Rhinoplasty (Nose Surgery)
It has been said that rhinoplasty is the most difficult of all plastic aesthetic surgeries. For a patient, the most important aspect of their rhinoplasty is that they make sure to carefully choose their rhinoplasty surgeon based on the surgeon’s knowledge, skill, care, experience, and natural artistic vision. The aesthetics of the nose define a person’s appearance, shaping their character, attractiveness, and beauty. It reflects their family history, ethnicity, and culture. For many years, people from all different walks of life have been reshaping their nose, either for cosmetic reasons or to project their image or place in society. An ethnic nose can be maintained while changing selected undesired aspects.
The nose is the central feature of the face, so it is no surprise that rhinoplasty, or a nose job, has become vastly popular among different races, cultures, and genders. The central focus of a face should be the eyes (“The eyes are the windows to the soul”). A large nasal hump, a crooked nose, or a bulbous nasal tip can distract the focus away from the eyes. Rhinoplasty can be performed to change the shape, size, or profile of the nose to harmonize with the other facial features, paying particular attention to eliminating these features that draw attention away from the eyes. Rhinoplasty can result in subtle or significant changes that can make a huge difference in the overall facial structure, appearance and overall confidence of our patients.
Rhinoplasty can correct:
- A deviated septum and associated breathing problems (septoplasty)
- A crooked nose
- A nasal tip that is enlarged, amorphous, bulbous, or drooping
- A bump, hump, or depression on the bridge
- Nasal asymmetry
- Nose size that is unbalanced in relation to face size
- Nostrils that are large or wide
- A “botched” nose job with revision rhinoplasty
- Ethnic nose refinement in Asian, African American, and Mestizo noses
Am I a Candidate for Nose Surgery?
Ideal candidates for rhinoplasty should be sure they want to have the surgery for the right reasons. They have given thought to changing the appearance of their nose for many years (except in cases of an acute traumatic injury to their nose). They should be in good health and have realistic expectations about not only the degree of aesthetic improvement of their nose but also the fact that changing their nose will not change everything they dislike about their lives. It is important that the patient is specific about what they want to change about their nose and share their aesthetic and functional (nasal breathing) goals with their rhinoplasty surgeon. To get a clear idea about rhinoplasty and what you can achieve, schedule your consultation with Dr. Persky in Encino, the San Fernando Valley, and Calabasas to discuss your desired results.
Good communication with your surgeon is an essential part of your consultation. Make sure you tell your doctor exactly what you don’t like about your nose and what results you are hoping to achieve. At the time of your consultation, Dr. Persky will examine your nose internally and externally and then take photographs. He will use computer imaging to provide you with a better idea of how your results could look. You will also be shown before and after photos of previous patients. A customized rhinoplasty procedure plan will be created based on your anatomy, diagnosis, and aesthetic goals.
What Does the Rhinoplasty Procedure Entail?
Rhinoplasty can be performed under intravenous (IV) sedation or general anesthesia. The procedure is performed at a state-certified outpatient surgery center and takes between two to four hours, depending on the changes that need to be made to the nose. The surgery is either performed using the open surgical technique (a small, inconspicuous incision at the base of the nose) or the closed surgical technique (incisions within the nostrils). With both surgical approaches, part of the bone and cartilage can be removed to reduce the size of the nose, or cartilage grafts may be added when necessary to create a strong foundation for a narrow, ethnic, amorphous, crooked, traumatized nose (or for revision surgery). Dr. Persky is expert in both approaches to rhinoplasty. During your septorhinoplasty surgery, your nose is straightened and sculpted to the desired natural shape and any internal septal deviation is corrected.
How Long Is the Recovery?
From a patient’s perspective, once the anesthesiologist gives the IV medication, it seems as if you are asleep for a pleasant one-minute dream (Dr. Persky will tell you to think of your favorite places, people, or activities just before the sleep meds are given). After surgery, your nose will feel stuffy due to mucus and dried blood in the nose. A small moustache dressing gauze is taped under your nose and changed as needed for the first 24 hours. A splint and tape are placed on the nose to keep it straight, protected, and in place. Dr. Persky does not typically use uncomfortable internal gauze packing after rhinoplasty, allowing for a much more comfortable recovery period with less swelling and bruising. You will spend about 60 to 90 minutes in the recovery room, and then you will be able to return home with your designated driver.
For the first 48 hours, patients are instructed to keep their head elevated above their heart (rest and sleep on two to three pillows.) There is surprisingly minimal discomfort; however, TYLENOL® or a prescribed narcotic pain reliever can be used if needed. Patients may feel like they have sinus pressure or a mild headache for a day or two. Two to three days after surgery, the nose will be cleaned by Dr. Persky. The tape and splint will be removed five to six days after surgery. Patients should expect some bruising and swelling for the first seven to 10 days. They should be presentable by 7-10 days. Most physical activities may be resumed after three weeks.
I highly recommend Dr. Persky. I’ve been going to him since 2007 and completely trust his judgment. Not to mention his pleasant bedside manner. Five stars all the way around.
What Are the Results?
The nose continues to heal and evolve during the first year after surgery, at which time the final result can be appreciated. However, the nose will continue to look better over the years as the skin thins and normal scar tissue fades away. Breathing may be difficult for the first 1-2 weeks but will become normal over time. Patients should see subtle changes that make a dramatic improvement not only in the nasal profile but also to the overall harmony of the face. Patients may also experience improved breathing through their nose.
Facial plastic surgeon Dr. Persky has been performing rhinoplasty for more than 30 years. His natural artistic vision, sculpting artistry, skills, and experience ensure that you are in capable hands when undergoing your rhinoplasty. Dr. Persky is also proud to announce that rhinoplasty specialist, Ari Hyman, MD, has joined us, bringing with him his state-of-the-art rhinoplasty techniques and natural artistic vision. Dr. Hyman trained with the world’s top facial plastic surgeons in New York City and Chicago, including top rhinoplasty surgeon and professor, Dean Toriumi, MD. Our patients now have the benefit of two rhinoplasty experts.