Rhinoplasty (nose job) is the operation performed to reshape the nose.
Who is a good candidate for surgery?
Your surgeon should carefully analyze the inside and outside of your nose. Be sure to tell your doctor about previous trauma and surgery that you may have had. It is helpful to have specific changes for your nose in mind when you visit your surgeon, but this is not essential. What is important for you and your surgeon is to agree on a plan for the desired changes you wish to make. The surgeon may make suggestions based on his/her artistic values. Some patients have anatomic limitations that may make the proposed suggestions unrealistic.
How is the rhinoplasty performed?
Typically, changing the shape of the cartilages and bones underneath the skin will change the way the nose looks. The surgeon will make these changes through inconspicuous incisions. In some cases, only incisions inside the nose will be used (closed rhinoplasty), while in others, these incisions are connected by a cut along the columella, the column of flesh that separates the two nostrils (open rhinoplasty). Often, the rhinoplasty operation is combined with a septoplasty operation. Most rhinoplasty operations are performed under general anesthesia in the operating room. Despite this, most patients go home the same day. The typical operation usually lasts for a few hours.
What is the recovery from surgery like?
Recovery from rhinoplasty involves several phases. For the first 24 hours, you may experience some nausea, and you should avoid eating substantial amounts of food. The incisions inside the nose are closed loosely, to minimize the risk of hematoma (blood accumulation in the tissues). Because of this, the nose has a tendency to ooze blood for a few days. During this time, it is helpful to wear a small gauze pad (drip pad) beneath the nostrils. Limiting strenuous activity and keeping the head elevated will cut down on much of this oozing. Most people get swelling and bruising around the eyes in addition to swelling inside and outside the nose. The bruising resolves in about 7-9 days. Placing a cool pad over the eyes for the first 48 hours will help with the bruising. Most of the swelling is gone by two weeks. If the nasal bones are reshaped, contact sports should be avoided for 6 weeks. When an open rhinoplasty is performed, the tip of the nose is likely to feel rubbery for 6-12 months until lymphatic channels re-develop in the columella. Some numbness and tingling in the nasal tip are also likely during that time. Small, subtle changes in the way the nose looks can occur for a year and beyond the following rhinoplasty.
When should I come back to the doctor?
Most patients need to come back eight days after surgery to have their cast removed. Some will also have sutures taken out at that time.
When can I go back to work?
Workers that perform heavy tasks should avoid work for two weeks. After 2 weeks, patients may resume their normal exercise routines. Some office-type workers are able to return to work after 4-5 days to read mail, make phone calls, and do some work with the computer. Despite this, most patients are fatigued easily and find that they can’t work a full day until 9-11 days after surgery.
Will my insurance pay for this?
Most insurance companies consider rhinoplasty a cosmetic procedure and do not cover the costs. There are some exceptions, and these are judged on a case by case basis.