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Posted July 02, 2018 in

Inform, May 2003

It’s unavoidable. When you look into the mirror, the first thing you notice is your nose. Prominently occupying the center of the face, its appearance may be pleasing. For some of us, however, a large nasal hump or cooked nose may be a lifelong source of self-consciousness. We recently spoke to board-certified plastic surgeon, Dr. Ronald M. Friedman, M.D, who has coauthored several articles on rhinoplasty (nasal reshaping) in the leading plastic surgery journals. Dr. Friedman has also contributed to rhinoplasty texts, including three chapters in the recently published book, The Dallas Rhinoplasty: Nasal Surgery by the Masters. We asked him to outline the procedure.

The Consultation

Dr. Friedman performs the entire consultation and will personally address each of your questions. Since no two noses are exactly alike, he takes the time to individualize each surgery. For most people, he feels that radical change is neither necessary nor desirable. Rather than creating a “cookie cutter” nose, he prefers to improve the features that bother you and leave the remainder undisturbed. At the consultation, you will view a large number of “before and after” photos, review extensive written information, and have an opportunity to speak to other patients who have undergone rhinoplasty.

The Surgery

The surgery is performed under general anesthesia (provided by a physician anesthesiologist) at Dr. Friedman’s AAAASF- accredited outpatient facility, the West Plano Plastic Surgery Center. Conveniently located on the campus of Presbyterian Hospital of Plano, the Center offers a high level of privacy and personalized attention. Nasal reshaping is performed through small incisions on the inside and underside of the nose. Dr. Friedman generally prefers non-destructive techniques, such as reshaping the cartilage with sutures, rather than performing extensive cutting or removal. He believes that minimizing trauma to the nasal tissues leads to a faster recovery and more predictable surgical results. Following nasal reshaping, the incisions are closed with tiny stitches. An external nasal splint is often placed. Internal nasal packing is unnecessary.

If you are having difficulty breathing through your nose, internal nasal procedures (such as straightening of a deviated septum) may be performed at the same time. Most insurance companies will cover the costs of any internal nasal surgery.

After Surgery

Discomfort is usually mild and well-controlled with prescription medication. Most patients return to light activities within a few days. Initially, you must sleep with your head elevated and avoid heavy nose blowing. Strenuous exercise should be avoided for at least two weeks.

The Results

Most patients notice an immediate improvement in nasal shape. As the swelling subsides, nasal appearance will generally continue to improve over the next several months. Final results are apparent at approximately 12 to 18 months. Of note, a national average of 12 percent of rhinoplasty patients undergo request subsequent revisional surgery. In contrast, Dr. Friedman’s rate of revision is currently under 4 percent.

If the appearance of your nose is a source of frustration and concern, rhinoplasty may be worth considering. For many people, it provides significant improvement – not only in appearance but also in attitude and self-confidence.