1. Am I a good candidate for this procedure?

There are several reasons you may consider rhinoplasty (nose surgery).

  • You may feel your nose is too large or too small.
  • Your nose does not seem to fit with the rest of your face.
  • Your nose is crooked, badly shaped, or out of alignment.
  • Having a nasal blockage inside your nose that causes trouble breathing
  • Having a birth defect that you would like improved, or just improvement, not perfection, in the appearance of your nose.

If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.

2. Where and how will you perform my procedure?

After numbing the area, Dr. Hsu will make incisions to access the bones and cartilage that support the nose. There are two general techniques for making the incisions: open and closed (endonasal). By adding or removing bone and cartilage and adjusting the supporting structures inside the nose, the size of your nose can be reduced or increased and the nose may be shortened or lengthened. Tip grafts made of cartilage can be used to remodel the tip of your nose, making it more uplifted, longer, shorter, or thinner. Your skin and other soft tissues will remodel to assume the shape of the underlying structure. In some patients, tissue fillers or fat grafts can be added to increase volume in desired areas. 

In addition to incision options, there are various methods for augmenting your nose or smoothing surface deformities.

  • Autologous cartilage grafts taken from your nasal septum (the wall inside the nose that divides one air passage from the other) offers the best chance for a natural result. If cartilage and bone have already been removed from the nasal septum, then ear or rib cartilage and sometimes bone from the skull are other options.
  • Although solid silicone implants are available for nasal surgery, these are foreign materials that may become infected or react poorly with your nasal tissues and have to be removed. That is why natural cartilage, if a supply is available, is the most trouble-free option.
  • Fillers or fat grafts may also be injected to smooth the nose, to camouflage deformities or indentations, or to add volume in desired areas.

3. What surgical technique is recommended for me?

These decisions will be based on the requirements of your specific procedure and in consideration of your preference and Dr. Hsu's best judgment. Dr. Hsu and the assisting staff will fully attend to your comfort and safety.

Typically, Dr. Hsu advocates for the open rhinoplasty approach because it fully opens the nose, providing better visualization of the nasal structures and a more direct route for surgical manipulation; the small scar at the base of the nose is barely visible once it heals. Advocates for the endonasal approach say that it permits more limited dissection of nasal tissues, offers excellent visualization of nasal structures, and eliminates the visible scar at the base of the nose.

4. How long of a recovery period can I expect, and what kind of help will I need during my recovery?

After surgery you may be asked to wear a nasal splint over your nose for support. The splint will protect your nose while you sleep and shield it from accidental bumps. You may also have a small triangular bandage beneath the tip of your nose. Nasal packing will be placed inside your nose for additional support; it acts as an internal splint to hold everything in place and to keep the airway clean and free of crusts. Some surgeons insert a small tube in each airway to allow the patient to breathe more freely when the packing is in place. Expect some swelling and bruising and possibly some mild discomfort.

Your face will be puffy, and the areas around your nose and eyes will be bruised and swollen after surgery. You may need to keep your head elevated and relatively still for the first few days after surgery. Dr. Hsu may prescribe a pain medication to deal with any pain you may experience. You will have to limit your activities for a few days to weeks and wait at least six weeks before you can engage in exercise or athletics.

All surgical packing within your nose will be removed within four to seven days after surgery. The splint and bandages on your nose will be removed in a week to ten days. It takes about ten to fourteen days before most of the swelling and bruising improves. Your return to work or school depends on how much exertion your job or your school activities require. Most normal activities can usually be resumed within three weeks, but you should avoid strenuous exercise, straining, bending, and lifting until cleared to do so by Dr. Hsu. Minor swelling of your nose may persist for up to a year but most likely will not be noticeable to others. It will be a few months before you can expose your reshaped nose to direct sunlight, and it may be a number of weeks before you can wear glasses without special support, such as tape, if the bones in your nose were altered.

 

5. What are the risks and complications associated with rhinoplasty?

Fortunately, significant complications from rhinoplasty surgery are infrequent. This surgery is usually performed without any major problems. Risks and potential complications of surgery is should be discussed during your consultation. The risks in most surgeries are similar. Some of the potential complications of all surgeries are:

  • Adverse reaction to anesthesia
  • Hematoma or seroma (an accumulation of blood or fluid under the skin that may require removal)
  • Infection and bleeding
  • Changes in sensation
  • Scarring
  • Allergic reactions
  • Damage to underlying structures
  • Unsatisfactory results that may necessitate additional procedures.

You can help minimize certain risks by following our advice and instructions, both before and after your rhinoplasty.