A Guide To Rhinoplasty: The Most Demanded Surgery for Reshaping the Nose

Opening space above septum and between nostrils during rhinoplasty

Rhinoplasty, also called a “nose job,” is a very popular procedure that involves reshaping the nose, often for cosmetic reasons, but sometimes also for functional reasons like correcting structural deformities of the nasal region. Growing consciousness about one’s appearance coupled with increasing accessibility to surgical contouring for correcting appearance are top most reasons why surgeries like rhinoplasty are on the rise today.

The nose- the most prominent facial structure- defines one’s features and consequently has a great influence on aesthetic appeal. The option of completely altering the appearance of the nose through rhinoplasty is what draws most individuals displeased with their appearance to undergo this procedure.

The aesthetic improvements that can be made include altering the size of the nose, removing a bump, amending the tip or bridge of the nose, changing the shape of the nostrils, as well as modifying the angle between the nose and lips. Rhinoplasty also modifies nasal cartilages and bones to improve one’s overall visual appeal.

The two routinely practiced techniques in rhinoplasty are open and closed procedures.

‘Open’ Procedure (The External Approach)

This procedure involves making an extra incision on the columella or nasal septum along with internal nasal incisions. This extra incision gives the surgeon an easy access to the internal structures of the nasal region.

Scarring might occur, although this is not very visible and almost disappears as the wound heals. Open surgery is slightly more invasive than the closed technique and may involve a different recovery period, with a potential for greater swelling and pain.

This technique came into existence about a decade ago and since then, most surgeons have begun to consider this as a more superior technique, especially when operating on challenging cases.

‘Closed’ Procedure (Endonasal Approach)

The terms rhinoplasty and endonasal or closed procedure were synonymous until the open approach gained more popularity. However today, both terms have gained a distinct place in rhinoplasty nomenclature.

The closed procedure is a preferred choice in less challenging cases wherein nose structure can be altered with internal (or endonasal) incisions. These patients have excellent shape of the tip of the nose, have little or no hump to be removed and surgical repair is minor. The main benefits of this procedure are zero scarring and a quicker return to a normal appearance.

Selecting An Ideal Candidate

Assessing a candidate for physical and psychological health is a crucial step to ensure most positive surgery outcomes. The surgeon also assesses health, medical history, and any medications or allergies that the patient has prior to surgery.

Age is an important factor to bear in mind before performing rhinoplasty. The best results from rhinoplasty can be seen only after the nasal bone develops completely, which occurs after the age of 14-15 in girls and 15-16 in boys.  If the procedure is done before this age, the candidate risks undergoing a revision rhinoplasty to correct any unsatisfactory outcomes due to growth of the nasal bone.  There are no older age regulations for adults.

In emergencies involving trauma to the face, age is overlooked and rhinoplasty is performed on children with the sole aim of restoring most of the original nose.

Apart from age, physical considerations such as having a wide nose, a nose disproportionate to the face, a nasal tip that droops, flared nostrils, or a bump on the bridge of their nose etc, qualify a candidate for a nose-job. Rhinoplasty can also be performed on patients with deformities in the internal nasal structure or have nasal fractures and relieve them from associated problems such as troubled breathing.

Finally, realistic expectations are an important element in what makes a good candidate. Good candidates simply want to improve the nose appearance, but do not seek perfection.  These individuals are well adjusted and otherwise happy with their lives.

Complications Of Rhinoplasty

A restricted anatomical access to the nasal region undeniably makes rhinoplasty or a nose job the most demanding of all facial surgeries. Needless to say, complications can arise during a nose job and therefore a careful estimation of the deformity preoperatively; clarity on the techniques that can be used for correction, and meticulous execution of the surgery is absolutely critical in minimising associated risks and complications.

On the surgeon’s part, the ability to predict possible complications on a case-by-case basis is a vital skill. This ability helps reduce the incidence of complications and treat them once they have occurred. Some common complications seen with rhinoplasty are:

  1. Abnormal shape of nose (underresection, overresection, and/or asymmetry)
  2. Airway obstruction
  3. Anaesthesia reaction
  4. Post surgical bleeding (may require nasal packing to control it)
  5. Burst blood vessels
  6. Infection (risk is less than 1%)
  7. Loss of smell and structural support
  8. Permanent numbness (risk is less than 1%)

Consult With a Qualified Plastic Surgeon

Rhinoplasty requires the expertise of an experienced and accredited surgeon. Plastic surgery is expensive, as most procedures are not covered by medical insurance. Therefore, one would want to confident of positive surgery outcomes as the results last a lifetime. Rhinoplasty done correctly can have a profound effect on one’s visual appeal and self-esteem. To ensure best results, make sure to consult with a highly qualified and reputable cosmetic surgeon.