Nasal Surgery (Rhinoplasty)

The nose is the center and perhaps the most defining feature of the face. If you like your nose, you will feel self-confident. If you dislike your nose, you will feel as though everyone notices and judges it. Nasal surgery (Rhinoplasty) is one of the most common elective surgeries performed today, and it can have a dramatic effect on your appearance and self-confidence, as well as your breathing.

Nose surgery can correct or enhance a number of different types of issues, such as:

  • A bump or hump on the nose
  • A flat nasal bridge
  • A bulbous and/or flat nasal tip
  • A long or wide nose
  • A hooked nose
  • An asymmetrical or crooked nose
  • Indentations on the nose
  • Large nostrils
  • Breathing problems such as a deviated septum

If you have a nasal obstruction like a deviated septum or enlarged turbinates, these can be corrected simultaneously while your nose is improved cosmetically. If you have a deviated septum, for example, and cartilage is needed to fix an esthetic problem with your nose, it’s easy to use some of the cartilage from the septum in one procedure.

At the Center for Facial and Body Rejuvenation, our board-certified facial plastic surgeons approach every nose surgery individually. They are also both trained and board-certified in Otolaryngology (ENT)-Head and Neck Surgery and Facial Plastic and Reconstructive Surgery. They spend time with you to understand what you dislike about your nose, as well as the source and cause of any nasal structural issues, and they examine you carefully to determine the best surgical plan to create a more pleasing, functional nose.

Some things to keep in mind when determining how you want your nose to look include: (1) Taking into consideration the proportion of your nose with your other facial features. The proportion between your nose and chin is especially important. (2) Bearing in mind that while you might like your friend’s nose or the nose of a celebrity, that nose will not look the same on your face.

We also take into account the differences between male and female noses. In addition, different ethnicities have different features, so rhinoplasty is tailored to conform to your ethnicity.

We have performed numerous successful nose reshaping surgeries for patients in the greater San Francisco Bay area. With two board-certified facial plastic surgeons in our office, you have the option to receive a second opinion within the same office.

While rhinoplasty is a cosmetic procedure for the majority of patients, if you have a breathing problem, a portion of your surgery might be considered medically necessary. In that case, some insurance carriers may cover part of the cost of the procedure.

Some patients decide to have a facelift, chin augmentation, cheek augmentation, forehead lift, or eyelid surgery at the same time as their rhinoplasty for a more comprehensive rejuvenation of the face.

Your Nasal Surgery Procedure

If we determine that you have a deviated septum, we may correct this condition during your nasal surgery. If you have a complex breathing problem, the non-cosmetic portion of your surgery can be performed at the same time as the correction of your aesthetic concerns.

Rhinoplasty can be done under local anesthesia if your surgery does not require repositioning bones. If the procedure involves breaking bones, then you will be given the option of general anesthesia. If local anesthesia is suggested, you will be sleepy, but you will be comfortable. Most people have little recollection of their surgery after the anesthesia wears off.

There are two main rhinoplasty techniques – open and closed. Closed nasal surgery does not require an external incision, but is a technique utilized for refining the nose. The surgeon does his or her work through the nostrils only. The external or open rhinoplasty involves a small incision across the tissue between the nostrils (the columella). The scar is small and hidden underneath the nose. This approach is utilized if more extensive nasal surgery is involved.

We use closed nasal surgery when possible, but some cases may require the open technique in order to provide you with the best result.

If you have a bump on the bridge of the nose or a crooked bridge, the bone may have to be shaved in order to create a straight, smooth bridge, or the bones may need to be repositioned to achieve an aesthetically pleasing appearance. If your nose is too wide, the nostrils must be reshaped. If your nose is too long or hooked, the internal cartilaginous structures would need to be repositioned.

In some cases, cartilage is taken from one part of the nose or ear, sculpted to a desired shape, and then grafted to the internal skeleton of the nose. There is much artistic judgment utilized in crafting a nose to blend in with your facial features.

During your pre-operative consultation, Dr. Cheng will help you decide which rhinoplasty technique is best for your aesthetic goals.

Recovering from Rhinoplasty

A few hours after your surgery, you can go home in the care of a friend or relative. You will not be able to drive right away.

For 2 weeks, bruising and swelling is common. It will take many months and even up to one year for your nasal tissues to mature and reveal their final shape. But it’s important to realize that within a short time (1-2 weeks), the swelling will not be as noticeable, and you can reappear in public. You can take pain medication, and we recommend sleeping upright for a few nights to minimize the swelling.

Splints on the outside of the nose, and sometimes the inside, will support the new structure for about a week during the healing process. Packing of the nostrils is not usually necessary, but some patients might need it for a few days.

Some minor bleeding from the nostrils is normal for the first week. It is important to avoid rubbing or blowing your nose for seven to ten days. You should be able to wear eyeglasses after a few days to a week, but Dr. Cheng will give you specific instructions depending on your specific surgery.

Most people take 10 days off from work (or school) after rhinoplasty. Slow walking is usually resumed a few days after the procedure, but contact sports will need to be avoided for up to 6 weeks if your bones have been repositioned.

We will remove your sutures in about a week. We will also see you for post-operative examinations to make sure that you are healing well.

Schedule a consultation

At the Center for Facial and Body Rejuvenation, our board-certified facial plastic surgeons approach every nose surgery individually.

Schedule My Consultation