Rhinoplasty

Nose reshaping or rhinoplasty, is a surgical procedure that can reduce or increase the size of your nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip. It may also correct a birth defect or injury, or help relieve some breathing problems.A patient who is considering rhinoplasty should carefully select his or her surgeon. Rhinoplasty is one of the most difficult plastic surgery procedures to perform. The difference between a good result and a poor result is a millimeter. It is essential that you choose a surgeon who is not only qualified and experienced, but a surgeon who has a strong aesthetic style and talent. Rhinoplasty surgery is as much about art as it is surgery.

Dr. Rohrich is a *board-certified, internationally recognized plastic surgeon. One of his specialties is rhinoplasty and he is credited with developing new surgical techniques to improve the science. As a surgeon and sought after speaker, Dr. Rohrich is invited to lecture on rhinoplasty at teaching seminars worldwide. He is co-editor of Dallas Rhinoplasty Nasal Surgery by the Masters and co-author of Secondary Rhinoplasty. For more information about rhinoplasty surgery, please view the "Frequently Asked Questions" or his " Resource Library" for related articles, websites and video clips.

* American Board of Plastic Surgery

Am I a good candidate for the surgery?

The best candidates for rhinoplasty are healthy individuals who are looking for improvement, not perfection, in the way they look. You may be a good candidate if you are physically healthy, psychologically stable, and realistic in your expectations. Age may also be a consideration. Dr. Rohrich prefers not to operate on teenagers until after they have completed their growth spurt, around 14 or 15 for girls, and 15 to 17 for boys. It is also important to consider teenagers' social and emotional adjustment and to make sure they, not their parents or friends, want the surgery. Deciding to have elective surgery should not be an impulsive decision but rather one that is carefully thought out.

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What should I expect from my consultation?

During your consultation, Dr. Rohrich will ask how you would like your nose improved. He will examine the inside and outside structure of your nose, and discuss the possibilities with you. He will also explain the factors that can influence the procedure and the results. These factors include the structure of your nasal bones and cartilage, the shape of your face, the thickness of your skin, your age, and your expectations.

You will learn about the surgery, its limitations and risks, and discuss your needs and concerns. This will help Dr. Rohrich better understand your expectations and determine whether they can realistically be achieved. After your consultation a photographer will take photographs for your medical record and you will meet with Dr. Rohrich's patient coordinator to discuss surgery fees and schedule dates. You may also schedule an additional consultation to preview computer imaging. These may help you visualize the results of each technique that Dr. Rohrich has specifically designed for your surgery.

Be sure to tell Dr. Rohrich if you have had any previous nose surgery or suffered an injury to your nose, no matter how long ago it was. You should also advise him of any allergies or breathing difficulties, of any medications or vitamins you take, of recreational drug use, or if you smoke.

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How is the surgery performed?

There are two types of rhinoplasty surgery, endonasal and open. Endonasal approach is performed from within the nose with the incision inside the nostrils. The open approach, which Dr. Rohrich prefers, is performed by separating the skin of the nose from its supporting framework of bone and cartilage. This approach allows Dr. Rohrich to see the entire structure of the nose. He will then sculpt the nose to the desired shape. The nature of the sculpting will depend on the nature of your problem and Dr. Rohrich's preferred technique. There are an infinite number of techniques which can be utilized to sculpt the underlying framework.

When the surgery is complete, a splint is applied to help your nose maintain its new shape. Soft plastic splints may also be placed in your nostrils to stabilize the septum and divide the wall between the air passages in order to improve your nasal airway.

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What happens the day of surgery?

Your rhinoplasty surgery will be performed at either one of our specialty hospitals or an accredited outpatient surgery facility.

Prior to your surgery, oral medications are administered for your comfort and to lessen anxiety, as needed. General anesthesia is preferred for most plastic surgery procedures. You may be required to stay overnight in the hospital depending on the extent of your surgery. Rhinoplasty usually takes 2 to 3 hours to complete, although complicated procedures may take longer.

Be sure to arrange for someone to drive you home and stay with you to assist you the first couple of days while at home. The "Patient Care" section on this site gives instructions to prepare for surgery, including guidelines on eating, medications to avoid, drinking and smoking. If you are a smoker, you will be asked to stop smoking well in advance of surgery.

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What is the recovery like?

Immediately following your surgery, you will have a splint on the outside of your nose and a small gauze at the bottom of your nose. You will have some discomfort and/or pain following surgery. During the first twenty-four hours, your face will feel puffy, your nose may ache, and you may have a dull headache. While you are in the hospital your pain control is intravenous for the extent of your stay. You will be given prescriptions for pain medication and antibiotics as needed after your discharge.

You will notice that the swelling and bruising around your eyes will increase at first, reaching a peak after 2 to 3 days. Most of the swelling and bruising should disappear within two weeks or so. A little bleeding is common during the first few days following surgery and you may continue to feel some stuffiness for several weeks.

Your splint will be removed at about 5 to 7 days after surgery and your sutures will be removed after 7 to 10 days, sometimes sooner. Some bruising may persist for 2 to 3 weeks and you may tire easily. It is not uncommon for some patients to feel disappointed and depressed at first. By the third week, you'll look and feel much better. Most patients are back at work 1 to 2 weeks after surgery.

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What should I know about my results?

You will see final results at the top of your nose at 6 to 9 months, and at the tip, between 9 months and a year following surgery. After surgery, small burst blood vessels may appear as tiny red spots on the skin's surface. These are usually minor but may be permanent. As for scarring, when rhinoplasty is performed from inside the nose, there is no visible scarring. When an "open" technique is used, or when the procedure calls for the narrowing of flared nostrils, the small scars at the base of the nose or between the nostrils fade in time and are barely noticeable.

Back to top What does the surgery cost?

At the time of your initial consultation, you will be quoted a price that will include Dr. Rohrich's fee as well as hospital and anesthesia fees. Fees are due in full at least two weeks prior to your surgery. Checks, money orders, cash and credit cards may be used for payment. A $500.00 deposit will reserve a specific time and date for your surgery. If you have a deviated septum due to trauma or any breathing difficulties, insurance may sometimes cover the costs. Please be sure to bring your insurance information with you to your consultation appointment.Back to top