Rhinoplasty Surgery (Nasal Cosmetic Surgery, Nose Job, Nasalplasty)
Nasal cosmetic surgery (rhinoplasty, nose job, nasal plasty) is one of the most commonly performed procedures by Dr. Zemplenyi at the Bel-Red Center for Aesthetic Surgery. Reshaping of the nose (rhinoplasty) can improve and restore harmony between the nose and the rest of the face. Whether a hump (bump) on the nose, a crooked outline, or the shape of the tip of the nose is the concern, all these can be addressed with rhinoplasty. Parts of the nose may be reduced in size whereas other aspects of the nose may be augmented (made more prominent) with a rhinoplasty in order to achieve improved proportions and aesthetic harmony. These changes are accomplished by reshaping the nasal framework (cartilage and nasal bone) while the overlying skin drapes over the internal structures altered by the rhinoplasty. Smaller corrections to the nose can be accomplished with a non-surgical nose-job using fillers. Fillers can be used to improve proportion or the profile by building up the bridge of the nose or filling in irregularities.
During your consultation for a Seattle rhinoplasty (nasal surgery), Dr. Zemplenyi will usually analyze various views of your nose with the assistance of computerized imaging to aid in mutual communication. Dr. Zemplenyi will address your desires and wishes so that your procedure becomes individualized and tailored for your needs. For example, a hump (bump) can be reduced in size or the tip narrowed to diminish its prominence in the frontal and side profile views. The nasal tip (lobule) may need to be altered by careful reshaping of the cartilages at the tip of the nose to provide narrowing and increased refinement. A prominent, protruding nasal tip may be recessed back while a droopy tip may be supported by a cartilage graft. A wide nasal base (flared nostrils) may also need to be narrowed. In contrast to reduction rhinoplasty needed in many Caucasian patients, in cases of ethnic rhinoplasty (African-Americans, Asians, Latinos) the nasal pyramid usually requires building up (augmentation). Depending on the complexity of the proposed changes, the nasal tip and the framework can be accessed from the inside of the nose (closed approach) or through a small outside incision between the nostrils (open approach). Advanced techniques are used to correct nasal deformities as encountered in patients with a cleft lip nose.
A twisted (crooked nose) requires straightening and reshaping of the twisted region including correction of the underlying septal cartilage that pushes the nose to one side. This problem is addressed by combining a rhinoplasty and a septoplasty known as a septorhinoplasty.
As an experienced nasal surgeon Dr. Zemplenyi performs revision rhinoplasty on patients who underwent their first nasal surgery elsewhere. Additionally, patients who have suffered a broken nose can combine repair of the broken nose and any resulting breathing difficulty with a cosmetic rhinoplasty to improve previously existing bothersome nasal features. Patients are referred and travel to see Dr. Zemplenyi from Seattle, Bellevue, the entire Puget Sound area and as far as Oregon, California, Florida and New York.
Surgery & Anesthesia
Dr. Zemplenyi performs rhinoplasty at the Bel-Red Center for Aesthetic Plastic Cosmetic Surgery under conscious sedation anesthesia (“twilight sleep”) or under general anesthesia (also please see our Anesthesia & Sedation page). Depending on the complexity of the surgery Dr. Zemplenyi chooses a closed or an open approach rhinoplasty. During the rhinoplasty nasal surgery Dr. Zemplenyi follows a step- by-step strategy that has been worked with your input during the pre-operative consultation. Rhinoplasty may also be combined with surgery to improve nasal breathing (septoplasty, turbinoplasty & nasal valve surgery) or with sinus surgery (also please see our Functional and Reconstructive Surgery section for more information).
Non-Surgical Nose Job
A non-surgical nose-job or liquid rhinoplasty is an alternative to conventional nasal surgery. This alternative method uses fillers, instead of surgery, to reshape the nose. The procedure involves small, precise injections of one of several fillers into specific areas of the nose to achieve the desired result. The procedure takes about 15 to 30 minutes. If necessary, touch-ups can be done on a follow-up visit several weeks later.
After Your Surgery
As Dr. Zemplenyi does not pack the nose after a rhinoplasty post-operative discomfort is greatly diminished. The discomfort is usually easily controlled with prescribed medications, and many of our patients do not experience the need to use narcotic medications beyond the first 24 to 48 hours. A check-up visit with Dr. Zemplenyi occurs within the first 24 to 72 hours. A plastic nasal splint stabilizes the nose during the first week. Most patients remain at home for the first week, but some patients return to work with the nasal plastic splint still in place. Camouflage cover-up make up is available through our esthetician services and may be applied, if necessary, once the splint is removed. While most of the swelling and bruising resolves within fourteen days the final rhinoplasty result is not achieved until about twelve months following the operation when all of the residual swelling resolves, and the skin envelope conforms to the underlying modified nasal framework.
- What is Rhinoplasty?
- Rhinoplasty is cosmetic surgery of the nose which sculpts the nose to enhance facial proportions and harmony. It is a procedure in which nasal features a person finds objectionable are adjusted by removing, repositioning or reshaping bone or cartilage. By altering various aspects of the nose, aesthetic nasal surgery can fashion a more attractive, balanced facial contour. Surgery can be performed to correct:
- An upturned, drooping, wide tip
- Large, flared nostrils
- Hump on dorsum
- Nasal size in relation to facial features
- At what age can a rhinoplasty be performed?
