Rhinoplasty

Rhinoplasty is a surgical procedure to reshape the nose.  Common goals in rhinoplasty are to reduce the bridge of the nose, refine the appearance of the tip, or to make the nose straighter.  Some patients may also seek to improve their nasal breathing through a successful rhinoplasty.  The best way to learn about a rhinoplasty is through an in-person or virtual consultation with a board-certified surgeon who performs this surgery frequently.

As a double board-certified surgeon, Dr. Pepper’s goal is to preserve form and function in a manner that is harmonious with the rest of the face.  For example, the patient shown below desired significant change to the bridge of the nose, having sustained several fractures of the nose.  In order to effectively recontour the bridge, the bone and cartilage was shaved and then mobilized into a more symmetry and refined position.  In addition, a small piece of tissue from the left side of the scalp was placed over the bridge of the nose in order to further keep the contour smooth.  The nasal tip was refined and brought into harmony with the bridge of the nose.  A successful rhinoplasty therefore involves many broad components.  First, accurate analysis and understanding of the problem.  Second, shared goals between patient and surgeon.  Third, the ability to manipulate the bony components of the nose.  Last, delicate repositioning of the cartilage in order to refine the anatomy of the nasal tip.   

In general, there are two methods of performing rhinoplasty surgery: external versus endonasal.  Dr. Pepper performs mostly open rhinoplasty and this technique is overall the most common approach in the United States today.  The advantages of the external approach include higher accuracy for the placement of cartilage grafts and tip sutures.  However, both approaches are safe and effective in the hands of a well-trained surgeon.

Patients are asked to limit their activity in the first several weeks after rhinoplasty and to ice the nose to limit bruising.  Pain should be well controlled with prescribed medication.  Most patients are comfortable working from home the second week after surgery, but this depends on the patient and the extent of surgery.  A cast is placed on the bridge of the nose to limit swelling and also to protect the nose from accidental contact.  Soft silicone splints are kept inside the nose to speed internal healing.  Both the case and the splint are removed one week after surgery.  Patients typically return to work one to two weeks after a rhinoplasty, but this can vary depending on occupation and other factors.

One of the most helpful ways to decide on a rhinoplasty is to undergo a “virtual rhinoplasty” during a cosmetic consultation using digital imaging software under the guidance of your potential surgeon.  The second part of that statement is important: your consulting surgeon can model results for you that are reasonable and achievable.  Anyone can manipulate a digital image.  However, a very experienced surgeon like Dr. Pepper can help you to visualize a likely outcome in his hands.  If you would like a rhinoplasty consult, please call us at (650) 736-3223 (FACE).