Rhinoplasty is a surgical procedure that can help improve the appearance of your nose. It can be performed on adults and children, but it’s important to note that rhinoplasty is not recommended for people under 18 years old unless there are medical reasons for doing so.
If you’re unhappy with the size or shape of your nose, rhinoplasty is the obvious solution. Getting a nose job does more than just change your nose; it changes how the rest of your face is perceived and allows all your facial features to work together to create a beautiful you. And if you’re in the Rio Grande Valley, the Rios Center for Plastic Surgery, located in Edinburg, Texas, is a perfect choice. Finally, you can achieve the facial symmetry you’ve always longed for.
What Is Rhinoplasty?
This Rhinoplasty procedure is commonly known as a nose job, and although it has great aesthetic uses, it has vital medical uses as well. Nose jobs are often used to correct impaired breathing that has been caused by issues with the structure of the nose. There are many reasons a person may choose to seek out a nose job. Some people choose to get this procedure after a trauma, such as after breaking their nose. Some may seek it out to fix the natural size and shape of their nose to make it more appealing and to allow it to fit in more smoothly with the other facial features.
Of course, getting a nose job is a common choice for those with nasal breathing issues. One of the most common causes of breathing impairments is a deviated septum. This is where the nasal septum, or the bone and cartilage that divides the nasal cavity in half, is off-center or crooked. This can make breathing difficult, and having this procedure is the perfect way to find clear air.
Getting a nose job can make the nose size more balanced in relation to other facial features. It can be used to change the nose width at the bridge or at the nostrils or to change the nose profile’s visible humps or depressions. It can fix a nasal tip that is enlarged, upturned, down-turned, or hooked. It can also fix nasal asymmetry or nostrils that are large or upturned.
Types of Procedures
Each nose job is unique. Every patient seeking a nose job comes in with different needs and expectations. While the surgeon will follow the same basic steps, they have to plan each treatment and procedure specifically for the patient in question. By customizing treatment, surgeons are able to provide the best possible care on an individual basis. Depending on what your specific needs are, there are four main types of nose jobs that your doctor may suggest.
Closed Rhinoplasty
This is the most popular type of nose job because all the incisions are left hidden inside the nose. Once you are healed from the procedure, you won’t have any visible scarring. The soft tissue of the nose is lifted slightly upward, leaving the bone and cartilage accessible to the doctor so they can perform the necessary changes to the structure of your nose.
This type of nose job is less invasive than the other types, so there are several advantages to choosing this option. There is generally less nasal tissue irritation with this procedure and a decreased likelihood of post-operative edema, or swelling. Part of the reason for decreased irritation is that the doctor does not make any surgical cuts on a portion of the nose called the columella. Because of the less-invasive nature of this surgery, there is less time spent inside of the operating room, as well as a faster post-operative recovery for the patient.
This procedure is useful for patients who require small structural changes to their noses. Because this version of the procedure is less invasive than other forms of rhinoplasty, however, the doctor also isn’t able to create massive structural changes. If you require a more intensive nose job, you will need a different type of surgery.
Open Rhinoplasty
This version of the procedure is more intensive and has historically been useful for patients who need more extensive work done on their nose. If you need more than a minor change to the structure of your nose, it is likely that the surgeon will suggest this type of nose job. The surgeon starts by making small incisions in the area between your nostrils and underneath your nose, in an area called the columella. This allows the surgeon to move the skin from a large part of your nose.
Then, the skin is lifted up to allow access to the inside of the nasal cavity so the surgeon can reshape the structural parts of the nose. After reshaping the necessary areas, the doctor will suture up the columella and tape the nose to encourage stabilization. After taping, the doctor will place a splint over the finished nose that has been sculpted specifically for the patient. The splint works to protect the healing tissues of your nose for the next week.
This type of surgery is often chosen for patients who require extensive grafting. It’s also suggested for patients who have a variety of nasal issues, such as collapsed valves from a previous hump removal or structural deformities due to genetics. It’s also often suggested for patients who do not have genetic deformities but have acquired nasal deformities after severe trauma to the nose.
Filler Rhinoplasty
This type of nose job is less common and is non-surgical. Because of this, it can be done not just by cosmetic or plastic surgeons, but assistants and dermatologists as well. This type of nose job is perfect for people who want to correct a minor imperfection in their nose.
