Rhinoplasty is a surgical procedure performed to modify the external appearance of the nose. Every rhinoplasty is different, depending on the individual’s aethestics. Reduction rhinoplasties include those that address a prominent hump on the dorsum, while others are augmentation rhinoplasties, including those that address saddlebag type nasal deformities. Areas we address with rhinoplasties include the projection or width of the nasal tip, the width of the nasal base, the width of the nostrils, and the width and height of the nasal dorsum.
PRE-OPERATIVE – SURGICAL PREPARATION
Preoperatively the patient may be requested to have blood testing such as CBC and serum electrolytes or electrocardiogram, depending on existing medical conditions. The patient will also be advised to abstain from certain foods and medication, such as Aspirin, Ibuprofen, Vitamin E, garlic and broccoli, as well as to abstain from smoking or alcohol use, for several days prior to surgery. These precautions decrease the risk of bleeding and circulation complications. Photos of the existing area will be taken in order to assess the improvement obtained by the procedure.
The procedure takes approximately 1 to 2 ½ hours. It is performed under general anesthesia in an accredited surgical facility in an office, or in the hospital operating room. The surgical approach can be open or closed. In the case of an open rhinoplasty, an incision is made in the septum through which the skin of the nose is elevated. In the case of a closed rhinoplasty, an incision is made in the inside of the nose. The method will depend on the aesthetic goals. Many rhinoplasties require cartilage grafting to be performed. The most common source of this cartilage is the nasal septum, although remnants of the trimmed nasal tip cartilage could also be performed. On occasion, ear or rib cartilage is required. Rhinoplasty is commonly accompanied by other nasal procedures including submucous septal resection (removal of bone and cartilage in the nasal septum) and turbinectomy (removal of bone in the nasal passage). When surgery is complete, the inside of the nasal passage will be packed to decrease intermittent bleeding, and a splint will be applied externally and bandaged on.
POST-OPERATIVE – RECOVERY
Postoperatively the patient will be seen in the office several times for follow-up examination and evaluation. The splint is usually removed within a week. Patients can expect some discomfort for the first 24-48 hours. Swelling and ecchymoses (black and blue) can be expected and will subside in time. Swelling in particular takes 2-3 weeks to resolve. The patient will be advised to abstain from salty food which can increase the swelling in the operative site. If necessary, pain medication will be prescribed.
Some possible risks and complications can occur with this procedure, including those that could occur with any type of surgery, such as bleeding, infection and, most uncommonly, anesthesia complications. Other possible risks and complications include nasal irregularity and septal perforation. These and any other less common risks and complications will be discussed with you at the time of surgical consent. It is necessary for the patient to comply with our pre- and post-operative instructions in order to decrease the likelihood of complications. Nationally, nasal revisions are required approximately 8-10% of the time.
The fee for this procedure varies depending on the geographic location of your surgeon, the reputation of the surgeon, and the complexity of the individual surgical procedure. Our fees for the procedure range from $14,000-$20,000. You may incur other fees such as anesthesia or operating room fees. Any secondary surgeries required will not be included in this initial surgery fee.