Rhinoplasty is the plastic surgery procedure to change the appearance of a man’s nose. Since the nose is critical to breathing and health, rhinoplasty requires the skillful hand of a qualified plastic surgeon who can artistically balance principles of a masculine nose with function of this critical area of the body.
If you are unhappy with the appearance of your nose — for example, the shape, size, bridge, tip or nostrils — or you have difficulty breathing through your nose, then the plastic surgeons at Chicago Aesthetic Surgery Institute can help. Combining refined surgical skills with artistic principles to improve facial harmony and balance, plastic surgeons like Dr. Szczerba have years of experience working with the prominent and complex features of the nose. Read more about rhinoplasty and how a skilled surgeon at Chicago Aesthetic Surgery Institute and a Chicago cosmetic surgeon can help enhance the appearance of your nose.
Surgery Candidates for Men’s Rhinoplasty
Rhinoplasty candidates should be at least 16 years of age or older (according to the guidelines of the American Society of Plastic Surgeons) and in good health. Smoking is not an absolute contraindication to rhinoplasty surgery but is generally not recommended for nasal surgery. Cocaine use is an absolute contraindication to rhinoplasty surgery. Participation in heavy contact sports that cannot protect the nose definitely need to be avoided during the healing phase of rhinoplasty.
Rhinoplasty candidates should have strong personal motivation for wanting to reshape their nose and not be influenced by anyone else. Rhinoplasty candidates are encouraged to examine pictures of themselves to identify what features they would like to refine and then look through before-and-after photographs of patients with similar noses to see what changes are realistic to accomplish.
You may be a Chicago Rhinoplasty (nose reshaping) surgery candidate if you have:
- A bump or a hump on the bridge of the nose (when viewed from the side profile)
- A large, boxy or bulbous tip to your nose
- A crooked or off-center nose
- A tip that droops
- A wide base
- Nostrils that are wide or that flare
- Difficulty breathing through your nose
- A prior injury to your nose leaving you with a changed shape to your nose
The Office Visit Prior To Surgery
The office visit prior to surgery is very important in the planning process of a mens’ rhinoplasty; it’s the perfect time to tell your plastic surgeon the changes of the nose you are trying to achieve. At the Chicago Aesthetic Surgery Institute, the plastic surgeon will then take a thorough medical history, take photographs and perform an exam of the inside and outside of your nose. The photographs are then imported into a computer program that allows morphing your nose to your specific preferences. The aesthetic goals of a man’s rhinoplasty definitely need to be specifically customized to guide our plastic surgeons to your aesthetic goals.
With those ideas in mind, the plastic surgeons at Chicago Aesthetic Surgery Institute can determine what type of rhinoplasty to recommend: an open rhinoplasty or a closed rhinoplasty. Additional procedures to ensure improved or proper breathing despite the external changes of the nose are also discussed at this time.
The Procedure
General anesthesia or, for smaller rhinoplasty procedures, IV sedation is used for rhinoplasty surgery. To keep our patients safe and comfortable during the procedure, we utilize licensed anesthesiologists and nurse anesthetists.
As determined in your visits prior to surgery, the procedure can be performed using either the open or closed surgical technique. During an open rhinoplasty, the plastic surgeon makes an incision in the columella (the skin area between the tissue separating the nostrils). The skin of the nose is then gently lifted from the underlying cartilages allowing direct visualization of the changes the plastic surgeon is performing. During a closed rhinoplasty, the surgeon makes the incisions hidden inside the nose gaining access to the underlying structures without disrupting the skin of the nasal tip.
The surgeon then reshapes and sculpts the bones and cartilage of the nose. The nasal bones are typically contoured first, setting the height of your new nose. Then, the cartilages of the middle 1/3rd of the nose are repositioned to the desired levels while ensuring internal proper breathing alignment of the cartilage. The base of the nasal bones are adjusted to both align the nasal bones and reduce the width of the nose. Finally the nasal tip cartilages are sculpted, repositioned and secured to the desired contours. For those patients who need nostril changes, the nostrils can be adjusted prior to placing the protective nasal cast.
If need be, internal nasal procedures to improve both appearance and breathing can be performed during the procedure. Correcting a deviated nasal septum with a procedure called a septoplasty removes cartilage segments of the nasal septum that obstruct breathing and also allows the surgeon to straighten and realign your nose. Pieces of cartilage from the septum (the partition in the middle of the nose) can be used to support and straighten the nose. Breathing through the nose can also be improved by adjusting the turbinates of the nose. The turbinates are made of bone and are covered with the internal lining of the nose called mucosa. The turbinates guide airflow and add moisture to the air that is moving within the nasal airway as one breaths. Adjusting the bone of the turbinate and shrinking the mucosal lining of the turbinate allows breathing the same, or even improved during rhinoplasty surgery.
Once the bones and cartilages of the nose are sculpted and the airway of the is optimized, with closed rhinoplasty the surgeon carefully closes the internal incisions with fine absorbable stiches. For open rhinoplasty, the skin is pulled back down over the new shape of the nose (for open rhinoplasty) and the surgeon closes the incisions internal incisions and the columellar incision with fine sutures or stitches. If internal airway work is performed, temporary internal nasal splints are then added to keep the nasal airway open despite swelling. Protective strips and a plastic moldable cast is then applied over the dorsum of the nose.
A splint on the outside of the nose is typically placed during the procedure to protect and hold the nasal tissue in place while the nose heals from the procedure. Patients will experience some bruising and swelling, which will dissipate in time. With internal breathing procedures such as septoplasty, internal splints are also used. It is critical for the rhinoplasty patient to follow all post-operative instructions for an optimal outcome. This includes resting at home and keeping the head elevated for a certain period of time, and carefully tending to the incisions. Patients should take about a week to 10 days off of work, and avoid bending, lifting or strenuous activity during the recovery period. Restrictions on cleaning the inside of the nose and particularly restrictions on blowing the nose is customized to the procedure performed. As mentioned above, patients will experience swelling, which will dissipate in time. Swelling after more extensive nasal surgery may take several months for all the swelling to disappear. Final outcome in rhinoplasty takes up to one to two years. Regular follow-up appointments will be scheduled to check progress, remove the cast and stitches and answer any questions about the recovery period. Photographs are usually taken at specific visits to capture your new look!
Benefits and Risks of Rhinoplasty Surgery
Rhinoplasty can dramatically improve the appearance of a patient’s nose and bring refinement and balance to one’s overall look while maintaining or even improving one’s ability to breath through the nose. The plastic surgeons at Chicago Aesthetic Surgery Institute and Dr. Szczerba have refined their surgical techniques over the years to produce consistently beautiful, long-lasting and safe results. Rhinoplasty may also alleviate breathing difficulties due to a deviated septum or other nasal abnormalities.
As with any surgery, there are risks. There is a slight risk that the outcome of the surgery will need further refinement, requiring additional surgery. Other risks include bruising and bleeding, asymmetries of the nose, recurrence of deformities like a bump on the nose or the slow return of deviation of the nose. Much less frequently seen risks such as difficulty breathing through the nose, infection, poor wound healing, anesthesia complications, perforation of the lining of the nasal septum during septoplasty, numbness in the skin and rupture of small surface vessels are possible but not commonly seen. If you are concerned about these risks, speak with our Chicago rhinoplasty surgeons and learn about the measures they take to avoid or minimize them.