Nose Reshaping (Rhinoplasty)

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Plastic surgeons usually recommend that patients wait until they are at least 14 or 15, and possibly older for boys, before undergoing rhinoplasty. This is because the nose may not be fully developed at a younger age. If you are a teen, your plastic surgeon will want to be certain that you have thought carefully about surgery and that the desire to change your appearance is based on your own feelings rather than those of your parents or friends.

Assuming you are in good health, there is no upper age limit for having your nose reshaped. Rhinoplasty is sometimes performed in conjunction with a facelift or other rejuvenate surgery to correct aging changes of the nose such as a drooping tip.

Sometimes certain breathing problems related to the internal nasal structures can be corrected at the same time as nose reshaping is performed. Your plastic surgeon will be able to help you determine whether these structures should be modified along with reshaping your nose.

                         

Your Personal Consultation

During the initial consultation, you may be asked to look in a mirror and point out exactly what you would like to see improved. This will help your plastic surgeon to understand your expectations and determine whether they can realistically be achieved.

 

Am I a good candidate for rhinoplasty?

Some of the indications that you may be a good candidate for rhinoplasty are:

  • your nose appears too large for your face
  • there is a bump on the nasal bridge when viewed in profile
  • your nose seems too wide when viewed from the front
  • the nasal tip droops or plunges
  • the tip is thickened or enlarged
  • your nostrils are excessively flared
  • your nose is off-center or crooked
  • previous injury has made your nose asymmetrical

It is important that you have a clear idea of how you would like your nose to look and, at the same time, realize that there are limitations to the procedure. Patients with sufficient physical and emotional maturity who undergo rhinoplasty because they want to enhance their self-image are usually very satisfied with their decision.

Your plastic surgeon can provide further information if you have an interest in any of these additional procedures.

 

How will my plastic surgeon evaluate me for rhinoplasty?

You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions you may have, medical treatments you have received, previous surgeries including repair of nasal injuries, and medications that you currently take. Your plastic surgeon may also ask whether you have difficulty breathing through your nose, suffer from allergies that may cause nasal stuffiness, or are a chronic user of nasal spray. It is important for you to provide complete information.

In evaluating you for rhinoplasty, your plastic surgeon will conduct a routine and painless examination of your internal nasal structures. Your skin quality as well as the size and shape of your nose and its relationship to your other facial features will be carefully studied. In some instances, your plastic surgeon may recommend surgery of your chin, making it either more or less prominent, to improve facial balance. This procedure can be done at the same time as your rhinoplasty.

 
When will I learn about the cost of surgery?

It is understandable that you would like to have information about the cost of surgery as soon as possible. Your plastic surgeon must first complete a thorough evaluation before your individualized surgical plan can be developed. Following this, the fees required for your surgery will be discussed with you. While most insurance plans will not pay for aesthetic nose reshaping, they frequently will cover surgery performed on the internal structures of the nose to improve breathing problems. Your   plastic surgeon can discuss this with you at the same time of consultation.

 

How Rhinoplasty is Performed?

Because of individual factors, not everyone will achieve the same results from rhinoplasty. Your surgeon’s goal is to obtain the best possible results for you.

 

Where are the rhinoplasty incisions placed?

Alterations may be made to increase or decrease the nasal bridge, reduce the size or width of the nose, narrow the nostrils, change the angle between the nose and upper lip, or reshape the tip.

Rhinoplasty Incision

Small wedges of skin, as shown, are removed to narrow the base of the nose or reduce the width of the nostrils.

The surgical techniques employed will depend primarily on the goals established by you and your plastic surgeon. In many instances, all of the incisions will be placed inside your nose, where they will not be visible. If the base of the nose is narrowed or the nostrils reduced, small wedges of skin at the base of the nostrils will be removed. Incisions are hidden in the natural crease where the nostril joins the cheek.

Sometimes a very short incision is made across the vertical strip of tissue that separates the nostrils, called the columella. This technique is called an "open rhinoplasty." Whatever incisions are used to reshape your nose, they will ultimately be very inconspicuous.

 

How is my plastic surgeon able to reshape my nose?

Rhinoplasty Incision

Incisions are placed inside the nose to provide access to the cartilage (blue shaded area) and brown (light brown shaded area) that form the nasal framework.

Through the small incisions described previously, work is done on the cartilage and bone that form the framework of your nose.

Sometimes, the position of certain bones may need to be altered slightly in order to make your nose look narrower and straighter. If your nose needs to be built up in some areas, this can be done using nasal cartilage, or perhaps bone or cartilage from another site. The skin and soft tissues then redrape themselves over this new "scaffolding."

 

Understanding Risks

Fortunately, significant complications from rhinoplasty are infrequent. Every year, many thousands of people have their noses reshaped, experience no major problems and are pleased with the results. Anyone considering surgery, however, should be aware of both the benefits and risks.

Rhinoplasty Incision

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