Rhinoplasty is a complex procedure commonly referred to as a “nose job”. Rhinoplasty requires attention to detail and an understanding of the nuances and proportions of the face as a whole. The nose is in the center of the face and therefore commands significant attention. A change in one’s nose can have a significant impact on one’s psyche, both positive and negative. Rhinoplasty can be performed for both cosmetic and functional reasons.
Rhinoplasty is typically performed for cosmetic, functional, or reconstructive reasons, or a combination.
This is probably the most common reason for patients seeking out a plastic surgeon. Many patients may be unhappy with the overall appearance of their nose. The first thing Dr. Arslanian will ask you during your consultation, is to describe, in detail what it is you do not like about your nose. To some it might be too wide or too narrow, too long or too short, too bulbous or too pointy. Or maybe there is a hump they do not like, or an asymmetry. Some patients are not happy with their nose but want to maintain their “ethnicity”. This often requires some more investigation and planning to ensure the we can improve on the parts of your nose you do not like, and enhance other parts to ensure you maintain that cultural background if that is something you are interested in.
This is typically secondary to previous injury to the nose, or it may be genetic. Patients will often complain of breathing difficult, chronic sinusitis, allergy problems, or a crooked nose. This type of surgery will sometimes be covered by insurance and requires similar but different maneuvers to achieve the desired results of improved airway patency.
This type of Rhinoplasty is may be done after removal of skin cancer on the nose, or secondary to a previous cleft lip/nose deformity from childhood. These cases require special techniques and often may require several operations to achieve an adequate reconstructive outcome.
Often patients may complain of breathing problems but also not like the appearance of their nose. In these cases the insurance company may agree to pay a portion of the cost if deemed medically necessary, and the patient will be required to pay for the rest of the work that is considered cosmetic.
The ideal candidate is one in good health without significant medical problems. They should be have reasonable expectations of outcome and understand the potential risks and complications that may occur. Patients should be able to clearly articulate what it is that bothers them about their nose and how they would like to correct it. Patients should not have had a recent major life event, as the stress of such things may convince a patient to embark on a procedure as a solution to the stress in their life. They should be in a right mind with clear goals and expectations.
During your consultation, you will meet with Dr. Arslanian and his staff and have the opportunity to discuss your individual situation as well as your concerns and aesthetic goals. Dr. Arslanian will will take a detailed history and perform a complete examination of your face and nose. Photos will be taken to help Dr. Arslanian point out certain things and explain his approach to rhinoplasty. If you are deemed a good candidate, he will discuss the various options for rhinoplasty and make sure you are happy with your decision. He will also show you photos of other patients before and afters to help determine what you are looking to achieve. After answering all your questions, you will then sit down with the surgical coordinator to discuss timing, pricing, and any other questions you might have.
Additional Options to Consider
Non surgical Rhinoplasty:
In some cases, if there are minor areas of concern, you may be able to temporary correct the problem with the use of non surgical techniques such as dermal fillers and volumizers. Dr. Arslanian is an experienced injector and can quite possible reshape your nose without surgery at all. This will require a consultation to determine if you are good candidate, and you will need to keep in mind that the results are not temporary but an alternative to undergoing more extensive surgery.
The chin and nose are in a critical pairing together. The two help to set the frame of the face both in profile view and from the front. Many times patients may have a larger nose with a hump, but also a very weak chin. In these cases a procedure may be recommended to improve the size, shape and projection of the chin. This can be done by surgically repositioning the bone, or by the use of facial implants to augment the chin. Treating one area and not the other area can sometimes lead to a disproportionate looking facial profile.
Prior to surgery you will be given instructions on the day, time and location of your procedure. You will be given your prescriptions that Dr. Arslanian prescribes, and all of your paperwork including consent forms will be signed. In some cases you may need to obtain medical clearance from your physician or specialist, and possibly meet with the anesthesiologist and undergo additional lab work depending on your medical issues and personal situation.
The procedure will be performed as an outpatient in an accredited surgery center with a board certified anesthesiologist in the safest conditions possible. The surgery will be performed under general anesthesia. Pre-operative markings will typically be made the morning of surgery.
After you are asleep, Dr. Arslanian will start by making his incision under the nose. Dr. Arslanian performs an open Rhinoplasty technique so that he can completely address the entire nose under direct visualization and achieve the best result possible. He will then proceed with opening the nose and determining what problems are presents. He will then potentially harvest cartilage from the middle of the nose, the septum, or sometimes from the ear or rib depending on what is required. He will then begin using grafts and other techniques to shape the nose and improve the breathing if that is a concern. He will then close the incisions. Sometimes the nasal bones will need to be fractured and repositioned. A splint will then be placed over the nose and sometimes splints will be placed internally as well. You will then be awakened and moved to the recovery room.
You will go home the same day of surgery and rest. You will be given pain medicine to help with the first week. You will likely be swollen and have some black and blue bruising around and under the eyes. At 1 week the splint and sutures are removed. You will keep your head elevated and ice as needed to minimize swelling. Swelling can take a good 4-6 weeks to resolve. Even then, it can take up to one year for all the swelling to resolve, the scar tissue to soften, and the grafts to take their final shape and position. Patience is very important in this procedure as results can continue to change over the course of the year.
Patients can expect their nose to continue to change for up to a year. This can be a dramatic and emotionally difficult procedure for patients given the central importance of the nose in the facial profile. It will take several months, in many cases, for patients to be used to the new appearance of their face. That is why a strong emotional health is just as important as physical well being going into this procedure.
The cost of rhinoplasty can vary depending on the conditions that will be treated and any additional or alternative procedures that the patients chooses as well. In some cases, insurance may cover a fraction or all of the procedure. Please schedule a consultation with Dr. Arslanian in order to receive a price quote.