Frequently asked Questions - Rhinoplasty

How long will my nose surgery take?     Typical rhinoplasty cases last about 2 - 3 hours depending on the complexity and areas to be addressed.

How old do I need to be before I can have rhinoplasty?     Age is not as much of a factor as growth maturity.  Nasal surgery should not be performed until someone has reached or is close to reaching skeletal, or more specifically, craniofacial maturity.   For females, this is often by age 16 and males by 17.  If you are still growing rapidly or your shoe size is increasing every 6 months, then it’s probably best to wait.  If you expect (or hope) to grow 1-2 inches more, this is not much of an issue as 1-2 inches in height does not amount to much in the way to nasal growth.  On the other hand, if you are in your growth spurt and may grow 4-6 inches more, then waiting is the most prudent decision.

Will my results look natural?     A skilled rhinoplasty surgeon will be able to tailor your surgery and to allow a natural appearing result.  It is important to set goals that allow your nose to fit in with your other facial features.  The nose should not be the “star” of the face.  It needs to be a “supporting cast member”.  This is illustrated by thinking about a couple of movie stars or models that you think are especially beautiful.  Chances are, you don’t think they are attractive because of their noses.  They probably have other striking features such as their eyes, lips, cheek bones, jaw line, etc.  People notice a bad nose, but usually not a good one.

I don't know how to describe the area of my nose that I don't like.  What's this part?  (Click here to be taken to our nasal soft tissue anatomy educational tutorial)

Will my nasal bones need to be broken?     This depends on the goals you are trying to achieve.  If only tip work is being performed, then often the nasal bones do not need to be broken.  On the other hand if a large bump is being removed or the nose needs to be narrowed, then frequently the nasal bones will need to be broken.  The video below explains the reasoning behind this.

 
 

Will I get black eyes from my nose job?     If the nasal bones need to be broken, then you will probably get black eyes for 1-2 weeks.  If the nasal bones do not need to be broken, you may still get back eyes, but the likelihood is lower.

Does breaking the nasal bones make the recovery longer or more difficult?     Swelling, pain and inflammation are incrementally (not exponentially) worse.

How long is recovery after rhinoplasty?     There are different stages of recovery.  You will have a splint on the outside of your nose and possibly stitches under your nose for 1 week.  You will be noticeably swollen for 2 weeks.  Approximately 80% of the swelling will be gone by 3 weeks.  The last 20% of the swelling takes several months to subside.  Everyone is different and the amount of swelling an individual can expect is dependent on many factors including what maneuvers were performed during rhinoplasty, how well they take care of their nose post-operatively, and very importantly, the thickness of their skin.  Thicker skin swells more and takes longer to go away.

Will I need open or closed rhinoplasty?     Dr. Yoo performs both open and closed rhinoplasty techniques.  The plan is tailored to the goals of surgery and your specific anatomy.  Revision surgery and larger changes usually require an external (open) approach.

What does the scar look like from an open rhinoplasty?     The scar is generally very inconspicuous once healed.  For the first few months, it will be pink compared to the surrounding skin.  Once healed, it will look like the photo below.  The scar is highlighted by the blue arrows.  Click on the image to enlarge.

 

 

9 months post-op open rhinoplasty scar

 

 

How long after rhinoplasty can I fly?     Dr. Yoo generally asks his patients to avoid flying for 1 week (give or take a few days).

When can I start blowing my nose again?     After 2 weeks, you can resume gently blowing your nose.  When its OK to resume nose blowing, avoid any pulling or pushing of the tip of the nose with your fingers.  For the first two weeks use saline nasal spray/mist as much as possible to help soften and clear the blood and mucous.

When can I resume working out or exercising?  After 2 weeks, you can resume activities where you are going to raise your blood pressure such as running, weight training, Yoga, etc.  If you start working out and your nose throbs, this is your body's way of telling you to take it easy for a couple more days.  The reason is that you risk getting a nose bleed if you raise your blood pressure during the early recovery period.  The first thing that someone is going to want to do if you get nasal bleeding is to pinch your nose to help stop it.  This is obviously not conducive to optimal healing.

When can if resume activities where I might bump my nose?  After about 6 weeks your nose will be roughly as strong as it was before the operation.  The strength of the nose returns faster than the sensitivity subsides.  So, even though the nose may be quite strong, it will still feel quite delicate and sensitive to the touch.

