Rhinoplasty | Houston
Rhinoplasty is the clinical term for nose surgery. A rhinoplasty can change your nose, removing imperfections or simply making it more proportional with the rest of the face. The nose is one of the most predominant features of the human face. When someone is unhappy with their nose it's often the only thing they can see. We want to help with that.
Rhinoplasty is one of the original cosmetic surgeries, first performed in the United States in 1887. The surgery involves making incisions to access the underlying bone and cartilage. Depending on your goals, your surgeon may remove some bone and cartilage, or he may add tissue. Once he has altered the underlying structure of the nose, the skin and tissue is re-draped over the new structure.
Nose surgery is a delicate procedure, and our surgeons take great pride in their ability to give our patients the nose they’ve wanted. This procedure can really change a patient’s self image.
Goals of Rhinoplasty
Every nose is different. How you see your nose now, and how you want to see it is a huge part of the process of getting a rhinoplasty. Goals may include enhancing breathing performance as well as improving appearance. Rhinoplasty can involve modifying skin, cartilage, bone, or all three.
During rhinoplasty, your surgeon may attempt to do one or more of the following:
- Modify the bridge
- Open breathing passages
- Reshape the tip
- Remove a hump
- Reshape or resize the nostrils
- Repair an injury
- Reshape or resize the nostrils
- Increase or decrease size
If you are concerned about keeping ethnic traits of your nose while changing others, you may want to consider ethnic rhinoplasty.
How The Procedure Works
There are two methods to rhinoplasty: closed or open. During your consultation, your surgeon will discuss which method he believes fits your needs. This will be a joint decision.
In open rhinoplasty, your surgeon makes an incision across the columella, the sliver of tissue between your nostrils. The soft tissue is then lifted upward and off the bone and cartilage. The open method completely exposes the underlying structure, making more dramatic modifications possible. After your surgeon reshapes the bone or cartilage, the soft tissue is then brought back down.
In closed rhinoplasty, your surgeon will make all of the necessary incisions inside the nose. This method makes no visible scarring, but it can limit the extent of reshaping possible.
If your goal is to build up an area of the nose, your surgeon can take cartilage or other material from the septum, the ears, or a rib. Sometimes we use synthetic implants.
If you are looking to shrink the size of your nose, your surgeon may break the nasal bones.
Primary Rhinoplasty Case ID: 0291
Primary Rhinoplasty Case ID: 0273
Primary Rhinoplasty Case ID: 0569
This is a side by side comparison of a primary rhinoplasty on a young woman with a larger tip.
Teen Rhinoplasty Case ID: 0470
This is a 17 year old patient that was heading off to college and felt that his profile looked “weak” and was causing him to have anxiety and low motivation and confidence. Part of this came from his tall and thin nose but also his recessed chin. We performed a primary rhinoplasty and placed a medium sized chin implant as well. These after pictures were taken 1 year after his surgery.
Revision Rhinoplasty Case ID: 0477
This is a 25 year old professional female who underwent a primary rhinoplasty in the Middle East 3 years prior to presenting. After surgery she had immediate nasal obstruction and over time had a collapse and derangement of the structure to the point where she presented below. She had severe scarring to the inside of the nose as well presenting a very difficult problem functionally. She had complete nasal valve collapse and septal deviation. She underwent a revision rhinoplasty using structural rib grafting, with ear cartilage grafting, septoplasty, nasal valve reconstruction and skin grafting to the inside of the nose to fix extensive scarring of the internal nasal passages. The after pictures below were taken one year after her revision surgery.
Primary Rhinoplasty Case ID: 0319
Ethnic Rhinoplasty Case ID: 0509
This young latino woman always felt her nose made her face look heavy. She didn’t want to make changes that would run counter to her heritage but wanted a more feminine and streamlined look. She underwent hump reduction via an open approach, alar base excisions (shown here to demonstrate how well the wounds tend to heal) and tip rotation and refinement. The pictures shown were taken 4 months after the surgery.
