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Overview : Medical Name: Rhinoplasty Ideal Candidate: Healthy, non-smoker Designed to Improve: Size, shape, proportion, angle of the nose Type of Anesthesia: General Recovery Time: Bruising and Swelling 3- 7 days; Return to most activities 1-2 weeks Procedure Location: Our State-of-the-art private surgical facility Practitioner: Board Certified Plastic Surgeon, Dr. Michael Salzhauer Estimated Cost: $3,900 - $6,000 Rhinoplasty, the surgical reshaping of the nose (commonly called a “nose job”), is one of the most popular and requested plastic surgery procedures. The goal of the procedure is to alter the nose to a more ideal look, shape and size. This can be done several ways such as by reducing or increasing the size and length, changing the shape of the bridge or tip, narrowing the nostrils or otherwise changing the angle of the nose. The desired result is a beautiful nose that has created an overall improved appearance to the face and is in harmony and balance with other facial features. Rhinoplasty is most often performed for cosmetic reasons, but can also correct a birth defect or nose injury or relieve chronic breathing problems. Although a common procedure, it is by no means a simple one, and requires the skills and experience of a board Certified Plastic Surgeon; one who has had specialized training in cosmetic surgery and proven experience in achieving aesthetic results. Over 252,000 rhinoplasty procedures were performed in 2010, according to the American Society of Plastic Surgeons (ASPS), placing it in the top five most popular plastic surgery procedures in the US. ABOUT THE RHINOPLASTY PROCEDURE Rhinoplasty generally takes from one to hours and is performed while under general anesthesia. You will be asleep, and not feel or remember anything. The surgery is performed on an outpatient basis, and most patients can be discharged to go home after just a few hours in recovery. During a Rhinoplasty surgery, Dr. Salzhauer commonly makes a small incision at the base of the nose and then lifts the skin away from the nasal framework and sculpts the underlying bone and cartilage to create the desired new shape. The skin is then refitted over the new framework and reattached using tiny absorbable stitches. A splint may be applied to help the nose heal in its new shape and, in some procedures, soft supports or packs are applied to support the septum during the healing process. The patient may experience minor pain, puffiness, swelling and bruising around the nose and eye areas, but this will begin to subside after a few days. Strenuous activities or stress on the nose area (including blowing the nose) must be avoided for several days to allow the tissue time to heal. Nasal packing is removed after a few days and stitches removed within two weeks. The real results may start to be seen after two to four weeks. At Bal Harbour Plastic Surgery Associates, we pride ourselves on providing unparalleled patient care. We will actually send a member from our medical team to your house the next day to check on you. The convenience of not having to leave your home and drive to our office for your first post-operative follow up visit is just one reason why so patient’s have awarded us as Patient’s Choice. RHINOPLASTY PROCEDURE TECHNIQUES Depending on the complexity of the surgery and the patient’s nasal structure, one of three common techniques may be used: open rhinoplasty, closed rhinoplasty or tip plasty. Open Rhinoplasty Open RHINOPLASTY is used for reducing the overall size of a large nose or when more access is required to re-sculpt the bone and cartilage and is often the chosen technique used by Dr. Salzhauer. A small incision is made in the column between the nostrils (the columella), allowing the nasal skin to be lifted back off the underlying structure of the nose and allows Dr. Salzhauer have a clear view of the nasal anatomy. The bone and cartilage are then sculpted to create the desired shape and size of the nose and the nasal skin is then readhered. Closed Rhinoplasty Using this procedure, several incisions are made inside the nostrils without lifting the nasal skin. The bone and cartilage of the nose are altered from within to achieve the desired contour of the nose. This procedure is usually performed when only minor changes are desired. Tip Plasty This procedure is used when only the tip of the nose is to be surgically altered. The surgeon may use either the standard or open rhinoplasty to achieve the desired effect. WHAT RHINOPLASTY CAN ACCOMPLISH Increase/Reduce Nose Size and Shape: The surgery will alter the width of the bridge, span of the nostrils or change the angle between the nose and upper lip in order to achieve a nose size and shape that is more in harmony and balance with the patient’s facial features . Remove a Hump or Point: One of the most common procedures is the removing of a hump on the bridge of the nose to achieve a more aesthetic profile. Another common procedure is to reshape the tip of the nose to bring it more into balance with the size and shape of the nose . Correct a Birth Defect or Relieve Chronic Breathing Problems: Rhinoplasty surgery can correct abnormally small nasal passages to improve breathing. Also, common birth defects such as a crooked nose or separation of the bone, deviated septum or detached cartilage can be corrected. IS A RHINOPLASTY RIGHT FOR YOU? Who is the Ideal Candidate for Rhinoplasty? The ideal candidate is in good general health