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Rhinoplasty

Nose Job in Las Vegas NV

nose jobRhinoplasty, commonly referred to as a “Nose Job” is a surgery that is performed to improve the appearance and/or the breathing function of a nose.

Rhinoplasty surgery is performed to accomplish the following look of your nose:

  • Reducing the “hump”
  • Altering the shape of the nostrils
  • Redefine the tip of the nose
  • Reducing the width of the nose
  • Straightening a crooked nose
  • Adding to the bridge of the nose
  • Lifting a tip that points down

Rhinoplasty can improve the function of your nose by:

  • Correcting a deviated septum
  • Reducing swollen Turbinates (inside the nose)
  • Supporting the nostrils to prevent collapse

Who is a candidate for Rhinoplasty Surgery?

The typical candidate for rhinoplasty surgery is an individual who has concerns with the shape, size or function of their nose. Individuals who seek rhinoplasty surgery must meet the minimum criteria of being in overall good health to undergo surgery and have psychologically stable mindset with realistic expectations of outcome. Patients who can undergo rhinoplasty surgery may be as young as 15 years old with the consent of their parent or guardian.

Changes to the nose:

Altering the appearance of the nose can result in a dramatic change to an individual’s appearance. The patient must be prepared to potentially look different than they currently are. The reason for this is that the human mind can perceive differences in the shape of the nose much more precisely than any other part of the body. It is the basis in which we recognize other individuals in the nose is often the center of our facial identity. Often times patients who present for rhinoplasty surgery have considered surgery for many years before ever seeing a physician. The changes with rhinoplasty surgery can help improve an individual’s self-esteem greatly if they are unhappy with the appearance of their nose.

The consultation:

During your consultation Dr. Khorsandi at VIP Plastic Surgery will evaluate your nose and the surrounding structures of your cheek, eyes, face and chin. He will evaluate your breathing and examine the internal structures of your nose looking for irregularities such as a deviated septum, cartilage collapse, inflamed lining and structural abnormalities. Dr. Khorsandi will evaluate your goals for surgery and discuss your motivation for seeking treatment. He will take a detailed history and will want to know about any significant medical problems such as bleeding, reaction to anesthesia, hypertension, psychiatric issues, or tendency for scarring. It is very important that Dr. Khorsandi be informed of any previous nasal surgery that has been performed. This may include minor sinus surgery or previous rhinoplasty surgery. It is also important to inform Dr. Khorsandi if you have had a history of any drug use such as cocaine, or excessive tobacco use as this may alter his technique for your surgery.

Dr. Khorsandi will take both 2-D and three-dimensional Vectra photographs. With the 3-D vector system Dr. Khorsandi will simulate what he intends to do with your surgery. He will show you what your outcome may look like and may additionally suggest things that may enhance your outcome or be complementary to your rhinoplasty surgery such as a chin augmentation or fat grafting.

He will review the procedure and his technique and will take feedback from you regarding the proposed procedure. He encourages you to ask questions as they arise so that you may feel comfortable with the subject matter and what he is discussing with you.

Prior to surgery:

Dr. Khorsandi will provide you with a prescription for preoperative lab work and if necessary may refer you to your primary care physician for preoperative clearance if you should have any ongoing medical issues. Dr. Khorsandi will provide you with specific instructions and asks that you refrain from taking any blood thinners such as aspirin prior to surgery. If you are on a blood thinner or aspirin at the direction of your cardiologist he may require that you have an evaluation and cardiac clearance. It is important that you cease smoking at least two weeks prior to surgery, and for one month following surgery. Smoking can inhibit good healing and lead to poor cosmetic outcomes. The day before surgery you may eat a light dinner and may not eat or drink after midnight. If you take morning medications you may take them with a sip of water.

The surgery:

Rhinoplasty surgery is specifically tailored to the individual needs of each patient. Surgery is performed on an outpatient basis, at an accredited surgery center. You will need to arrive one hour prior to surgery and will need to have an adult take you home afterwards and to assist you at home. Dr. Khorsandi will see you in the preop holding area and will review the operative plan with you. You will then be taken to the operative suite and placed under general anesthesia.

