Rhinoplasty

Rhinoplasty

Address Cosmetic Concerns & Functional Impairments with Nose Surgery

Do you feel constant dissatisfaction with the shape, size, or appearance of your nose? Do you have a nose that is misshapen or crooked? Both cosmetic and functional concerns can be corrected with rhinoplasty by Ohio facial plastic surgeon Dr. David Hartman. Nose surgery can restore confidence in your appearance by correcting nasal abnormalities and improving how your nose harmonizes with the rest of your facial appearance.

Functional Rhinoplasty for a Deviated Septum & Enlarged Turbinates

Rhinoplasty (nose correction surgery) is sought for a variety of reasons, from the aesthetic to the functional, or both. Generally, functional (nasal airway) concerns are best addressed by focusing on improving the nasal septum (the cartilaginous and bony wall that separates the right and left nasal airways) or turbinates (fingerlike projections on the inside of the nose that regulate temperature and humidity of incoming air).

Flattening of the nose during the process of birth or injury to the nose suffered later in life can bend or fold the septum – the vertical plane of cartilage and bone – and thus restrict normal airflow of breathing. Septum straightening surgery, called septoplasty, is often paid for by health insurance when the crooked septum is indeed causing difficulty breathing through the nose.

Enlarged turbinates may also be a functional concern. Inside the nasal cavity, there are three turbinates on each side – they are called the superior, middle, and inferior turbinates. Many patients have airflow problems from hypertrophy (i.e. enlargement) of the inferior turbinates, caused by allergies, hormones, sinus problems, or other concerns. This condition can be corrected with a turbinate reduction, which can be performed as part of a septoplasty or rhinoplasty.

Functional nasal concerns are best addressed by a facial plastic surgeon who also has years of training in otorhinolaryngology or otolaryngology (ear, nose, and throat surgery). Dr. Hartman is one such surgeon, who is dual board-certified in otolaryngology-head & neck surgery as well as facial plastic and reconstructive surgery.

What is Rhinoplasty?

As one of the most frequently performed procedures in the country, rhinoplasty achieves what non-surgical treatments cannot – permanent correction of the shape, size, overall appearance, or function of the nose.

Cosmetic rhinoplasty is the term applied when the concern is the aesthetic appearance of the nose. Common concerns include a “hump” on the middle length of the nose; a boxy, bulbous, drooping, or misshaped nasal tip; a nose that is twisted; or a nose that is too big or too small for the face.

Excellent rhinoplasty surgeons are well-trained in hundreds of techniques to reliably achieve the subtle corrections required for a particular nose. Modern rhinoplasty emphasizes the preservation of natural support and function of the nose to assure that the post-rhinoplasty nose remains structurally sound, normally functioning, and natural-looking for a lifetime.

The appearance of the chin may also play a role in how well the nose harmonizes with the face. A weak chin makes a nose look even more prominent. When the chin is very weak or receded, enhancing the chin with an implant or dermal filler may be performed along with the rhinoplasty. In the Midwest, quality cosmetic rhinoplasty costs from a board-certified plastic surgeon are in the $5,000 to $10,000 range.

While rhinoplasty can provide a dramatic, long-term improvement in your facial profile, some patients with relatively minor nasal imperfections may benefit from a “non-surgical rhinoplasty” treatment with dermal fillers. A consultation with a board-certified facial plastic surgeon is the best way to determine which cosmetic procedure may be appropriate for you.

Health insurance may cover surgery that restores normal nasal shape when that shape was altered (i.e. “acquired deformities”) due to trauma such as automobile accident, sports injury, or altercation/fight. Procedures designed to correct nasal injuries are termed “open reduction of nasal fracture,” or “major nasal-septal reconstruction.”

What Can I Expect During Rhinoplasty Surgery?

Rhinoplasty is either “open” or “closed.” In open rhinoplasty techniques, a tiny incision is made at the narrowest part of the columella – the tiny strip of skin that faces downward at the base of the septum between the nostrils.

Closed rhinoplasty does not involve an outer incision and leaves no incision mark on the outside of the nose. It offers the surgeon less internal visibility but is a good choice for nasal hump removal. Open rhinoplasty offers greater visibility when there is extensive work needed on the tip of the nose. When the incision is performed well, and the skin heals with no abnormalities (which it almost always does), the resultant scar will be very difficult for casual observers to identify.

Internally, there are multiple techniques used to improve the nose depending on the type and level of correction necessary, and as such, vary accordingly from patient to patient. Only after an in-person consultation can Dr. Hartman determine the exact steps of your rhinoplasty.

What is the Recovery Like?

  • Swelling may be only present for a couple of days after less extensive rhinoplasty. Significant swelling – which may include swelling around the eyes or cheeks – can occur in more involved cases where the nasal bones (in addition to cartilages) are reshaped. Even this more extensive swelling typically resolves in a week or so. However, a very subtle thickening of the skin covering of the nose can take months before it completely thins back to normal.
  • The extent of bruising can vary widely depending on several factors, such as how involved the rhinoplasty is; how easily the patient tends to bruise; and the surgeon’s care and skill. When bruising does happen, it generally clears up within seven to 10 days.
  • Depending on the state of the nasal airway before the surgery, nasal airflow may be better or worse immediately after the surgery. Saline rinses are useful for starting the day after surgery. The full extent of nasal airway improvement may take several days to a couple of months to be fully realized.
  • Tingling, pain, or numbness in the roof of the mouth or front teeth may last a few hours to several days after surgery. A dull, achy pain of the nose itself may be present for several days. Prescription medicine may be useful for the first day or two, after which over-the-counter pain relief is generally sufficient to manage any discomfort.

Dr. Hartman generally leaves soft silicone stents inside the nose for one to two days after a septoplasty. About 80 percent of his patients return to work or school in the first week, even in more extensive rhinoplasty cases. After the initial healing from rhinoplasty is complete, your nose will continue to gradually refine over months till it yields its final, permanent results.

A well-performed rhinoplasty will result in long-term improvements in both aesthetics and function, with the procedure yielding a high rate of patient satisfaction. We monitor your progress through follow-up appointments and discuss any necessary aftercare to reduce the small risk of infection and complications. Dr. Hartman’s surgical patients are given his mobile phone number and are encouraged to text or call for any post-operative concerns.

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