Commonly referred to as a “nose job” or nasal reshaping, the goals of rhinoplasty may be entirely cosmetic, entirely functional, or they may include both cosmetic and functional goals.

A cosmetic rhinoplasty seeks to improve the aesthetic appearance of the nose.

A functional rhinoplasty, or nasal valve correction, aims to optimize airflow through the nose to alleviate symptoms of nasal obstruction without having a negative impact on the nasal aesthetics. Patients with nasal obstruction are candidates for functional rhinoplasty when their condition cannot be managed medically or with septoplasty or turbinoplasty alone.

Functional rhinoplasty is also commonly referred to as a nasal valve correction and a septoplasty. The goal of the functional rhinoplasty is to improve nasal obstruction caused by the anatomic structure of your nose. Commonly, patients have narrowing or collapse of the nasal valves which are specific anatomic areas in the nose. These areas are important for the adequate perception of nasal airflow.

Not all nasal obstruction is caused by anatomic defects of the bone and cartilage of the nose. Sometimes mucosal inflammation is the cause of or contributes to the symptom of nasal obstruction. Frequently, this is caused by under lying allergies and mucosal inflammation.

During your initial consultation with Dr. Lindsay, she will discuss your nasal concerns and goals with you. Important elements of your history include symptoms of nasal obstruction, previous nasal surgery, allergies, sleep quality, and previous treatments. She will examine your nose, noting factors such as age, ethnicity, skin type and thickness, your specific anatomic features as well as any prior fractures or surgical procedures.

Once she understands your expectations, together you will set mutual, realistic goals for your rhinoplasty. Dr. Lindsay will discuss rhinoplasty options and techniques, with the aim of correction and improvement to achieve these goals. In addition, we will take photographs of your nose to help Dr. Lindsay work with you to plan the procedure that is just right for you.

Many patients find it helpful to bring a list of questions and a friend or family member to their first appointment.

Rhinoplasty that includes both cosmetic and functional goals may be done together as a dual functional and cosmetic rhinoplasty.

An open rhinoplasty is a rhinoplasty in which an incision is made on the outside of the nose. Most commonly this incision is located on the bridge of skin between the nostrils called the columella. The incision is placed so it is in the least visible place possible on the nose. Sutures stay in place for between 7 and 10 days.

A closed rhinoplasty is a rhinoplasty performed in which all incisions are on the inside of the nose. There are not external incisions. Not all changes through the nose can be made through a closed rhinoplasty approach. Dr. Lindsay will discuss with you whether a closed rhinoplasty will meet you functional and aesthetic goals.

BEFORE SURGERY

Do not smoke for at least 4 weeks before and after surgery!

A responsible adult must provide a ride home to be discharged.

Do not eat/drink anything after midnight before surgery.

AFTER SURGERY

Swelling and crusting inside the nose will gradually subside which will cause difficulty breathing. Some patients will breathe better right away but most will take a few weeks to months to have the final breathing result.

Starting the day after surgery spray nasal saline at least 4 times a day into each nostril. Nasal saline can be used more frequently as needed.

When sleeping avoid sleeping on the side or on your stomach with the nose directly touching the pillow as constant pressure on the nose at night can cause recurrent deviations. If possible, elevate your head on at least 2 pillows at night.

For pain, initially take 2 Extra Strength Tylenol. If this is not effective, take Non-Steroidal Anti-Inflammatory medications (Motrin, Ibuprofen, Advil, etc.) If this is not effective, you may take the pain medication prescribed by your physician. Most patients do not require narcotic pain medication after surgery. Avoid all alcoholic beverages, especially while taking any prescriptions.

Do not blow your nose instead wipe or dab nose gently with gauze pad or tissue; change dressing under nose as needed.

Shower the day after surgery. If you have a cast on your nose, avoid wetting or sticking directly in shower head. Brush your teeth gently with a soft toothbrush and avoid excessive manipulation of the upper lip.

For the first week after surgery avoid heavy lifting and activities that increase your heart rate or blood pressure as this can increase your risk for a nose bleed. Your nose will act as a ‘guide’ for how much activity you can do if it begins to throb stop your activity and rest. Most patients have returned to normal activity by 2 weeks, but we recommend no swimming for 3 weeks.

Follow up 5-10 days after surgery for stitch, cast, or splint removal. Out-of-town patients plan accordingly.

If you had an open approach (have blue sutures on the columella, the skin between the nostrils) use a cotton swap soaked in hydrogen peroxide to loosen any crusting on the incision line. Your nose, eyes, and upper lip are likely to show swelling and discoloration. Bruising usually clears up within 2 weeks in most patients. Use ice compresses on the cheeks to reduce inflammation. Do not place the ice directly on the nose to avoid direct pressure on the nose. The ice should be applied while awake for 20 minutes at a time, alternating 20 minutes on and 20 minutes off throughout the day.

Limit your sodium intake to less than 1200 milligrams per day to prevent significant swelling.

Do not wear glasses on the bridge of the nose at least 8 weeks after the nasal cast is removed if you had osteotomies (breakage of the nasal bones to straighten the nose) . Ask how to tape your glasses to the forehead to avoid pressure on the nose.). Contact lenses may be worn after surgery.

Avoid significant sun exposure for at least 2 months after surgery. Starting one week after suture removal apply sunscreen on your nose, including the incision line in the morning and use silicone gel at night to reduce the redness of the incision line.