The surgery is generally performed with a small incision at the base of the nose and the remainder of the incisions on the inside of the nose. Depending on your individual needs, the cartilage may be reshaped, partially resected, sutured, and/or resuspended. Cartilage grafts may be used to enhance certain areas of the nose such as the tip. The septum of your nose may be addressed if deviated and correcting maneuvers may be made to improve your breathing and airway. If the surgery is a revision of surgery for correction of a previous rhinoplasty additional cartilage may be harvested from behind the ear or from another location. Often times, the bony parts of the nose need to be corrected with precise fracturing and resetting.

At the end of the surgery sutures will be placed inside the nostrils which are absorbable and do not need to be removed. Several small non-absorbable stitches will be placed at the incision at the base of the nose and these will be removed 5 to 7 days postoperatively. You will also have packing in the nose, which will be removed during the postoperative period and there will be a rigid splint on the back of the nose to protect it during your recovery.

Postop course:

Rhinoplasty is generally a very well tolerated procedure. Postoperative pain is well controlled with analgesic medication. If bony work is performed there may be some bruising that is noticeable around the eyes. Taking the homeopathic oral supplement Arnica Montana postoperatively can minimize this. To reduce swelling patients may also use a frozen bag of peas over the eyes taking care not to place pressure on the bridge of the nose in any way. The splints placed on the nose will protect the surgery to a certain extent however any direct trauma or significant pressure to the nose may alter the outcome. Patients are encouraged to avoid blowing their nose in the first week, however patients may use saline spray to flush the nostril. Patients are encouraged to sneeze through their mouth and avoid any strenuous activity for the first week. Furthermore patients are encouraged to sleep with their head elevated for the first 48 hours. Postoperatively patients are placed on antibiotics until the splints are removed from the nostrils. You may shower after surgery however you must keep the splint on the nose dry and avoid the direct spray on your face. Dr. Khorsandi will see you in the office postoperatively to remove the splints and sutures.

Complications of rhinoplasty surgery:

Although rhinoplasty surgery can provide you with significant improvement to your personal appearance, all surgery carries risk. The risks of rhinoplasty surgery include reaction to anesthesia, bleeding, infection, hematoma, septal injury, asymmetry, warping of the cartilages, bony callus development, contour irregularities, numbness, problems with healing, altered sense of smell, and need for further surgery. For each patient healing is different and although Dr. Khorsandi expects good results for all of his patients, there is no guarantee of an exact outcome. In some situations regardless of technique it may not be possible to achieve the look that you desired. If this is the case a secondary surgery may be needed to reach your intended goal. Dr. Khorsandi will work to help meet your expectation.

Postoperative swelling:

Rhinoplasty patients will experience varying degrees of postoperative swelling. A large percentage of the swelling will resolve within the first few weeks however in the ensuing months the nose may feel more firm with a small amount of swelling gradually dissipating. Typically within 6 to 12 months all swelling has resolved and the final result can be expected. Thus it is important to expect ongoing changes throughout the year with refinement of the look as time progresses.

Revision rhinoplasty:

Patients who have undergone previous rhinoplasty present a specific set of challenges for the plastic surgeon. Dr. Khorsandi previously pursued a fellowship in advanced aesthetic surgery focusing on revision rhinoplasty surgery under one of the countries top revision rhinoplasty specialists. He has personally performed revision rhinoplasties in patients who have undergone two, three, and sometimes four unsuccessful previous surgeries. The techniques for these patients vary from individual to individual, but Dr. Khorsandi is committed to helping patients achieve a normal balanced look to their nose.

Additional procedures:

The nose sits at the center of the face however it is related to many adjacent structures including the cheeks, the upper lip, and the chin. For many patients a lack of cheek projection may cause a nose to look larger than it actually is on side view. Sometimes augmentation of the cheek with the patient’s own fat through a fat grafting procedure can provide a harmonious balance to the mid-face and improve the appearance of the nose. Furthermore many patients who undergo rhinoplasty may benefit from evaluation of their chin in profile. If it is deemed that the chin is disproportionate in relationship to the projection of the nose and Dr. Khorsandi may recommend a chin augmentation, to again provide a harmonious balance to the face. It is important to understand that Dr. Khorsandi takes a holistic approach to facial appearance and may recommend procedures, which may enhance your overall appearance.

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