Rhinoplasty, or nose surgery, is a surgical procedure able to improve the appearance and function of the nose. The nose can be made to better match the patient’s ideal look by reducing or increasing the overall size, removing a hump, changing the angle between the nose and the upper lip, changing 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.
While Dr. Frankel receives referrals from near and far for fixing noses that have previously been operated on, he also performs primary rhinoplasty. The first operation is the best opportunity to deliver optimal results because the anatomy is undisturbed and there is no scar tissue or missing cartilage. With this in mind, Dr. Frankel puts as much planning and effort into a first nose job as into a revision. Most of this time involves in depth discussion with the patient regarding their desires and pre-operative evaluation of the nose as well as the overall facial balance.
Dr. Andrew Frankel is a world-renowned facial plastic surgeon specializing in rhinoplasty and revision rhinoplasty. Browse the site to learn more about the doctor, his Beverly Hills offices, and having your surgery in Los Angeles. The goal of initial nose surgery is to give the patient the nose they have always envisioned themselves with. To this end Dr. Frankel utilizes computer imaging to aid in communication with patients and to offer them the opportunity to have input.
Good candidates for a nose job includes men and women who are physically healthy, realistic in their expectations, and looking for improvement in the appearance and/or function of the nose. It’s generally recommended that it only be performed on younger patients once the nose has completed its growth, which tends to occur around the age of fourteen for girls and later for boys.
The procedure is often performed in a surgeon’s office-based facility and can take between one and two hours to complete. General anesthesia or a combination of local anesthesia and sedation may be used. Incisions may be confined to the inside of the nose, referred to as closed rhinoplasty, or may an involve an additional small incision under the tip of the nose, referred to as open rhinoplasty.
Once the incisions are made, the skin of the nose is separated from the underlying bone and cartilage. The bone and cartilage are then sculpted to the desired shape and the skin is redraped over the new framework and the incisions closed. Some discomfort can occur during the first couple of days after surgery, and pain medication may be prescribed. Antibiotics and other medicines, such as a saline nose spray, may also be prescribed. Within six or seven days after surgery, the splint and stitches are usually removed. Bruising may also occur and should fade so that you feel comfortable enough in social situations by around the tenth day after surgery. Swelling is also common and can take months to fully fade. Patients are typically able to return to work within one to two weeks, though strenuous activities should be avoided for two to three weeks.
The potential complications associated with nose jobs may include adverse anesthesia reactions, incomplete improvement, infection, small burst blood vessels, and the need for additional surgery.
When a primary rhinoplasty does not yield the desired results, a revision may be able to correct the lingering issues. Not all surgeons are experienced with, let alone specialists in, revision rhinoplasty. For difficulty breathing that has resulted from a previous nose job or dissatisfaction with the appearance of the nose, a revision rhinoplasty expert can help.
Nose surgery has one of the highest revision rates of any surgery, at roughly 15% nationwide, because of the complexity of the procedure. Revision rhinoplasty requires additional skill and training since there may be scar tissue present and a loss of cartilage. The procedure can range from minor changes to complicated adjustments. Sometimes missing structures must be replaced with cartilage grafts if too much was taken out the first time.
Recovery for revision rhinoplasty typically is less painful and yields less bruising. Other aspects of the recovery are very similar.
Other Types of Rhinoplasty
Dr. Frankel performs many forms of nose surgery, including, but not limited to:
Refinement Rhinoplasty – This surgical procedure puts the nose in better proportion with the rest of the face. Refinement techniques may combine hump reduction, tip rotation, change in the projection of the nose, tip refinement, or narrowing of the nostrils.
Reduction Rhinoplasty – It is a common complaint that the size of the nose is too large. Reduction rhinoplasty reduces the size of the nasal structure, which consists of bone and cartilage. The skin will shrink to the new smaller nose.
Ethnic Rhinoplasty – Ethnic rhinoplasty is a procedure which requires an artistic ability to maintain a person’s ethnic identity while improving the look and/or function of the nose. People of Asian, African, Hispanic, Middle Eastern, and all other backgrounds have qualities that are linked to their heritage. For many, it is important that they hold on to their uniqueness while enhancing their look.
Adolescent Rhinoplasty – A nasal surgery can be performed on teenagers once the nose has finished growing; around 14 to 15 years old or later. Defects in the nose can cause turmoil for an adolescent’s self-esteem and their sense of belonging. It is a personal decision, which should be discussed in depth between the teen, parents and doctor.
Functional Rhinoplasty – Trouble breathing may be a side effect of a deviated septum. Surgery to correct this problem is called septoplasty. Often septoplasty is combined with cosmetic nose job.
Nasal surgery may be performed for cosmetic purposes, or a combination procedure to improve both form and function. It also may alleviate or cure nasal breathing problems, correct deformities from birth or injury, or support an aging, drooping nose.
Patients who are considering nasal surgery for any reason should seek a doctor who is a specialist in nasal airway function, as well as plastic surgery. This will ensure that efficient breathing is as high a priority as appearance. Contact Dr. Frankel for more information.
Nasal Tip Rhinoplasty
Tip Rhinoplasty refers to shaping of the nasal tip. This can be done closed or open. Most tip sculpting procedures , in my opinion, are best done through an open approach where your surgeon can three dimensionally see the cartilage frame right before his eyes without having to pull and yank it around through small nostril incisions. Many of the tip revision rhinoplasties I do are on noses that have been operated on through a closed approach. While closed rhiinoplasty can give you good results. Often times, the tip cartilages need much much more finesse and attention to detail so that the nose does not warp and look weird over time. Structural grafts and tip suturing techniques can be used together to effectively and elegantly shape the nasal tip.
It is rare to only need a tip rhinoplasty. Many times, it is best to harmoniously balance all aspects of the nose and reshape the bridge and other related or adjacent areas on the nose.
To view some rhinoplasty patient photos, visit our photo gallery.