Nose Surgery – Rhinoplasty

Rhinoplasty – Reshaping the Nose

The nose is one of the most distinctive features on the face. It divides the face into halves and acts as the main structural element of the face’s profile. Feeling uncomfortable with the shape of your nose can be detrimental to your self-esteem, holding you back from the living the life you deserve. Rhinoplasty is a 3- dimensional surgery that can reshape, reduce or augment the shape of the nose to balance your unique facial features and help boost your self-confidence. Top Plastic Surgeon, Dr. Shvidler is passionate about rhinoplasty and loves performing surgery on the nose. He will act as a sculptor to create a natural, new nose to compliment your existing features and harmonize the proportions of the face. Dr. Shvidler’s main goal with surgery is always to achieve a very natural, balanced result that won’t be recognizable as having been surgically altered and will leave you feeling confident, but most importantly, still feeling like yourself.

Your nose is a very important part of your face, not only does it affect your overall appearance, but it is highly functional. The nose is the most sculptural element of your face, with a complex structure of cartilage and skin projecting outwards from a bony bridge. There is a great deal of variation in human noses and there is no one “perfect” nose, however there are some universal ideas of what makes a good nose, a balanced, symmetrical shape that harmoniously fits the rest of the face.

Rhinoplasty has been utilized for millennia. Treatments for the plastic repair of a broken nose are first mentioned in an Ancient Egyptian medical text, the oldest known surgical treatise, dated to the Old Kingdom (from 3000 to 2500 BC). Of course, surgical practices have advanced a great deal since then, but the idea of a nose being integral to a person’s appearance is much the same.

Tacoma Rhinoplasty

Before – After

Rhinoplasty – Science and Art

Rhinoplasty is surgery to reshape the nose and commonly known as a ‘nose job’. It is a plastic surgery procedure for correcting and reconstructing the form, restoring the functions, and aesthetically enhancing the nose by resolving nasal trauma (blunt, penetrating, blast), congenital defect, respiratory impediment, or a failed primary rhinoplasty. Most patients ask to remove a bump, narrow nostril width, change the angle between the nose and the mouth, as well as correct injuries, birth defects, or other problems that affect breathing, such as deviated nasal septum or a sinus condition.

A ‘nose job’ is arguably the most demanding of all facial surgical operations, and it demands a thorough understanding of both art and science behind a successful surgery. Each case has its own challenges and requires a careful evaluation of the problem and a clear understanding of the techniques available for correction.

The actual rhinoplasty surgical procedure typically takes between one and two hours. If you are having reconstructive work done, or you are having a more complicated procedure, the surgery may take somewhat longer. Dr. Shvidler can tell you what to expect in your particular case. Initially, incisions are made and the bone and cartilage support system of the nose is accessed. Alterations then may be made to increase or decrease the nasal bridge, reduce the size or width of the nose, narrow the nostrils, change the angle between the nose and upper lip, or reshape the tip. The majority of incisions are made inside the nose, where they are invisible. Sometimes a very short incision is made across the vertical strip of tissue that separates the nostrils, called the columella. This technique is called an “open rhinoplasty.” Whatever incisions are used to reshape your nose, they will ultimately be very inconspicuous.

Why Choose Rhinoplasty?

Nose surgery is divided into these categories: cosmetic, functional, and reconstructive. Examples of cosmetic procedures on the nose include reducing a prominent bump on the bridge or refining a bulbous nasal tip. Functional improvements involve opening the nasal airways so that it is easier to breathe. Birth defect of the nose may require several surgical procedures before the results are sucessful. That is reconstructive surgery.

Most of us notice someone’s nose only when it is not in balance with their face, whether it’s too large, too wide, or misshapen. If you are dissatisfied with the shape or proportion of your nose, you are likely dissatisfied with your overall facial appearance, so you may be a candidate for Rhinoplasty. Nose surgery can improve the way you look at yourself, as well as how others see you. Many of our nose surgery patients have both cosmetic and functional concerns about their nose. An example would be a severely deviated septum that results in a blocked nasal airway and a visibly crooked nose. Other patients may seek medical treatment for breathing problems, but would also like to improve the cosmetic appearance of their nose. For instance, a patient may have nasal airway obstruction and an unattractive bump on the bridge. There are advantages to correcting both functional and cosmetic problems at the same time.

Patients in need of functional nose surgery will have problems breathing through the nose, a feeling of congestion or nasal inflammation, loss of smell and alterations in tone of voice. The cause of these disorders can be due to mechanical obstructions in which a deviation of the septum or a turbinate hypertrophy occurs, or there is an inflammation of the mucosa that, when thickened, causes obstruction. One of the most important causes of inflammation is environmental allergies. Patients with symptoms such as nasal respiratory insufficiency, excessive discharge or nasal voice should see Dr. Joe, an Otolaryngologist ( ENT specialist) to perform a thorough examination of the nose, nostrils and its function.

Reconstructive Rhinoplasty is implemented when the nose has been damaged through trauma, cancer, congenital defect or to repair a previous surgery. The surgery often entails the use of grafts to rebuild the basic structure of the nose but all three layers of the nose must be carefully put together: the inner mucosal lining, the cartilage framework, and the outer skin and soft-tissue envelope. Due to the complicated anatomy of the nose, this is one of the most challenging of all plastic surgery procedures.

