Nose Surgery (Rhinoplasty)

What is Rhinoplasty?

Rhinoplasty is a surgical procedure done to correct a prominent, unusual, asymmetric, or irregular nose. It is one of the most commonly performed cosmetic procedures. Rhinoplasty can also be used to correct an undesirable nasal tip or to reshape the span of the nostrils. This surgery can help with your self-image if you are self-conscious about your nose.

Who is a good candidate for Rhinoplasty?

Candidates must be in good health, have no active diseases or serious, pre-existing medical conditions, and must have realistic expectations of the outcome of the surgery. In general, rhinoplasty should not take place until after the nose approaches adult size. Usually this is after age 14 for girls, and 15 for boys, since boys tend to have their growth spurt later than girls. Not every teenager who dislikes his or her appearance is a good candidate for rhinoplasty. Many teens will outgrow their dissatisfaction with their nose. Roughly 10% of all rhinoplasties are performed in people younger than nineteen. In adults, the aging process causes skin to lose its elasticity, resulting in a nose becoming longer and drooping. Surgery to elevate the nasal tip may give the patient a younger look.

NOTE: You may not be a candidate for surgery if you smoke, have recently quit smoking, or if you are exposed to second-hand smoke. Primary and secondary smoking decreases blood flow to the body's tissues. This can result in prolonged wound healing, skin loss, infection, increased scarring, and a number of other complications depending on the kind of procedure performed. Click here for more information related to smoking.

How is the procedure performed?

The technique chosen for your surgery will be determined by your anatomy, your surgeon's preferences and your desired results, which will be discussed during your initial consultation.

The two major techniques are called closed rhinoplasty and open rhinoplasty. In the open technique, an incision is made in the skin between the two nostrils (the columella). This technique allows the surgeon to completely visualize the internal structures of the nose and place sutures precisely where they are required. The disadvantage of open rhinoplasty is that the post-operative swelling may take significantly longer to subside. The scar from the procedure is most often quite small and will fade rapidly. Closed rhinoplasty does not require an external incision. This does not disturb the tissues as much as the open technique and the patient will heal more quickly.

Options to Enhance the Procedure

Some patients seeking to undergo rhinoplasty may also want to alter the shape of their chins or cheekbones. In these cases, your surgeon may recommend implants as a part of the operative plan during your initial consultation. Additionally, if you are having breathing problems, they may be improved by a procedure called septoplasty, which corrects defects or deformities of the nasal septum.

List of Physicians Who Perform the Rhinoplasty

For details about education, experience, and specialty in this clinical area, please visit these physician profile pages:

  • Paul S. Cederna, M.D.
  • Steven Kasten, M.D., M.H.P.E.
  • Adeyiza O. Momoh, M.D.

Planning for Your Surgery

First, schedule a personal consultation with your plastic surgeon. Communication is vital in reaching your goals. You will have the opportunity to discuss your goals and the results you'd like to achieve. Your surgeon will work with you to reach an understanding about what you can expect from this procedure and what long-term benefits you will experience. Every patient is different, and your surgeon will choose the surgical technique and treatment plan that is right for you. During your initial consultation:

  • Provide a complete medical history. Include information about any previous surgical procedures; past and present medical conditions; and all medications or herbal supplements you are taking.
  • Expect your surgeon to examine the structure of your nose and other facial features.
  • Be prepared discuss possible risks and complications of the procedure.

Preparing for Your Surgery

You will be given specific instructions on how to prepare for your surgery. A pre-operative information packet will be provided that explains everything you should do and know before your surgery date. Your plastic surgical team will instruct you on how to prepare for surgery, including guidelines on eating and drinking, smoking, and which vitamins and medications should be taken or avoided. You should arrange for someone to drive you home after your surgery, whether your surgery is done on an outpatient or inpatient basis. You may also want to make arrangements for someone to help you out for a day or two after you leave the hospital.

Where Your Surgery Will Be Performed

Your procedure will take place in the University of Michigan Hospitals' state-of-the-art surgical suites and recovery areas. The majority of these procedures are completed on an out-patient basis.

Types of Anesthesia

General anesthetic is used so that you will sleep and remain comfortable throughout the procedure. Local anesthesia with intravenous sedation is also an option for some patients.

After Your Surgery

Click here for information about how to care for yourself after the surgery and what to expect during your recovery. It is very important that you follow your surgeon's instructions. This will promote healing and improve progress towards your new physical appearance. Also, it is important that you attend all scheduled follow-up appointments so that your surgeon can assess your long-term results and answer any questions or concerns you may have.