Doctors for Rhinoplasty Treatment

Rhinoplasty, commonly called Nose Job and medically termed Nasal Reconstruction, is a procedure that is performed to alter or change the appearance, shape, size, and/or structure of the nose as required. It is one of the most commonly performed cosmetic surgeries in India, with a success rate above 97%.

While most people believe that rhinoplasty is purely cosmetic, it is also performed for reconstructive purposes and can correct various medical concerns, including breathing issues and nasal injuries. Some common aesthetic and medical concerns that can be successfully addressed by rhinoplasty include the following:

• Correcting the hump or depression in the nose
• Changing the size and shape by modifying bone and/or cartilage
• Improving nose profile or elevation to make it harmonious with other facial features
• Reducing or enlarging the nostrils
• Correcting a congenital abnormality or birth defect in the nose
• Correcting a deviated nasal septum to improve breathing
• Repairing a broken nose or correcting other traumatic injuries

Along with being the most common, it is also one of the most complex cosmetic surgery. Thus, it is crucial to choose an experienced and highly skilled surgeon to get the desired results.

Based on the concern that is corrected during rhinoplasty, it is classified into the following types:

• Cosmetic Rhinoplasty: In this type of rhinoplasty, only aesthetic components of the nose are addressed, including correcting a hump, depression, size or position of the nostrils, etc. This is mostly done to make the nose symmetrical and create a facial balance.
• Functional Rhinoplasty: As the name suggests, this type of rhinoplasty addresses functional problems with the nose, including deviated nasal septum, nasal injuries, turbinate reduction, nasal valve repair, etc.
• Secondary Rhinoplasty: This type of rhinoplasty is performed to correct or improve the results of the first rhinoplasty surgery or to address the problems that occurred after the initial surgery.
• Ethnic Rhinoplasty: This type of rhinoplasty involves altering the nose's appearance differently to the patient’s ethnic descent.

Besides these, rhinoplasty is further divided into two types based on the technique used to do the alteration. These two types are:

• Open Rhinoplasty: This technique involves making tiny incisions between the nostrils on the columella and lifting the skin to expose the internal structures. The open rhinoplasty technique makes it easier for the individual to make the required modifications in the nose’s shape and structure.
• Closed Rhinoplasty: This technique involves making an incision inside the nostrils and is suitable when only minimal alterations in the nose’s shape and structure are required. It restricts the scope of the procedure but has key advantages over open rhinoplasty.

The right technique for rhinoplasty is chosen based on the extent of modifications required. For instance, if the surgeon needs to fix a deviated septum, a closed rhinoplasty will be performed. If the surgeon needs to correct a depression or hump or needs to use advanced cartilage grafting techniques to support the nasal structure, the open rhinoplasty technique will be used. To learn more about these techniques and their pros and cons, it’ll be best to talk to a doctor.

Before rhinoplasty surgery, the surgeon will take a detailed medical history of the patient to evaluate his/her overall health. A physical exam is done to evaluate the nasal bone, cartilage, muscles, skin, and soft tissues along with the internal structures, such as septum or turbinates.

If the patient has functional disorders, such as turbinate hypertrophy or septal deviations, a nasal endoscopy may be recommended by the doctor to plan the exact steps of the surgery.

Pre-operative photos of the nose from various angles are also taken for analysis and planning. The photos are used as a reference to the changes that need to be done and also show the before and after effects of rhinoplasty.

Before proceeding with the surgery, the surgeon will discuss the patient’s goals and expectations and also list the potential side effects, risks, and complications that can arise before or after the surgery. The surgery planning is done, and written consent is obtained from the patient.

The exact steps of rhinoplasty surgery vary from one patient to another, depending on their individual needs. The general steps involved are given below:

• The patient is given anesthetic medicine to put him/her to sleep. The type of anesthesia (local anesthesia with sedation or general anesthesia) used depends on the patient’s preference and the complexity of the procedure.
• Tiny incisions are made either inside the nose (closed rhinoplasty technique) or on the columella (open rhinoplasty) based on the changes that need to be done.
• If open rhinoplasty is performed, the skin covering the nasal bone and cartilage is lifted properly. If the closed technique is used, the internal structures are accessed safely through the incisions.
• The corrections may be done as below:
1. A large nose will be reduced by removing excess bone and cartilage.
2. Elevation is added to the nose tip by adding a cartilage graft.
3. A dorsal hump is reduced with the help of scissors or scalpel.
4. A depression in the nose is augmented using homologous or autologous tissue or synthetic implants.
5. A deviated septum may be corrected either by resecting the deviated bone or cartilage.
• Once the underlying nasal structure is sculpted as required, the skin is carefully placed back, the incisions are closed carefully, and external and/or internal splints are placed to support the newly modified structure.

Rhinoplasty can take around 1 to 3 hours to complete, and after the surgery, the patient’s vitals are observed closely until the effects of anesthesia wear off. After that, the patient is transferred to the recovery room and is discharged after a few hours.

