By: Dara Liotta, MD | Chief Medical Director, City Aesthetics at Totum Health
Nose reshaping is extremely common. Chances are that you know someone who has had a nose job…you may have even contemplated changing your own nose. According to the American Academy of Facial Plastic and Reconstructive Surgery statistics, rhinoplasty, or the “nose job”, has remained the most requested surgical procedure for both men and women for five years in a row.
Rhinoplasty procedures, including primary (first time) nose jobs, revision nose jobs, functional nose surgery, and “liquid rhinoplasties” (nose reshaping without surgery) occupy the majority of my time. There are many options available for improving the nose – in both form and function. The terminology, however, can be confusing. Here I will explain the different options as simply as possible.
The least invasive option is the non-surgical, “liquid” rhinoplasty. During a liquid rhinoplasty, a combination of Botox and facial fillers like Juvederm are used to reshape the nose. This treatment is best suited to camouflage a “dorsal hump”, or bump on the profile view of the nose, but works well for some other issues as well. Not all nose concerns are amenable to liquid non-surgical rhinoplasty, but if you are among the lucky (or unlucky, depending upon how you look at it) ones whose nose can be improved with non-surgical treatment, the results are dramatic and instant, and are achieved without the pain and downtime of surgery. The in-office procedure takes about 20 minutes, and there is no need for anesthesia. Results are not permanent, however; they last between 1-2 years depending on the filler used.
The Traditional “Nose Job”
Rhinoplasty surgery (a “nose job”) and revision rhinoplasty surgery (second- or third-time surgery), can alter almost any aspect of the nose, and does so permanently. During surgery, a huge variety of techniques can be used to address the different parts of the nose. Some common reasons people seek rhinoplasty include a crooked nose, wide (or “bulbous”) nasal tip, and dorsal nasal “hump”.
What Is Involved
In my practice, rhinoplasty surgery is performed under general anesthesia in an operating room. On average, the surgery usually takes between 2-3 hours, depending upon the particulars of the surgery. Surgery can be performed with incisions completely inside the nose (endonasal), or with a small incision on the outside of the nose, across the bottom (external). Choice of endonasal or external approach is based on the aesthetic goals of the surgery.
Recovery from the surgery is not painful, but people look much worse than they feel during recovery. Most likely, you will want to give yourself 10 days or so before you rejoin society. After surgery, patients wear a small plastic cast on the bridge of the nose for one week. More often than not, the nasal bones need to be broken during surgery, which results in some nice shiners that stick around for 7-10 days. Swelling inside the nose, as well as stuffiness, are common for the first few weeks following surgery. You’ll look and feel pretty well after about 10 days to 2 weeks, but your nasal bones won’t be fully fixed into place for 6 weeks. Overall, healing from rhinoplasty is a gradual process: I advise people to expect to see 85% of the final result one month following surgery, 95% 6 months following surgery, and the final cosmetic result 1-2 years after surgery.
Functional Nose Surgery
A well-trained surgeon should be as interested in the function of your nose as the look of it, and should be well-trained to address both. Functional nose surgery may include septoplasty (straightening the wall between the left and right side of the nose), opening up the breathing passages, and/or reinforcing the walls of the nose to prevent collapse of the nose. Old school rhinoplasty was about cutting away bone and cartilage to make the nose smaller. This philosophy is what produced the pinched in, ski-sloped noses of old you can see on Madison Avenue. Modern rhinoplasty is as much about improving and maintaining the breathing function of the nose as it is the cosmetic look of the nose. Good nose jobs don’t look like nose jobs; they look natural, not plastic.
Now you know the nose basics.
As a trained ENT surgeon as well as a cosmetic surgeon, Dr. Dara Liotta is especially skilled in the art of rhinoplasty. Interested in learning more? Please call (212)288-2222 to speak with one of our patient engagement professionals.