Nose Reshaping (Rhinoplasty)

What is rhinoplasty (nose reshaping)?

Your nose is the focal point of your face. While the shape of your nose is usually inherited, the appearance may be altered by birth defects, injury or prior surgery. Nose reshaping, or nose surgery (rhinoplasty) is a procedure that can help improve the appearance of your nose, thereby enhancing facial harmony. It can be used to change the shape, size, or proportions of your nose. It can also be used to correct breathing problems caused by structural abnormalities inside the nose, such as a deviated septum. Rhinoplasty is one of the most common plastic surgery procedures performed today.

What are the goals of the rhinoplasty surgery?

The goal of rhinoplasty is to produce nasal shape and size that restores facial balance while at the same time preserving or improving the function of the nose.

Rhinoplasty may be performed for cosmetic reasons, such as modifying:

  • the overall size (reducing or increasing the size of the nose)
  • the width of the nose, at the bridge
  • the tip of the nose
  • the nose profile (reducing humps or filling in depressions)
  • the projection of the nose
  • nostrils that are large or wide
  • the angle between the nose and upper lip
  • asymmetry or deviation

Rhinoplasty may also be performed for functional reasons, such as correcting any breathing problems related the internal nasal structures.

Who is a suitable candidate for rhinoplasty?

Rhinoplasty is a good option for you if are looking for improvement in your appearance and have realistic expectations of what can be accomplished with surgery. You should be fit and physically healthy, and your facial growth should be complete (this usually means waiting until you are in your late-teens).

What is done during rhinoplasty surgery?

The surgery is done on an outpatient basis (this means you will go home the same day), under general anesthesia, and usually takes 2 to 3 hours to complete. After you are asleep, a local anesthetic will be injected into the area to reduce discomfort after surgery. Incisions will be made to allow the skin that covers your nose to be gently raised. This allows access to the structures of the nose which will be reshaped. Reshaping is done by altering the cartilage and/or bones of your nose. If your nose needs to be made larger, cartilage from your nose or another part of your body may be used. If the septum is deviated, it will be straightened to improve breathing. The skin will then be closed over the new form of your nose. Patients will generally be ready to go home 2 hours after surgery is finished.

Where are the scars?

As plastic surgeons, we realize the importance of the cosmetic outcome.  We will make every effort to optimize the scar size and conceal it in the least visible area of the nose. In many cases, it is possible to improve the appearance with very little scarring. The incisions in rhinoplasty are usually placed inside the nose so they are not visible. An incision may also be placed across the columella (the narrow strip of tissue that separates the nostrils). If external incisions are required, they will be placed in well-hidden areas, such as the crease where the nose and cheek join, or where the nose and lip join.

It is important to realize that scar formation varies between individuals and is highly dependent on a person’s genetic predisposition.  Scars typically fade over time but their final dimensions and colour are difficult to predict.  At the consultation, the plastic surgeon will talk to you about this.

Where is the surgery performed?

All surgeries are performed at Women’s College Hospital as day surgery by the plastic surgery senior resident under the supervision of a faculty plastic surgeon.

What to expect in the recovery? How long will I be off work? When can I resume exercise?

The procedure itself can take from 2 to 3 hours depending on how much work is required. At the end of the surgery, a padded splint will be applied on the outside of your nose to support the new structure and shape during the initial healing period. A gauze packing or splints may be placed inside your nose for a few days to help reduce bleeding. If there are external incisions, sutures will be used and will need to be removed 5 to 7 days after surgery.

For the best results, you should plan on resting and taking it easy after surgery. For the first few days after surgery, most patients experience some swelling and discomfort at the surgical site. After which you will starting feeling better and returning to your normal self. You should plan on being off work for 1 to 2 weeks. During your recovery, you should refrain from strenuous physical activity including lifting and pulling for 4 weeks following surgery. Additionally, you should avoid any pressure on your nose including eyeglasses.

You may experience numbness of the skin following surgery; this is usually temporary. Additionally, you should expect bruising and swelling of the nose and around the eyes. Bruising usually peaks after a few days and disappears within 2 weeks. Most of the swelling will also resolve within 2 weeks. However, patients do often have residual swelling that affects the tip of the nose for a number of months after surgery (lasting up to a year). This residual swelling may come and go, and be worse in the morning.

What are some common complications of surgery?

Complications of nose surgery, like those of other cosmetic procedures, are uncommon but may include unfavorable scarring, asymmetries, bleeding, infection, swelling and numbness. Specific to rhinoplasty surgery, risks including bruising, nose bleeds, dryness in the nose, and breathing difficulty can occur. In some patients, a second procedure may be required to correct residual asymmetry or unfavourable scarring.

When will I see the final results of the surgery?

Healing after rhinoplasty is a gradual process. Some mild swelling may persist for several months, and it may take up to a year for your results to fully appear.