This type of nose job is done by using an injectable filler such as Juvederm or Restylane. The filler works to even or fill out small issues in the nose. It’s a great option for those with small issues because it’s non-invasive and quick. One downside, however, is that the results are not permanent. Over time, the body reabsorbs the filler, which effectively erases the changes that were made.
Revision Rhinoplasty
This kind of intervention is done after a primary nose job. After having the procedure, a patient may choose to have a revision if they aren’t happy with the original results of the nose job. Patients may also choose to have a revision if they are happy with the results but would like to address further changes.
Another common reason for a revision is breathing difficulties. It’s relatively common for individuals to experience mild breathing issues after having a nose job. Because a surgeon is adjusting the structure of your nose, they may accidentally create, or uncover issues that result in, a small obstruction that affects your breathing.
Different Types Of Rhinoplasty
Rhinoplasty is one of the most common cosmetic surgeries in the world. The nose is one of the first things people notice about your face, which is why rhinoplasty has been so popular for so long. Many people choose to have a rhinoplasty because they want their nose to look more attractive or symmetrical, while others choose it because they have breathing problems caused by structural issues with their noses. Whatever your reason might be for considering a rhinoplasty, there are many different types available for you to explore with your surgeon before making any decision about what type of surgery would be best for you!
Septorhinoplasty
A septorhinoplasty is a procedure to correct the structure of the nose. The word “septorhinoplasty” comes from the Greek words for “Septum” and “Rhinoplasty,” which mean “nose.” Septum refers to bone that divides your nostrils in half, while rhinoplasty refers to plastic surgery on your nose.
This type of cosmetic surgery can be used to improve breathing problems caused by structural issues with your nasal passages or even certain facial features like wide cheeks or narrow nostrils. A specialist will reshape these areas so that air flows freely through them when inhaling and exhaling, preventing snoring issues too!
Cosmetic Rhinoplasty
Cosmetic rhinoplasty is a procedure to improve the appearance of your nose. It can be performed under local or general anesthesia, depending on the patient’s preference and needs. The surgery lasts about an hour and involves making changes to both sides of the nose, including:
- Straightening curved nasal bones
- Shaping flared nostrils and narrowing them down by removing excess skin from inside the nostrils (the columella)
- Reshaping tip cartilages (cartilage that helps support and shape your tip)
Ethnic Rhinoplasty
If you are not Caucasian, then this is the procedure for you. Ethnic rhinoplasty is a technique that allows surgeons to maintain ethnic and cultural features while correcting nasal deformities.
The goal of ethnic rhinoplasty is to make the nose look more like your own culture’s ideal nose by balancing out its proportions and features. This can be done through changing the tip, bridge or nostrils of your current nose so that they match those of someone from your own ethnicity group (for example: Asian).
Age Appropriate Nose Job
- Age Appropriate Nose Job
- Nose Jobs For Older People
In recent years, rhinoplasty has become more common among older people. This is due to the fact that there are many factors that contribute to aging such as sun exposure and smoking, which can damage the skin and cause sagging in the nose area. In addition, children who have been diagnosed with breathing problems may need a revision surgery later in life if they grow out of their original surgery or if it was performed incorrectly by an inexperienced surgeon.
Solutions for a Crooked or Off Center Nose
If you have a crooked or off center nose, rhinoplasty can be a great solution. The procedure may also be used to help people who want to make their noses smaller or larger.
The first step in getting a new nose is choosing a surgeon who has experience with this type of surgery. It’s best if they have performed hundreds of procedures and can show you pictures of their work before and after surgery so that you can see what your results will look like. Your surgeon should also give honest feedback about whether they think they are able to get the results that are important to you
Dorsal Hump Removal
A dorsal hump is a bony projection that is visible on the outside of your nose. It can be removed with a rhinoplasty procedure, or reduced with fillers. It’s common to have a dorsal hump removed along with other procedures like tip refinement or tip rotation, if necessary.
When it comes to fixing prominent noses, there are many options available for surgeons who want to help their patients achieve an attractive new look without going under the knife.