and physical condition, and is emotionally and mentally stable. The candidate should have realistic expectations of what can be achieved with rhinoplasty surgery and a clear understanding of what the surgery entails. The best results are achieved on candidates who have reached full bone development (usually at least sixteen years of age). While excellent results can be achieved on older patients, younger patients tend to heal more quickly. What are the Most Important Considerations for Rhinoplasty? Realistic expectations of what can be accomplished by rhinoplasty can only be gained by a free and candid communication with a Board Certified Plastic Surgeon qualified to give a full assessment of the specific candidate’s emotional, mental and physical capability to undergo this procedure. It is especially important for teenagers to understand the surgery procedure and recovery process prior to treatment. It is equally important that the candidate give the surgeon a complete medical history and a clear understanding of his or her goals and expectation. During an initial consultation, the surgeon will discuss the options, risks and limitations of each technique and make recommendations based on expectations and the candidate’s general health and medical history. The surgeon will review pre-surgery preparation instructions, the actual surgery procedure, including anesthesia, and the expected results. Post-surgery instructions will also be reviewed to ensure a successful recovery. It is also very important for a candidate to discuss with family and friends the surgical options and to create a support group to assist in pre- and post-surgery procedures and give both moral and practical support which will go far towards achieving the most successful results in the shortest recovery time. COST OF RHINOPLASTY The price range for rhinoplasty, including surgeon’s fee, facility, and anesthesia , is $3,000-$6,000. Fees do vary from state to state and from one plastic surgeon to another. The cost is based upon the type and complexity of the procedure. Other items which may affect the final cost may include pre-operative lab fees and post-operative expenses such as prescriptions. A higher surgery price does not necessarily ensure a more skilled practitioner so you should always ask for referrals and review testimonials and “before and after” photos before choosing a Board Certified Plastic Surgeon. Financing options.tba RHINOPLASTY PROS & CONS Pros • Permanent aesthetic improvement can be achieved in a short period of time • Effective repair of an injury or birth defect • Improvement of breathing by opening up nasal passages • Increase in self-confidence due to an improved facial appearance Cons • Mild to medium pain or discomfort and nose bleeding for several days, with swelling and bruising for up to two weeks • Patients with unrealistic expectations for achieving a "perfect nose" may be disappointed • Although uncommon, an additional surgery may be necessary if the procedure is complex or the desired result is not achieved the first time • Loss of time off from work or study, ranging from three to eight days RHINOPLASTY - FAQ Is rhinoplasty safe? Although rhinoplasty is a delicate surgery requiring a skillful and experienced surgeon, it is one of the oldest and most popular forms of plastic surgery, and so ranks as one of the safest and most common plastic surgery procedures. When the physician’s instructions are followed, the risk of infection or other complications are minimal. Is rhinoplasty permanent? Rhinoplasty is permanent when the final results are satisfactory to both patient and surgeon. However, if the desired result is not achieved , another surgery can be performed, but should be done by a surgeon experienced in follow-up rhinoplasty. Complex surgeries may also need follow-up procedural work. Should I have a general or local anesthetic? For more complex procedures general anesthesia is usually recommended, but either general or local can be used. The patient’s general health, age, and response to painkillers and sedation are also taken into account. Advances in anesthesia techniques and delivery make either choice comfortable and low risk options. How extensive is the operation? Complex open rhinoplasy surgeries are extensive with significant skin and bone modification and movement, while other procedures such as standard or tip plasty are not as intensive or extensive. It is important for the patient to fully understand the scope of the surgery once a particular procedure is chosen. What is the recovery time? Recovery time varies according to the patient’s general health, age, and the type of surgery performed. Typically, pain, swelling, and bruising subside after three days, but the area will remain sensitive for up to two weeks and in some cases moderate swelling and bruising can last for a few months. Initial recuperation requires 3-5 days so a week of absence from work is generally recommended. What are the postoperative instructions? Post-operative patients are always advised to avoid sun exposure and strenuous activity (including nose blowing) for the first week so as not to aggravate the wound and slow the healing process. The surgeon or his staff will supply a written list of post-operative instructions, including hygiene, exercise, diet and level of activity. Following these instructions carefully is the best way to achieve the best results in the shortest length of time.
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