Rhinoplasty, also known as a nose job, is the name for plastic surgery designed to improve deformities and appearance of the nose.
A specialist in rhinoplasty, Sacramento plastic surgeon Dr. Thomas Kaniff has helped hundreds of patients achieve a better looking and often better functioning nose. Dr. Kaniff is Board Certified in plastic surgery of the nose.
Nasal surgery is usually performed at Kaniff Cosmetic Medical Center, Dr Kaniff’s Sacramento plastic surgery clinic. We generally prefer “twilight” anesthesia in which intravenous medications are supplemented by local anesthesia.
The operation consists of carefully removing any “excess” bone and/or cartilage while rearranging or reshaping the remainder. The procedure is performed from the inside of the nose (endonasal approach), leaving no external scars except in special circumstances. Whenever possible we prefer the “closed” technique (endonasal rhinoplasty), but perform the “open” technique (external rhinoplasty) when necessary to achieve the best result.
An often asked question by persons contemplating rhinoplasty is, “do you have to break my nose?” In our technique, we make an incision into the nasal bones when they need to be repositioned thereby eliminating the more antiquated technique of “breaking” the bones and resetting them. We feel this technique allows for better control and reduces the patient’s anxiety about having surgery.
At the completion of surgery, a small protective adhesive dressing and splint are applied to the nose, which are removed in about one week.
Although a drip dressing is applied which obstructs the nostrils, we do not ordinarily “pack” the nose after surgery. Patients, therefore, are more comfortable and generally less swollen. With our procedure, a special technique of suturing the internal nasal tissue back in place eliminated the necessity of packing. This technique has been one of the greatest advances in nasal surgery, reducing much of the undesirable after surgery discomfort experienced by patients whose noses are “packed.” With elimination of nasal packing, pain, swelling, bleeding, discoloration, etc. are dramatically reduced make the recovery period much more pleasant.
In practically all out patients, at the end of one week most of the swelling and discoloration has disappeared. Some swelling of the nose (which the patient feels, more than anyone else sees) is present, but progressively diminishes by two weeks; 90% by two months. The remaining swelling disappears at the rate of about 1% per month. The final result is not present for about one year, occasionally longer.
Most rhinoplasty surgery (nose job) is performed because that patient desires an improvement in the appearance and/or nasal function. You may simply want a nose which is in harmony with the rest of the face rather than one which is out of proportion with respect to the other facial features. On the other hand, it may be, as is often the case, that the nose is becoming progressively more disfigured the older you become and breathing difficulty occurs.
Since rhinoplasty surgery is as much artistic in nature as it is scientific, rarely are any two of our patient’s noses identical. We strive to make each individual’s nose fit her or his face. Like faces, every nose is different; some noses are too long, some have large humps, some project too far from the face, and so on.
Prior to surgery, photographs are taken and computer imaging is done so that we may study the characteristics of the nose and face. The nose surgery is planned in much the same way an architect plans a house; the goal is not only to improve the shape of the nose but also to have it enhance the appearance of the entire face.
The alterations necessary will be determined by many factors, including one’s height, skin thickness ethnic background and configuration of other features such as the forehead, eyes and chin. All in all, we strive to achieve a natural looking nose, rather than one which appears to have been operated upon. No patient really wants an assembly line “nose job”; they want a nose individually tailored to their own features.
Many over the age of forty remark that they have disliked their nose “all their life” and have now decided to have corrective surgery. Providing the individual is in good health, it is never too late to have rhinoplasty. It is often done as part of a facial rejuvenation program with facelift surgery and eyelid plastic surgery, to improve the undesirable signs of aging. A longer drooping nose may be a “tell-tale” sign of aging, and repositioning the drooping tip of the nose can be performed to give a more youthful appearance.
Some individuals have deformities of the inside of the nose which impair breathing, cause headaches, or contribute to sinus trouble. These problems cannot be satisfactorily treated medically without simultaneously straightening the external nose.
1. Open vs. Closed Rhinoplasty
A closed rhinoplasty is a nose job performed using incisions hidden inside the nose. An open rhinoplasty is performed using incisions inside the nose, as well as, a skin incision across the skin bridge between nostrils known as the columella.
The closed rhinoplasty technique is suitable for most rhinoplasty surgeries. The advantage of the open rhinoplasty technique is better visualization of the nasal tip cartilages. A rhinoplasty surgeon can convert from a closed rhinoplasty approach to an open rhinoplasty approach if better visualization of the tip cartilages is needed. An open approach may be chosen from the start, such as revision surgery or the placement of numerous cartilage grafts.
2. How old do you have to be to have rhinoplasty?
Rhinoplasty or nose job surgery is appropriate once an individual has achieved the majority of their body and nose growth. For women this may be as early as 15 years old and for males 16 or 17 years old. Factors other than physical maturation are, also, important when considering the correct age for rhinoplasty. Emotional maturity is as equally important as physical maturity. Participation in contact sports is another factor to consider when deciding at what age to have a rhinoplasty.
3. How long does it take to heal from a rhinoplasty?
The nasal splint comes off one week after a rhinoplasty or nose job surgery. Most bruising is gone after 7-10 days, however most people don’t get significant bruising. Swelling is down 80% in two to three weeks, 90% is down in three months and the remaining swelling improves about 1% per month. Many rhinoplasty patients return to work or school when the splint is removed. However, it is important to avoid any bending, lifting or straining for two weeks following rhinoplasty surgery. Sleeping elevated for six weeks can also help keep swelling down.