What is rhinoplasty?
Rhinoplasty is a procedure where your surgeon changes the shape of your nose (cosmetic rhinoplasty) or operates at the level of the nasal valves to improve breathing (functional rhinoplasty). It can be cosmetic, functional, combined (both), ultrasonic (when performed with an instrument called a Piezotome) or medical (when performed using soft tissue fillers).
Rhinoplasty is considered by many as the most difficult cosmetic surgical procedure, as it combines structural and functional aspects to preserve and improve breathing, as well as a meticulous artistic component to precisely sculpt the shape of the nose while accounting for future healing.
How many types of rhinoplasty are there?
There are eleven types of rhinoplasty:
- non surgical rhinoplasty: injection of hyaluronic acid fillers into the nose using a syringe without the need of any anesthesia
- mini-rhinoplasty: the combination of a non surgical rhinoplasty and alar base reductions (surgery to reduce the size of the nostrils), all performed under local anesthesia
- cosmetic rhinoplasty: surgery to change the shape of the nose
- functional rhinoplasty or septorhinoplasty: surgery to improve nasal breathing through the nasal valves
- revision rhinoplasty: nasal surgery after previous nasal surgery
- ethnic rhinoplasty: rhinoplasty on patients that are non-Caucasian, such as Mediterranean rhinoplasty, African American rhinoplasty, Middle Eastern rhinoplasty, Asian rhinoplasty, and Hispanic or Mestizo rhinoplasty
- ultrasonic rhinoplasty: rhinoplasty using a piezoelectric instrument that sculpts the bones without damaging the soft tissue
- open (external) rhinoplasty: rhinoplasty performed using a combination of incisions inside the nose and outside the nose (at the level of the columella)
- closed (endonasal) rhinoplasty: rhinoplasty performed using only incisions inside the nose
- preservation rhinoplasty: rhinoplasty performed to remove a hump, without dissecting the skin on top of the nose, by preserving a maximum of native tissue
- combined: any combination of the techniques above
Dr. Moubayed performs all of the rhinoplasty types listed above.
Which is better, open or closed rhinoplasty?
Open and closed rhinoplasty are types of approaches. The approach needs to be adapted to each patients. In general, the external (or open) approach enables better precision, better control, better visualization, and produces better results. The only difference that the patients notice between the two approaches is a that the external approach leaves a little scar under the nose that generally heals well and is barely visible after a few months.
In Dr. Moubayed’s practice, we practice both closed and open rhinoplasty, and usually use the approach that is the most appropriate for each patient most often to maximize the chances that our patients get the best results.
Comparing open to closed rhinoplasty incisions
Source: Moubayed et al., Facial Plastic and Reconstructive Surgery: Concepts, Questions, Answers, 1st ed.
What are the risks of rhinoplasty?
Like any surgery, a rhinoplasty presents the universal (but minimal) risks of scarring, bleeding (and bruising), infection (superficial or deep), and pain (temporary or permanent).
However, the main risk of any cosmetic surgery is to not be satisfied with the result. After a proper consultation that includes a complete examination and photo simulations, Dr. Moubayed can generally produce the nose desired by the patient. However, we do not control the healing of tissues, and some patients heal in an unpredictable way producing asymmetries or irregularities that can sometimes require touch-ups.
Any rhinoplasty involves the rare risk of producing a perforation in the nasal septum, but this usually does not produce any symptoms. If it is symptomatic, it is amenable to repair with another intervention.
The tip of the nose is numb for a few months after surgery but this generally recovers.
Finally, any nasal surgery has the risk of producing nasal obstruction. Dr. Moubayed uses a modern approach to rhinoplasty that always considers the functional aspects of the nose in order to preserve and improve breathing.
What happens during a consultation for rhinoplasty?
A consultation starts with a complete questionnaire and physical examination. Some patients require an endoscopic exam using a camera the size of a spaghetti to examine your nose from the inside. Photos are taken and simulations are performed in real-time to simulate what is feasible in surgery. This is an essential communication tool as some patients want changes that are not always possible in surgery.
Then, we talk about surgery and recovery, and Dr. Moubayed answers any and all questions you may have.
Multiple consultations are sometimes necessary before deciding to proceed with rhinoplasty. Cosmetic facial surgery is an important decision to make and it is important that you are well informed before proceeding with it.
Before and after photos of rhinoplasty
Please see our rhinoplasty photo gallery for before and after photos below
How long is recovery from rhinoplasty?
Patients leave the surgical center the day of surgery and recover at home with plastic and tape on the nose, small silicone splints inside the nose, and sutures under the nose. All of these are removed 5 to 8 days later, and patients can return to their daily activities. Any residual bruising at this point can be hidden with concealer.
Light physical activity can be resumed after a week, but for more intense activities such as weightlifting, we recommend waiting three weeks to minimize the risk of nosebleeds.
How can I find the best surgeon for a rhinoplasty in Montreal?
When choosing a surgeon for a rhinoplasty, there are multiple factors to consider:
- Rhinoplasty is a highly specialized operation that requires repetition and experience. Does your surgeon do rhinoplasty on a weekly basis?
- Is your surgeon specialized in both cosmetic and functional rhinoplasty, and knows all techniques to preserve and improve your breathing during surgery?
- Does your surgeon perform the latest techniques and technologies such as preservation rhinoplasty and ultrasonic rhinoplasty?
Nothing replaces a consultation to determine if you and your surgeon are a good match. Proceeding with rhinoplasty is an informed decision that should be taken after a thorough discussion and evaluation by a specialist.
Five ways to know if you are a good candidate for rhinoplasty
- Your nose is not in harmony with the rest of your face
- You have realistic expectations
- You are in good health
- Your skin is not too thick
- You might have a breathing problem at the same time