Rhinoplasty, also known as a “nose job” or nose reshaping procedure is used to adjust the size of the nose in proportion to the face. According to the Plastic Surgery Statistics Report compiled by the America Society of Plastic Surgeons, rhinoplasty is the third most performed cosmetic surgery in the year 2017.
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Common indications for a rhinoplasty include:
- Post-traumatic aberrations or deformities following an accident or injury
- An asymmetrical or deviated nose
- Having a nose of abnormal width (too narrow or too wide)
- Breathing problems or obstruction due to the septal deviation or internal valve collapse
- A depressed nose bridge or nose with visible humps
- An enlarged, drooping or bulbous nasal tip
Types of Rhinoplasty
- Reduction rhinoplasty: Just like the name, reduction rhinoplasty is used to reduce the size of the nose. It is a very common plastic surgery procedure. To decrease the size of the nose, the surgeon may employ a technique called alar base reduction. This procedure involves removing a wedge of tissues from the point where the nose intersects the cheekbones.
- Post-traumatic rhinoplasty: Post-traumatic nose job is done on patients who may have suffered a trauma to the nose. In most cases, the patient always has a fractured nose. This procedure is used to correct the nasal septum and to align the cartilage of the nose.
- Reconstructive rhinoplasty: Reconstructive rhinoplasty may be required by patients who may have lost part of their nose to an accident, extensive burn involving the face, nasopharyngeal cancer or a chronic disease. During this procedure, the surgeon reconstructs the nose using skin flaps or grafts and other advanced techniques. Depending on the extent of damage to the nose and complex nature of this procedure, candidates may need to undergo multiple surgeries over a long period.
- Aging rhinoplasty: Different changes occurs in our body as we grow older, including our nose. Despite been largely made up of cartilage and reaches its maximum length at the age of 16, the shape of the nose may change over time. Certain people may experience breathing difficulties due to narrowing of the nasal passages or the tip of the nose may begin to droop. Depending on the changes caused by aging, aging rhinoplasty can be used to correct any of these issues, giving the patient a youthful and rejuvenated appearance.
How Much Does Rhinoplasty Cost?
Just like any cosmetic and plastic surgeries, the total cost of rhinoplasty can vary greatly and is determined by several factors. These include:
- Physician’s experience: A skilled and experienced surgeon, with an outstanding reputation, will definitely charge more than a less experienced surgeon. Many patients don’t mind paying more for an experienced surgeon, as long as they get the desired results.
- Geographic location: A rhinoplasty will cost more in a city than in rural regions.
- Hospital or surgical facilities: Rhinoplasty can be performed in any of these places: a hospital, ambulatory surgical centers or private surgical clinics.
Private surgical clinics are the least expensive and are usually done in the surgeon’s office. A private clinic has its benefits. Patients can enjoy some privacy and personalized care. Price usually ranges from $1,000 to $3,000 per procedure. Ambulatory surgical centres cost much than a private clinic. The facilities, equipment and every other thing the surgeon may need to perform any plastic surgery procedures safely, are owned by a third party. Ambulatory surgical centers charge around $3,500 or more for a single procedure. Hospital or surgical facility is the most expensive of the three. Despite been the most expensive, it offers more advantages, especially for patients at risk of surgical complications such as severe bleeding. A nose job can cost as much as $6,000 or more.
- Anesthesia fees: Depending on the surgical procedure and choice of technique, rhinoplasty may be done under local or general anesthesia, and this will affect the total cost of the surgery. An anaesthesiologist’s services can cost up to $500 per hour.
- The extent of treatment: The degree of complexity of any surgical procedure can also add to the overall cost. It is logical that complex procedures will take long hours, and is, therefore, more expensive compared to very simple or short procedures. Factors that may contribute to the complexity of a rhinoplasty include Nasal obstruction, severe septal deviations, abnormal skin thickness, very soft or weak cartilage that may require grafts and multiple nasal injuries.
- Post-surgical care and recovery: While initial recovery is generally quick, healing may take up to a year or to three years. During this period, patients may require certain medications or visits, and these may influence the final cost of treatment.
The cost of procedure and recovery can range between $6,000 to $15,000
Non-surgical Rhinoplasty
Non-surgical nose job or Filler Rhinoplasty is a non-invasive procedure suitable for people who wish to enhance and soften humps, lumps, and bumps and to raise nasal bridges and even nasal tips using injectable dermal fillers.
Non-surgical rhinoplasty has gained so much popularity within the world of facial and cosmetic surgery due to the minimal risks and error associated with this procedure. This procedure is very popular amongst people from the middle east and Asians due to their peculiar “saddled shaped nose” and depressed nasal bridge.
A dermal filler containing hyaluronic acid (Juvéderm, Perlane, Restylane, or Volume) are injected into the selected areas marked for improvement until a noticeable change is observed. This whole process takes approximately 15 to 30 minutes. The duration of the result of a non-surgical rhinoplasty depends on the half-life of the type of dermal filler used. Most hyaluronic acid fillers such as Juvéderm and Volume are temporary fillers and have a half-life of about 6 months. Semi-permanent fillers such as Radiesse is made up of calcium hydroxyapatite, the same mineral found in the bone, but suspended in a liquid-based gel carrier. Radiesse has a longer half-life of more than a year.
Before carrying out this procedure, the surgeon wishing to use a dermal filler must be experienced and familiar with this technique and must have a contingency plan in place in case of possible complications.
Non-surgical rhinoplasty is highly contraindicated in a certain group of people. These include patients with any acute or chronic skin disease, pregnant women, lactating mothers and patients with a history of allergies or sensitivity to dermal fillers. Also, extreme caution should be taken in patients who have a history of trauma to the nose or have had a nasal surgery.