Where will my rhinoplasty be performed?  Most surgeries are completed in our own fully accredited surgery center.  We use top board-certified anesthesiologists and registered nurses to help take care of you.  The primary difference is that your experience is much better with more privacy and more control than if it were performed at an outside surgery facility.

Who do I contact if I have a problem after surgery?  Dr. Yoo is available 24 hours a day.  He wants to personally know about any questions or concerns you may have so they can be addressed in a timely fashion.  Patients of Dr. Yoo are able to reach him via telephone even at night.

Is there anything that I can do to make the swelling go away faster?     During the perioperative period, use of Arnica Montana can decrease swelling and bruising.  Sleep with your head elevated (2-3 pillows or a wedge).  Take warm (not hot) showers for the first 2 weeks.  Limit elevating your blood pressure for 2 weeks.  After two weeks if there is excessive swelling, Dr. Yoo may ask you to tape your nose at night and perform gentle massage to help reduce swelling.

I have a crooked nose.  Can this be fixed and if so, how?     Nasal deviation is a difficult problem for many surgeons.  Consistent results require an expert rhinoplasty surgeon who can recognize the various causes of a crooked nose.  Several different maneuvers may be employed including osteotomies, cartilage grafting, and advanced suture techniques.  The goal of surgery is to make the nose straighter.  It is important to understand that usually a significantly crooked nose will be greatly improved, but not be perfectly straight after surgery.

 

Crooked nose deformity - Nasal bones deviated to the patient's left.  Severe high septal deviation to the left.  Repair required osteotomies, green stick fracture of the perpendicular plate of the ethmoid, spreader grafts and septal reconstruction.

 

Where is the cartilage for a graft taken from?     The answer depends on where the graft will be used.  The preferred cartilage for most grafts is taken from the inside of the nose.  If you have had a septoplasty in the past, there may not be enough cartilage left for grafting purposes and an alternative would need to be used.  The most common alternative sources include ear cartilage and rib cartilage.  Dr. Yoo uses several novel techniques that frequently obviates the need to harvest cartilage from other locations.

The bottom of my nose is wide.  Can this area be narrowed?     Yes, the ala can be narrowed by making small wedge excisions at the corners of the nose (alarplasty).  The exact location and orientation will depend on the shape of your individual ala and whether your goal is to narrow the nose or decrease the flare.

What does the scar look like from alar base reduction?     As with most incisions that are meticulously closed, it is generally very inconspicuous once healed.  For the first few months, it will be pink compared to the surrounding skin.  Once healed, it will look like the photos below.  The scar is highlighted by the purple arrows.  Click on the image to enlarge.

Do I need a chin implant?     The forehead, nose and chin should be in harmony with one another.  If you have a weak chin, this will make your nose appear larger than it is and a chin implant may improve your rhinoplasty outcome.  Chin implants are made of silastic material and look completely natural when well placed.  One important consideration is that if you have an overbite, your chin may be better treated by orthognatic surgery rather than an implant.

What is tip-plasty?     This is a non-standardized term referring to rhinoplasty that only addresses the tip (lower 1/3) of the nose and not the bony pyramid and midvault (upper 2/3). 

I’d like to have breast augmentation done at the same time, but I want you to do my rhinoplasty.  Will I need two separate surgeries?     Not necessarily.  Dr. Yoo often collaborates with talented plastic surgeons who specialize in body work.  We can arrange for you to have both surgeries at the same time.

Do I need someone to take care of me after the operation?     You will need someone to take you home after your operation and stay with you until the anesthesia fully wears off.  For patients who have concerns about being alone the first night, SKY can arrange for a nurse to stay with you.

I am coming from out of town.  Where should I stay after my operation?     Our patient care coordinator can arrange lodging for you.  There are many hotels and resorts near SKY ranging from affordable to luxury.  SKY has an exclusive relationship with Rancho Valencia and is able to offer special rates for our out of town guests.  Your SKY concierge can arrange transportation to and from your visits as well.

How long after primary rhinoplasty can revision rhinoplasty be performed?     This depends on the problem.  Some issues can be addressed within the first few months of surgery.  Most revision rhinoplasty operations should wait until 6-12 months have elapsed.  This allows for the swelling to subside and a better evaluation to take place.  The soft tissues will also be less inflamed allowing the revision operation to be less difficult.