Rhinoplasty – commonly called a “nose job” – is a cosmetic surgical procedure that reconstructs and improves the appearance of the nose. Keep reading to learn more about rhinoplasty, but if you are considering it for yourself, you should also speak with a good Boston cosmetic surgeon.

A primary goal of rhinoplasty is changing the shape of the nose, and that makes it one of the most popular cosmetic procedures available. More than 200,000 rhinoplasty procedures were performed in the United States in 2018, according to the American Society of Plastic Surgeons.

What Are the Four Main Types of Rhinoplasty?

You may not realize that there are several different types of rhinoplasty procedures, but if you’ll keep reading, you will learn briefly about each type, what it entails, and what it accomplishes. The several types of procedures include:

1. open rhinoplasty
2. closed rhinoplasty
3. secondary rhinoplasty
4. filler rhinoplasty

A Brief Introduction to the Four Main Types of Rhinoplasty Procedures

When substantial reshaping of the nose is the goal, a surgeon will perform open or “external” rhinoplasty. The surgeon makes incisions in the columella (the bottom part of the septum) to lift the skin and tissues in order to see clearly the inner anatomy of the nose.

When only a minor reshaping of the nose is the goal, a surgeon will perform closed rhinoplasty. Incisions are made inside the nose. Its skin is separated from the cartilage and bone, which may then be reshaped, augmented, rearranged, or removed as desired.

Secondary or “revision” rhinoplasty is performed when problems persist or arise after an earlier rhinoplasty procedure. Depending on its specific goal, a secondary rhinoplasty may be either an open or a closed procedure.

Filler rhinoplasty is far less invasive. It uses injectable fillers for filling out depressions and for smoothing the nose’s tip to achieve symmetry. Injectable fillers, although effective, provide only temporary results and require the patient to return for “touch-ups,” usually about once a year.

How is Rhinoplasty Performed?

Reshaping the nose may be achieved with closed rhinoplasty that hides incisions within the nose or with open rhinoplasty when a surgeon makes an incision across the columella tissue separating the nostrils.

Soft tissues covering the nose are raised through these incisions, giving the surgeon access to conduct the reshaping procedure. After the underlying nose structure is formed into the shape that is desired, the skin and tissues go back and the incisions are closed.

Rhinoplasty enlarges or reduces nasal structures using cartilage that may be grafted from other parts of the body – usually from the septum – although in some cases ear cartilage may be used.

After the Procedure

Immediately following rhinoplasty, a surgeon may insert internal tubes and splints for supporting the nose as healing begins. Those tubes and splints usually stay in for about a week. Rhinoplasty surgeries usually last from one to two hours, but some patients will need slightly more time.

Upon waking from surgery, your nose will be splinted and packed to reduce bleeding. You may feel “stuffed up” like you have a cold, but you should not be feeling pain. Any bruising around the eyes and cheeks should fade within the first two weeks after the procedure.

Have someone stay with you for the first two or three days after the surgery. You may feel fine, but with someone else’s help, you can make sure that nothing disrupts your first days of recovery.

When is Rhinoplasty Recommended?

While many patients seek rhinoplasty for purely cosmetic reasons, other patients need rhinoplasty surgery for these and other health reasons:

1. To repair a restricted air passage that may cause difficulty with breathing or sleeping or other problems with the sinuses. If a patient has a deviated septum, rhinoplasty can straighten it and enhance the patient’s breathing.

2. Broken noses may heal crookedly. Cosmetic surgery immediately after a nose is broken may help a patient avoid the more difficult corrective surgery that will be needed if the nose heals asymmetrically.

3. An untreated blood clot in the septum can damage surrounding cartilage, cause the nose’s bridge to collapse, and create a condition called “saddle nose.”

How Do Patients Prepare for Rhinoplasty?

Prior to a rhinoplasty procedure, a patient should avoid smoking, arrange to be away from the job for the recovery period – at least one week – and arrange transportation, as you can’t drive home by yourself after rhinoplasty surgery.

Additionally, patients will need to avoid anti-inflammatory drugs, aspirin, and herbal supplements. All of these can increase bleeding. A patient may need to have a physical exam, take particular drugs in advance of the surgery, or adjust his or her current medications.

A patient’s recovery time will hinge on the precise details of the procedure, but most patients can return to work in about a week. The improvements should be visible within fourteen days, but the final results may not be fully visible for six months and sometimes longer.

What Should You Ask the Doctor

Your rhinoplasty surgeon should explain fully to you the risks and complications associated with the surgery. Be sure that all of your questions are answered and that you’re entirely comfortable before moving forward with the procedure. The questions you should ask your doctor include:

1. Are you board-certified? Your rhinoplasty doctor should be certified by the American Board of Cosmetic Surgery (ABCS).

2. How many rhinoplasties have you done? A tummy-tuck or breast enhancement specialist may have little or no rhinoplasty experience, and vice-versa. Choose a doctor who specializes in rhinoplasty and who has performed it on patients of all ages and genders.

3. What anesthesia is provided, and by whom? Anesthesia should be administered only by a board-certified physician anesthesiologist or a certified registered nurse anesthetist. ABCS-certified surgeons work only with trained and licensed anesthesia professionals.

What Does Rhinoplasty Cost?

Most cosmetic surgical procedures are elective, so most patients pay personally and directly. However, if you’re seeking rhinoplasty for a health reason – such as a breathing problem related to a deviated septum – a rhinoplasty procedure may be covered by your health insurance plan.

You should be given a personalized and detailed fee quote during or after your first consultation with a cosmetic surgeon. If the quote sounds too good to be true, it probably is, although a high price is no guarantee that a surgeon is skilled or that you will be satisfied with the results.

When you choose the right Boston cosmetic surgeon and you faithfully adhere to that doctor’s instructions, in just several weeks after the procedure, you’ll be feeling and looking great and enjoying the benefits of your rhinoplasty surgery.