Types of Rhinoplasty

FUNCTIONAL: Septoplasty or Turbinoplasty?
Functional rhinoplasty includes surgical interventions aimed at improving the passage of air through the nose. When are carried out on the nasal septum (a midline cartilage structure that divides the nose into right and left sides) the procedure is called septoplasty and when carried out on the turbinates (The bone in the nose that is situated along the side wall of the nose and covered by mucous membranes.) the procedure is called turbinoplasty.

Functional improvements involve opening the nasal airways so that it is easier to breathe. The most common functional problem is a deviated septum (a midline cartilage structure that divides the nose into right and left sides).

Nasal functional surgery is carried out through the nostrils or natural nasal openings so there is no scar left. Usually the shape of the nose is not affected in functional surgery. Impairment of nasal breathing is considered a health problem and is typically covered by health insurance.

COSMETIC: Septorhinoplasty
The nose is also important aesthetically because it is in the center of the face and is a sign of identity that we recognize most in people. On more and more occasions patients seek an ENT specialist who will not only act on any problem with nasal function, but also tackle any aesthetic problem the patient may have. In these cases, the most common procedures are, ‘aesthetic rhinoplasty,’ or ‘septorhinoplasty.’The patient may desire a nose which better harmonizes with the rest of their face, or in the case of the drooping nasal tip, a “lifting” of the nose can be performed. In this surgery, more than most, an artistic sense is necessary. The deformity must be corrected while preserving the natural appearance and avoiding the “operated on” look. At the same time, the alterations must put the nose into proper proportion with the rest of the face.

RECONSTRUCTIVE:
Rhinoplasty is perhaps the most challenging of all plastic surgery procedures. This is due to the complicated anatomy of the nose and the ‘vagaries of healing’. When a second surgical procedure is performed, the experience of the surgeon becomes even more important. Joseph Shvidler M.D. is the best qualified surgeon in the Pacific Northwest performing Reconstructive Rhinoplasty.* Reconstruction may entail a series of surgical treatments of a nasal injury in an effort to bring the nose back to its pre-injury state or changed by previous surgery. If the nasal injury is very recent (within days), it may be possible to correct or improve nasal deviation without surgery. Reconstructive rhinoplasty may be covered partly or entirely by medical insurance.
* Read More: Biography and Education, Credentials and Publications

Nose Surgery – Recovery & Aftercare

Once your rhinoplasty is complete, a splint will be put on your nose to help support the new shape. After an intervention on the septum or turbinates, it is common to have dressing inside the nostrils. Packing or soft plastic splints may be placed inside your nostrils to help stabilize the interior structure of your nose. These dressings prevent bleeding and help the healing of the septum. A patient is usually discharged on the same day and does not need to spend a night in hospital. If packing is placed inside the nose during surgery, it is removed 2-3 days following the surgery. In the immediate days following surgery, you will experience bruising and swelling around the eyes. Cold compresses often reduce the bruising and discomfort. Nasal dressing and splints are usually removed 7-10 days after surgery.

While recovery is only a few weeks, it may take up to a year for your new nose to fully take on its new shape. Some results of rhinoplasty can be seen shortly after surgery, the final result of the procedure will typically take 3-4 months. The most subtle changes may take a year or more to see following surgery. After the majority of swelling has subsided, patients will have an initial idea of the final result. The amount of change that occurs following surgery is dependent on the treatments performed.

Gig Harbor Rhinoplasty

Before – After

After removal of the dressings it is important to establish good nasal hygiene. A serum of cleansing fluid should be instilled through the nostrils and any scabs that appear should be cleaned with swabs soaked in oxygenated water and then have antibiotic ointment applied. In cases where cosmetic surgery is performed, a splint or similar device will be used to prevent the nose from moving in the immediate post-operative period. This splint is usually removed a week after the surgery.

Dr. Shvidler will provide specific instructions on how to care for the surgical site and prescribe any pain medication you may need during the healing process. As the swelling goes down you might be anxious to get a look at the new you but it’s important that you follow all recovery procedures and take the time to heal. After your follow-up appointment, it’s up to you to maintain a positive attitude about your recovery, use sunscreen, eat the right foods and make healthy choices in your lifestyle to keep your new nose in tip top shape.

To Summarize

Rhinoplasty can help promote self-confidence for those that suffer from extreme nasal irregularities. Having a facial surgical procedure, such as rhinoplasty, may be daunting and leave some people concerned that it’s a difficult and painful operation. Dr. Shvidler will use his expertise to help ensure you’re comfortable and confident through the entire process of the rhinoplasty procedure. He will artistically sculpt a new nose to better balance the face and create a more uniform profile. With his years of experience and creative thinking, Dr. Shvidler will provide you with customized care and a unique solution for your individual face. Dr Joseph Shvidler will answer the commonest questions on a nose job, including the reasons you may opt to have one. Please, feel free to contact Dr. Joe today!

Dr. Shvidler Performs the following types of Rhinoplasty

Primary Rhinoplasty

Modification of the nasal profile
Modification of the tip
Repair of contour irregularities
Straightening of the nose with or without major septal repair

Revision Rhinoplasty

With or without grafting
Ear, septal or rib cartilage grafts
Repair of Vestibular Collapse or Narrowing
Placement of cartilage grafts to widen and stiffen nasal passages
Alar batan, spreader, butterfly graft
Rhinoplasty with Cleft Lip and Palate
Correction of nostril and tip asymmetry

Rhinoplasty after injury or accident

Correction of saddle nose
Correction of deviated nose
Reduction of nasal bony fractures
Cosmetic Rhinoplasty
Modification of the nasal profile
Modification of the tip
Repair of contour irregularities
Straightening of the nose
Modification of alar base
Modification of forehead and nose junction