Rhinoplasty 101

Introduction to Rhinoplasty Surgery (a series)…Part 1

The Rhinoplasty is the focus of our blog today. The rhinoplasty procedure is the quintessential example of what plastic surgery is in definition. It is a cosmetic change outwardly on the nose of the human face. It takes a great amount of skill, many hours of fellowship time… and then some, for a physician to learn this complicated popular cosmetic surgery. A rhinoplasty can be performed for both cosmetic concerns; as well as, reconstructive reasons such as obstructions. The Rhinoplasty ranks #3 in the United States right behind breast augmentations and liposuction. In 2017, over 218,924 confirmed cases of nose jobs were completed in the US. And actually this was a 2% drop from the previous year. Statistically, worldwide, the Rhinoplasty surgery ranks # 2 at over 786,852 cases. This also was a 1% drop from the previous year according to the ISAPS. Nonetheless it still ranks high in cosmetics and will continue to rank high. Why? The human face has symmetry, and it is what we see first. Any birth defect, trauma or a self perceived non-symmetry of the nose can cause emotional anxiety in some and in trauma, life threatening. Biologically/genetically speaking, a facial anomaly could decrease the chances for a mate and offspring (survival of the fittest). It’s not like the nose can be hidden in a shirt or sock. If it was not such a big deal, then there would be no need for the training and board certifications. Lastly we think the decrease percentage-wise of rhinoplasty surgeries may be due in part to the age of the millennials. Yes this group of kids are changing everything today from vaccinations in children to now rhinoplasty. The millennials are opting more for non-surgical options such as fillers. We still believe traditional rhinoplasty is not going anywhere.

First of all as in any surgery, there is a potential to have a negative outcome. I am sure that the days of Michael Jackson’s Body Dysmorphic Disorder (BDD) and subsequent multiple surgeries AND the public exposure of his catastrophes did not help fellow plastic surgeons. The perception of, “Why did Michael Jackson do this to himself”, or more importantly, “Why did the plastic surgeon/s continue to operate?” was on many folks minds. So it is important to point out that people who are beginning to research this elective surgery, should do diligence in their research. No words can describe the importance of a patient’s studious work that is required in searching for the right plastic surgery doctor for you. You may see several before you become comfortable. At the same time, plastic surgeons are interviewing you during consultation to look for signs of unreasonable expectations and especially BDD. So first off… you the prospective patient should have a healthy expectation of outcomes. During the consultation your surgeon should completely inform through a discussion, your goals, the doctors anticipated results, possible surgical or medical limitations, the planning, as well as complications that are in fact possible. When you do finally settle on the right plastic surgeon for you, then you should trust him/her and let them do their work.

As far as the procedure is concerned, nasal cartilages and bones are changed/modified by fracture or shaving of the nasal bones. Sometimes tissue is added to aesthetically improve the outer surface of the nose. Rhinoplasty is also performed to correct nasal trauma from sports injuries or motor vehicle accidents. The goal is to restore the appearance of the nose and not leave it disfigured. In an obstruction, a septoplasty in combination with a rhinoplasty will typically clear blockage to increase air movement through the nose.

Rhinoplasty surgery is typically an outpatient procedure and may or may not require general anesthesia dependent upon the case (but most require general anesthesia). You will need someone to take you home and you will have several follow up visits over the course of the first year.

We will explore more specific aspects of the rhinoplasty including a historical prospective, anatomy, pre and post-operative expectations, etc.

To be continued…

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