Non-Surgical Rhinoplasty
Non-surgical rhinoplasty is a good option for people who want to improve the appearance of their nose but don’t want surgery. It involves using filler injections to improve the shape of your nose.
This method can be effective for people who have a small amount of asymmetry and are looking for minor changes, such as narrowing or sharpening their tip, straightening out bumps and curves in their bridge, or reducing drooping nostrils that might make them look older than they are.
types of rhinoplasty implants
Nasal implants are synthetic products that are placed in the nose to alter the size, shape, or overall structure of the nose. Implants are typically placed for two reasons- either to enhance the shape of the nose as an adjunct to rhinoplasty, or to improve the nasal airway by strengthening the nasal valve area (link to nasal valve). The materials used may vary but can be made of Medpore, Gortex, or may be silicone based.
The use of nasal implants has been common practice among many surgeons worldwide for decades. Cited benefits for implant use is the ease and convenience of using pre-made material that can be placed during a procedure. This may cut down on operating costs and time. Other surgeons believe that it provides predictable and reliable results during surgery. However, the reality is that although there are many benefits of using implants, patients must be informed with regards to potential complications associated with use of synthetic materials in the nose.
One of the major concerns with introducing foreign materials in the nose is the risk associated with infections and local reactions. If the material used in the nose becomes infected it may be very difficult to treat with antibiotics. Antibiotic treatments may not reach the grafted area in a high enough concentration to treat the infection. As a result, patients may be placed on antibiotics for prolonged periods of time, sometimes for months. Sometimes these antibiotics are administered through an IV, if oral antibiotics are not strong enough. Finally, even if the symptoms of an infection subside, the infections may not always be completely treated and patients may experience occasional flare ups requiring further treatment. The infections may also not develop right away. As long as there is foreign material in the nose, there is always the risk of an infection. This can occur 1 year after surgery, or 20 years after surgery. In my practice, I see patients that have developed an infection on average 11 years after the initial placement of the graft.
Often times if the infection cannot be adequately treated with antibiotics, the implant must be removed. This creates a dilemma for the surgeon and the patient. The implants typically have formed an integral part to the overall structure of the nose, and the infection is associated with severe scarring. Removing the implant is both difficult and may severely alter the shape and structure of the nose. Removal can compromise the appearance of the nose, and a person’s ability to breathe. As a result, the graft must be replaced.
Many considerations must be taken into account prior to removal and replacement of a nasal implant. One consideration is the timing of the replacement and reconstruction. Some surgeons advocate for removal of the implant with a reconstruction using a different material at a secondary date. This reduces the risk of the new construct becoming infected, allowing the tissues to heal from the infection for a specific amount of time. Some surgeons may wait a few weeks, others may wait a year. The major disadvantage is that removing the implant may leave the nose “deformed” and unsightly for a long period of time. Other surgeons however may elect to reconstruct the nose in the same setting. Reconstructed materials may range from using new synthetic materials or to the use of rib or ear graft (link to rib graft). Overall, it is most advisable to avoid the use of new synthetic materials if you have already had an infection with a prior implant- so patients typically undergo rib and cartilage grafting to reconstruct the nose after implant removal.
It is important to recognize the long term risks of using synthetic materials in the nose. You should have an open and honest conversation with your surgeon to understand fully all the available options so that you can make an informed decision about your treatment plan.
Dr. Mourad’s Approach: A Patient Story
The following is a 39 year old female that had a rhinoplasty 17 years prior to seeing Dr. Mourad. During that surgery a synthetic implant was placed. This implant was used to make a “new bridge” of the nose. About 1 year prior to seeing Dr. Mourad, she developed pain, swelling, redness, and drainage around her nasal bridge. She sought treatment from multiple plastic surgeons. She was placed on multiple courses of antibiotics for several months with no resolution. She continued to have discomfort, pain, and swelling in the area. She returned to her original surgeon who recommended implant removal, with definitive reconstruction at a secondary surgery 1 year after. This seemed like an unacceptable option to the patient.
Figure-1: The above photos show the patient when she presented to Dr. Mourad for evaluation. As you can see she has an infection on the side of her nasal bridge. She has tried to eradicate the infection with antibiotics for a full year prior to seeing Dr. Mourad.
