FAQ's related to Rhinoplasty

It is important to note that common frequently asked questions relate to the cost of elective procedures, such as cost of cataract surgery, or about new types of body sculpting procedures, such as Zeltiq.

What is Rhinoplasty / Nose Job?

Rhinoplasty is a surgical procedure performed to modify the size and shape of the nose in order to give it a more pleasant look. Harmonize your nose and show off a really proportionate face. Rhinoplasty also called nosejob.

Rhinoplasty may also be performed to reduce the dorsal hump, modify the nasal tip, narrow the nostrils, reduce the width of the nose, change the angle between the nose and the upper lip, and straighten or narrow the nasal bridge.

Who is the best candidate for Rhinoplasty?

Any individual, either male or female, after 16 years of age, who is interested in cosmetic improvement in the shape of the nose, can undergo this procedure. The usual indications are:

  • For cosmetic reasons, i.e., to enhance the shape of their nose.
  • To correct a crooked nose or deformity as a result of injury.
  • Have difficulty breathing as a result of nasal passage obstruction.

What does Rhinoplasty do ?

It corrects un-aesthetic characteristics in noses that are too long or too big, bulbous, with a hump or with a ‘hanging’ tip. It narrows the nostrils, if they are too wide. It corrects deformities such as those acquired as a result of accidents. It helps correct certain breathing problems. It can give the nose a more masculine or feminine look, according to the standards of proportion and harmony prescribed for each sex.

What is the ideal age for undergoing a Rhinoplasty operation?

Rhinoplasty operation is done after the completion of the natural growth of the nose, which is usually fifteen years in girls and sixteen years in boys. There is no maximum age limit, but I usually do not recommend this surgery after fifty years of age. If somebody visits me for Rhinoplasty after fifty, I will have thorough psychological counseling with them before performing the surgery.

What is the procedure of Rhinoplasty or nose job ?

The procedure of Rhinoplasty takes about 1 – 2 hours. Rhinoplasty is usually performed on an outpatient basis. Incisions/ cuts for Rhinoplasty are made depending on the reshaping job that needs to be performed. The skin of the nose is separated from its underlying bone and cartilage which are cut and trimmed to obtain the desired results. The skin is then redraped over the bone and cartilage. Incision(s) is sutured and nose packs are placed to minimize the chances of bleeding. These incisions become imperceptible soon after the surgery.

What anesthesia is used for Rhinoplasty?

Local anesthesia and complementary sedation, or general anesthesia.

Length of surgery:
One or two hours

There is usually no need for hospitalization; it is done on an outpatient basis. Sometimes, a 24-48 hour hospital stay may be required, depending on the type of correction required for that individual.

What are different types of Rhinoplasty procedure ?

Reduction Rhinoplasty:
Bone or cartilages are removed in an effort to change the shape of the nose. This is done for humped noses, where there is an excess nose height seen.

Augmentation Rhinoplasty:
It is done for the low bridge noses or saddle noses. These clients seek enhancement of their nose height. It is done by adding cartilage, bone, or implant material on the dorsum of their nose. I personally prefer natural material which exists within their nose.

Closed Rhinoplasty:
Improves the contour of the nose by making the incisions inside the nose and removing, shaving or repositioning the cartilage and bone.

Open Rhinoplasty:
Improves the contour of the nose by making the incisions inside the nose along the nostrils and across the columella(vertical strip), and removing, shaving or repositioning the cartilage and bone.

Will only Rhinoplasty help me with breathing problem ?

No, there is a special procedure called Septoplasty for that. Septoplasty is a nasal operation that is used to straighten or reshape the septum. It is performed on patients who have difficulty breathing as a result of a mal-positioned septum. Septoplasty will not change the shape of the nose, and can be performed alone or in addition to Rhinoplasty. When we perform both at a time it is called septo-rhinopalsty. Turbinate Surgery is nasal surgery that is used to improve breathing by opening the nasal air passages.

How painful is the operation ?

Pain is tolerable; it is controlled after surgery with the help of analgesics in the form of tablets.

What are the common adverse effects after Rhinoplasty?

One can divide side effects into immediate and delayed. Immediate side effects include pain, swelling, slight bleeding, and discomfort in the nose. Eye swelling, watering, and headache due to a blocked nose after surgery are common and usually subside after 3-4 days. Delayed effects, such as persistent swelling, are possible but typically resolve with time.

Failure to accomplish the goal is usually due to unrealistic expectations of the patient or over-assurance by the surgeon.

Results after Rhinoplasty can be compared to a step ladder, where one can climb a few steps after surgery but not necessarily reach the top step. Results depend on the type and severity of the deformity of the nose, along with the surgeon’s technical artistry and expertise. Therefore, the most important factor is proper understanding regarding the nature of the deformity and having realistic expectations about the results, which will lead to a satisfying outcome for the patient after surgery.

What about the use of implants for the nose ?

Implants are used on the depressed noses to improve the height of the nose. There are many varieties of implant materials available, of which most commonly used are Silicone and Medpor. Both are inert materials i.e. body will not reject the material when it is inserted in the tissues. They are well tolerable by body without producing reactions. Especially implants are better acceptable on thick skinned noses. Rarely implants may get infected or rejected by the body either immediately or over a period of time. Regarding aesthetic result implant proved adequate bulk and shape to the nose.

I'm going to get my nose done soon and my doctor also recommended getting a chin implant because he says my nose will still appear 'big' because my chin recedes. Do people get both these procedures at the same time ?

This is a very common recommendation from a cosmetic surgeon. A weak chin can make even an ideal nose look larger than it actually is. Chin augmentation is a relatively minor procedure when implants are used, although it does have some risks of its own, such as lower lip numbness. A more extensive procedure would be to detach a piece of the lower jaw at the chin and move it forward and reattach it to the jawbone. Either type of chin augmentation can be done at the same time as a Rhinoplasty. Chin augmentation is often performed by a maxillofacial surgeon, who may be a medical doctor or a dentist.

I have thick nasal skin and a surgeon I spoke with said that I may not be able to see much detail with my Rhinoplasty. Is this true ? Should I see another surgeon ?

For many patients with thick skin, the skin is thinned out in the surgery as the tip is worked on, which can help with definition. But many patients with thick skin actually do better with Rhinoplasty. Very thin skin, shows every little imperfection.

Revision Rhinoplasty

Revision Rhinoplasty

These are terms used to denote a repeat Rhinoplasty due to either a complication of previous surgery or inadequate improvement in the result.

Various deformities found in these clients are:

  • Persisting deviation
  • Nose height problems, either more or less
  • Tip problems
  • Nostril problems, like unequal size, large, small etc.
  • Functional problems, related to breathing

Reason for deformities include:

  • Inadequate assessment before surgery
  • Poor planning lead to wrong result
  • Bad execution also leads to wrong results
  • Surgeon not having experience in performing Rhinoplasty on individuals of particular ethnic origin
  • Inexperienced Rhinoplasty surgeon in performing operations on complex noses
  • Sometimes implant problems, like extrusion, migration, infection, etc.

The most common reason for Revision Rhinoplasty is unrealistic expectations by the client. Therefore, Rhinoplasty surgeons should study the psychological nature and expectations of the results by the client before performing the surgery.

Dr. Venkataramana has experience performing Revision Rhinoplasties and is very choosy in operating on these clients. A thorough history of the case regarding previous surgery, revealing factors for unhappiness, psychological assessment, future outcome of the redo surgery, and expectations of the results are considered. If all factors are favorable, then he will take up the case for secondary Rhinoplasty.

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