Nasal Reconstruction (Rhinoplasty)

Nasal reconstruction (rhinoplasty) can be a functional and/or esthetic facial cosmetic surgery that changes the shape of the nose. During rhinoplasty, an oral and maxillofacial surgeon (OMS) can reduce or increase the size of a nose, change the shape of its tip or bridge, reduce the span of the nostrils or alter the angle between the nose and upper lip. Patients typically undergo nasal reconstruction to improve breathing, alter the appearance of the nose, or both.

Nasal Reconstruction Surgery Consultation

Every surgical procedure should begin with a consultation that discusses the goals of the surgery, medical conditions, potential risks and other factors to ensure the surgeon and patient have a mutual understanding.

During a consultation for nasal reconstruction surgery, patients should be prepared to discuss:

The patient’s goals for the surgery (e.g., improve breathing, change appearance or part of a multi-procedure effort).
Medical conditions, including drug allergies, any previous relevant treatments and any problems with the patient’s eyes.
General health, particularly any pre-existing conditions or risk factors for the procedure.

When planning the procedure, the surgeon will take into account the nose and all facial features as well as use photos or software to display the nose from different angles for before-and-after evaluations.

It is important for an honest discussion of expectations to occur during a consultation. A patient’s age, health, skin texture, bone structure and other factors can affect the results of nasal reconstruction surgery.

A consultation also is the ideal time to ask essential questions about the procedure, such as:

What is expected of the patient to achieve the best results?
What type(s) of anesthesia will be used?
How long will recovery be?
What are the risks and complications of nasal reconstruction surgery?

Rhinoplasty Procedure

Your OMS will develop a specific plan based on your goals and needs. The following can occur during surgery:

Patients will be under general anesthesia or a local anesthesia with sedation depending on the complexities of the surgery.
Rhinoplasty may be performed through a small cosmetic incision at the base of the nose (between the nostrils) or from inside the nose.
The surgeon will adjust the positioning of bone and cartilage beneath the skin toward the patient’s desired goals.
Depending on the extent of the nasal reconstruction, the surgeon may use additional cartilage from the nose itself or other donor sites. Implants also may be used.
If the patient has a deviated septum, the surgeon also can correct that during the procedure.
After the changes are made, the surgeon will reposition the skin and tissue, and stitch the incision closed.

Recovery after Rhinoplasty

Patients are monitored in a recovery room after the surgery and may leave later the same day. If there are underlying health concerns, a patient may be asked to stay overnight. After returning home, patients should follow their surgeon’s recovery plan, which typically includes:

Keep the head raised higher than the chest during bed rest.
Change gauze as directed.
Avoid strenuous activities.
Avoid blowing the nose and any extreme facial expressions.
Take care when brushing teeth to limit upper lip movement.
Wear front-fastening clothes and avoid pulling any clothes over the head.
Follow instructions regarding any nasal splint.
Use of SPF 30 sunscreen is recommended to reduce the risk of irregular discoloration from sun exposure.

Temporary swelling and bruising are to be expected. Discoloration around the eyelids will fade after a few weeks. Full nasal swelling will decrease over several months, and progress can be tracked with the surgeon by comparing the results to the “before” photos.

Find an OMS near You

Oral and maxillofacial surgeons are experts in face, mouth and jaw surgery, and many specialize in facial cosmetic procedures. Find an OMS trained in cosmetic facial procedures to discuss your goals and schedule a consultation to determine which procedures are right for you.

While surgery may refine, rejuvenate or enhance existing features, the decision to have rhinoplasty or other facial cosmetic procedures should not be made lightly. Please talk with your OMS to understand expectations.