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Questions & Answers

Why is nasal surgery called rhinoplasty?
The word rhinoplasty comes from the Greek word rhino (meaning nose) and plasty (meaning to mold or to shape).
How old you have to be to have a rhinoplasty?
Rhinoplasty can be performed by the age of 17 in most individuals. Patients have completed their facial growth by that time.
How long does the surgery take?
For most patients the surgery lasts between one and two hours depending on how complex the problem is. Patients who are having revision rhinoplasty may require a longer surgical procedure.
What form of anesthesia is used for rhinoplasty?
The procedure can be performed under a general anesthetic or local anesthetic with IV sedation or under a general anesthetic. This can be discussed with Dr. Hart. As to which would work best in your particular case.
Does the procedure require an overnight stay?
In most cases the procedure is done on an outpatient basis. You will need someone to pick you up and take you home and stay with you for the first 24 hours.
How long before I can resume normal activities?
Most patients can resume normal activities within a few days. It is preferable to avoid exercise for approximately 2 weeks. You will have a splint on the outside of your nose for the first five to seven days. This will be removed in the office at that time.
Is the procedure performed open or closed?
In most cases the procedure can be performed with all the incisions on the inside of the nose. That means there will be no external scars. Some patients who require detailed work on the nasal tip or are having a second rhinoplasty procedure may require a very small incision under the tip of the nose midway between the tip and the lip. This usually heals with a unnoticeable scar.
When should I look at my nose critically in terms of the result?
In most cases it takes a minimum of six months to see the fine detail following rhinoplasty. Most noses look good at six to eight weeks but fine ultimate result takes at least six months.
Is the procedure in the same for ethnic noses?
The exact procedure for each patient has to be individualized especially for ethnic noses. It is important to determine if the patient wants to retain certain ethnic qualities to their nose. Particularly in these cases photo imaging is very helpful in making the correct decision.
What are the risks of a rhinoplasty?
Every surgical procedure has potential risks most of these occur very infrequently. Adverse reactions to anesthesia, bleeding, infection, irregularities that may require additional treatment, these are however quite rare.
What is the usual postoperative course?
The amount of bruising varies from patient to patient. Most discoloration and swelling begins to subside after two to three days. Once the splint is removed, you can begin to use make up if desired. Minor residual swelling particularly in the nasal tip may persist for several months but usually is not noticed by others. In most instances packing is not used. In some cases when packing must be used it stays in two to three days after surgery. The nasal splint is worn for one week. Exercise should be avoided for two weeks.
What is revision rhinoplasty?
Revision rhinoplasty refers to a second or third procedure performed to correct deformities of the nose which have resulted from prior rhinoplasty surgery.
Who is a good candidate for revision rhinoplasty?
Patients who are physically healthy and realistic with regard to their expectations of improving the appearance and or function of their nose following a previous rhinoplasty.
What is discussed during a consultation for revision rhinoplasty?
Dr. Hart will discuss with you what problems you're having with your nose with respect to appearance and/or function. He will note your complaints and your prior history of surgery. He may need to obtain prior records. He will discuss with you your options with regard to treatment. He will explain all details of the procedure that is being proposed. He may suggest photo imaging to make certain that you are both on the same page with regard to your wishes and expectations.
Where is the revision rhinoplasty procedure performed and how is it done?
Revision rhinoplasty can be performed in a hospital setting or in a freestanding ambulatory surgery Center. The procedure is performed either under general anesthesia or a combination of sedation and local anesthesia. The details of the procedure are very individualized. Often good exposure is the key to obtaining the best result. Working on the nose is like working on a tent. The shape of the tent is determined by the position of the polls and the ropes. Similarly the shape of the nose is determined by the position of the cartilage and bone. Sometimes certain grafting techniques are used using cartilage from the septum, ear or occasionally, the rib. This can be necessary if certain elements are missing due to the prior surgical procedure.
How long does the procedure take to perform?
This is variable, depending on the problem has to be corrected. It can take as little as an hour to an hour and half or as long as three hours to perform.
Where are the incisions made in revision rhinoplasty?
The incisions may be confined to the inside of the nose or in certain situations an additional small incision may be made between the tip of the nose in the upper lip.
What is the scarring like following revision rhinoplasty?
The incisions that are made inside the nose result in no visible scarring. If an incision is required between the nasal tip and the lip, there will be a scar that is generally minimally noticeable.
Is a revision rhinoplasty more painful?
In most cases patients do not experience as much pain from a revision rhinoplasty. The discomfort is usually managed well by oral pain medications. All of Dr. Hart patients receive his pager number to call directly if there are any problems.
What is the recovery like after revision rhinoplasty?
Patients will experience some bruising and swelling. Which usually lasts one to two weeks. The external splint that is used is removed in seven days. Any external sutures are removed also at seven days. Most female patients can cover any bruising or swelling with makeup after one week. Most patients also return to work at this time. Patients are cautioned to avoid heavy physical exercise for three weeks following surgery. 90% of the swelling has gone within six weeks. The remainder may take several months to fully resolve.
Will I be able to drive home and do I need someone with me after surgery?
You will need someone to drive you home either a family member or friend. It is best to have someone stay with you for the first 24 hours after surgery.
Will my insurance cover revision rhinoplasty?
If your procedure is performed to correct breathing difficulties some portion of the procedure may be covered by insurance. If the procedure is done mainly for appearance reasons then insurance typically will not cover the procedure.
What are the risks of revision rhinoplasty?
Some of the risks are similar to any surgical procedure. These would include anesthesia reactions, bleeding, infection, and the need for additional surgery. Others are more commonly associated with revision rhinoplasty such as recurrence of any deformity, excess scar reaction and prolonged swelling. Most of these complications occur infrequently. Dr. Hart will be glad to discuss these in more detail at the time of your consultation.
Can revision rhinoplasty be financed?
There are a number of financing options that are available through our office. [click here to find out more]

 

 

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Hart Cosmetic & Reconstructive Surgery Institute
969 North Mason Road, Suite 170, St. Louis, MO 63141
Phone: (314) 991-1700 • Fax: (314) 628-9504