What is Rhinoplasty?
Rhinoplasty or nose-reshaping surgery improves the balance and aesthetics of a patient’s face. Our noses are the centers of our face. Nose re-shaping surgery refines the appearance of the nose and enhances the unique natural beauty of the patient by creating improved balance, symmetry, size and shape of the nose to enhance the patient’s facial features. Many people are self conscious about the appearance of their nose. They may not like its shape or perhaps their nose suffered an injury in an accident or during sports. Undergoing a rhinoplasty procedure often greatly improves a person’s self esteem and self confidence about their appearance.
Nose re-shaping (rhinoplasty procedures) effectively straightens a crooked nose, reduces nose size, narrows a nose, refines the tip, or smooths a bump in the bridge of the nose. A natural looking nose enhances a patient’s face and increases the appeal of their facial symmetry and individual beauty.
Assessment and Treatment for your Rhinoplasty Procedure
The first step in considering a rhinoplasty procedure is to schedule a consultation appointment with Dr. Woods. Dr. Woods has over twenty years of experience creating beautiful noses for patients. View our patient gallery of results. Dr. Woods is a double board certified Ear Nose & Throat (ENT) and Facial Plastic Surgery specialist trained at the renown Johns Hopkins Medical Center. He is the Chair of the ENT Department at Honor Health Shea Hospital, and, he has extensive experience with the physical structure and health of your nose.
Your consultation appointment provides the opportunity to discuss your unique circumstances, health concerns, and your facial and nose features, as they relate to your rhinoplasty procedure. Proper evaluation of the nose is critical to understanding which techniques to apply during the various stages of the operation in order to obtain the best possible result.
Understanding Your Nose
Understanding the parts that make up your nose is important before your rhinoplasty surgery. Additionally, some people suffer from medical conditions or have suffered trauma or injuries that affect their breathing and sinuses. Corrective procedures often are combined to address and correct such issues during a rhinoplasty.
The nose can be broken down into three basic compartments. The dorsum (the outer
surface), the tip, and the intranasal structures.
Internal Nose Components
Inside the nose is a structure called the septum which separates right from left in the
midline and provides support to the tip and the dorsum. If the septum is not straight,
then narrowing of the nose can result in a constriction of airflow on one or both sides
of the nose. Additionally, the septum can create tension on the dorsum or tip which
can distort the shape of the nose, if it is not properly addressed. Some patients with these issues undergo a septorhinoplasty correcting both the internal issues of the septum and the shape of their nose.
Along the side walls of the nose are structures called inferior turbinates which warm
and humidify the air we breathe. These often need to be reduced in size to make room
for improved airflow through the nose.
Evaluating the function of your sinuses should be considered based on your history. If
you are having sinus problems, the time to fix these issues is at the time of your
rhinoplasty. This can be performed safely at the same time without interfering with
the cosmetic outcome.
Evaluating the Exterior of the Nose
The outside of the nose is composed of skin, cartilage, and bone. Each of
these contribute in different ways to the shape of your nose and must be recognized
and considered when deciding upon the proper approach to creating the appearance you desire for your nose.
The skin itself must be evaluated. The thickness of the skin is an important contributor
to the outcome. Very thin skin can easily expose any irregularities or sharp edges of
the cartilage and bone, so techniques which create soft and smooth edges are
preferred. Very thick skin is more difficult to manage. It may disguise any irregularities,
but it will also diminish the final outcome, as all the work done on the nose will not
show through as well. Techniques which add cartilage for support, create sharper
edges, and thinning of the skin must be considered.
The tip of the nose is formed by the lower lateral cartilage. This C-shaped
structure has a medial and lateral component (crura) and a midpoint referred to as
the dome. The relationship of these three parts to each other, their size and shape, its
connection to the septum and the dorsum, and its proportion to the dorsum defines
the appearance of the nasal tip.
The shape of the tip can be described as boxey (square, wide, thick, tall cartilage); thin
(pointy and long); over-projected (sticks out too far); under-projected (cartilage is too
short); over- or under-rotated (piggy or droopy). The tip’s relationship to the dorsum
and the lip form angles which should be taken into consideration when planning the
surgery. The length of the dorsum, the tip, and the upper lip have particular ratios
which can have dramatic effects on the appearance of the nose when properly
The Top of the Nose – The Dorsum
The dorsum is the top of the nose and is made up of the nasal bones and the upper
lateral cartilage. Most frequently, there is too much of both bones and cartilage,
giving the appearance of a bump and excessive width. The dorsum’s relationship with
the septum, the tip, and the facial bones create various issues which need to be
addressed, so they can be managed with the proper technique.
If the dorsum is straight, but too big and wide, then trimming the cartilaginous middle
third of the nose and then rasping down the over-projected nasal bone will provide a
smooth and aesthetic profile. To narrow the nose, narrowing or removing part of the
bone is created along the junction of the nasal and facial bones and then infractured.
If the nose is crooked, then the source of the deviation must be found so that it can be
rectified using the right technique.
It is important to remember that everyone heals differently. Here are a few general guidelines on what to expect after your surgery.
Post surgery a small splint will be placed on your nose. This will protect the nose and keep it stable for approximately 3 – 5 days. You may have nasal packing to reduce swelling and help with the bleeding. This packing is placed in your nose during the surgery and removed the next morning.
Mild to moderate discomfort is to be expected after the surgery, and this is typically alleviated with prescribed painkillers. Typically, patients are able to stop taking the medication 48 hours after the surgery. Bruising and swelling from the surgery also are common, and you may even develop two black eyes from the surgery.
You will need to keep your head elevated for a period of time as prescribed after the surgery. It also is important to sleep on your back for a few weeks after the surgery to avoid putting pressure on your nose.
Be Careful – Your New Nose Will Be Sensitive
Avoid trauma to your nose after your rhinoplasty. This means no contact sports, and being careful in general situations where you might get bumped in the nose (children and pets are common culprits). If you wear glasses, you should not wear them for a few weeks after your surgery, but contacts are okay. Also, be gentle washing your face. The skin on your nose is sun sensitive for a few weeks, so be sure to apply sunscreen (once your doctor gives the okay).
When Does My Nose Look Normal Again?
Typically, most of the swelling diminishes within two weeks post rhinoplasty surgery. Within a month the remaining swelling should be gone. Everyone heals and responds differently, so the key is to be patient. Allow your body to heal and recover fully.
Facial & Nose Expertise for Your Rhinoplasty Procedure
As you can see, the surgical procedures must be tailored to each individual nose and
the patient’s needs. The nose must be evaluated as a whole by examining each of its
parts, determining how they interrelate with one another and with the rest of the face
and body type. Dr. Woods combines both artistry and surgical expertise, along with specialized medical knowledge to deliver natural, beautiful results.
It is here that having a surgeon that is both a nose and facial expert with extensive experience in creating beautiful, balanced aesthetics and a healthy, well functioning nose is critical.
Read Dr. Woods’ Blog What to Expect from Your Nose Job for information on recovery periods and what to expect from your rhinoplasty.
You can also learn more about why Double Board Certification is important for you as a patient and your doctor’s qualifications at the following two sites:
View Gallery of a sample Dr. Woods’ patient results.