Call us at 469-467-0100
Nasal Surgery (rhinoplasty) is a procedure performed to improve the nose in one or both of the following ways:
Dr. Friedman customizes rhinoplasty to each patient, depending upon the specific internal and external nasal problems and the patient's desires. There is not a universal type of rhinoplasty that will meet the needs of every patient. The best candidates for surgery are looking for improvement, not perfection, in the appearance of their noses.
In some patients, deviation of the nasal septum may cause the nose to appear crooked and/or may interfere with breathing through the nasal passages. Septoplasty to straighten and/or remove a portion of the septum may be performed to improve these problems. Surgery performed to improve nasal breathing is generally covered by insurance. However, reshaping of the nose is considered cosmetic surgery and is not covered by most insurers.
Dr. Friedman performs rhinoplasty under general anesthesia on an outpatient basis. The procedure is performed in his AAAASF-accredited surgical facility, the West Plano Plastic Surgery Center, which is located on the campus of Texas Health Presbyterian Hospital of Plano. He strictly uses physicians—not nurses or technicians—to administer your anesthesia.
Incisions are located inside the nose with the exception of a quarter-inch incision between the nostrils on the underside of the nose. The small external incision (open rhinoplasty) enables better control over nasal reshaping. If the nasal bones are to be refined by fracture, 3 mm (one-eighth inch) incisions are used along the upper outer nose. The incisions generally heal with inconspicuous scars.
Pain is usually mild and well-controlled with prescription pain medication. Most patients return to light activities within 3 to 5 days. External nasal splints (if used) and stitches are removed 1 week after surgery. Heavy straining should be avoided for about 4 weeks. Improvement in nasal shape is generally apparent shortly after surgery, but final results may take 12 to 18 months.
When you visit our office, Dr. Friedman will discuss your particular problems and concerns. He will give you a realistic expectation of what you can expect from surgery. We will also show you a variety of "before and after" photos of rhinoplasties performed by Dr. Friedman. If you wish to speak to other patients who have undergone nasal surgery, we will be happy to provide phone numbers.Back To Top
Typical rhinoplasty goals include reduction of nasal hump, narrowing of the nose, elevation of the nasal tip, and/or reduction of fullness from the nasal tip. If you have problems breathing from the nose, this may also be addressed at the time of rhinoplasty.
To be a reasonable candidate for rhinoplasty, you must have significant cosmetic problems (such as a hump or an excessively wide nose) that can be improved with surgery. If you have a subtle problem, surgery may not be worthwhile. Similarly, you must have realistic expectations regarding the potential surgical results. Most patients achieve improvement with rhinoplasty, but no one achieves perfection.
A closed rhinoplasty involves incisions inside the nostrils without an external incision. An open rhinoplasty involves the same nostril incisions with a small incision across the columella (the skin between the nostrils). Many plastic surgeons, including Dr. Friedman, believe that an open rhinoplasty provides greater flexibility and more surgical options, as the nasal framework is directly visualized during the procedure. The columellar scar is very small and is generally quite subtle (see photos).
Over 50% of patients undergoing rhinoplasty benefit from planned nasal fractures. These are performed to narrow the width of the upper nose, help straighten a deviated nose, or to reduce the chance of a flat nasal bridge after removal of a large nasal hump. If the nasal bones are fractured, a splint is worn for one week after surgery. Some bruising of the lower eyelids usually occurs.
Dr. Friedman does not use nasal packing for rhinoplasties. If you are undergoing septal surgery, internal nasal splints may be placed for 3 to 4 days. If you are strictly improving your nasal shape, no internal splints or packs are used.
One week before surgery
The evening before surgery:
Before you leave home:
Day of surgery: at the facility before surgery
Day of surgery: at the facility after surgery
At home after surgery:
Instructions for your first postoperative visit (about one week after surgery)
The stitches, flesh-colored nasal tape, and the nasal splint (if present) will be removed. You will continue use of antibiotic ointment over your incisions twice daily for about 3 more days. Following this, you may begin scar massage with Mederma, Vitamin E, or Aloe Vera twice daily. Continue scar massage for about 3 months.
1 week after surgery: you may resume casual walking but must not engage in vigorous exercise that increases your blood pressure or heart rate. You may resume driving once you are off of your pain medication and can see clearly. Avoid freeways until you are comfortable with city driving.
3 weeks after surgery: you may gradually resume regular exercise.
Please sleep with your head elevated. You may sleep on your back or part way over (pillow under your shoulder and hip). Do not sleep on your side until about 3 weeks after surgery.
You should begin gentle massage to the nose one week after surgery. This will help reduce swelling and any areas of firmness. You may apply lotion to your hand and massage in an upward and outward direction. You will notice that the upper nasal swelling resolves much faster than the lower nasal swelling.
You may begin light showers but should avoid scrubbing your incisions. Avoid immersing your face in a pool, lake, or ocean for 4 weeks.
One week after surgery, you may resume use of any medications or supplements that you discontinued prior to surgery. However, for at least 3 weeks, you should avoid Motrin, aspirin, and any other product that may thin your blood.
Do not smoke for at least one month (and preferably much longer) after surgery. Smoking may increase your risk of infection, lung problems following anesthesia, and wound healing problems.
You may resume intercourse about 3 weeks after surgery.
You may begin use of makeup one week after surgery. Sunglasses or a camouflage makeup (available at most department stores) may be helpful to hide any bruises. Do not place makeup directly over your incisions until 3 days after the stitches are removed.
Please feel free to ask Dr. Friedman or his staff about any additional questions or concerns.Back To Top