there are some important things you should know to avoid even before your surgery begins. That way you can take the necessary steps to decrease swelling and keep bleeding to a minimum from the minute you leave the office.
Touching the Nose
It is absolutely critical that you avoid touching your nose right after a rhinoplasty procedure. Even the slightest brush or impact against the nose could injure the delicate nasal tissues that have just been operated on and you risk damaging the rhinoplasty. You may even feel some pain or discomfort in the area. As you may have also guessed, do not blow your nose for any reason as this could also cause serious damage or injury to sensitive nasal tissues.
Dr. Ardesh will recommend that patients refrain from wearing glasses for the first two to five days after a rhinoplasty. Resting a pair of glasses on the bridge of a nose that has just undergone rhinoplasty surgery threatens to injure the nasal tissues. If you are unable to see without glasses, it is suggested to wear contact lenses instead.
Washing the Face
The nose is typically set in nasal splint and gauze dressing after a rhinoplasty is finished. Dr. Ardesh instructs his patients not to get these wet for at least a week. Therefore, washing the face will need to be done very delicately and safely so avoid taking a shower and use only a small damp washcloth or towel to clean the area of the face surrounding the nose.
Avoid any activities that require even the smallest amount of physical exertion. Do not attempt any strenuous motion or actions such as fitness workouts, lifting heavy objects, running or jogging, jumping, or any type of aerobic activity. Physical labor can apply unnecessary pressure to the nasal tissues and cause them to become injured and start bleeding.
To reduce the risk of injury to the nasal tissues or nasal cavity, Dr. Ardesh will advise you to sleep on your back for the first couple of weeks after the surgery is performed. It is also important that you sleep in an elevated position to help you remain on your back until the morning. Sleeping in this position will allow you to breathe easier and help to bring down any residual swelling and bruising. Avoid wearing nasal strips while you sleep and relocate any additional pillows or objects in the bed to keep them from falling on to your nose or face during the night. It is also advised that you keep pets out of the bedroom during the initial recovery period as they could injure your nose by mistake while you sleep.
It is highly recommended that women avoid wearing makeup during the recovery period as this could interfere with the healing process and increase the risk of infection in and around the surgery site. The best way to reduce the appearance of bruising around the eyes is to closely follow Dr. Ardesh's post-op guidelines and recommendations. Do not try to cover the bruises with make up.
How Much Does Rhinoplasty Cost?
The cost of a rhinoplasty can vary greatly from one patient to the next because each patient is different. The price of the procedure will depend on the same combination of factors that play a role in determining how long the procedure may take. The type of rhinoplasty you select could affect the cost along with other expenses related to how much anesthesia is needed for surgery to any facility and testing costs along with the medications prescribed by Dr. Ardesh after the procedure.
Discussing your case with Dr. Ardesh can give you a much clearer understanding of the type of procedure that is best for your situation and the steps needed to get you the results you want and deserve.
Many health insurance providers have strict rules for covering the costs related to plastic surgery procedures. If a rhinoplasty is performed for cosmetic purposes your health insurance provider may not include such a procedure as part of your policy coverage as the surgery may be deemed non-essential. However, a rhinoplasty that is performed for medical reasons could be covered either in part or in full based on the limits of your policy.
Consult your health insurance policy to review which costs are covered by your provider and those you will be expected to pay yourself.
© Ardesh Facial Plastic Surgery. All Rights Reserved. Designed by Studio III
Accessibility: If you are vision-impaired or have some other impairment covered by the Americans with Disabilities Act or a similar law, and you wish to discuss potential accommodations related to using this website, please contact our Accessibility Manager at (888) 417-8101.