She then sought an evaluation with Dr. Mourad. She was concerned with having the implant removed and the subsequent nasal deformity. Her original surgeon recommended delaying any reconstruction for a year. This would have significantly altered her appearance. Dr. Mourad then offered implant removal followed by immediate reconstruction using her own rib. Dr. Mourad is an expert in nasal reconstruction and rib harvest.
Figure-2: The above photo demonstrates what the patient looks like after implant removal. She has what is called a “saddle nose” deformity, in which she is missing her entire nasal bridge. Spending a year with this deformity would have been extremely difficult for the patient.
Figure-3: Dr. Mourad used a special minimally invasive technique to obtain grafting material to reconstruct her nose.
If you have an infected nasal implant from Medpore, Gortex, or a silicone base. Contact board-certified head and neck surgeon Dr. Moustafa Mourad.
types of nose surgery to breathe better
Nasal obstruction is characterized by a decreased ability to breathe through one or both sides of the nose and can have a significant impact on daily life. Some of the ways this can interfere in lifestyle include:
Determining the exact cause of the obstruction is paramount to successfully treating the obstruction. Nasal obstruction can be caused by a single factor or a combination of many factors. The most common causes of nasal obstruction are:
Each of these factors must be carefully evaluated to see how they contribute to your symptoms. Depending on the cause of the nasal obstruction, these issues may be treated with medications, nonsurgical interventions such as nasal cones, or with surgical correction.
What to Expect During Your Appointment
At your first appointment you will meet with the surgeon who will carefully review your personal and medical history along with a thorough examination of your nose; both inside and out. Be prepared to discuss any difficulties breathing through your nose as well as any previous nasal surgeries. The examination may include nasal endoscopy to carefully inspect the structures inside the nose. This involves placing a small endoscope into the nose to see more detail than is visible looking directly through the nostrils, a topical numbing spray will be used prior to the exam.
Your surgeon will explain the details of the surgery, operative risks, expected recovery time, post-operative medications and restrictions along with follow up visit schedule. You should expect the opportunity to ask all questions you may have about the surgery and understand what to expect throughout the process.
Surgical Treatment Options
Surgical treatment options will vary depending on the identified cause of your nasal obstruction. Your surgeon will tailor treatment to match your individual needs. Sometimes additional cartilage is necessary in order to provide a stable nasal structure, this may be obtained using cartilage removed from the far back portion of the septum, the ear, the rib, or cadaveric cartilage.
Septoplasty
One of the possible causes of nasal obstruction may be a crooked (deviated) septum. The septum is the part of the nose that divides the nostrils. Septoplasty surgery involves straightening and occasionally removing crooked areas of the septum. Depending on where the septum is deviated, surgery may be performed in different ways. If the septum is crooked toward the back of the septum, then often times, a traditional “endonasal/closed” septoplasty is performed. This approach uses an incision inside the nose and does not change the appearance of the nose. If the septum is crooked at the front, or the entire septum is so crooked that it causes the outside of the nose to appear crooked, then an “external/open” approach is utilized. This approach is used for rhinoplasty surgeries as well and involves a small incision along the front of the nose called the columella. Although this incision is on the outside of the nose, it typically heals so well, that it is imperceptible. When this approach is taken, the entire septum is treated, and the external nose also will appear straighter after surgery.
Before & after septorhinoplasty: frontal view.
Before & after septorhinoplasty: side view.
Nasal Valve Repair
The nasal valves are known as the most narrow points within the nasal passageway. When these valves are narrow or weak, it can cause significant nasal obstruction, also known as nasal valve collapse. The two most narrow areas in the nose are at the external valve and the internal valve. When the external valves are narrowed, this sometimes can appear as deep creases along the upper nostrils. When the internal valves are narrowed, this sometimes can appear as a pinched nose at the middle region of the nose. The nasal valves may be narrowed at rest, or may narrow only with inspiration.
Signs of nasal valve collapse include:
There are several surgical techniques utilized to address nasal valve issues. These techniques involve placing a cartilage graft and sutures to help support the structure of the nasal valve. Like a septoplasty, the incisions may need to be placed inside the nostrils or a small incision may need to be placed across the columella. The surgical approach to repairing nasal valves depends on the severity and location of the obstruction. Nasal valve surgery can be performed at the same time as the septoplasty and turbinate reduction, if all procedures are needed.
