Rhinoplasty is a procedure that can change the shape and size of the nose to improve its function and aesthetic appeal. Rhinoplasty surgeons may alter the nose by changing the structure of the nasal cartilage and the soft tissue that covers the nose. The procedure is commonly known as a “nose job” and is one of the most common plastic surgeries chosen by patients. Dr. Robert Mounsey in Toronto, ON is a premier rhinoplasty surgeon who sees patients from all over the world and performs a variety of different types of rhinoplasty surgery.
The Rhinoplasty Surgery
Rhinoplasty is usually performed using general anesthesia and the surgery takes about two hours. After the anesthesia takes effect, Dr. Mounsey will make incisions on the outside edges of the nostrils and at the columella (the skin tissue which separates the nostrils). He then lifts the soft tissue up so he can see the inside of your nose, including your cartilage and nasal bones. From there, Dr. Mounsey can change your cartilage by removing parts of it, reshaping it, or by using grafts or implants to achieve the right internal structure. After the inside of your nose is finished, the soft tissue is placed back over your nose and adjusted if necessary. The incisions are then closed with sutures and your nose is bandaged.
The Rhinoplasty Recovery
Patients will typically experience swelling as well as some pain or discomfort, especially in the first few days after surgery. It’s also common for bruising to occur around the eyes. Pain medication can be used to help you through the worst of your recovery, and cold compresses will help you keep the swelling under control. Dr. Mounsey will have other suggestions for you to make the recovery as easy as possible.
Dr. Mounsey often uses a splint to keep your nose stable and protected during your recovery. Your nose may also have packing if it needs extra stability. The packing will be removed after the first day and the splint can be removed within a week. Other bandages or dressings may be removed at this time, as well.
The total recovery time will vary from patient to patient, but most people are able to return to work after about a week. You should avoid strenuous activity or exercise for at least a month. Bruises will take about ten days to fade. The swelling may take as long as 12 months to completely disappear, but the majority of it will be gone within four weeks.
Types of Rhinoplasty
Just as noses come in many different shapes and sizes, nose surgery comes in many forms as well. This is a highly customizable procedure, allowing the surgery to be tailored to the individual patient and their desired results. As such, there are many different types of rhinoplasty, including the following:
The most common type of rhinoplasty is cosmetic rhinoplasty, which involves changing the way your nose looks so it’s more aesthetically appealing. This can involve anything from smoothing out a small hump or bump on the nasal bridge or straightening out a crooked nose, to reshaping the nasal tip. The nasal bridge can also be raised or lowered, and the nasal tip can be reangled or lengthened. The soft tissue between the nostrils can also be reshaped if it causes your nostrils to be disproportionate or if the tissue hangs too low.
Sometimes patients need to have their nose changed because it doesn’t function properly. Your nose is supposed to filter and warm air as it moves through your nasal passages into your lungs. However, if your nose is damaged or has some sort of congenital defect, breathing can be more difficult. You may also experience problems like frequent nosebleeds, snoring, or sleep apnea.
Functional rhinoplasty is a type of rhinoplasty that helps your nose work better. This usually involves fixing the structure of your septum. The septum consists of the bone and cartilage located in the middle of your nose. Ideally, your septum should be straight and centered in your nose, creating equally-sized nasal passages and nostrils. When your septum is bent, crooked, or twisted due to some sort of damage or defect, a septoplasty can be performed to help straighten and fortify it.
Other problems that are often fixed with functional rhinoplasty include turbinate reduction and nasal polyp removal. The turbinates are shelves of cartilage located at the back of your nose that help to clean the air as it moves into your lungs. Turbinates can become enlarged if there is too much cartilage or through excess stimuli (like an allergic reaction). When the turbinates become enlarged, they can obstruct your breathing. A rhinoplasty surgeon can remove the extra cartilage to reduce the size of the turbinates. Nasal polyps are small growths in your nasal passage that can also be removed by a rhinoplasty surgeon.
Noses look different from person to person based on several factors, including ethnicity. Different cultures and ethnicities have facial characteristics which are unique to each of your features. These characteristics contribute to the overall balance and proportion of your face. Ethnic rhinoplasty focuses on changing the way your nose looks while preserving your ethnicity in your face. There are different subtypes of ethnic rhinoplasty that you can consider based on your personal heritage. Not all noses look the same within an ethnicity, but it gives Dr. Mounsey a good starting point when he is considering how your nose contributes to your appearance.
