Rhinoplasty or nasal reshaping is the second most common plastic surgery performed in the United States. Rhinoplasty can increase or decrease the tip; it can narrow or widen the tip; it can push the tip down or pull it up. Rhinoplasty can also decrease a bump on the nose and make it less wide. Dr. Michael J. Lee believes that rhinoplasty is about restoring balance to the overall face and refining the appearance of the nose.
|Why Choose Dr. Michael J. Lee for your Rhinoplasy?
Additional training and experience with an emphasis on natural, long lasting results that decrease the risk of breathing problems in the future.
Dr. Michael J. Lee believes that rhinoplasty is not only about making the nose look better but providing good support to make sure that the results are long lasting and to minimize the chance that breathing is worsened by the surgery.
Patience is required when it comes to the final result. The cartilage framework underneath the nose can be changed immediately but the skin and fat that lay on top of the cartilage can take several months to years to adapt to its new structure. Individuals with thick skin and a fatty nose may take longer.
Are you a good candidate for rhinoplasty?
A good candidate for rhinoplasty or any other elective cosmetic surgery is someone who is in good medical health with reasonable expectations and has enough physical aspects of the nose that can be improved with surgery.
Individuals who use cocaine are absolute contraindications for surgery because it increases the risk of the necrosis and loss of the overlying skin as well as the cartilage support underneath the nose.
If you have already had a rhinoplasty or had recent significant injury to the septum or mucosa, you are a poor candidate until the healing and swelling has improved. This usually takes six months to one year.
What is the recovery like?
Rhinoplasty is an outpatient surgery and takes about two to three hours to complete. Significant pain is unusual; any pain usually subsides after one or two days. Swelling underneath the eyes can occur as well as swelling in the tip. This swelling decreases over the next 5-7 days.
The splint and sutures are removed at one week. Dr. Lee recommends sleeping on two pillows with the head elevated for that first week. For individuals that like to sleep on their side or stomach, Dr. Lee recommends a “U” shaped travel pillow to encourage sleeping on the back.
The majority of swelling and bruising is usually gone within the first week. Most people who work or go to school find that they can return in one week. The swelling continues to decrease over the next month but the final degree of swelling in the tip may last up to one year.
What are some of the complications from rhinoplasty?
Complications from rhinoplasty are uncommon but include bleeding and infection as well as deviation of the nose and breathing problems. The sensation to the nose is decreased temporarily after rhinoplasty and takes several months to return.
If cartilage grafts are used, there may be complications from this surgery as well which include holes and bleeding around the septum, the ear and the rib. If rib cartilage is used for more complicated surgeries, there are additional risks from this procedure.
Are rhinoplasty surgeries covered by insurance?
Rhinoplasties are generally not covered by insurance. Sometimes if there is documented trauma to the nose and collapse develops in the nose or the nose is severely deviated, a rhinoplasty may be covered by insurance. If you are a candidate, Dr. Lee can submit a letter to your insurance company with your photographs and your insurance company will let you know if it will be covered.
Most times, if there are breathing problems related to the septum, a septoplasty can be covered by insurance while an additional fee is paid to have the rhinoplasty performed.
If you are considering a rhinoplasty and septoplasty please see the next question.
What is a rhino/septoplasty?
Rhinoplasty and septolasty are two procedures that are often performed together. The septoplasty is a procedure to remove portions of the septum to improve breathing. The septoplasty can be performed without changing the appearance of the nose and the incisions are inside the nose. Septoplasties are most successful in individuals who have breathing problems as a result of a deviation in the septum as the cause of their breathing problems.
Rhinoplasty can be performed at the same time which allows one anesthesia and one recovery. Many times, insurance will pay for the operating room time and anesthesia fees associated with the septoplasty which can decrease the overall cost.
Closed versus Open Rhinoplasty
Rhinoplasty can be performed through incisions inside the nose or with an incision at the bottom of the nose. When the incisions are hidden inside the nose, it is called a closed rhinoplasty. When there is a small incision at the very bottom of the nose, then it is called an open rhinoplasty.
Closed rhinoplasties tend to have less early swelling and have the obvious advantage of no external incision. Unfortunately, since the incisions are hidden inside the nose, it is more difficult to visualize the changes made to the nose. For most surgeons, this means that there is a slightly higher degree of difficulty as well as a higher chance that deformity is not corrected well. More and more surgeons are performing open rhinoplasty because of this difficulty.
For Dr. Michael J. Lee, a closed rhinoplasty is performed when the changes desired on the nose are related to a bump on the bridge of the nose and minimal changes need to be made to the tip. An open rhinoplasty is, otherwise performed to allow better visualization and a better chance at correcting the deformity.
A secondary or repeat rhinoplasty can be performed at around one year from the previous rhinoplasty. This surgery usually has more risks associated with the surgery because the skin and cartilage are scarred.
The chance of success and improvement lie in the proper diagnosis for the reasons that the deformity is still present. Sometimes it is an uncorrected problem or sometimes it is caused by the previous surgery.
Most times additional cartilage and support is needed to the nose and the cartilage is taken from the septum, back of the ear or small portion of the rib.
Dr. Lee has performed many of these secondary rhinoplasties and developed experience with using these additional cartilages and operating on noses that have had more than one or two previous surgeries.