Nose Job Procedure

Techniques (Open and Closed)

During a nose job, tissues may be removed, reshaped, or added to, depending on the needs of the patient. There are two basic techniques that are used to effectively perform a nose job procedure. Which procedure your plastic surgeon uses will depend primarily on the complexity of your situation. The two basic nose job techniques are:

• Closed or internal
• Open or external

In a closed or internal nose job, the plastic surgeon makes all incisions on the inside of the nose. This allows the surgeon to make changes to the form or function of the nose without leaving any visible scars from the procedure. A closed nose job is really only appropriate for very straightforward procedures because the placement of the incisions can make it difficult for the plastic surgeon to reach certain parts of the nose or perform complex operations.

closed rhinoplasty incision lines

An open or external nose job, on the other hand, involves cutting the columella, the strip of skin between the two nostrils. By cutting the columella, using a Z or W shaped incision, the doctor is better able to expose the pyramid-shaped bone and supporting cartilage tissues of the nose. This allows for more complicated and delicate maneuvers during a nose job.

Step-by-Step

The first step in a nose job is anesthesia. You and your surgeon will discuss anesthesia during the initial consultation. Though some patients are able to have only local anesthesia and a light sedative during their procedure, in some situations general anesthesia is more appropriate. In particular, if your nose job is going to be lengthy or complicated, your surgeon may recommend general anesthesia.

On the day of your procedure, you will be given anesthetic and then you’ll be moved into the operating room where your face will be cleaned with a special anti-bacterial solution. The staff will hook you up to intravenous fluids and medications. Then, the doctor will be ready to begin.

A typical nose job procedure takes between 1 and 2.5 hours. The doctor will begin by making incisions in your nose in the appropriate locations. For a closed nose job surgery the incisions will be made inside the nose and for an open surgery, an incision will be made in the columella. Shaping of the nose will then be done using special tools that are designed specifically for nose jobs.

After the surgeon has finished shaping the nose, incisions will be sown up and the nose will be packed with sterile dressings and splinted to keep the new structures in place. Finally, you will be moved into a recovery area to awaken fully from anesthesia.

Recovery

Because you may be somewhat groggy or sleepy after your surgery, you will be required to have someone drive you home after your nose job. Some patients feel a bit nauseous after they awaken from general anesthesia. It is also common for patients to feel pain around their nose immediately after surgery and in the hours following the procedure.

Someone should stay with you for the first 24 hours after your surgery. Most patients stay in bed with the head propped up on a pillow for the first day after the procedure. Having someone around to help out with meals or other responsibilities is essential during this time. Below are some other tips to help you recovery more quickly from your nose job:

• Sleep with your head slightly raised
• Don’t wear make-up
• Don’t spend a lot of time in the sun
• Do not wear glasses (though contact lenses are fine) for at least 6 weeks
• Avoid strenuous activity until your doctor gives you permission
• Keep the surgical dressings on your nose dry
• Replace the tape on your nose per your doctor’s instructions
• Take medications on time
• Use a cold compress if your doctor says it’s okay
• Get plenty of rest
• Stay hydrated
• Eat nutritious meals
• Avoid traumatizing the nose as it heals

After a nose job, there are some common side effects that many patients experience. Most of these issues will slowly fade away as the patient recovers. Patients may experience swelling, bruising, and pain around the nose. The nose may be stuffy and some patients may have skin that peels, numbness, or bleeding that occurs during the recovery period.

Risks

All surgical procedures involve some risk and a nose job is no exception. Talk to your doctor at an initial consultation about the potential risks associated with having a nose job. The following are some of the most common risks associated with a nose job:

• Ongoing pain
• Breathing difficulties after the surgery
• Numbness in the face
• A nose that is asymmetrical
• Nosebleeds
• Ongoing swelling
• Skin discoloration around the nose
• Scarring

Benefits

There are a number of benefits that patients can enjoy by having a nose job. Not only can a nose job improve a patient’s appearance, but it can also sometimes help patients sleep better or snore less. Functional issues such as sleep apnea can sometimes be corrected with surgical reconstruction of the nose. Talk with your doctor to learn more about the benefits if you feel that a nose job could benefit you either cosmetically or functionally.