Many people tend to believe that rhinoplasty surgery’s usefulness is limited to cosmetic improvements, but it also has numerous medical benefits for the individual. When performed by a skilled plastic or cosmetic surgeon, rhinoplasty can provide the following aesthetic and medical benefits:

• Improves Appearance and Boosts Confidence: As the nose is one of the most prominent parts of the face, it draws attention all the time. When the individual doesn’t feel comfortable with his/her own features, they often develop self-esteem issues, which affects their confidence as well. Rhinoplasty addresses these concerns by improving the individual’s appearance, which ultimately leads to a boost in self-confidence.
• Improve Breathing: Rhinoplasty can correct the structural deformity in the nose, such as deviated septum, which can significantly improve breathing problems and also reduce the risk of repeated sinus infections.
• Repair a Broken Nose: The surgery can even fix a nose that is injured, broken, or has some other deformities that are caused by physical trauma.
• Correct Birth Defects: Rhinoplasty can correct congenital defects in the nose, whether it is bone or cartilage. This can improve the overall appearance and function of the nose simultaneously.
• Resolve Sinus Problems: The surgery corrects the structural issues with the nose and, therefore, treats sinusitis in most cases, which provides the individual relief from issues like headaches, nasal congestion, snoring, sleep apnea, etc.

The general side effects of rhinoplasty surgery include swelling, redness, bruising, and inflammation around the nose, eyes, and cheeks. These side effects are temporary and mostly resolve on their own as the nose heals. They are considered serious when the symptoms don’t go away after a month or so.

Rhinoplasty also has some risks and potential complications that may arise during or after the surgery. These include the following:

• Reaction to anesthesia can lead to aspiration or arrhythmia.
• Changes in skin sensation due to nerve damage.
• Difficulty breathing due to either placement of splints or other complications.
• Infection in the incision site due to bacterial growth.
• Nasal septal perforation may occur, which can affect breathing.
• Scars may heal abnormally due to some reason.
• Skin discoloration or hyperpigmentation around the nose.
• Unsatisfactory results and need for additional surgery.

Most of the potential complications can be mitigated successfully by the combined efforts of the surgeon and the patient. The surgeon takes the necessary measures to reduce the risk of these complications arising, and the patient needs to follow the post-op care instructions diligently for a smoother and faster recovery.

The initial recovery after rhinoplasty takes place around one month, and the complete recovery may take several months up to a year. The splints placed inside and outside the nose will be removed after 1-2 weeks, and the swelling and bruising will also take 2-4 weeks to resolve. Even then, patients may experience some residual swelling in the upcoming months as the nasal structure stabilizes.

During the recovery period, the patient will have to follow all the care instructions given by the doctor for optimal healing. The general recovery tips will include the following:

• Take the prescribed medications, including painkillers, antibiotics, anti-inflammatory medicines, nasal sprays, ointments, etc., as directed.
• Use ice packs for cold compresses to manage the swelling and bruising in the treated area.
• Don’t blow your nose, and try to avoid dusty areas that can cause sneezing.
• Sleep in an elevated position as long as recommended by the doctor.
• Don’t put too much pressure on the bridge of the nose, and avoid wearing spectacles or eyeglasses until the nose heals completely.
• Avoid going out in the sun during the first few weeks, and even if you go out, consider covering the face with a scarf or hat to avoid direct sunlight contact with the treated area. Also, use sunscreen.
• Be careful about the foods you eat, especially during the first few weeks when the nose is extremely sensitive. Start eating soft foods and switch to solid foods gradually as the nose heals.
• Avoid smoking and drinking alcohol for at least a month, as it can interfere with the healing process and increase the chances of post-op complications.

Take regular follow-ups with the doctor to monitor your recovery and have patience. Many patients fail to understand that the final results of rhinoplasty surgery can take almost a year to become fully apparent. Therefore, it is crucial to manage your expectations and listen to the doctor’s advice.

Rhinoplasty surgery cost in India starts at Rs. 70,000 and goes up to Rs. 1,50,000 or more. The overall cost of rhinoplasty is determined by various factors, which include the following:

• The extent of modifications that need to be made to the nose structure
• Type of rhinoplasty being performed (cosmetic, functional, ethnic, or secondary)
• The surgeon’s expertise and overall experience
• The choice of hospital or clinic (private or government and multispecialty or super-specialty)
• Hospital/clinic-related expenses (room rent, OR charges, nursing fee, etc.)
• Pre-operative assessments and post-operative care
• Type of anesthesia used and anesthetist’s fee
• Additional treatment or procedures combined with rhinoplasty

The final cost of the nose job is calculated after accounting for all these factors. Typically, rhinoplasty is considered a cosmetic surgery, thus, you will have to cover the treatment expenses from your own pockets. However, if rhinoplasty involves correcting or addressing a medical concern, such as deviated septum, turbinate reduction, injury repair, etc., the insurance company may cover the cost of the procedure partially or completely, depending on your policy’s terms and conditions.

To get clarifications regarding insurance coverage for rhinoplasty, it’s advised to talk to the insurance provider, as they can provide detailed information about co-pays, deductibles, or other clauses that may be associated with the treatment.