Rhinoplasty is a cosmetic operation that changes the external appearance of the nose by changing the contour and position of the cartilages and bones inside. The techniques that accomplish these changes are both old and young — they have evolved as plastic surgeons have altered them over the years. Some older techniques have been abandoned because the long-term results are not optimal. Most patients seek a plastic surgical rhinoplasty consultation because they feel their nose is out of concert with their other facial features — for example, it is too wide, too long, has a large hump, or the tip is too boxy.
Patients often complain about decreased airflow and septal deviation when seeking rhinoplasty. These airway flow problems can be addressed with functional nasal surgery — such as a septoplasty, turbinate trimming, and spreader grafts. These operations can possibly be reimbursed by your insurance after they are pre-authorized. Rhinoplasty surgery to improve the appearance of your nose cannot be billed to an insurance company.
The Rhinoplasty Consultation
Dr. Lori L. Cherup will listen to your concerns about the appearance of your nose. She will then examine you and compare your anatomy to normal diagrams and normal ideal noses, and diagnose the abnormalities and measure them in millimeters. Rhinoplasty is a surgery of millimeters. She will then describe the maneuvers that will be used to change your anatomy — they are performed in a stepwise fashion according to your surgical game plan.
During the consultation, Dr. Cherup may photograph your facial image with our new VECTRA three dimensional system. From this image, Dr. Cherup will change your nasal proportions and discuss the changes with you to better understand your goals and make you understand the surgical limitations of what can be done with your nose. You will leave with a printed image of what your nose could look like.
Male Rhinoplasty Patients
Dr. Lori Cherup enjoys understanding the special needs of male patients. Most patients want a significant change, but one that is still natural and masculine in appearance. Achieving the degree of change, and limitations of the patient’s skin texture, anatomy, and symmetry with the rest of his features, will be discussed thoroughly. A too-severe change in a male nose can make a male face look feminine. Dr. Cherup will advise the patient against maneuvers that might lead to that result.
The Rhinoplasty Surgery
Local IV sedation or general anesthesia, often necessary for male patients, will prepare you for your surgery, which will take one-and-a-half to two hours. Dr. Cherup employs the endonasal technique, meaning all incisions will be made inside the nose. Occasionally, she employs the external or open rhinoplasty approach, which utilizes a small incision across the columella (the strip of skin between the nostrils).
During surgery Dr. Cherup will address the shape of the tip cartilages, the height of the dorsal bones and cartilage, the width of the nasal bones, and the shape of the nostrils. When the surgery is finished, your nose will be packed gently with soft yellow Xeroform gauze that supports the internal mucosa and encourages clotting. A splint will stabilize your nasal bones if they have been infractured — you can choose your color of splint since you will be wearing it for five to six days! A gauze drip-pad will catch the drops of mucus and blood that may drip for few days. Dr. Cherup will see you in either one or four days to remove the packing, which does not hurt.
Swelling will last for 3 to 12 months. The final result will not be completely apparent for 12 months.
Difficulty breathing through the nose will occur. After the crusts (boogers) have fallen out, the nose can be irrigated with saline and gently cleaned with Q-tips just in the very front of the nares.
Numbness is normal and will disappear in three months. Dripping of either mucus, or clear liquid will stop by one month. Keep Kleenex near you.
Residual asymmetries may be apparent. Dr. Cherup will never promise to achieve perfect symmetry in your nose, especially if your nose started off crooked. Dr. Cherup will strive to make your nose as handsome as it can be. A revisional surgery will be considered after 12 months if the significant improvement can be achieved by a small surgery.
Septal perforation is rare. If the septum does not heal perfectly, a small hole may result in it. The hole is usually asymptomatic. If problems such as bleeding, crusts, or whistling arise, it may be necessary to repair the perforation.
Learn More about Rhinoplasty
For more information about rhinoplasty or septoplasty, please call Dr. Cherup at (412) 220-8181 or (877) 441-0639.