Are you considering nose reshaping?

• Are you unhappy with the size, shape or contour of
  your nose?
• Is your nose out of proportion with your other
  facial features?
• Are structural problems with your nose making
  breathing difficult?

If you answered “yes” to any of these questions, nose reshaping surgery may be a good option for you.

What is nose reshaping?

Nose reshaping, or rhinoplasty, is a popular plastic surgery procedure that can make your nose more visually pleasing and bring it into better balance with the rest of your face.

In addition to improving your appearance, rhinoplasty can correct structural defects in the nose, such as a deviated septum, that may be causing you breathing problems, chronic stuffiness, post-nasal drip and even snoring.

How is the nose reshaped?

The sculpting of the nose during rhinoplasty must be highly individualized to complement your facial features. Depending on your needs, nose reshaping can:

• Eliminate a “bump” in the bridge of the nose
• Change the shape of the nostrils
• Raise or lower the bridge of the nose
• Turn the tip of the nose up or down
• Reduce or enlarge the tip of the nose

Can nose reshaping be done in conjunction with other facial plastic surgery?

Yes—in fact, rhinoplasty is often performed in combination with other procedures to achieve optimal facial harmony. These other procedures may include:

• Chin implants or osseous genioplasty
• Cheek augmentation
• Lower eyelid lift
• Jaw augmentation
• Neck lift
• Ear setback
• Lip augmentation

During your personal consultation, Dr. Rappaport will evaluate your face, listen to your goals and recommend a surgical treatment plan to give you the results you desire.

Is rhinoplasty ever performed for rejuvenation?

Yes. As people age, the tip of the nose often starts to droop. Nose reshaping can be done in conjunction with a facelift to raise the tip of the nose by putting in a piece of cartilage. This results in a more youthful appearance.

What will my face look like after nose reshaping?

Computer imaging technology has made this question easy to answer. During your personal consultation with Dr. Rappaport, we will take photos of your face, then use computer imaging to illustrate how you will look after nose reshaping surgery so you can visualize your options.

The computerized images will show you how you will look after rhinoplasty, and make it easier to decide whether to go ahead with any additional procedures Dr. Rappaport may recommend for you.

How is a rhinoplasty performed?

There are two methods of rhinoplasty surgery: open and closed.

• In an open rhinoplasty, a small incision is made in the tissue between the nostrils.
• In a closed rhinoplasty, the procedure is totally internal.

Whether your procedure will be open or closed depends on the details of your case. Dr. Rappaport will advise you on the surgical method he recommends for you and explain the procedure.

Does rhinoplasty require a hospital stay?

No. Nose reshaping surgery typically takes one to two hours and is done on an outpatient basis. Local anesthesia with sedation or general anesthesia is used.

Is rhinoplasty considered cosmetic or reconstructive plastic surgery?

Nose reshaping can be cosmetic surgery, reconstructive surgery—or both. For example, you may have a rhinoplasty to reshape the tip of your nose, which is considered cosmetic surgery, as well as to correct a deviated septum, which is a reconstructive procedure.

When is rhinoplasty considered
reconstructive surgery?

Nose reshaping is considered reconstructive plastic surgery for patients with:

• A traumatic injury to the nose
• A congenital abnormality
• A functional or obstructive disorder of the nose, such as a
  deviated septum

Does insurance cover rhinoplasty?

If rhinoplasty is performed to correct an abnormality, it is considered reconstructive surgery and may be covered by insurance. Our office can help answer your questions about whether the nose reshaping procedure you have in mind is reconstructive surgery and, if so, help you apply for insurance benefits.

How does insurance handle a rhinoplasty that is both reconstructive and cosmetic?

If some portions your nose reshaping procedure are reconstructive and others are strictly cosmetic, we will help you request insurance authorization for the reconstructive portion only. The costs for the cosmetic portion of the procedure, as well as any charges for reconstructive surgery not covered by your insurance, are
your responsibility.

What can I expect right after nose reshaping surgery?

You will wake up with a splint, some packing in your nose and small tubes with a drip pad for drainage. You can expect to be swollen, bruised and stuffed up. Your cheeks and jaw may be sore. Oral medications will keep you comfortable.

How long is the recuperation period after rhinoplasty?

With the exception of exercise, you can resume your normal routine almost immediately. The external and internal splints are usually removed after one week. In four to six weeks, most of the swelling will subside and your nose will continue to progress toward its ultimate shape in 12 to 18 months.

Dr. Rappaport answers questions about nose
reshaping surgery

How has rhinoplasty changed over the years?

“Rhinoplasty today is a much more conservative procedure than it was in the 1960s or 1970s. When I perform a nose reshaping, I strive for an appearance that's going to stand the test of time—not just a ‘bobbed’ or ski-slope nose. I concentrate on structural integrity and a nose that will be in optimal balance with your facial features.

“The results of nose reshaping should be appropriate for a lifetime—you don't want to someday have an 18-year-old's nose on an 80-year-old's face. It's not a good look.”

How old should a patient be before having
rhinoplasty surgery?

“It's important for a patient to have reached physical maturity before having nose reshaping surgery. Girls tend to mature more quickly than boys; they may undergo rhinoplasty as early as age 15 or 16. Boys normally reach physical maturity by age 17 or 18. It's also important that a boy or girl has developed emotional maturity before undergoing nose reshaping surgery.”

Are there special concerns for younger
rhinoplasty patients?

“Like all plastic surgery patients, teens undergoing nose reshaping surgery need to have realistic expectations. Plastic surgery can indeed improve your appearance—but it can't be expected to make you more popular or solve other problems in your life.”

Will you have to break my nose?

“No, this is a myth. In nose surgery today, the smallest possible instruments are used to cut and shape structures of the nose including the bone, but nothing is broken.”

My friend looked awful after her rhinoplasty surgery. Can you help me heal better?

“Anytime there is trauma to the nose, you will experience bruising and swelling around the immediate area. Some patients are more resistant than others. Your friend probably looked worse than
she felt.

“To help you heal better, I will prescribe special pre- and post-surgery vitamin supplements to reduce bruising and promote your healing. It is also important to sleep upright for the first week and use cold compresses to reduce the swelling.

“Keep in mind that more or less swelling and bruising is no indication of the overall success of the surgery or surgical skill.”