The term “rhinoplasty” refers to plastic surgery of the nose. Typically, this surgery involves making changes to the nose’s external structure. A “cosmetic” rhinoplasty is performed mainly to improve the appearance of the nose, while a “functional” rhinoplasty is performed to help patients breathe better. A functional rhinoplasty usually involves repair of the nasal valves, which are the internal nostrils. These valves may need correction if they are narrow, collapsed, or scarred from a prior surgery.
A rhinoplasty may be performed at the same time as a septoplasty, which involves straightening the wall between the two sides of the nasal passages to improve breathing. Our ENT surgeons have extensive, intimate knowledge of nasal anatomy, aesthetics, and function, and we will be happy to discuss a treatment plan that is tailored to fit your specific needs.
A rhinoplasty is typically performed under general anesthesia. Incisions are made to allow access to the underlying cartilage, bone, and other nasal structures. When these incisions are hidden completely inside the nostrils, it is referred to as a “closed” rhinoplasty. Often, a small incision may need to be performed at the base of the nose to improve exposure, in which case it would be an “open” rhinoplasty.
Depending on the needs of the patient, cartilage and bone may need to be removed or added. More recently, there has been a move away from extensive cartilage removal (“reduction rhinoplasty”) and a greater emphasis on cartilage grafting to improve the contour of various parts of the tip or bridge of the nose. These cartilage grafts are often taken from the nasal septum itself, although sometimes ear, or even rib cartilage, may need to be harvested. Further reshaping may need to be performed with sutures to the cartilage. “Osteotomies” – or deliberate fracturing of the nasal bones – are often performed to straighten or narrow the nasal bones themselves.
At the conclusion of the procedure, the outside of the nose is taped and some form of external cast may be applied. Plastic sheets and/or packing may also be temporarily placed inside the nose depending on the procedure and the surgeon’s preference.
For more information on surgical instructions or what to expect after a rhinoplasty, please click on the following link to the Raleigh Capitol Ear, Nose, & Throat website.