Rhinoplasty is usually an outpatient procedure performed under IV sedation or general anesthesia. It usually takes from 1 to 2 hours to complete. Surgeons use one of two techniques when performing nose surgery. 

Dr. Orseck may use one of two techniques: the incision is either made within the nostrils, thus hiding scars after surgery, or across the columella (the vertical strip of tissue separating the nostrils) in an “open” procedure, where scars are small and hidden on the underside of the base. In both procedures, the skin is lifted, the bone and cartilage sculpted, and the skin is replaced and stitched closed.

With both methods, the surgeon gently lifts the soft tissues covering the nose. The surgeon sculpts the bone and cartilage to the desired shape. Any additional cartilage needed to augment the nose can often be taken from the septum. If the patient has a deviated septum, the surgeon will adjust the septum and the inner structures of the nose to improve breathing. Then the tissues are re-draped and stitched closed. If the patient desires nostril reshaping, this is done as the final stage of rhinoplasty.

Immediately after surgery, your nose and eyes are usually bruised and swollen. Splints and some packing material will remain inside your nose for a few days. During this period, you may experience some nasal pain or a dull headache, as well as some bleeding and drainage from your nose. Most patients are comfortable enough to return to regular activities in about a week. Contact lenses can be worn immediately after the procedure, but glasses may need to be taped to your forehead or propped on your cheeks for up to seven weeks.

While you will be able to resume normal activities about a week after surgery, you will have to protect your nose while it heals by observing the following directives during the post-operative period:

• Avoid strenuous activities
• Take baths instead of showers
• Avoid blowing your nose
• Avoid constipation
• Avoid making exaggerated facial expressions
• Brush your teeth gently
• Avoid pulling clothing over your head
• Use sunscreen of SPF 30 or higher
• Limit dietary sodium
• Do not use ice packs

Complications arising from a rhinoplasty are rare and usually minor when they do occur. These may include infection, nosebleeds, or a reaction to the anesthesia. Some patients may experience recurring nosebleeds or numbness in or around the nose. On rare occasions, the nasal septum may be perforated, but this can be repaired. In general, a rhinoplasty is considered a very safe surgical procedure.

Revision, or secondary, rhinoplasty corrects deformities caused by a previous operation on the nose. It is a more difficult procedure to perform than primary rhinoplasty because there is less cartilage to work with, and there may be scarring or tissue contracture. When performed by a highly skilled plastic surgeon, however, a revision rhinoplasty can improve both the appearance and the function of the nose.