Non-surgical rhinoplasty is not without its potential complications and seems to be on a rise due to its popularity. Dermal filler is not a treatment that should be taken lightly. A misplaced injection into an end artery or terminal artery that supplies the retina of the eyes would cause immediate blindness and necrosis of the surrounding skin and nostrils. There is currently no reliable remedy to this complication. Other minor risks include bruising, pain, bleeding and infection. The safest place to inject a dermal filler is along the bridge of the nose, away from the arteries.
The average cost of a non-surgical rhinoplasty using hyaluronic fillers is around $2,500. Permanent fillers last longer but are not cost-effective, costing an average of $4,500 for the whole procedure.
Surgery still remains the preferred choice of treatment for patients with a significantly asymmetrical or misaligned nose or patients with breathing difficulty resulting from a deviated septum.
Teen Rhinoplasty Nose Job
Rhinoplasty is very common among teenagers. As teenagers approach adolescence, their body begins to undergo many physical and physiological changes, including changes to the face. The face begins to increase in length and width, affecting the nose shape and size. These changes can cause teenagers to become self-conscious, unhappy and insecure about their appearance. Regardless of the reason for a nose job, plastic surgeons recommend that girls should be above the age of 15 and boys above the age of 18 before undergoing a rhinoplasty. Emotional maturity is also very important. Teenagers must be matured enough to fully comprehend the procedure, the risks, and its implications. Teenagers who are not mentally and emotionally prepared for a nose job will be advised to wait. The need to have a nose job should not be influenced by unrealistic expectations or body dysmorphia, which is very common in this age group.
Rhinoplasty to Make Nose Bigger
Men with a smaller nose with respect to the face can make it bigger with a nose job surgery or rhinoplasty. Certain factors can make the nose to be smaller such as a short septum, pinched nose, over-rotated tip, and supratip depression. An open rhinoplasty procedure can be done by inserting an implant to make the nose stronger and appear more masculine.
How Long Does Rhinoplasty Take to Heal?
One burning question every patient asks before going agreeing to a rhinoplasty is how long it takes for the nose job to heal after surgery? Healing and recovery depend largely on the type of procedure used. The downtime for an open procedure is between one to two weeks. For closed procedures, recovery usually takes five to six days.
To prevent swelling and bleeding, you will be asked to rest your head slightly elevated above the chest. Painkillers such as ibuprofen and aspirin should be avoided during the healing and recovery period. This is because these drugs are anticoagulants (they inhibit the blood clotting process), and can increase the risk of bleeding.
Smokers always have a hard time healing from any facial surgery such as rhinoplasty, as substances found in cigarettes can impact the healing process. Nicotine constricts your blood vessels, resulting in less oxygen and blood getting to healing tissues. Smokers are advised to refrain from smoking cigarettes before and after surgery so as to speed up the healing process.
Large Nose Rhinoplasty
A large nose can be reduced and reshaped in proportion with the face. This can be achieved using a reduction rhinoplasty. This procedure can be used to correct bumps on the bridge of the nose, a pronounced flared nose and an elongated nasal tip.
Rhinoplasty for Nose Bridge
It is possible for patients to have a rhinoplasty surgery to restore a dorsal hump or bump on the bridge of their nose. The nose can be restructured by reducing the width of the nasal bridge, the base of the nose and the tip. In cases where the bony vault is wide, controlled fracture of the bones (osteotomies) can be done to trim the bony vault of the nose and narrow the point of inflection where the cheek appears to merge into the lateral wall of the nose.
Cartilage Only
Cartilages can be used alone for rhinoplasty. It is the most important and safest graft used in rhinoplasty. The ear cartilage, septal cartilage, and rib cartilage can all be harvested as materials for nose augmentation. Each cartilage has its own unique characteristics. For example, ear cartilages possess a natural curve, high elasticity, and moderate thickness. It is suitable for areas of the nose that requires a curvature.
How to Find the Best Plastic Surgeon for Your Perfect Nose Job
Finding the right and most-qualified plastic surgeon for your ideal nose job is the one factor you must put into consideration. Therefore, it is important you do your homework and proper research. Using the internet is a good way to start your research.
Patients should look for plastic surgeons certified by the American Society of Plastic Surgeons (ASPS). This certification gives you the guarantee and assurance that the surgeon will adhere strictly to stringent standards of safety and ethics, and that he or she will perform procedures approved by the board. Experience is also very important. Due to the complexity and architecture of the nose, the surgeon must possess the skill set and ability to manipulate and restructure the nose with high precision and accuracy, in order to achieve an aesthetically pleasing result, while preserving its physiological functions.
References
Bray, D., Hopkins, C., & Roberts, D. (2010). Injection rhinoplasty: non-surgical nasal augmentation and correction of post-rhinoplasty contour asymmetries with hyaluronic acid: how we do it. Clinical Otolaryngology, 35(3), 227-230. doi: 10.1111/j.1749-4486.2010.02125.x
McKeown, D. (2013). The risk of blindness following ‘non-surgical rhinoplasty’. Journal Of Plastic, Reconstructive & Aesthetic Surgery, 66(8), e238. doi: 10.1016/j.bjps.2013.03.045
Nemati, S., Banan, R., Alizadeh, A., Leili, E., & Kerdari, H. (2013). Ultrasonographic evaluation of long-term results of nasal tip defatting in rhinoplasty cases. The Laryngoscope, 123(9), 2131-2135. doi: 10.1002/lary.23862
Sahan, A., & Tamer, F. (2017). Non-surgical minimally invasive rhinoplasty: tips and tricks from the perspective of a dermatologist. Acta Dermatovenerologica Alpina Pannonica Et Adriatica, 26(4). doi: 10.15570/actaapa.2017.29