- Rhinoplasty can be performed after the face has fully developed. This occurs at about 15-16 in young women and 16-17 in young men.
- How can I prepare for a rhinoplasty?
- Taking care of your well-being will make both the surgery and recovery easier. Thus eating a healthy diet, performing regular cardiovascular exercise, avoiding smoking and keeping weight under control will promote uncomplicated healing. If you are on blood pressure medications, your hypertension should be under good control. You need to avoid blood thinners including aspirin for about ten days prior to surgery. Herbal supplements and vitamin E should likewise be avoided for that amount of time prior surgery to minimize the possibility of bleeding. During your pre-operative visit we review and counsel patients about all pertinent precautions. Your pre-operative visit will include state-of-the-art computer imaging to illustrate changes that you wish and the results that can be achieved. We require an electrocardiogram and a clearance by your primary care physician if you are over 60 years old and sometimes younger, as dictated by your particular health circumstances. Laboratory testing may also be indicated. You will receive and our staff will review pre-operative instructions about medications and food intake for the night before and the morning of surgery. It is also important to arrange for post-operative care with someone to pick you up after the procedure and stay with you the night following surgery. Post-operative visits will be arranged and Dr. Zemplenyi is always on call at any time after surgery for questions and concerns.
- What kind of anesthesia is used during a rhinoplasty?
- At the Bel-Red Center for Aesthetic Surgery we are dedicated to making our Bellevue and Seattle patients as comfortable and anxiety-free as possible. Patients are offered the choice of twilight sleep sedation or general anesthesia, however, most rhinoplasties are performed under twilight sleep sedation. For general anesthesia we use experienced, board certified anesthesia providers who are dedicated to safety and comfort in our outpatient surgical setting.
- What are the steps in rhinoplasty?
- Rhinoplasty can be performed using a closed approach, in which incisions are hidden inside the nose or an external approach with an incision made across the columella, the narrow strip of tissue between the nostrils. These incisions allow access to the tissues underneath the skin, cartilage and bone, for reshaping, removing and repositioning. The pros and cons of these options are discussed with the patient during the preoperative visit.
The nose is then reshaped by addressing the relevant aspects that need adjustment.
- Bone is shaved to remove a dorsal hump
- Precision nasal bone cuts (osteotomies) are made to narrow a wide nasal bridge
- Cartilage is harvested (from nasal septum or ear cartilage) and added to build up the bridge of the nose
- A strut is added to strengthen or raise the nasal tip
- Cartilage is removed to narrow a bulbous tip
- Cartilage is sewn together to narrow a broad tip
- Cartilage is removed to slim flared nostrils
- Is packing left in place inside the nose after rhinoplasty?
- Dr. Zemplenyi does not place packing into the nose after rhinoplasty, increasing post-operative comfort and making breathing less restricted.
- What is the recovery time for rhinoplasty?
- Typically, the initial swelling after nose surgery subsides within a two to three weeks. However, residual swelling, especially in the tip of the nose, can take about a year to resolve as the contour refines. Swelling can also vary through the day, being more prominent in the morning. There may be some bruising around the nose and eyes which usually improves over about a week and can be covered with camouflage make-up if one feels self-conscious. The splint, if one has been placed, comes off after about a week. Social and work activities can be resumed at that time.
- Post procedure care for rhinoplasty?
- You will receive written and verbal post-operative instructions after your surgery. It is important to arrange for post-operative care with someone to pick you up after the procedure and stay with you the night following surgery. Discomfort in the first few days after surgery is usually easily controlled with oral pain medications. Post-operative visits will be arranged and Dr. Zemplenyi is always on call at any time after surgery for questions and concerns.
- Is there pain after rhinoplasty?
- Pain is usually not severe after rhinoplasty. There can be mild to moderate discomfort after any nasal surgery which can be relieved with oral pain medication for the first few days. Discomfort decreases as swelling inside the nose decreases, making breathing easier.
- How do I know if my medical insurance will cover my nasal surgery?
- Cosmetic nasal surgery is not covered by insurance. However, our office can help our Bellevue and Seattle patients determine if functional nasal surgery to improve breathing and nasal obstruction is covered by your insurance.
- Can other surgery be performed along with cosmetic nasal surgery (rhinoplasty)?
- Since a goal of rhinoplasty is to achieve facial balance, Dr. Zemplenyi frequently performs chin implant surgery and nose surgery during the same operating session. The combination of reducing the size of the nose and augmenting the prominence of a weak chin, results in more balanced features and a more pleasing appearance. Chin augmentation, chin implant surgery, is not covered by insurance. Sinus surgery and surgery to decrease breathing obstruction can also be performed with rhinoplasty. These may be covered by insurance.
- How much does a rhinoplasty cost?
- The cost of nasal cosmetic surgery varies on the complexity of the procedure and the level of anesthesia used.
- What are the risks and limitations with rhinoplasty?
- Patients with thick skin many not experience as much of an improvement in appearance as those with thinner skin since thicker skin may not conform and contract to the newly sculpted underlying framework. After nasal surgery, patients may experience nose bleeds, numbness, holes in the nasal septum, infection, difficulty breathing and swelling. These are usually of a temporary nature, resolving with proper care and time. There can also be a need for revision surgery.Rare sequelae can include deep vein thrombosis, cardiac, pulmonary and anesthetic related complications.
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