Procedure name:
“Nose Surgery” - Rhinoplasty

Anticipated result of the procedure:
Rhinoplasty is a procedure to change the size or shape of the nose. It can be used to reduce or increase the size of the nose, change the shape of the tip or the nasal bridge, narrow the opening of the nostrils, change the angle between the nose and the upper lip, correct a birth defect or injury, or help relieve some breathing problems. If you are unhappy with the appearance of your nose, rhinoplasty can produce effective, permanent results that will bolster your self-esteem and improve your self-image.

Procedure Description:
During surgery the skin of the nose is separated from its supporting framework of bone and cartilage, which is then sculpted to the desired shape. The nature of the sculpting will depend on your problem and your surgeon's preferred technique. Finally, the skin is redraped over the new framework.

Many plastic surgeons perform rhinoplasty from within the nose, making their incision inside the nostrils. Others prefer an "open" procedure, especially in more complicated cases; they make a small incision across the columella, the vertical strip of tissue separating the nostrils. When the surgery is complete, a splint will be applied to help your nose maintain its new shape. Nasal packs or soft plastic splints also may be placed in your nostrils to stabilize the septum, the dividing wall between the air passages.

Length:
Usually 2 to 4 hours

Anesthesia:
General anesthesia.

In/ Outpatient:
Outpatient procedure.

Temporary Side Effects:
After surgery-particularly during the first twenty-four hours-your face will feel puffy, your nose may ache, and you may have a dull headache. Plan on staying in bed with your head elevated (except for going to the bathroom) for the first day. You’ll notice that the swelling and bruising around your eyes will increase at first, reaching a peak after two or three days. Most bruising will be gone within two weeks.

Recovery:
Most rhinoplasty patients are up and about within two days, and able to return to school or sedentary work a week or so following surgery.

Duration of Results:
Permanent.

Risks:
Problems breathing through the nose, asymmetries or minor deformities requiring revision, and scarring are all possible risks.

• Medications to improve nasal airway

Top Duke specialists:
Jeffrey R. Marcus, MD
Michael Robert Zenn, MD
Detlev Erdman, MD

FAQS

I have trouble breathing through my nose and have terrible sinus problems. Will my insurance policy pay for nose plastic surgery (rhinoplasty)?
The condition described is usually associated with a deviated septum or a bent internal framework of the nose. Most of the time this results from trauma such as a broken nose, but many patients with this condition cannot recall an episode where this might have occurred. The condition described in this question, however, could also result from allergies or the two conditions can exist simultaneously. Careful examination is needed before surgery to separate the two conditions.

While individual insurance policies can vary, in general, functional surgery to improve breathing is considered a covered benefit in many group policies. If additional correction of a cosmetic deformity of the nose is done at the same time, the cost of this part of the procedure is usually not covered by insurance.

Where are the incisions placed during nose plastic surgery?
In general, most or all of the incisions in rhinoplasty are hidden in the inside of the nostril. While external incisions hidden in the creases where the nose meets the cheek or across the columella (the lower part of the nasal septum) can be used, incisions on the bridge or tip are not usually used in cosmetic surgery of the nose.

Will my nose grow after surgery?
In general, our noses tend to elongate as we enter the middle years of our life and drooping of the tip of the nose can occur in the later years as elasticity disappears from the body. While undergoing a cosmetic rhinoplasty as a teenager or young adult will not prevent the effects of aging on the nose, the final shape that results from this surgery is durable. Regrowth of bumps and deformities corrected by the operation is a rare occurrence.