Procedures » Surgical Procedures
• Rhinoplasty (nose plastic surgery, "nose job")
"...Thank you so much for everything! I am infinitely happier with my much cuter nose..."
—E. W., revision rhinoplasty patient
When we look at someone we tend to notice their eyes and mouth first. After all, these are the most expressive parts of the face through which we display our thoughts and emotions. Centering these features is the nose, and its location in the middle of the face can profoundly affect the overall look of the face.
Rhinoplasty ("rhino-" = nose, "-plasty" = to shape), sometimes crudely called a "nose job", is plastic surgery to alter the shape of the nose. It is a particularly popular procedure here in the greater Jacksonville, Florida and Ponte Vedra Beach area where there is an emphasis on looking one's best.
Commonly, people seeking cosmetic rhinoplasty to alter their appearance feel that their noses are out of balance with their facial proportions or are detracting from their other more attractive facial features. For some it's a large hump, for others it's a bulbous nasal tip. Some are concerned that it's too droopy, or too wide, or too crooked, too long, or too pointy. Some patients may additionally have nasal obstruction.
Each individual is absolutely unique in regard to the specific characteristics of the nose that concern him or her. Creating that balance of size, shape, and proportion while maintaining a natural, unoperated look is the goal of modern cosmetic rhinoplasty. And like most plastic surgery, the best rhinoplasty is the one tailored to the individual patient.
A note about Revision Rhinoplasty: There are many reasons why a patient who's had a rhinoplasty may seek a revision. Most commonly, a patient is simply dissatisfied with the appearance, but nasal obstruction, wound complications, excessive scar contraction, and even "surgical misadventure" can be appropriate reasons for revision. Given the added complexity of revision surgery, we believe that being a specialist in plastic surgery of the face and nose can be especially helpful. Dr. Pearson enjoys seeing patients who are considering revision rhinoplasty and the additional challenges that it entails.
In part because rhinoplasty is a custom-made operation every time, it is arguably the most difficult of the cosmetic plastic surgery procedures. Not only does the nose serve an esthetic role, but its size and proportions are also intimately linked to its structural and functional roles, such as proper nasal breathing.
"We want to do your last rhinoplasty (even if it's your first)..."™
—David C. Pearson, M.D.
Despite these concerns, however, satisfaction rates among rhinoplasty patients tend to run very high. To help achieve this high satisfaction rate, it's important that patients thoroughly discuss with Dr. Pearson their specific concerns about their nose so that there exists a clear, mutual understanding of the intended result. Only then will Dr. Pearson be able to outline what can and what cannot be achieved through rhinoplasty.
A note about Non-Surgical Rhinoplasty: Sometimes reshaping the nose does not require a surgical rhinoplasty, but rather a much less invasive option: the so-called "non-surgical nose job." Non-surgical rhinoplasty typically involves the injection of various fillers such as Juvederm (and now Bellafill) to contour minor irregularities and disproportions. A small hump, for example, can sometimes be concealed simply by filling in the radix (the root of the nose). A minor curve, twist, or depression can be similarly camouflaged to create a straighter or smoother nose.
Patients particularly like that non-surgical rhinoplasty is less expensive than surgery, is done in the office under local anesthesia, and has essentially immediate results with little to no downtime. Of course, non-surgical rhinoplasty will never replace surgical rhinoplasty for more advanced correction, but it's often a nice option for patients who only need minor tweaks to the appearance of their nose.
Frequently Asked Questions about Rhinoplasty:
- What happens if I proceed with rhinoplasty ("nose job")?
If Dr. Pearson feels that you are a good candidate for rhinoplasty and you feel that results he expects to achieve coincide with your desires then several things will need to be arranged for your surgery. Pre-operative photographs, routine lab work, a physical exam, and various paperwork will need to be completed. Typically a second visit is then arranged shortly before your surgery date. This will allow you time to think over the many things discussed in your initial consultation, and it will allow you time to have additional questions or concerns answered.
- Where is rhinoplasty surgery performed?
Dr. Pearson performs most of his surgery at Fleming Island Surgery Center or Middleburg Surgery Center. Both are state-licensed outpatient surgical facilities fully accredited by the AAAHC (Accreditation Association for Ambulatory Health Care). Both locations are close to his office (and a conveniently short drive from Jacksonville, Florida). Both facilities offer excellent safety while also providing the privacy and convenience patients desire.
- What kind of anesthesia is required for a rhinoplasty? Do I need to stay in the hospital?
In most cases rhinoplasty is performed on an out-patient basis under general anesthesia overseen by a licensed anesthesiologist (a physician), meaning that you will be completely asleep for the procedure (modern anesthesia techniques have tremendously improved the safety and comfort of general anesthesia and we have found that most patients prefer this route). Most patients go home a few hours after their procedure. You will not be allowed to drive for the first 24 hours, and we insist that you have a responsible adult with you for the first night.
- How long does a rhinoplasty take?
Again, because of the custom nature of this sort of surgery, exact times cannot be given. On average, rhinoplasty may take two and a half to three hours. Depending on the specific steps your surgery will require, operating times can be as short as one and a half hours or as long as four or more hours for a revision rhinoplasty. Dr. Pearson will be able to give you a better estimate at the time of your consultation.
- When are the follow-up visits after rhinoplasty?
In many cases you will be seen in the office the day after surgery and again at about a six days post-op. Dr. Pearson also likes to see patients two weeks, six weeks, three months, six months, and one year after surgery. These are at no charge to you and more visits may be necessary. Yearly follow-up after the first year is appreciated but not essential.
- Is rhinoplasty covered by my insurance carrier?
When done solely to improve the appearance of the nose (i.e., a cosmetic rhinoplasty) the patient will be responsible for the entire cost of surgery. Exceptions may apply when the procedure is primarily reconstructive, or when a portion of the rhinoplasty is for the purposes of improving nasal breathing. Check with your insurance carrier for a specific answer. Call us for more details.
- I've heard there are different approaches to rhinoplasty. Which does Dr. Pearson use?
Broadly speaking, rhinoplasty techniques fall into two main categories: closed rhinoplasty and open rhinoplasty. The closed approaches are the original classic techniques for rhinoplasty, while the open approaches are more modern techniques (approximately 30 years old, but popularized and refined in the mid-1980s). Dr. Pearson has been trained in both techniques but generally prefers the open approach, especially for the more difficult revision rhinoplasty. It is important to realize that there is no one approach to rhinoplasty that is "the best". Rather, surgeons choose that approach which in their hands gives consistent, predictable results.
- What should I expect after rhinoplasty? How long will I be off from work? How long will it take to heal?
Everyone heals individually, and no two people will have exactly the same procedure. We caution patients that the timelines for recovery are rough guides only. Generally, you can go back to work as soon as you feel able, which is generally within a few days, but most patients will take one to two weeks off. Engaging in strenuous physical activity or heavy lifting should be avoided for two weeks after your rhinoplasty. Bruises, if present, will have faded by about 14 days. Bruises as well as any incisions can be concealed early with proper camouflage makeup, if desired (check with Dr. Pearson). However, other standard cosmetics should be avoided for the first week after surgery. Final contour of the nose takes longer, and you can expect to see continued improvement and refinement of the nose for up to a year or longer. In most cases, though, by two weeks rhinoplasty patients no longer "look surgical" and can engage in work and social activities without worry about their appearance.
Rhinoplasty, despite its complexity, can often make a substantial improvement to a person's appearance. For more information about rhinoplasty and cosmetic facial plastic surgery here in Fleming Island, Orange Park, and the greater Jacksonville, Florida area, please contact us or call (904) 215-7377 to schedule an appointment.