Second only to the eyes, the nose is the most prominent feature of the face. Thus it can be distressing when the nose does not appear in harmony with the rest of one's appearance. Not surprisingly, Rhinoplasty, surgery to reshape the nose, is one of the most common of all cosmetic surgery procedures. Rhinoplasty can reduce or increase the size of the nose, change the shape of the tip or bridge, narrow the span of the nostrils or change the angle between the nose and the upper lip. Although many desire Rhinoplasty to cosmetically enhance the shape of their nose, others seek surgery after a facial injury or to help relieve breathing problems. When having surgery to correct such a functional problem, medical insurance may cover a part of surgical costs.

If you have been thinking about how Rhinoplasty might enhance your appearance, please consider consulting with Dr. William Boss, the plastic surgeon on our staff at the Cosmetic Skin and Surgery Center. Dr. Boss will discuss your individual expectations and review your medical history, and then recommend the surgical technique that would work best for you.

Are you a good candidate?
Rhinoplasty can enhance your appearance and self-confidence, but it will not necessarily change your looks to match your ideal. Remember that improvement, not perfection, is the goal. The best candidates are healthy individuals with realistic expectations. Although there is no upper age limit for nose reshaping, most surgeons prefer not to operate on younger patients until they have finished growing, usually around age sixteen for girls and somewhat later for boys. A person's social and emotional adjustment is of course taken into consideration.

About the consultation
Rhinoplasty is usually a safe procedure with infrequent complications. When performed by a qualified plastic surgeon this procedure can help you achieve your new desired profile. Nevertheless, while complications are unusual Dr. Boss will discuss any side effects with you. He will review the special technique he plans to use for you and show you before and after pictures of patients with similar noses. He may also discuss with you if any additional facial procedures may enhance the effects of your nose surgery. Some patients elect chin or cheek procedure to be performed at the same time. In about 1 case out of 10 a second procedure may be required. Such cases are unpredictable and their corrective surgery is usually minor. Dr. Boss will discuss the expected outcome as well as timing and type of anesthesia recommended. Dr. Boss's communication skills and ability to relate to his patients and explain techniques will make you fee comfortable.

The surgery
Rhinoplasty requires approximately one and a half hours to perform depending on the extent of the correction. The procedure is commonly performed under local or general anesthesia on an outpatient basis. During the 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 specific anatomy. Finally, the skin is redraped over the new framework. Depending upon your needs, Dr. Boss may use an open or closed technique. In the closed technique, incisions are made inside the rim of the nostrils. In the open technique, incisions are made near the base of the nostrils. In either case, the soft tissue of the nose is then separated from the under lying cartilage and bone. The cartilage and bone are the sculpted into shape. At the same time, internal problems such as breathing obstructions can be improved by removing or changing the shape of the obstructing matter. 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 paced in your nostrils to stabilize the septum, the dividing wall between the air passages.

After the surgery
Most rhinoplasty patients spend the first day in bed with the head elevated. On the second day they are up and about. After about 3 days, the bruising and swelling around the eyes starts decreasing. Within a week, the splint is usually removed and the patient can return to school or work. There may be some swelling and bruising around the nose and eyes that are improved with ice compresses and head elevation. It is common to experience some nasal stuffiness, particularly if you had surgery of the septum. Dr. Boss usually recommends a period of 2 weeks before you can gently blow your nose. You need to be careful to avoid injury and sun exposure of the area for 8 weeks. Dr. Boss will give you instructions as to when you can recommence exercise and strenuous activity.