What is a Rhinoplasty?
The term rhinoplasty means to change the shape of the nose.
The term septoplasty means to change the shape of the septum.
The term septorhinoplasty means to change the shape of the septum and the nose.
The term nose job is a colloquial term often used interchangeably with rhinoplasty.
While there are a variety of terms and definitions, all nasal surgery has the fundamental goal to improve the patient’s nasal breathing and/ or the patient’s appearance. The nose is composed of three layers. The external lining is the skin and soft tissue envelope. In individuals with thick skin the amount of definition in the nasal tip is limited. In individuals with thin skin, the risk of imperfections in the nasal structure being visible is higher. On occasion the external soft tissue envelope can be thinned by removing soft tissue or augmented by adding fascia grafts and/ or fat. However, most often the soft tissue envelope is not modified during surgery. The middle layer is the actual bone and cartilage structure of the nose. This consists of the nasal bones, upper lateral cartilages, lower lateral cartilages, and the septum. These are the structures that are modified during rhinoplasty and septoplasty to change the shape and improve the appearance of the nose. Cartilage grafts are typically taken from the septum to strength the nose and help prevent collapse of the nasal valves during breathing. The internal lining of the nose is called mucosa. This is not modified during rhinoplasty surgery but is often mobilized to gain access to cartilage that is being modified. It is important to not damage this mucosa during surgery to prevent complications.
To access the cartilage and bone of the nose, incisions must be made. An “open rhinoplasty” is when a small incision is made on the bottom of the nose that connects to incisions on the incision of your nose. An “endonasal or closed rhinoplasty” is when all incisions are made inside the nostrils. Each approach has advantages and disadvantages; however, it is not the approach that determines the outcome. Rhinoplasty is an art, and each surgeon will have a different approach much like each artist will have a different style.
Preservation rhinoplasty is a technique that was first described in the literature over 100 years ago and has been utilized by a small group of surgeons for well over 50 years. Over the past 10 years, it has gained more widespread use due to international surgeon collaboration. It is an excellent technique for certain cases.
Dr. Namin’s Philosophy
There is no reason to operate unless you are bothered by the appearance of your nose and/ or have difficulty breathing through your nose. The surgeon and patient should only proceed if the operative goals are defined and agreed upon. There is not really a line between cosmetic and functional. This type of terminology has really gained traction due to the dominant force insurance has in the delivery of health care. The ultimate goal of rhinoplasty is to improve the patient’s quality of life and self-confidence. During the consultation Dr. Namin will ask you about what features of your nose bother you, prior nasal surgery, prior nasal trauma, and breathing problems. Dr. Namin will then develop an operative plan and simulated appearance. This simulated appearance is not a guarantee, but more so a means of communication. It helps Dr. Namin ensure that his vision aligns with the patient’s vision. The risks of the procedure and the anticipated post operative recovery are discussed. Prior to proceeding with this type of operation it is very important for Dr. Namin and the patient to be in agreement in regard to the operative goals and for the patient to have an understanding of potential complications as well as the expected postoperative recovery.
Rhinoplasty Postoperative Recovery
After you wake up from surgery you will have a cast on the outside of your nose, and possibly splints on the inside of your nose. Bruising and swelling will be the worst during the first week. If present, the bruising typically subsides by 10-14 days after surgery, and by this time you typically feel comfortable resuming social and work events without have obvious signs of the recent surgery. About 80% of the swelling will resolve by one month after surgery. The remaining 20% of swelling slowly subsides over the next 6-12 months. Pain is typically worst during the first three days, and then begins to subside thereafter. Numbness of the nasal skin and sometimes the upper front teeth and roof of the mouth can be experienced after surgery. This typically resolves over the course of a few weeks to months. Avoid blowing your nose for the first three weeks after surgery. Arnica Montana can be taken during the first 4 days after surgery to help minimize the bruising. Gentle walking around the house and store is encouraged beginning the day of surgery. Light exercise can be resumed two weeks after surgery, and vigorous exercise can be resumed three to four weeks after surgery. Sleeping with the head of bed elevated can help decrease the amount of swelling.
Rhinoplasty Before and After
How Much Does a Rhinoplasty in St Louis cost?
Estimate price range: $7,000 – $9,000
Rhinoplasty Postoperative Timeline
Day of Surgery: Dr. Namin will meet with your family or friend after the procedure is completed. You will wake up with a cast over your nose and possibly splints on the inside of your nose. You will typically spend 1-2 hours in the surgical facility after the procedure is completed. It is important that someone spends the first night after surgery with you.
Post Operative Day 1-3: Use cool compresses for up to 20 minutes every 4 hours. Sleep with head of bed elevated. Bruising and swelling typically peak during this time frame.
Post Operative Day 8: Dr. Namin will see you back in clinic. The cast on your nose and the splints inside your nose will be removed. Swelling and bruising begin to improve. If you are traveling from out of town you can plan to return home after this appointment.
Post Operative Week 2: Most bruising is resolved, and typically can return to social events or work. Can resume light exercise.
Post Operative Weeks 2-4: Most of the swelling will subside during this time frame. By 4 weeks after surgery, we expect about 80 of the swelling to be resolved. The last 20% of swelling slowly resolves over the course of the first year.
Post Operative Week 4: Dr. Namin will see you for your second post operative visit. Can resume vigorous exercise.