In order to assist my patients, I have compiled a series of FAQS (Frequently Asked
Questions) about rhinoplasty. This information is not meant to take the place of a
private consultation in my office. It is meant to educate patients and clarify any
misconceptions or fears about the procedure. I may generalize in certain areas for
the sake of brevity.
Q. What is a rhinoplasty (also called a “nose job”)?
A. A rhinoplasty is a surgical procedure designed to improve the shape, form, and function of the nose. It some patients, it addresses aesthetic imbalances such as a nose that is too large for the face, a “bump” on the nose, a nose or nostrils that appear too wide, or a nose tip that lacks projection or droops. For others, it corrects or improves the ability to breathe through the nose, and requires a septoplasty as well.
Q. What is my approach to a rhinoplasty?
A. I assess each patient and formulate an individualized plan that is surgically sound and achieves the desires and goals of the patient. I strive to produce a natural appearing nasal shape which is in balance with the surrounding facial features. My goal is to avoid the typical “nose job” look. The post-surgical nose should look as if the patient was born with it. Each rhinoplasty is personalized to create a nose that fits a patient’s unique facial features and enhances a patient’s appearance. It is important to understand that there is no such thing as a “perfect nose” which can be reproduced on each patient.
Q. How many of these have you done?
A. As of 2015, I have performed over 650 rhinoplasties, or an average of 33 per year.
Q. Are you board certified and is that important?
A. I am board certified in both plastic surgery and general surgery. Board certification means that your doctor has achieved the highest level of excellence and competence in his or her field. You may view my other credentials and achievements at www.collini.com/dr-collini.
Q. Is your surgical facility state-licensed and certified?
A. The Renaissance Center for Plastic Surgery is licensed by the State of Pennsylvania as a Class C (the highest level) Ambulatory Surgery Center. The Renaissance Center if also Medicare-approved and certified by the Accreditation Association for Ambulatory Health Care (AAAHC). It is also a member of the American Association of Ambulatory Surgery Centers (AAASC).
Q. What is the difference between a rhinoplasty and a septoplasty…and will my insurance pay for either of these procedures?
A. A rhinoplasty is a cosmetic procedure performed to improve appearance. A septoplasty is a functional procedure performed to improve nasal breathing.* When the two operations are performed together, it is a called septo-rhinoplasty. A rhinoplasty is NOT covered by insurance, but most insurance companies will cover the cost of the septoplasty.
*The septum is the tissue that separates the nostrils. Inside the septum is cartilage. If the cartilage is twisted, misshapen, or broken either at birth or by trauma later in life, it can veer off to one side and obstruct nasal breathing. A septoplasty will correct this condition, but it will NOT change the shape of the nose nor will it eliminate snoring.
Q. How long do the results last?
A. The result is PERMANENT. A rhinoplasty lasts forever. The bump that is removed or the tip that is softened will not “grow back” afterward.
Q. Who is a good candidate for a rhinoplasty and at what age?
A. Most patients say that the appearance of their nose has bothered them since adolescence. Rhinoplasty is often performed in girls, after maturity, at fourteen or fifteen, and boys at fifteen to sixteen. But the ideal candidate is the individual who is mature and has very specific goals in mind about the outcome of the surgery. . . can verbally express what it is that he or she dislikes about the appearance of his or her nose. . . and understands the limitations of surgical intervention and that minor imperfections are acceptable. The ideal candidate understands that the procedure will improve self-esteem and appearance but can not change social skills or solve intimacy problems. In other words, the ideal candidate has realistic expectations.
Few people ever regret having a rhinoplasty. The only exceptions occur when patients had the operation in their teens and now, values having changed, they wish they had kept a more “ethnic” nose. That is in hindsight. At the time, their nose made them miserable, BUT that is why the ideal patient is one who is mature and has very clear goals in mind.
Q. How do I know what my results will look like postoperatively?
A. After listening to a patient’s desires, I take a profile view of the nasal region and draw on the nose to show what can be realistically achieved with a rhinoplasty. Although this is not a guarantee of the postoperative results, it acts as a bridge between the expectations of the patient and the aesthetic eye of the surgeon. This bridge must be crossed before the surgical intervention is scheduled.
Q. Where is the surgery performed? How long does it take? Will I be asleep?
A. A rhinoplasty is performed as an outpatient procedure using general anesthesia or sedation and local anesthesia at the Renaissance Center, our own state-of-the-art surgery suite. It takes approximately 2 hours for completion. If a septoplasty is also performed, the combined procedure will take approximately 2 to 2.5 hours. All recuperation is done at home.
Q. Is having a rhinoplasty painful?
A. Rhinoplasty is not a painful procedure. Patients complain more of discomfort and swelling than of actual pain. We provide pain medication if needed, but most patients do not need them.
Q. Are there risks involved?
A. All surgery is associated with a certain number of complications no matter how slight. Rhinoplasty is no exception although the usual complications after a rhinoplasty or septoplasty are minor. Infection and hematoma (bleeding) are the most complications but are usually prevented by antibiotics and eliminating blood thinners before surgery. Numbness and bruising are considered part of the procedure and do not last very long. Please read the Consent Form for a complete listing of all possible complications.
Q. What can I expect before and after surgery?
A. All patients are screened for any serious medical problems to assure they are healthy prior to surgery. You must avoid aspirin for 4 weeks before and two weeks after the procedure. You need to avoid garlic, vitamin E, alcohol, Chinese food (and MSG), Indian food (and curry powder), and the medications in the “Drugs to Avoid” handout. Patients are forbidden to smoke for at least two weeks before and two weeks after surgery.
Nasal packing is NOT used. A small paper nasal splint is applied on top of the nose and this is removed 6 days after the surgery. If a septoplasty is performed, a nasal sponge or tampon (NOT the old-fashioned nasal packing) is placed in each nostril to prevent postoperative nasal bleeding. This is also removed 6 days after surgery.
After the procedure, you will have some swelling and/or bruising. Bruising usually lasts 2 to 3 weeks but may take longer to disappear, especially in older patients. I also have some patients take vitamin C (1000 mg a day) for three weeks after surgery to help with healing.
Sometimes the tip of the nose remains numb, tight and swollen for several months. This is more of a nuisance than an actual medical problem. The nose smoothes out and softens over time, and the numbness will go away. This is the normal healing process and always settles over time.
Q. Are the scars noticeable?
A. I perform a “closed” rhinoplasty technique in 90% of patients. The incision scar is located inside the nose and is not visible. If an “open” approach is necessary, the incision is placed in the column of skin between the nostrils. The scar typically heals so well that is not visible to a casual observer. This is discussed in detail before surgery so you will know which incision you will get.
Q. When can I drive my car or go back to work?
A. With the newer techniques and instruments for rhinoplasty surgery, recovery is faster than it was in the past. You may drive your car within 48 hours after surgery as long as your eyes are not excessively swollen. If they are, wait until the swelling subsides (4 to 5 days). Most patients return to work within one week. These estimated times may vary according to the patient’s age, nutritional status, healing capacity, individual skin chemistry, smoking history, and overall state of health. Seventy-five percent of the swelling in the nose resolves within one month. It can take from 6 to 18 months for the remaining 25% to completely heal, and it may take this long to appreciate the absolutely final result in some patients.