Nasal valve collapse: before & after surgery.
Alar retraction: before & after surgery.
Turbinate Reduction
Enlarged turbinates, located on the sides of the nose, can pose a problem for individuals by reducing airflow through the nasal passages. The three turbinates on each side of the nose play a crucial role in humidifying and heating the air we breathe in order to prepare it for entry into the respiratory system. However, when these turbinates become too large, they can obstruct the airflow, leading to difficulties in breathing and other related issues.
Common symptoms of enlarged turbinates include nasal congestion, difficulty breathing through the nose, frequent nosebleeds, and even chronic sinus infections. If left untreated, enlarged turbinates can significantly impact an individual’s quality of life.
For individuals struggling with airflow issues due to enlarged turbinates, there are various surgical options available to decrease their size and improve nasal breathing. Turbinate surgery, also known as turbinoplasty, is one common procedure used to address this issue. This surgery is most often performed as a supplemental procedure in conjunction with other nasal surgeries, such as septoplasty or sinus surgery.
During turbinate surgery, the size of the turbinates is reduced through techniques such as turbinate reduction or turbinate repositioning. This helps to alleviate the obstruction in the nasal passages and restore proper airflow. The goal of turbinate surgery is to improve the overall function of the nasal passages and alleviate symptoms associated with enlarged turbinates.
It is important to note that turbinate surgery is typically considered a safe and effective procedure. However, as with any surgical procedure, there are potential risks and complications to be aware of, such as bleeding, infection, and nasal obstruction. It is essential for individuals considering turbinate surgery to consult with a qualified ENT specialist to discuss their options and determine the best course of treatment for their specific condition.
In conclusion, enlarged turbinates can create significant challenges for individuals by obstructing airflow through the nose and causing breathing difficulties. Turbinate surgery is a common and effective treatment option for addressing this issue and improving nasal breathing. By seeking the appropriate medical care and guidance, individuals with enlarged turbinates can find relief and improve their overall quality of life.
What to Expect
The Day of Surgery
Functional nasal surgery is done in the operating room under general anesthesia. Expect to arrive to the hospital or surgery center one to two hours before your scheduled surgery time and remember not to eat or drink anything after midnight before surgery to minimize risks related to anesthesia. You will meet the Anesthesiologist and operating room team at this time. Your surgeon will also see you before the surgery begins to review the plan and make sure all of your questions are answered.
The surgery itself will last several hours. After surgery the skin of your nose will be covered with some surgical tape and often a plastic cast. Dissolvable sutures will be present inside the nose and if needed there may be some sutures on the strip of skin between your nostrils. Sometimes flexible splints are secured inside your nose. You may have some occasional oozing of blood from the nostrils as well as some swelling and discomfort of the nose. There may also be some bruising under the eyes.
In the recovery room you will be closely monitored to ensure your pain is well controlled and all of your vitals are stable. At this point you will be cleared for discharge home. You will need a friend or relative to drive you home after surgery and stay with you for the first one to two days after surgery.
During Your Recovery
After surgery you will be discharged home with prescriptions for pain medication and possibly antibiotics or anti-nausea medication. You will also have written wound care instructions which include spraying the inside of your nose with a saline spray several times per day and applying antibiotic ointment to the incision lines. It is common to have some intermittent drops of blood from the nostrils for the first several days that can be dabbed away with a tissue. Expect your nose to feel congested after surgery, especially if splints are placed inside the nose.
You will have pain following surgery, but with the medication the pain should be tolerable. This rapidly improves through the first week. You may also have some swelling or bruising under the eyes. Elevating your head during sleep and applying light weight ice packs to the cheeks can help speed up the resolution of the swelling and bruising. You should be up and around the house after surgery but avoid any strenuous activity, bending at the waist, or heavy lifting to minimize swelling, bleeding, and discomfort. Walking and light activity is encouraged and may help speed up your recovery.