Primary Rhinoplasty Case ID: 0588
This 28 year old female presented with concerns of nasal persistent cosmetic nasal concerns and wanted a Primary Rhinoplasty. She complained of a “heavy look” to her nose with a tip that was not “elegant” in her opinion and a dorsum with a hump that was common to her family. I reduced her hump and tailored her tip to fit with our discussions about her idea of what an “elegant nose” would look like after the surgery. These pictures were taken at 6 months after her surgery.
Primary Rhinoplasty Case ID: 0337
Primary Rhinoplasty & Chin Augmentation Case ID: 1564
Primary Rhinoplasty Case ID: 0344
Teen Rhinoplasty Case ID: 0484
This patient presented at the age of 16 for nasal obstruction and aesthetic concerns. We had multiple conversations in order to assess her motivations and make sure she was sure about what she wanted. I performed a septorhinoplasty with turbinate reduction and lowered her dorm and narrowed the tip, turning it up slightly as well. These after pictures were taken 1 year after her surgery.
Primary Rhinoplasty & Chin Augmentation Case ID: 0492
This young woman had always been self conscious of her profile and wanted to have a rhinoplasty. During her consultation I sat with her in front of her pictures and showed her what a chin augmentation would look like after her surgery. I did this using a morphing program that allows me to manipulate the images and demonstrate approximate results of surgery. We decided to do a septorhinoplasty, tip reshaping and medium chin augmentation. The photos below were taken at approximately 6 months after her surgery.
Am I A Candidate For Rhinoplasty?
When a patient comes to us exploring the possibility of nose surgery, there are usually three main purposes: cosmetic issues, injury repair, or to improve function.
If a person feels their nose is too bulbous or there’s a bump on the bridge, it can be a real issue. Here are common aesthetic reasons patients seek to make some changes:
• Their nose is too big or too small.
• The nose droops downward.
• They have overly flared nostrils.
• The nose isn’t proportional with the rest of the face.
• There is a prominent bump on the bridge.
• The nose has a bulbous tip.
• The nose is too wide or flat.
• Their nose is crooked from a prior injury.
People often injure their nose, but don’t always opt to correct it. Things like touch football games or even bumping into a wall in a dark room can alter the look and the function. We can correct both the appearance and the function.
Some people are born with nasal passages that are too narrow. Restricted airflow can lead to snoring and even sleep apnea. Functional Rhinoplasty can open constricted airways and vastly improve breathing function.
A good rhinoplasty result can completely change a person’s image. The nose is the central and most prominent feature of the face. A well executed rhinoplasty will draw less attention to a person’s nose, not more. Many of our patients say after rhinoplasty they receive many compliments on their eyes. When the nose is less prominent, other features come to the foreground.
It is important for our patients to understand there is no such thing as a ‘perfect’ surgical result. Nowhere is this more evident than in rhinoplasty. As a patient, you should be very skeptical of any surgeon that promises perfection or treats the outcome as a foregone conclusion. In skilled hands there is an excellent chance of success, however, rhinoplasty is one surgery in which there is an element of unpredictability. This is why the postoperative period is so critical, a time when the patient must adhere carefully to a strict regimen.
There are the general risks that accompany any surgery: anesthesia reaction, infection, bleeding, poor wound healing, scarring, and changes in skin sensation. Specific to this procedure, the patient may have difficulty breathing, skin discoloration and continued swelling, possible perforation of the nasal septum, or unsatisfactory final results. If further changes are necessary, revision surgery may be an option.
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Recovery After Rhinoplasty
Part of our process is making sure you feel comfortable and prepared for post op.
When your surgery is complete, we will pack your nose will your surgeon will place a splint on it. This splint will stay in place for about one week. Swelling and bruising are common. This is inevitable with the degree of tissue trauma as a result of rhinoplasty. A cold compress can help.
For the first week, you will need to keep your head elevated as much as possible, even when sleeping. You can expect bruising and swelling near the area around your eyes and nose. This usually lasts for 10-14 days.
If you wear glasses, you will need to tape them to your forehead for up to seven weeks to keep any pressure off of your nose. Any strenuous exercise or lifting that increases blood flow to the face needs to be strictly avoided for several weeks.