After our eyes, the nose is the next most prominent feature of the human face. And it’s right there looking back at us every morning when we first look in the mirror. That’s why it’s especially difficult if you don’t like the nose you have.

Maybe the tip is too bulbous. Maybe there’s a bump on the bridge. Maybe the nostrils flare. Maybe your nose seems too small or too big for your face.

Whatever the reasons a person wants to change his or her nose, they aren’t new. Nose surgery has long been a mainstay of cosmetic surgery, with the first “modern” rhinoplasty being performed in 1887.

At Dominion Plastic Surgery, our board-certified plastic surgeons can make the changes you seek in your nose, giving you a nose you like to see looking back at you in the mirror every morning.

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What Is Rhinoplasty?

Rhinoplasty is the clinical term for nose surgery. These surgeries change the size and shape of the nose. They can reduce nostril size or flatten the bridge. Depending on the goals of the patient, Dr. Mehan or Dr. Johnson may remove some bone and cartilage, or tissue may be added. Once the underlying structure has been modified, the skin and tissue is re-draped over it. Nose surgery is a delicate procedure, but it is highly rewarding for our Dominion Plastic Surgery patients.

Candidates For Rhinoplasty

There are many different reasons for wanting to change your nose, but they fall into three categories:

• Appearance — Not liking your nose can really impact how you see yourself. Aesthetics are the reason for most nose surgeries. There are many issues a person can have with his or her nose; these are the most common:

  • The tip droops

  • The tip is enlarged or bulbous

  • The nose is out of proportion with the rest of the face

  • There is a bump or depressions on the bridge of the nose

  • The sidewalls are depressed

  • The nostrils are excessively flared

  • The nose is crooked or off-center

• Injury — From a fall while skiing over at Snowshoe to bumping into a wall in the dark, impact on your nose can leave it permanently crooked or misshapen.

• Function — Restricted or blocked nasal passages can impact your sleep and your quality of life. Nose surgery can open restricted nasal passages and improve your breathing.

For patients to be eligible for nose surgery at Dominion, they must have finished their facial growth. For girls (who mature a little faster than boys), this will be at age 14 or 15 at the earliest. For boys, the minimum age is 15.

Both Dr. Mehan and Dr. Johnson stress that this surgery needs to be for the personal reasons of the patient. It can’t be done to please a partner or spouse. And it’s important to be realistic about what this surgery can and cannot do.

How Is Rhinoplasty Performed?

There are two basic methods for rhinoplasty: open or closed. During your consultation with Dr. Mehan or Dr. Johnson, you’ll share with us your goals for your surgery. We’ll discuss with you which option we think will deliver the best results.

In open rhinoplasty, an incision is made across the columella, the sliver of tissue between your nostrils. The soft tissue is then lifted upward and off the bone and cartilage. The open method completely exposes the underlying structure, making more dramatic modifications possible. Once the bone or cartilage has been reshaped, the soft tissue is then brought back down.

In closed rhinoplasty, all of the necessary incisions are made inside the nose. Obviously, this leaves no visible scarring, but it also can limit the extent of reshaping that can be done. If the patient seeks to build up an area of the nose, we can take cartilage or other material from the septum, the ears, a rib, or synthetic implants can be used. When the patient seeks to shrink the size of the nose, the nasal bones must be broken.

Rhinoplasty Recovery

When your surgery is complete, your nose will be packed and splinted. This splint will stay in place for about one week. We’ll provide a cold compress to help minimize swelling, and diligent use can really make a difference. But you will have swelling and bruising. This is inevitable with the degree of tissue trauma involved in rhinoplasty. For the first week, the goal is to keep your head elevated as much as possible, even when sleeping. The area around your eyes and nose will be bruised and swollen usually for 10-14 days. If you wear glasses, they will need to be taped to your forehead for up to seven weeks to keep any pressure off of your nose. Any strenuous exercise or heavy lifting that increases blood flow to the face needs to be strictly avoided for a number of weeks. We will discuss your particular restrictions at length with you, giving you a timeframe to return to your typical exercise and activity routines.

When Can I Expect To See The Full Results Of My Rhinoplasty?

At Dominion we sometimes have patients who express annoyance at their continued swelling after nose surgery. All we can say is that everyone heals in different ways, so patience is a valuable asset after these surgeries. Swelling can linger, often returning later in the day and at night for weeks. It can take up to six full months for a patient to fully realize their new nose, although this schedule varies dramatically with individual patient’s healing rates. In the end your patience will be rewarded — rhinoplasty is a very satisfying procedure. Patients who have hated their nose since adolescence are thrilled with their new nose and the way it changes their entire face.

Risks Of Rhinoplasty

This is a delicate surgery, but thanks to the expertise of Dr. Mehan and Dr. Johnson these are successful procedures. There are the general risks that accompany any surgery: anesthesia reaction, infection, bleeding, poor wound healing, scarring, and changes in skin sensation. Specific to nose surgery, the patient may have difficulty breathing, skin discoloration and continued swelling, possible perforation of the nasal septum, or unsatisfactory final results. If further changes are needed, revision surgery may be necessary.