Thank you for visiting our Frequently Asked Questions about Rhinoplasty Section. Click on a question and the answers will appear below.
General Questions
Rhinoplasty (aka a nose job) is plastic surgical operation on the nose, either for reconstructive, restorative or cosmetic purposes. “Rhinos” is the Greek word for nose and “plastikos” is the Greek work for “to shape”, so literally rhinoplasty means to “shape the nose”. Rhinoplasty involves the surgical repair of a flaw of the nose, including reshaping or resizing the nose. Rhinoplasty may be performed to change the size of the nose, change the shape of the nose, narrow the nostrils, and/or change the angle between the nose and lips. In addition, Rhinoplasty can involve reshaping of the nasal cartilages, nasal bones or both. Please feel free to contact the doctor at his NYC office for more information pertaining to rhinoplasty.
The two most common techniques of rhinoplasty performed (your main options for the incisions that your surgeon may use) are the closed (or endonasal) and the open rhinoplasty technique.
What is the difference between open and closed rhinoplasty?
Closed rhinoplasty describes the procedure when all the incisions by the surgeon are made internally (inside the nose). Open rhinoplasty describes when the incision is made in the skin between the nostrils (columella).
Why do most people get rhinoplasty?
Patients seeking Rhinoplasty give many reasons why they want surgery including:
-The nose is off-center or crooked
-The tip of the nose droops or is overly thick
-The nose is too large for the face or too long
-A bump or hump on the bridge of the nose
-A patient seeks functional nasal changes to help improve breathing
When someone has trouble breathing through their nose it is most likely because he/she has a deviated septum or an abnormal internal framework of the nose. This condition may be caused from trauma such as a broken nose. However, many patients with this condition can’t remember an incident where this might have occurred. The deviated septum or some sort of nasal obstruction could also result from allergies. While individual insurance policies can vary, in general, functional surgery to improve breathing is considered a covered benefit in most group health insurance policies and is therefore covered by insurance. Insurance will not cover your nose surgery if the reason is simply cosmetic.
Where is the rhinoplasty surgery performed?
Most of our rhinoplasty / nasal surgery cases are performed at the hospital that Dr. Portnoy is affiliated with in New York City St. Vincent’s Hospital and Medical Center. In addition your surgery may be performed in a fully accredited surgical suite in Manhattan, New York as out-patient surgery. Rhinoplasty is typically performed as an outpatient procedure in Dr. Portnoys NYC medical out-patient office and does not require an overnight stay.
Are there any age related issues?
Individual considerations are taken for the elderly, teenagers and children. There are no age restrictions for rhinoplasty surgery, that is assuming the individual is in good health and has reasonable expectations. Even so, the majority of patients receiving rhinoplasty are in their 20′s and 30′s. Individuals in their 40′s and 50′s, however, may have wanted to have it when they were younger but chose to have it later on as they got older. Dr. Portnoy will require parental consent for patients under the age of 18.
How old do you have to be to have rhinoplasty?
The facial and nasal bones are still developing during the teenage years which is why rhinolplasty is usually not recommend before the age of 15 female and 16 male. However, some patients choose to undergo rhinoplasty (commonly referred to as a nose job) surgery as early as 15. Obviously, parental consent is required for all patients under the age of 18.
Does the rhinoplasty procedure hurt?
The surgical procedure is done either with general or twilight anesthesia, meaning you won’t feel anything. You will discuss with Dr. Portnoy the type of anesthesia you prefer. Afterwards, you can expect your nose to be sore for about a week or so, but you should not experience any significant pain – if necessary Dr. Portnoy can prescribe you pain medication. Most patients, however, find this unnecessary.
When will I be able to see the results from my rhinoplasty surgery?
You will see a marked difference immediately but please recognize that your nose will be swollen inside and out for quite some time post-operatively. Most of the swelling disappears within the first one to two weeks. Furthermore, most of discoloration is usually gone by the end of the second week. However, most people (including yourself) would not acknowledge that your nose is swollen. Understand that the overall healing process is a slow and gradual one- and that can take up to one year to completely heal. What you should notice is that your nose will become softer, more refined and more natural in appearance over a 6-12 month period.
Surgical Questions
What should I expect post-operatively after my rhinoplasty surgery?
After your rhinoplasty surgery, Doctor Portnoy will have placed a gauze “drip” pad underneath your nose to assist with any oozing. You may also be asked to “ice” the nose and region around your eyes with a cold compress on the day of your surgery to help reduce bruising and swelling. Some patients require an external “splint” typically worn for several days following the surgery. On occasion, overnight packing of the nose may also be required which can be somewhat uncomfortable and compromise your breathing- however, most patients report no serious pain and overall little discomfort. Swelling and discoloration, particularly around the eyes, may persist for 7-10 days post-operatively. Lastly, your nose may be sensitive for about a month.
What will my nose look like after surgery?
In general, rhinoplasty (cosmetic nose surgery aka nose job) is performed to reduce excess cartilage and/or bone in the nose, removing irregularities and/or bumps to give a straightened, smooth, refined and, usually, enhanced appearance. The overall trend in contemporary rhinoplasty is to move away from an over-reduction of tissue that can reduce the ability to breath through the nose and towards an individualized tailored treatment to give a balanced and refined look without compromising function. During your consultation with Dr. Portnoy at his New York City office you can bring in photographs, if you elect, to suggest the look you desire.
How long will I need to take off of work?
Not long. Depending on the type of anesthesia, you will need approximately 2 to 4 days off. If your nasal tips are modified, you may have bruising for 10 to 14 days and will wear a protective splint for about a week. Heavy exercising should be avoided for at least 2 weeks.
Where will the incisions be made?
In most of my cases, the incisions are made inside the nose. In selected cases an incision may be made in the skin between the nostrils. This is more likely in patients who require a more complicated rhinoplasty.
Are there medications I should avoid prior to rhinoplasty?
Yes. there are some medications to stay away from before your surgery. Prior to your scheduled surgery, Dr. Portnoy will give you a full medical evaluation and discuss which medications not to take prior to surgery.
Does the procedure leave any scars?
Any incisions made on the outside of the nose generally heal fast and the resulting scars which is essentially invisible. Meaning, no one would be able to notice that you had the procedure performed.
Will I have black eyes from the rhinoplasty procedure?
Maybe. If your rhinopalsty requires fracturing the nasal bones you most likely will have bruising and discoloration around the eyes for seven to ten days. The discoloration is not painful – it just appears that way. If your procedure is limited to tip or only cartilginous work you probably will not experience any bruising or discoloration.
How long will my nose be swollen?
80% of the swelling will lessen within 3 weeks. The remaining 20% may require up to a year. However, no one will notice the remaining swelling; during this healing period the nose becomes more refined.
Will I need to have someone help me out at home after my surgery?
It is recommended that you should have someone stay with you for at least the first night after your rhinoplasty surgery. It’s best if this is the same person who picks you up after surgery so they can be given necessary information and instructions about your discharge and recovery.
Is there a lot of bruising afterwards, and how long will it last?
Most patients experience seven to ten days of purple discoloration and swelling around the eyes and upper cheeks – this does vary from patient to patient. The nose itself will be swollen for around ten to fourteen days. The swelling at the tip of the nose can take a month or two after surgery to go away.