Here are types of ethnicities that commonly request rhinoplasty:
- Middle Eastern
- East Indian
Patients with Hispanic heritage tend to have a nasal tip that is a little wider and flatter. The nasal bridge of the nose may also be a little lower. With Hispanic rhinoplasty, Dr. Mounsey can refine the nasal tip, narrow the nose, and raise the nasal bridge as needed. Your nose will still work well with your other features without being drastically changed from your cultural background.
Like patients with Hispanic heritage, patients with Asian heritage tend to have noses that are a little wider and lower nasal bridges. The nasal tip usually has a round or bulbous shape. Asians often have thicker skin than other ethnicities, though this trait isn’t associated with every Asian patient. Skin thickness will vary from person to person, just as noses will vary from person to person. Asian rhinoplasty can reshape the tip so it isn’t so round and uses implants or grafts to raise the nasal bridge. The nose can be narrowed by moving the nostrils closer together.
The Rhinoplasty Consultation
During your rhinoplasty consultation, Dr. Mounsey will perform an internal and external examination of your nose. He will also discuss your goals for surgery as well as your health and medical history to ensure that you are a good candidate for the procedure. Dr. Mounsey uses the Canfield Medical Imaging System to help you visualize your new nose and understand what will happen during the procedure. You will also get a list of instructions to follow to help you get ready for surgery and the recovery process. Your consultation is the time to voice any concerns you may have and ask Dr. Mounsey questions about anything regarding the surgery process.
Who is an ideal candidate for rhinoplasty?
If you are unhappy with the way your nose looks, or your nose has trouble functioning properly, you can be considered for nose surgery. Ideal candidates are in good overall health and are nonsmokers. There are some medical conditions which may prevent you from having surgery, which is why it’s important for Dr. Mounsey to know your medical history. It’s also important for you to have realistic expectations about your nose surgery.
Are there any risks or complications associated with rhinoplasty surgery?
Yes, but most of them are extremely rare. Most patients will only experience swelling, bruising, pain, or discomfort during their recovery. There are more serious complications that can occur, including blood clots, numbness around the nose, poor reaction to anesthesia, implant or graft rejection, nerve damage, and excessive scarring. Dr. Mounsey will discuss all of the possible risks with you during your consultations and ways in which you can reduce your likelihood of serious complications.
Will my insurance cover my rhinoplasty surgery?
Most of the time, insurance companies won’t cover rhinoplasty as it’s considered an elective procedure. However, in the case of patients who need rhinoplasty to improve their quality of life, you may be able to get part or all of your rhinoplasty covered by your insurance. Revesse offers different financing options to help patients pay for their surgery when they can’t obtain insurance coverage.
Can my surgery be done without opening up my nose?
Nearly all rhinoplasty surgeries are open surgeries. The procedure can be performed to a very limited extent without removing the soft tissue, which is known as a closed rhinoplasty. This approach is only used on patients who need very minor adjustments that don’t require direct access to the inside of the nose.
What if I have more than one ethnicity in my heritage? How will that affect my rhinoplasty?
Dr. Mounsey uses information from a number of different sources to reshape your nose, including the structure of your face, the proportion and balance between your facial features, your family heritage, and what you are hoping to get out of the procedure. Even if you have more than one ethnicity, you will still get a nose that looks natural and fits your face, rather than one that perfectly matches the characteristics of one ethnicity over another.
If I want my nose to look different but I also want my breathing to improve, do I need to come in for two separate surgeries?
No. Functional and cosmetic rhinoplasty can usually be performed at the same time. In fact, it is generally preferred that all changes to your nose be done together to prevent the need for additional surgery.
I already had rhinoplasty, but I still don’t think my nose is perfect. Can I have another rhinoplasty surgery?
Yes, it is possible to have additional nose surgery on your nose. This is known as revision rhinoplasty. You should consult with a revision rhinoplasty specialist to determine if you and your nose are a good candidate for the procedure.
How do I schedule a rhinoplasty consultation at Revesse?
Patient consultations with Dr. Mounsey at Revesse Rhinoplasty and Facial Cosmetic Surgery in Toronto, ON can be scheduled by calling 416-438-2499. You can also reach Revesse at any time using the Contact page.