Frequently Asked Questions About Rhinoplasty

[hemalatha]

10. Are there any new techniques to repair a deviated septum. Is cauterization used? Does the nose always have to be packed after surgery?

There are many ways to fix a septum. Generally cautery is used only on the turbinates or the initial incision on the columella in open techniques. The septum is like a wall frame in a house. The skin (mucosa) over it is like wall paper, and the cartilage on the inside is like drywall. You place an incision in the front part of the nose where it is hidden and raise the wallpaper off the wall. Then you can perform the necessary correction to the drywall (cartilage) and when you put the wall paper (mucosa/skin) back it looks like nothing was done.

Usually packing will be required however, some patients are eligible for tubes or straws placed in the center of the packing on each side so that direct airflow through the nose is possible. Most patients find this a psychological discomfort rather than a physical.

[hemalatha]

11. I am 16 and have been thinking of rhinoplasty for a long time. At what age is it safe to have a rhinoplasty?

Usually rhinoplasty is performed at the earliest, 13 or 14 years of age in girls and 15 to 16 years of age in boys. Reason being, and it is a known fact, girls physically mature faster than boys and the collective goal is to perform surgery when at least 90% of the growth is complete. There are major growth centers in the nose that affect the growth of the face.

In cases of severe disfigurement due to accidents, surgery is performed in an attempt to restore the alignment of those centers. For lesser deformities surgery is deferred until after the teen stops growing. Rhinoplasties performed on teenagers and young adults, it seems, are often beneficial to the social development and self confidence of the individual.

In other words, this depends upon the stage of growth in the face as well as the gender of the patient. A qualified surgeon can better help you upon personal examination.

[hemalatha]

12. I'm getting a deviated septum and a hump fixed all in one and I wanted to know what kind of scarring I should expect. Also, how long is it after the operation that I'll see good results?

Usually, there is no visible scarring unless it is an open rhinoplasty. Some surgeons perform all of their rhinoplasties, open -- some, all closed. It solely depends upon the surgeon. You will find that most surgeons tend to disagree when it comes to technique. They either prefer open or they prefer closed, OR if they are highly skilled, know that it is case-dependent and different patients have different needs. If it is an open rhinoplasty the scar would be on the columella (the skin that separates the nostrils) sometimes resembling a straight line or a flattened z.

You can expect swelling, especially in the tip if you are having tip work performed. The swelling usually begins to subside within the first month but the end result may not be seen until at least 9 months [post-operatively. Although this time period tends to lean towards a year and over.

[hemalatha]

13. How much would a rhinoplasty, without insurance ect...be? Is the average price range like $5000 to $6000?

It really depends upon your region and the amount of work performed. If you just need a Tiplasty, with no bone work then it can average about $3,800.US. and up. The averages are as follows:

The average prices for rhinoplasty and it's related surgeries: Primary open rhinoplasty $3,152. - $6,500.; Primary closed rhinoplasty $2,879. - $5,800.; Primary Septoplasty/Turbinectomy $3,500. - $6,500.; Secondary open rhinoplasty $7,000. - $9,000.; Secondary closed rhinoplasty $2,643. - $10,000.; with implant: $2,500. - $10,200. Although, fees vary from state to state, region to region. Some more - some less.

[hemalatha]

14. It's been five months since my surgery and now since I started to get back in shape and returned to my gym. I have notice that when I run and workout my nose drips. It is very runny, here I am walking away and every few min. I have to use a tissue. Is this just part of the healing stage or need I bring this up to my doctor? Its really annoying! Has anyone experienced this at all?

Many patients complain of runny noses after rhinoplasty/septoplasty surgery. Some over 2 years. Most of the excess mucous production ceases at 9 months but can continue well after that. For now I can only advise to carry more Kleenex around as it may persist for several more months.

[hemalatha]

15. My PS mentioned a shot of cortisone to help some of the scar tissue. Why is this and what will this do?

A Injections of Cortisone or Kenalog can help break up excess tissue. It is a common remedy to inject steroids such as these and also is used primarily to reduce swelling and inflamed tissue. Although care must be taken regarding excess use of these injections as it can break down the tissue too much.

[hemalatha]

16. I'm going to get my nose done soon and my doctor also recommended me getting a chin implant because he says my nose will still appear 'big' since my chin goes a little further in then it should...Do people get both these procedures at the same time? And do you recommend I should do this?

This is very common. A weak chin can and does make even an ideal sized nose look larger than it actually is. The chin augmentation is a relatively minor procedure when implants are used although it entails some risks all on its own. Such as lower lip numbness which can be remedied (usually) by removing the implant and trimming the implant so that it is not pressing up against the nerve as much.

[hemalatha]

17. I have to get my cast off soon and wanted to know if it is going to hurt? Is there anything I can do beforehand?

Most patients report a little tenderness when the cast is removed but if your surgeon uses a cotton swab saturated with alcohol to help remove the adhesive from the tape and glue you should be okay. Although it really shouldn't cause you great discomfort.

The sutures that may be removed may hurt when someone else removes it due to them not actually being able to tell when they are hurting you. They also may snip your flesh slightly when the scissors are used to cut the actual suture. This isn't as rare as it as it should be and solely depends upon the surgeon's meticulous nature.

[hemalatha]

18. I have thick nasal skin and a surgeon I spoke with said that I may not be able to see much detail with my rhinoplasty? Is this true? Should I see another surgeon?

For many patients with thick skin, the skin is thinned out in the surgery as the tip is worked on. This really adds a lot to help with definition. Excess skin length just shrinks away as the swelling decreases. Also, many patients with thick skin actually do better with rhinoplasties because the flaps that are elevated are so firm that you can do a lot more with the cartilages and it is better hidden. Very thin skin, shows every little imperfection.

Going on several consults and getting a second, third and even more opinions is a good idea in any case. "Shopping" for surgeons is a serious matter and you should be as comfortable as you can be with a surgeon, his skill, and his bedside manner.

[hemalatha]

19. Is it improper to ask to speak with previous patients who have had revision rhinoplasty done by the surgeon I am considering for the same procedure?

Not at all! And you absolutely should. All surgeons should have a referral list of prior patients to discuss particulars and trade stories. I personally spoke with patients beforehand and as a matter of fact I am on my own doctor's referral list.

If you are wondering if all of the patients are going to be happy or receive compensation... I have found in my experience that there are about 1-2 patients who wish they had done more research beforehand or had gone to another doctor entirely so be advised that although this is unfortunate I think it is helpful to the patient considering the procedure to gain a well-rounded opinion.