Rhinoplasty (Nose Job)

An ideal candidate for rhinoplasty or septorhinoplasty surgery is typically 16 years of age or older with good to excellent health and realistic expectations. Most candidates include those whom have a significant nasal deformity and/or cosmetic concerns that make them feel self-conscious or unhappy.

Ideal candidates are well-adjusted and do not expect rhinoplasty surgery to transform them into someone else, but to correct concerns and restore facial balance.

Rhinoplasty is performed in the operating room under deep sedation. Depending on the goals of surgery and the anatomic considerations of the individual patient, either an “open” or “closed” approach is taken. With the open approach, a small incision is made on the skin separating the nostrils. This incision heals very well and generally becomes imperceptible with time. With the closed approach, all incisions are made inside the nose. Whichever approach is used, cartilage, bone, and soft tissue are shifted and reshaped to achieve the desired result. Benefits of Rhinoplasty include:

• Improves harmonization of nose and facial features
• Improves nasal breathing
• Can restore nasal appearance and function following nasal trauma
• Results are usually permanent
• Safe and effective

An in-office non-surgical rhinoplasty option is available for the right candidate. This can be done with the use of a dermal filler to even out the dorsum or add volume or shape to a certain area of the nose. These are typically performed by Dr. Manning and Dr. Henstrom in both Layton and Draper. If the goal is to decrease the size of any aspect of the nose, surgery would be required.

Following rhinoplasty surgery head elevation and an ice pack to the forehead are recommended. If nasal packing has been placed, it will be removed the following day. A nasal cast will be in place and removed one week following surgery as well as any stitches and splints. Significant pain is uncommon, but prescription pain medication is provided for any discomfort that does arise. Patients typically report a general feeling of discomfort and pressure in the face.

Most patients are ready to return to school or work after one week, but bruising often remains for about two weeks. Significant swelling is still present at one week when the cast is removed and resolves slowly over several weeks. Beyond this, subtle contour changes will continue to occur for up to one year as swelling continues to resolve.

More pre-operative information is given, along with prescriptions, at a pre-operative appointment at least 2 weeks prior to surgery.

Expect to be extremely happy with your rhinoplasty results and the harmonious balance restored to your face. Patients report getting a lot of positive feedback from others who tell them they look great but often are not sure what is different.

If a septorhinoplasty was performed, expect to breathe normally again with a significant decrease in previous nasal concerns. It does take time for internal swelling to go down as well, but you will experience significant improvement once all packing and splints have been removed.

The surgical total greatly varies with each patient but a typical starting price for a standard 3.5 hour procedure is starting around $10,000 for the physicians fee. The cost may be more depending on all that needs to be done and how long the procedure is going to take.  Rhinoplasty is a cosmetic procedure, therefore insurance will not be involved anytime there are cosmetic concerns being fixed.

The facial skeleton has generally completed normal growth by age 15-17 (usually earlier for girls and later for boys). Anytime after this time is a good age for a rhinoplasty. Exceptions are sometimes made for unusual circumstances or severe nasal deformities, but these determinations are best made through individual consultation.

Generally speaking patients need approximately 1 week of down time following rhinoplasty surgery. At this point the cast and splints (as applicable) are removed. Heavy exercise should be limited for 3 weeks.

Good candidates for rhinoplasty include patients with breathing problems with contributing structural issues (deviated nasal septum and/or external nasal deformity) as well as patients who are concerned with external nasal features that are personally bothersome or that contribute to an overall aesthetic imbalance.

Rhinoplasty generally takes between 1 and 4 hours depending on how much work is necessary.

Breathing problems are generally corrected with a combination of deviated septum repair, turbinate reduction, nasal bone repositioning, and spreader grafts (correction of narrow nasal valves).

Weir Excision is a procedure that reduces the nostrils. This can be done with a rhinoplasty under general anesthesia or alone in the office. Incisions are made on the side of the nostrils minimizing the possibility of visible scars. Utah Facial Plastic's surgeons use the weir excision technique to reduce the nostril sidewalls,  narrow the nostril base, and improve the nose's overall appearance if that is a concern for our patients.

The desired nose should complement the other features of the face. The ideal shape comes from an aesthetic concept, which has its roots in the perception of beauty, for either male or female. On the other hand, plastics surgeons and artists have come up with particular proportions and guidelines based on their study of beauty and faces. These guidelines provide surgeons with a baseline for analyzing the face for the aesthetically ideal nose. These are the angles a surgeon needs to consider when assessing the right projection for the nose.

NASOFACIAL ANGLE

If the nasofacial angle is one way to analyze the nose. If the nasofacial angle looks big, this means that the nose is projected far from the face. If the angel is short, the opposite can be true. A skilled facial plastic surgeon can get a good impression on the projection by looking at the nose in profile.

NASOMENTAL ANGLE

Often times, it’s a small chin that makes the nose appear larger than it actually is. Surgeons consider the nasomental angle along with others to determine what steps need to be taken for achieving facial harmony. The surgeon also determines whether the lips are properly aligned or linked to other facial parts.

NASOLABIAL ANGLE

An acute nasolabial angle is characterized by a droopy nose. If the nose is uplifted or too short, the nasolabial angle may be obtuse. 

COLLUMELLAR SHOW

Ideally, no more than 4mm of the columella , the area between the nostrils, will be seen at profile view. 

NASAL BASE

The nasal base width, lower lateral cartilages, nostril shape, tip projection all play a part in changing the base and alar sill.