The nose should function for normal breathing and blend into the overall shape and appearance of the face. Injuries and genetics play a major role in influencing patients to seek correction of nasal shape and size. Computer imaging is very helpful during the preoperative consultation to help prospective patients “see” the intended postoperative result and allow changes to be made BEFORE the actual surgery is done. It also allows patients to see the relationship between the nose and the chin on profile. Adding a chin implant to rhinoplasty is a common procedure and can dramatically improve the profile.
There is a whole spectrum of nose shapes and sizes all of which demand a careful plan and precision surgery. Dr. Grotting and Dr. Cohn enjoy nasal surgery, are challenged by it, and are experts at the various techniques required to repair or reshape the nose.
Who is a good candidate?
Most patients who are seen in consultation have a very good idea what they would like changed about their noses. For some, it is strictly the desire to breathe better. Interestingly, when we open up and support the breathing passages, the nose often looks better and more symmetric as well. An old adage in plastic surgery is “Form Follows Function”. This is very true for the nose.
The most common change that patients request is to reduce a large nose by removing some of the hump or to make the tip of the nose less bulbous. Also, patients who have already had a rhinoplasty somewhere often seek improvement at Grotting & Cohn Plastic Surgery.
How is the procedure performed?
Nose surgery is done in our fully accredited operating suite under local anesthesia with sedation or general anesthesia if you prefer. The procedure is usually done with the incisions made inside the nose (closed technique) or with a short incision across the skin between the nostrils (open technique). The obstructing portions of the nasal septum are smoothed out or removed, the bone and cartilage that forms the hump are reshaped, and the tip is formed into the proper configuration. Sometimes the nasal bones must be released (broken) to move them together to narrow the nose. A splint is placed on the bridge of the nose for one week and we will have you keep the steristrip tape on for one more week.
What can I expect for results?
Ideally, every patient who undergoes nose surgery would have excellent breathing and ideal shape. We are able to achieve such a result 85% of the time. That means that up to 15 % of patients might be candidates for a revision. The reason for this is that the various forces on the nose during the healing phase can result in small deformities that may need to be addressed at a separate time up to a year later. Also, swelling can stay in the nose tip for many months after surgery, so it takes about a year to see the “final” result. Nevertheless, you will immediately see a change when the splint comes off at one week.
Are there any complications?
Like all operations, bleeding and infection are standard risks but, fortunately they are rare in a rhinoplasty. On rare occasion, a nose bleed can occur in the first couple of nights after surgery which is usually easy to treat. Another rare event is a hole in the septum (partition between the left and right nasal airways) which might require additional surgery to fix. Prominent scars are uncommon. If you have allergies that result in sinus infections before surgery, these will continue afterwards, so sinusitis may persist.