Nose Surgery and Rhinoplasty
Nose surgery, or rhinoplasty, is designed to improve the shape, size and overall appearance of the nose with the goal of achieving enhanced facial balance. Rhinoplasty is one of the most difficult surgical procedures to perform. The delicate framework of the nose must be manipulated in a manner that not only produces ideal short-term results, but a final outcome that will last long-term.
At The University of Kansas Health System, our facial plastic surgeons, plastic surgeons and otolaryngologists excel in nose surgery. From primary rhinoplasty to complex secondary or revision rhinoplasty procedures, our surgeons have the advanced skill and expertise to achieve outstanding results for those seeking cosmetic and/or functional enhancement of their nose.
What is nose surgery?
Also known as rhinoplasty or a "nose job," nose surgery modifies the nasal shape and proportions to bring the nose into harmony with other facial features. Desired changes are often subtle, yet many people notice that their self-esteem is dramatically improved after rhinoplasty surgery. While many rhinoplasty surgeries are performed for cosmetic purposes, rhinoplasty can also correct functional breathing problems and deformities created by previous nasal fractures or genetics.
In addition to cosmetic rhinoplasty, our specialized team is skilled in multiple types of nose surgery:
In some cases, your surgeon may recommend combining nose job surgery with additional procedures, such as cheek or chin implants, to further enhance your results.
Who can have nose surgery?
People who choose to have rhinoplasty often find that nose reshaping surgery, which brings symmetry to the face, also improves their quality of life and self-confidence. Rhinoplasty can be performed to correct a range of nose size issues, from a nose that is too large to a nose that is bumpy, crooked or drooped, in addition to correcting some breathing problems.
How does nose surgery work?
Rhinoplasty can be performed for cosmetic reasons, to bring the nose into proportion with the face or for functional reasons to address breathing problems.
There are generally 2 techniques to perform rhinoplasty:
Benefits and risks of nose surgery
Rhinoplasty can accomplish the following improvements to the size, shape and function of the nose:
- Change the angle of the nose
- Enhance definition and structure
- Improve breathing
- Refine the nasal tip
- Revise the size or shape of the nostrils
- Smooth a hump or dip
- Straighten or narrow the bridge
A few of the risks associated with rhinoplasty include the same risks that can occur with any surgery, such as infection or scarring. Your surgeon will go over the benefits and risks of nose surgery in more detail during your consultation.
What happens during nose surgery?
The rhinoplasty procedure takes between 1-3 hours to perform and is generally performed under a local anesthesia with an intravenous sedation. If your plastic surgeon chooses a closed rhinoplasty, the incisions will be made inside your nose. With an open procedure, the incision will be made under the tip of your nose, where the skin can be lifted for a view of the nasal structure.
After your surgeon has made the chosen incision, your nasal bone and cartilage will be reshaped to bring the nose into balance. Sutures will be placed inside your nose and packing may be inserted to control bleeding.
After surgery, a protective splint is applied to the nose and remains in place for 1 week. Bruising and swelling around the nose and eyes is very common and usually improves over the first couple of weeks of recovery. Some people experience minor swelling that can persist for up to a year, depending on their skin type. Discomfort is generally mild and easily treated with medication. Within about a week after surgery, your surgeon will remove stitches and the protective splint. Most people return to work within 5-7 days.
Rhinoplasty from our expert surgeons can achieve results that last a lifetime. The internal nasal framework is permanently recontoured, and the outcome should continue to improve as swelling subsides. It may take up to one year for the nose to look fully refined. While results from nose surgery can be very enduring, selecting a qualified surgeon to perform your rhinoplasty is essential to enjoying long-lasting results. In general, those who specialize in facial procedures are able to provide the highest standards of safety and care, minimizing the potential need for a revision rhinoplasty.
While every surgical procedure typically leaves some type of scar, rhinoplasty offers the benefit of little to no visible scarring. This is possible due to the strategic incision placement from surgeons, yielding virtually undetectable postsurgical scars. Depending on which rhinoplasty procedure you have (open vs. closed), the nasal framework will be accessed either through an incision made internally, or on the undersurface of the nose. The internal incision for closed rhinoplasty is not visible and the open incision is placed along the base of the columella, typically blending into the natural crease.
In some cases, the appearance of the nose can be refined using nonsurgical injectable fillers, such as those found in the JUVÉDERM® and Restylane® product lines. The use of hyaluronic acid-based dermal fillers to adjust the shape of the nose is often referred to as a “liquid rhinoplasty,” a minimally invasive alternative to nose surgery that offers short-term yet effective results without anesthesia or downtime.
A liquid rhinoplasty can address minor contour irregularities, but the scope is limited. Fillers typically cannot address concerns about the angle of the nasal tip or adjust the dimensions of the nostrils. A nonsurgical nose job also can’t correct breathing problems or correct a deviated septum.
Swelling is an expected part of the rhinoplasty process and can last for several months after your procedure. That said, there are several ways to reduce inflammation for an easier recovery period while the face heals. Limiting salt intake can help decrease fluid retention and discourage further inflammation. Since swelling often worsens with heat, it’s also a good idea to avoid excessively hot showers or exposing the facial tissues to significant humidity. You should also avoid exercise in the early postoperative period.
You should avoid blowing your nose for at least 2 weeks after surgery. In some cases, such as after deviated septum repair, you may need to wait longer. Feeling congested after rhinoplasty is a normal response to the swelling of nasal tissues, but forcefully blowing the nose before it reaches an appropriate stage of healing can cause bleeding, internal damage and possibly an altered final outcome.
Eyeglasses should not rest on the nasal bridge for 4-6 weeks. We will be happy to show you how to safely adjust your glasses during the healing period. Contact lenses can be worn during the healing process, if needed or desired.
After surgery, you can clean the nose without disrupting the healed tissue by using a saline rinse or spray to irrigate the nostrils and keep the nasal lining from drying. To more thoroughly clean the inside of the nostrils, a cotton-tipped swab coated with petroleum jelly can be used to gently moisten and lubricate just inside the nasal rim. Take care to avoid putting excessive pressure on the soft tissues of the nose, as the internal bones and cartilage will be delicate.