Nasal surgery on a patient that has never undergone this type of surgery is called primary rhinoplasty. Primary rhinoplasty is the best opportunity to deliver optimal results because the anatomy is undisturbed and there is no scar tissue or missing cartilage.
Contact us to schedule a consultation for rhinoplasty surgery.
Table of Contents
Consultation and Planning
Dr. Frankel individualizes every patient’s care. He invests the time to fully understand patient expectations, learn complete history, evaluate the inside and outside of the nose, and take digital images. Dr. Frankel will discuss the cosmetic and functional expectations of your rhinoplasty Beverly Hills in detail to ensure all your questions are answered. Pre-operative computer imaging, or “photo-morphing,” is performed with all rhinoplasty patients before surgery, so they may have an active role in determining the desired outcome.
Surgical Process
For primary rhinoplasty, results are highly tailored toward each patient’s desires and individuality. The surgery is typically outpatient, with the operation performed in the Lasky Clinic under anesthesia. Procedures can vary widely depending on patient goals and aesthetic desires. Both open and closed approaches are utilized, depending on the situation and the patient’s anatomy, and will be discussed with Dr. Frankel before surgery.
Reduction
In reduction rhinoplasty, the overall size of the nose may be reduced, or specific areas may be made smaller, like the tip or a hump or bump.
Resizing is often done by removing cartilage and/or bone from the nose to achieve the desired shape and size. Reduction rhinoplasty reduces the framework size of the nose, but the skin that drapes over the nose is not touched. The elasticity of skin allows it to shrink to the size of the smaller frame.
Refinement
The term refinement in rhinoplasty generally refers to being able to elicit more detail at the tip. A nose that is more refined has more highlights emphasizing the underlying structure.
Refinement can be accomplished by making the cartilage more prominent or by thinning the overlying soft tissue. Sometimes both are done in order to allow for the beautiful underlying tip cartilages to be more fully appreciated.
Functional
Due to structural defects, a nose may require reshaping to function properly. Patients may be born with, develop, or acquire through an accident or physical confrontation, nasal defects that interfere with breathing, eating or sleeping.
Functional rhinoplasties are imperative to fix a variety of nasal abnormalities. It is as important to preserve or restore normal function as achieving an attractive cosmetic result. If you have difficulty breathing through your nose, the functional advantage of rhinoplasty can be as dramatic as the improvement in your appearance.
Adolescent
The right cosmetic procedure performed at the right time can greatly impact a young person’s physical and emotional development, as well as self-confidence. Dr. Frankel requires a consultation prior to surgery where he will assess the physical and emotional maturity of teenagers requesting surgery.
Dr. Frankel is known for being honest and frank with his youngest patients, discussing risks, recovery and reasonable expectations.
Primary Rhinoplasty Procedure
What to expect on the day of surgery
Anesthesia
The majority of all operations that Dr. Frankel performs will be under the direction of a board-certified anesthesiologist, and involve twilight anesthesia without the need for a breathing tube, ventilator or paralysis.
Even in surgeries taking several hours, the anesthetic is well tolerated and patients wake up quickly feeling very good. The entire experience is enhanced.
Day of surgery
The first one to two hours after rhinoplasty are spent in the recovery room on monitors and under the care of a registered nurse.
Patients are transferred to private rooms once they are more awake, where their families or friends can join them. Once fully alert, patients will be able to return home with a set of post-operative instructions.
Pain management
Rhinoplasty is not typically very painful, and most patients experience more discomfort than pain, particularly immediately after surgery while the local anesthesia is still working.
While recovering at the clinic, patients may receive intravenous medications to stem any acute pain. Patients are discharged from the clinic with their prescribed medications.
Emotions
You will likely feel a variety of different emotions before your surgery: excitement, anxiety, fear, etc. It is normal to have some apprehension before any operation, and in particular one that will change your appearance.
If you are questioning things, Dr. Frankel suggests that you trust yourself and the time and effort you spent making the decision to have surgery and choosing the best doctor.
What to expect after surgery
Swelling
Following surgery, a splint will be placed on the nose, both for protection and to help it maintain its new shape. The nose will be moderately swollen and stuffy for several weeks, and the remainder of the swelling will gradually resolve over the course of the next six to eighteen months.
Hydration
Sleeping with a humidifier can be helpful for the first two weeks after surgery. Once Dr. Frankel gives the go-ahead, use a nasal saline spray to help keep the inside of your nose moist. Using a saline spray will minimize crusting in your nose and will make breathing easier.
Rest and exercise
Rest for the week after surgery and avoid excessive smiling or bending over. Most patients can drive a car and return to work and social activities after eight days. Avoid strenuous/extreme physical exercise for three weeks, and contact sports should be avoided for eight weeks.
Recovery
Every patient heals differently. If you notice that a particular behavior or activity is causing swelling, do your best to avoid that activity until you have healed. Physical recovery from the surgery is fairly quick, but the nose will not achieve its final form for well over a year.
Nasal Surgery
Information about Nasal Surgery
Rhinoplasty, or nose surgery, is a surgical procedure to improve the appearance and function of the nose. It is considered the most difficult procedure in cosmetic surgery. With rhinoplasty, the overall size of the nose can be reduced or increased, a hump can be removed, the angle between the nose and the upper lip can be changed, altering the shape of the tip or the bridge or narrowing the span of the nostrils during nasal surgery. Some breathing problems may also be relieved.
Nasal Tip Rhinoplasty
Where a full rhinoplasty might involve changes to your nasal bone and interior structures, nose tip refinement removes or reshapes only the tip cartilages. While the recovery from this more limited operation might be easier for the patient, refining a tip can be very challenging for the surgeon.
Rhinoplasty Techniques
Closed Rhinoplasty
During a closed or endonasal rhinoplasty procedure, all of the incisions will be placed on the inside of the nostrils. This approach will not leave behind any visible scars, since they will all be contained within the nose itself. Once the incisions have been placed, your facial plastic surgeon will lift the skin to reveal the underlying cartilage and bone. He will then reconstruct the nose according to the changes you requested and the results you discussed during your consultation.
Some surgeons prefer the open rhinoplasty because it affords that direct view of cartilage, bone and nasal architecture. With a skilled and experienced plastic surgeon, a well-made incision on the skin between the nostrils heals until it is virtually invisible.
Open Rhinoplasty
For an open or external rhinoplasty procedure, your facial plastic surgeon will add one very small incision on the underside of the nose, on the skin between the nostrils. This extra incision will allow greater access to the nasal tip, as well as the lower and middle-third of the nose. Although this incision will be external, it is placed in an area that is very hard to see. Any post-surgical scarring that forms after the incision has healed is well hidden and will most likely go unnoticed.
Some surgeons remain partial to the closed rhinoplasty because by working from beneath the skin, they can see more clearly, in real time, the effect the procedure is having on the undisturbed surface of the nose.