The Seattle Rhinoplasty Center Patient's Complete Guide to Rhinoplasty


Rhinoplasty addresses changing the shape of the nose; the most defining characteristic of the face. When the nose is out of harmony with the rest of the face, patients become self conscious. For that reason, nasal surgery and/or rhinoplasty is performed. It is a very popular procedure in the United States, being third in popularity of cosmetic procedures performed. Rhinoplasty means to change form, shape or function of the nose. It is also referred to as a nose job and is performed for purely cosmetic reasons. It is a surgical procedure that is performed to bring the nose to a more harmonious balance with the rest of the face. A septoplasty is performed to improve a personís functional breathing from the inside of the nose and to improve the airflow dynamics through the nose. A turbinate reduction surgery on the inferior turbinates is also performed internally for breathing. A turbinectomy also improves the airflow through the nose. A Rhinoplasty can be performed together with internal functional breathing procedures. In addition, a broken nose can also be repaired if needed at the same time as a rhinoplasty or septoplasty. Nasal surgery is one of the more complex of all cosmetic procedures because the nose is a 3-dimensional structure that includes bone, cartilage and skin. These components must look symmetrical in a 3-dimensional fashion as well as allow for proper breathing. Making changes in one of these components can affect other elements within the structure of the nose, changing functionality as well as appearance. Following a rhinoplasty surgery, the patientís nose should look very natural and be in balance with the remainder of the face. Most close family members and friends do not recognize the fact that a patient has had a rhinoplasty surgery. They just look better.

There are two different techniques used for nasal surgery. There is open rhinoplasty and closed rhinoplasty. Dr. Portuese performs a closed rhinoplasty where all of the incisions are made inside the nose. This is called an endonasal or closed rhinoplasty. An open rhinoplasty is where the incision is made in the columella and the entire columella and tip is lifted upwards to be able to sculpt and shape the tip. This method takes longer to heal and there is more swelling and bruising associated with the surgery. The columellar incision can also be detected. Dr. Portuese does not perform this technique.

The goal of Rhinoplasty is to reshape and sculpt a new nose that fits harmoniously with the face and fits into the facial balance for each individual patient. Every nose job is different. There is no one perfect nose. There are some limitations to what a rhinoplasty can do for preexisting conditions. The amount of correction that can be achieved with the nose depends on certain characteristics and traits such as thickness and oil content of the skin, underlying structural support system of cartilage, bone, septum and projection of the tip. When looking to perform a rhinoplasty, realistic expectations from the patientís perspective are very important.

The nasal bone growth plates finish growing , usually age 15 for girls and about 17 for boys, and until that point cosmetic surgery should be withheld until the face is fully developed. The septum of the nose continues to affect the growth of the middle portion of the face and maxilla. Any changes to the septum either surgical or through injury, before it reaches maturation, can affect further facial development. In addition, it is also extremely important that at whatever age the rhinoplasty is performed, the patient is in excellent health and has no preexisting medical conditions. It is also very important to follow all pre- and postoperative instructions for a seamless surgery and postoperative recovery. Chronic health problems such as liver, heart, lung or kidney disease may render the patient unsuitable as a surgical candidate for cosmetic surgery. Uncontrolled high blood pressure can cause nose bleeds, diabetes can cause infections, and smoking can cause healing issues.

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