Your first post-operative visit will be scheduled for five to seven days after surgery. At that time you will meet with the surgeon to review your recovery. The external nasal splint will be removed at that time along with any sutures on the skin or splints inside your nose. Your nose will be carefully examined to assure that you are healing well. At this visit your surgeon will discuss the next steps in your recovery including any limitations on activity or work and additional follow up visits. Most people return to work one to two weeks after surgery. While recovery proceeds quickly in the following weeks, keep in mind that it will take a full year for all the swelling to resolve
Combined Functional & Cosmetic Rhinoplasty
Many of the cosmetic rhinoplasty procedures that address desired cosmetic changes to the nose use the same surgical approach that is used for functional nasal surgery, and it is common to combine surgery to improve breathing as well as the shape of the nose. When structural issues are present that require surgery to improve breathing, these procedures are typically covered by most insurance companies. Surgery to change the shape of the nose that does not affect breathing is not covered by insurance and carries a separate cost, but can easily be completed while you are having surgery to improve breathing.
Combined Functional Nasal & Sinus Surgery
Some people suffer from a combination of issues with nasal breathing and chronic sinus problems. We work with our partners who are specialists trained in sinus surgery to address your health needs.
What is the safest rhinoplasty
What is the difference between a surgical and a non surgical rhinoplasty?
A non-surgical rhinoplasty is a non-invasive alternative to traditional rhinoplasty, utilising injectable fillers to alter and shape a person’s nose without surgery.
This would be the best option for someone who wishes to alter the shape of their nose rather than its size. This procedure is great for correcting a number of nose issues, including smoothing bumps, straightening hooked or crooked noses and correcting nasal tip droops. The results are immediate and will last for up to a year.
Rhinoplasty surgery is generally a better option for those looking to make more significant, and permanent, changes to the size, shape and function of their nose. While this procedure is usually carried out for cosmetic reasons, a nose job can also help correct breathing issues and help alleviate the symptoms of sleep apnoea and snoring. The procedure also helps to correct noses that have been damaged through sports, accident or injury.
Rhinoplasty surgery can take between one and three hours, but it takes just 15 minutes to carry out a non-surgical nose job. Naturally the surgical option has a longer downtime, with a full recovery taking between six and eight weeks. With a non-surgical rhinoplasty, a patient will be able to return to work and their daily routine straightaway.
Prices for surgical rhinoplasty start from £6,900. Prices for non-surgical rhinoplasty start from £550.
Book an appointment with our expert surgeons here at the Cadogan Clinic to discuss the options available to you.
A state of the art, award winning clinic.
Founded in 2004 by world renowned plastic surgeon Mr Bryan Mayou, we now work with over 100 leading consultants and successfully treat over 20,000 patients each year. We have been winning industry awards since inception.
All of our treatments take place at our beautiful boutique premises in Chelsea. We have six consulting rooms and five operating rooms, as well as a dedicated pre and post-operative suite, and a full team of specialist nursing staff.
A Strong Tradition of Innovation
We were founded in 2004 by world renown plastic surgeon Mr Bryan Mayou, best known for his pioneering work in the area of liposuction, lasers and microvascular surgery. We continue to collaborate with pioneers in our field.
At Home in Sloane Street, London
We are proud that our state of the art award-winning clinic is located in one of the best neighbourhoods in the country
We offer surgical consultations in London, Birmingham, Chelmsford and Bristol, and attract international patients from all corners of the globe such as as the USA, the Middle East and Europe.
What are the different types of nose surgery?
There are five types of nose treatments that we offer here at the Cadogan Clinic. These include four surgical procedures – closed rhinoplasty, open rhinoplasty, septo-rhinoplasty and rhino-tip surgery – plus the quick, temporary non-surgical rhinoplasty. The type of surgery which is carried out will depend upon the patient’s desired outcome. Here we will look at these in more depth.
When is a surgical nose job right for me?
A surgical nose job is the best option if you are looking for permanent changes to the size and shape of your nose. Depending on your requirements, a surgeon can make your nose smaller (nose reduction), make your nose larger (nose augmentation) change the shape of your nose (including the nostrils) or change the angle between the nose and top lip.
If the appearance of your nose is causing you mental distress or having a major impact on your self-confidence, then a surgical rhinoplasty could help.
From a health point of view, if you are looking to correct any breathing issues then a surgical nose job is your only option.