Why get a nose job?
Rhinoplasty is the medical term for nose surgery, or a “nose job.” There are two main reasons you might get a nose job. For one, you might not like your nose. Your nose helps define your facial image and is one of the first things a person will notice about you. Through rhinoplasty, a surgeon can change the shape or size of your nose, but it is not without risk or cost.
You could also need rhinoplasty for medical reasons, such as injury caused from blunt-force trauma. For example, if you have suffered a sports injury, such as a softball to the face, you might need nose surgery to reconstruct your airways.
What happens when you get a nose job?
Before your surgery, you'll meet with your surgeon, and you will discuss how you would like your nose to look. Your surgeon might study photos of your nose beforehand and might also have a computer program that can morph your photos to give you an idea of what your nose might look like.
To begin the surgery, an anesthesiologist will put you under general anesthesia. The medical team might also inject some numbing medication, such as epinephrine.
There are two main ways for a plastic surgeon to perform a nose job — open or closed. During a closed surgery, there are no external cuts. Instead, your surgeon will make internal cuts. This procedure takes practice, and it's important to find out the level of experience your surgeon has.
During an open surgery, your surgeon will likely make one external cut along your columella, the tissue that links the nasal tip to the nasal base. Once your surgeon makes that incision, he or she will lift the soft tissue that covers your nose. Next, your surgeon will begin to shape and remove cartilage or bone, depending on what you've discussed.
The medical team might use a cartilage graft, using cartilage from your septum, to define the tip of your nose, if that's the focus. Your surgeon might also put sutures in your nose to help your nose attain a certain shape.
If you've had considerable damage and are seeking reconstructive surgery, your surgeon might use cartilage from your ribs or ears to provide better support to your nose. For reconstructive surgery, you'll have fine intricate sutures throughout your nose. In severe cases, your surgeon might need to use screws.
Does it hurt?
After the surgery, your nose and face will likely hurt. The pain and bruising you will have after the surgery will depend on how extensive the surgery is. Specifically, it depends on how much bone work the surgeon does. If your surgeon breaks your nasal bones to change your nose's shape, your nose will hurt more than if the bones weren't broken.
After your surgery, you might experience “black eyes,” or black and blue near your eyelids. It can be hard to taste or eat after the surgery. Breathing through your nose will be limited. It's important to refrain from sneezing or blowing your nose.
What are the risk factors?
For one, you might not get the results you wanted. It's important to have honest conversations with your surgeon before the procedure to ensure the best results.
As with any surgery, bleeding, infection and poor wound healing are a risk. If your surgery isn't done with proper technique, you could have a worse outcome.
Other risks of rhinoplasty include recurring nose bleeds, difficulty breathing through your nose, numbness in your nose, skin contour irregularities, chronic pain, unfavorable scarring or a hole in the nasal septum.
What's the recovery time?
You're usually on prescription pain medications, if you wish to take them, for about a week. You might experience a headache, which is sometimes caused from your pain medication. If you are experiencing severe headache, you should contact your doctor.
Your surgeon will want to see you a day or so after the surgery to see how you're healing. You will have cotton packing that your doctor will remove somewhere between a day and a week after surgery. You will likely wear an external splint held with some tape. The splint is meant to reduce swelling and hold the structure in place.
You might have to wear an internal splint inside your nose to support the structures. Your doctor will remove that in about a week. After the splint is off, you should see some results from the surgery.
What's the follow-up?
It can take up to a year before you see the full results, especially around the tip of the nose. This means your surgeon cannot do a revision until your nose has finished shaping.
In some cases, you might have a follow-up surgery to correct your chin. Sometimes, the procedures are performed together to ensure your face looks balanced.
Source: Dr. Kamal Sawan, chief of plastic surgery at OU Physicians; The Mayo Clinic; National Institutes of Health; American Society of Plastic Surgeons; National Human Genome Research Institute.