Rhinoplasty (Nasal Surgery)

Overview

Rhinoplasty –commonly referred to as a “nose job”– is a procedure to improve the appearance of the nose and provide more balance and harmony to the face. The face is like a painting and needs a focal point. Ideally, the eyes are that focal point, and a large, disproportionate nose is distracting. The goals of rhinoplasty are to sculpt the nasal bones and cartilage to bring balance to other features of the face. As the shape of the nose is intimately related to its function, anatomic deformities that cause breathing problems may be addressed at the same time.

Rhinoplasty surgery is one of the most challenging plastic surgery procedures. As a double board-certified facial plastic surgeon, Dr. Chung has had extensive training and experience with nasal anatomy and surgery. Dr. Chung is well known for her technical skills, artistic eye, and NATURAL appearing results.  She will never make a nose look “done,” and patients fly to Boston from all over the country seeking her expertise and skill.

Am I a good candidate for a rhinoplasty procedure?

If you wish to improve the shape or size of your nose –or simply wish to improve your nasal breathing, you may a good candidate for rhinoplasty.  Unsightly humps, crooked alignment, disproportionate size, or difficult breathing due to prior injury are all features that may be improved with rhinoplasty.  While there is no “correct” age for a rhinoplasty procedure, the most reliable and durable results are seen in patients over 16 years of age. The results from rhinoplasty are influenced by your inherent anatomy, ethnic background, and thickness of your skin. If you have had nasal surgery in the past and are unhappy with the results, you may be a good candidate for a revision rhinoplasty. Dr. Chung has significant experience with patients of all ethnic backgrounds with noses of all shapes, sizes, and forms. Ultimately, your wishes are important to Dr. Chung, who will tailor her surgical techniques to fit your goals and desires.

What happens during my initial consultation for a rhinoplasty?

During the initial consultation, Dr. Chung will listen to your concerns and wishes for improvement. Are you bothered by a hump? Is the nose too wide? Too long?  Any history of nasal trauma, nasal obstruction, and other nasal symptoms will be discussed. She will perform a thorough evaluation of the nasal bones and cartilage and evaluate the soft tissue envelope of your nose. Furthermore, pictures of your face will be taken to facilitate a discussion regarding the role of your nose in the overall balance of your face.   For example, Dr. Chung will also evaluate the position and definition of your chin, as it greatly impacts the appearance of the nose. A weak chin may make a nose appear larger, while a stronger chin will make a nose appear smaller.

Dr. Chung will also discuss the various techniques of rhinoplasty. The external, or open, approach involves a small incision that is made across the bottom of the nose.   The endonasal approach, on the other hand, places all the incisions inside the nose. Dr. Chung has significant expertise in both external and endonasal techniques and will discuss the advantages and disadvantages of both approaches as it pertains to your individual anatomy and goals. If you have difficulty breathing through your nose, Dr. Chung may also recommend a septoplasty to realign, the internal structures of your nose. Realistic expectations are tantamount to a good outcome and Dr. Chung will guide you on the changes that are optimal and attainable for your nose. While rhinoplasty may not give you a “perfect” nose, it certainly can create an aesthetically pleasing nose that is perfect for your face.

What happens during my rhinoplasty?

Depending on the extent and type of rhinoplasty, your procedure may be performed in the office or the hospital under sedation. The incisions are typically placed inside the nostrils, but may possibly be across the thin strip of skin in between the nostrils (columella). Regardless of the approach, all incisions heal extremely well and are barely visible over time. Through these incisions, the nasal bones and cartilage are sculpted to create an aesthetically pleasing appearance to your nose. Dr. Chung will also address your breathing concerns at the same time. For complex revision rhinoplasty procedures, Dr. Chung may use advanced techniques to rebuild the framework of the nose, using cartilage or bone harvested from other parts of the body such as the ear, hip, or head. At the end of the procedure, Dr. Chung will place tape and a nasal splint to protect your nose.

Complementary procedures

The position and definition of the chin greatly impact the appearance of the nose.   For this reason, you may benefit from a chin implant and neck liposuction at the same time as your rhinoplasty to improve the appearance of your profile and overall balance of your face.

What is the recovery like?

You will have a nasal splint taped on your nose for approximately 5-7 days. Immediately after surgery, there will be some swelling and bruising around the nose and possibly the eyes. This may get worse over the first 2 days after surgery before it gets better.   You will be asked to apply ice to your eyes for 48 hours. There may be some nasal congestion and possibly some mild bleeding. If you had an external incision made across the columella, the stitches will be removed in 5-7 days. Most patients return to work 1 week after surgery and may resume strenuous activity in 2 weeks.

What will I look like?

The majority of the swelling and bruising will resolve in 1 -2 weeks, but it will take up to a year for all the swelling to completely disappear. Ultimately, most people will not even know you’ve had a rhinoplasty, but you will have a wonderfully balanced appearance to your face.  Through rhinoplasty, you will experience first hand how an improved look inspires an improved outlook.

“A smile is happiness you’ll find right under your nose.”

Tom Wilson