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RHINOPLASTY

What would you like to change about your nose? Common requests for improvement include fixing a hump, making the tip smaller and correcting a crooked nose. The most important thing to the majority of people is having a final result that fits your face. There are ideal features and proportions commonly agreed upon by plastic surgeons that detail the perfect masculine and feminine noses; however, we need to consider your individual preferences and facial features.

Common problems addressed with rhinoplasty, commonly known as nose job:

  • Hump on bridge of nose: This is called a dorsal hump and is caused by prominent bone and cartilage on the bridge of the nose. This can be improved during rhinoplasty by rasping the bone down gradually to the desired level. The cartilage of your septum must often be reduced at the same time. This is usually trimmed to the desired level with special scissors or a scalpel. Dr. Vennemeyer performs the reduction gradually, frequently checking the shape until the bridge of your nose has the desired profile.
  • Bulbous or boxy nasal tip: The tip of your nose may appear too big and rounded from larger than average cartilage components making up the tip. Dr. Vennemeyer trims the tip cartilages (lower lateral cartilages) and places special long-lasting stitches that reshape the cartilages to create better tip shape. Sometimes pieces of cartilage borrowed from the septum, called grafts, are used to reshape the tip or add structural support.
  • Over projected nose: This is when your nose sticks out too far from your face. This can involve the tip, dorsum or both. Reduction of the bone and cartilage framework creates a better proportioned nose for your face.
  • Under projected nose: This is when your nose does not stick out from your face enough and may appear smashed in. In these cases, Dr. Vennemeyer uses cartilage grafts to create the structure necessary for the desired amount of nasal projection.
  • Droopy nasal tip: The tip of your nose seems to hang too low. This can make the bridge of your nose look excessively long. The tip cartilages are modified to create a more attractive nasal shape and length.
  • Wide nose: The bridge of your nose (nasal bone area) or the lower part of your nose around your nostrils (alar base) may appear too wide when you look into the mirror. The bridge of the nose is narrowed by fracturing the nasal bones along very precise lines (osteotomies) so that they can be repositioned closer together to create the desired nasal width. The alar base width can be narrowed by removing skin in the alar crease and nostril bases for a more balanced proportion.
  • Retracted nostrils: Your nose may lend a “snarl” appearance from excessively high arching skin over your nostrils (alar retraction). Special cartilage grafts, called alar rim grafts, can be placed during your rhinoplasty to improve retracted alar rims.
  • Crooked nose: Your nose is asymmetrical and the bridge or dorsum curves to one side excessively. This may involve the nasal tip, too. Frequently, but not always, this results from a broken nose in the past. Correcting a crooked nose can involve repairing the septum, repositioning the nasal bones and modifying the tip cartilages.

Rhinoplasty Basics

Nose reshaping is termed rhinoplasty by plastic surgeons and a "nose job" by most others. Reshaping the nose generally makes people look like a better version of themselves. Here is a basic summary of how a rhinoplasty is used to make changes to your nose.

  1. Incision is made inside nostrils and across skin between nostrils (columella)
  2. Skin elevated to access structural elements of nose: cartilage and bone
  3. Hump reduced with incremental rasping
  4. Bridge (dorsum) straightened along with septum, as needed
  5. Tip cartilages reshaped to correct bulbous or wide tip
  6. Special stitches and cartilage pieces (grafts) used to strengthen and improve shape
  7. Incision closed meticulously with stitches and splint applied to bridge (dorsum)

What to expect after a rhinoplasty

  • Time off work: 1 week in most cases
  • Avoid exertion: 3 weeks in most cases
  • Mild bruising and swelling in most cases
  • Mild to moderate discomfort for 3-5 days
  • Splint on bridge of nose for 1 week
  • Stitches to be removed at 1 week
  • Look pretty good/ normal at 1-2 weeks
  • Look good in pictures 4-6 weeks after procedure
  • Final result 6-12 months

Rhinoplasty recovery tips

Follow your plastic surgeons instructions after your nose job surgery. These are intended for general reference only:

  • Keep your head elevated between 30 and 45 degrees. Do not lay flat! This will minimize swelling.
  • Apply cool packs in 15 minute intervals to the areas around the eyes, cheeks and forehead. Avoid direct pressure on your nose.

Questions? We're here to help!

 

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