What is a Rhinoplasty?
A cosmetic rhinoplasty is a surgery that reduces and repositions tissue in the nose for better aesthetics. This often involves straightening the dorsal profile, reducing dorsal humps, reshaping the tip, and possibly narrowing the width of the nose.
For a nose that is lacking projection and definition, grafting techniques may be needed to build up projection of the tip and strengthen the dorsum.
The decision the type of surgery, however, is based on the patient’s anatomy and patient’s preferences.
These are big movements that are often intended to create subtle, millimeter changes to the shape of the nose once it heals. The thickness of the nose skin can affect the overall result, however, an improvement can be obtained for most patients.
What is the recovery like?
The postoperative time for most rhinoplasty patients is often fraught with trepidation.
During a rhinoplasty, the skin and soft tissues are often completely separated from the underlying bone and cartilage framework. The framework is modified and the skin is laid back down. After a rhinoplasty the nose swells from the trauma of surgery and the tissues become edematous. This makes the normally pliable skin firm and causes the nose to take on a “swollen” appearance in the first few weeks after surgery.
This swelling and firmness cause the tip to rotate, the dorsum to appear rounded, and the columella to swell and bow out from under the nose. As the initial swelling settles out over the first few weeks, the dorsum begins to settle, the tip starts to soften, and the columella swelling begins to dissipate.
The nose continues to settle over the next few months as the edema finally escapes and the soft tissues adapt to their new underlying framework. It may take 9 months to a year to see a final result.
Post-operative care after nose surgery helps patients achieve their optimal results. To encourage healing we utilize a unique regimen of post-operative care including icing, head elevation, supplements to decrease bruising, and silicone gel scar management.
What surgery is right for me?
A detailed examination will help delineate the best surgical treatment. The goal of a a rhinoplasty is to create an aesthetic nose with the size, shape, and projection that is desired by the patient.
During your consultation, measurements of the nose are used as a starting point to recommend a surgery. For some patients, digital computer simulations are used to help visualize the likely result.
I recently read a blog post by a plastic surgeon in Manhattan who specializes in rhinoplasty. The surgeon made a point that I have seen echoed by quite a few other plastic surgeons on RealSelf.com when answering questions from patients going through rhinoplasty recovery.
The question being posted across multiple online forums is: How different will the nose look 1 year after surgery as compared to 3 months, or 6 months? In other words, “If my nose looks great at 3 months, will it still look good a year from now? Or will it look overly defined and tight as more time passes?”
My opinion is this – there is no definitive answer. Each nose is different and no one can predict how your nose will change over time. However, one thing is glaringly clear to me about rhinoplasty recovery: If the nose doesn’t look good at 3 months, it isn’t going to look good in a year.