Since the start of the COVID-19 pandemic, many of us are spending more and more time on the computer screen. And seeing our faces on a screen daily has resulted in a renewed interest in facial plastic surgery. This is because facial plastic surgery offers a chance to make notable changes. For instance, a procedure known as rhinoplasty, also known as a nose job, will allow you to permanently alter the size, shape, and/or structure of your nose.
Before you head down this path, however, it is crucial to compile as much information as possible about the procedure, the potential outcomes, and the recovery. Keep reading as we present a patient’s comprehensive guide to rhinoplasty in Beverly Hills.
The First Consideration and Onward
A good place to begin is with a basic understanding of what rhinoplasty is, what it can and cannot do, and who might be a good candidate for this procedure.
What is Rhinoplasty?
When we talk about rhinoplasty, we are talking about a surgical procedure to change the structure of the nose. Keep in mind that your nose is made up of bone, cartilage, and skin, with bone making up the upper part of the nasal structure and cartilage making up the lower half. Depending on your aesthetic goals, rhinoplasty can alter any or all of these components.
During a rhinoplasty consultation, surgical goals are always determined in relation to your whole face. In other words, the goal of any nose job is to bring your nose into greater proportional harmony with the rest of your appearance.
Why Do People Get Nose Jobs?
Most people who choose to get a nose job simply dislike the look of their nose and wish to see a cosmetic change. This may mean they think it is too large, relative to the other facial features. It could also be that they dislike the shape of their nose, perhaps finding it to be too bulbous, or think that the bridge of the nose is too wide. Rhinoplasty may also repair a nose that is upturned or “hooked” at the end or a nose that has a “hump” along the nasal ridge.
In some cases, rhinoplasty may be used to correct problems that have resulted from a traumatic accident. In other instances, a nose job can be used to address a birth defect or correct breathing problems.
Am I a Good Candidate for a Nose Job?
While rhinoplasty can be an excellent solution for some patients, it is not recommended for everyone. The best way to ensure that you are a good candidate for rhinoplasty is to schedule a consultation with a facial plastic surgeon, who will talk with you about your needs and expectations, review your medical history, and provide a brief physical examination. The facial plastic surgeon can then verify whether you are eligible for a safe and successful procedure.
The best candidates for rhinoplasty meet the following criteria:
- They do not have any medical conditions that could prevent them from healing.
- They are not smokers.
- They have taken the time to talk with a facial plastic surgeon and have realistic expectations about their rhinoplasty outcomes, as well as the recovery.
With additional questions about your own eligibility for rhinoplasty, we encourage you to schedule a consultation with a facial plastic surgeon near you.
What are the Risks of Rhinoplasty?
With any surgical intervention, there can be some risks. It is important to be aware of risks and potential complications and to talk with your surgeon if you have specific concerns. Your surgeon will also be able to talk with you about specific steps for mitigating these risks.
The most common rhinoplasty risks are risk of infection, risk of excessive bleeding, and risk of anesthesia side effects.
Additionally, getting a nose job also increases your risk of the following:
- Trouble breathing through your nose
- Numbness around the nose
- Persistent pain, swelling, or bruising
- Issues that require a second surgery to correct
The best way to address these potential complications is to talk them over with your facial plastic surgeon prior to surgery.
The Research Stage
If you are a good candidate for rhinoplasty, the next step in the process is ensuring you select the right facial plastic surgeon and the right kind of surgery.
Selecting the Right Facial Plastic Surgeon
Here are a few tips for choosing the right facial plastic surgeon for your surgery.
Seek Board Certification
Ensure that the surgeons you are considering are board-certified. Surgeons who have this certification have gone through a rigorous screening process and proven that they have the high level of skill and experience necessary to promote patient safety, as well as to ensure optimal results. Note that, in order to become a board-certified facial plastic surgeon, doctors must obtain a lot of extra training and clinical experience. They must also strive to be committed to quality and to patient wellbeing.
Be aware that “cosmetic surgery” is not really a widely recognized or well-defined medical discipline, and cosmetic surgeons may not have anywhere near the level of training or skill possessed by a board-certified facial plastic surgeon.
To ensure your safety as well as the quality of your results, seeking a board-certified facial plastic surgeon is highly recommended.
Study Their Style
After confirming that a particular surgeon is board-certified, spend a little time studying up on their approach to facial plastic surgery. Remember that you are not simply looking for someone who is technically qualified but also someone whose style is aligned with your aesthetic goals and whose demeanor instills you with confidence.
Often, you can learn a lot just by checking before-and-after galleries on the surgeon’s website. Look for a wide variety of results that impress you in their elegance and proportionality. Also, spend some time browsing reviews and testimonials, which give insight from actual patient perspectives.
During your consultation, you can ask to see some additional photos and inquire about the surgeon’s approach to customization. It may also help to ask what kind of imaging or visualization equipment the surgeon uses to help you preview your rhinoplasty results.
Take some notes about the surgeon’s communication style and the friendliness of the office staff. You should always select a surgeon who you feel comfortable with and who instills confidence in their surgical ability. If you simply do not connect with a surgeon’s personality, that is reason enough to continue your search elsewhere.
Seek Someone Honest
As you look for a qualified facial plastic surgeon, be on the lookout for someone who will speak with you honestly.
The best surgeons do not overpromise, claim to work miracles or build unreasonable expectations about your rhinoplasty results.
Instead, a good facial plastic surgeon will help you develop realistic expectations both for your outcome and for the recovery, specifically allowing you to envision a new nose that is in greater harmony with your other facial features.
Choosing Your Surgery
There are two types of rhinoplasty surgery available: Closed rhinoplasty versus open rhinoplasty. And, for those who want to change the appearance of their nose but do not have the time or inclination for surgical intervention, there is a kind of non-surgical rhinoplasty available. (This is also known as liquid rhinoplasty.)
Naturally, this is something you will want to discuss with your facial plastic surgeon, who will consider your needs and goals and recommend the type of procedure best suited for meeting them.
Open rhinoplasty is a rhinoplasty procedure performed by making an incision in the columella, which is the soft tissue between the two nostrils. This incision allows your surgeon easy access to the underlying bone and cartilage structures.
A closed rhinoplasty is made with all necessary incisions inside the nostrils, completely hidden away. Without any external incisions required, this is generally considered to be the less invasive of the two surgical rhinoplasty options.
What About Liquid Rhinoplasty?
What about patients who wish to receive some of the benefits of a nose job but do not necessarily want to go under the knife for a surgical procedure? For these patients, the best option may be liquid rhinoplasty. This non-surgical treatment uses dermal fillers, which are injected into the nose to improve its shape and its contouring. A liquid rhinoplasty can help correct issues such as a drooping tip, asymmetry, or small bumps (dorsal humps) in the nose.
Some advantages to choosing liquid rhinoplasty include:
- The process is extremely quick, often taking as little as 15 minutes. (A surgical rhinoplasty procedure will take at least one full hour, potentially up to four.)
- Results are fairly immediate.
- There is very minimal recovery time; most patients feel ready to return to work on the same day they have their procedure.
- There is no anesthesia required for this non-invasive procedure.
It is worth noting that there are some minimal risks, including a risk of damage to your eyes (because the arteries at the end of the nose are connected to the eyes). Also, the results of liquid rhinoplasty are temporary, which means that if you like your results, you will need to receive regular maintenance procedures.
While liquid rhinoplasty is not a lasting or long-term solution, it may be something to consider or to ask your facial plastic surgeon about.
Once you have selected a facial plastic surgeon and gathered some basic information about the types of rhinoplasty that are available, you will be ready to schedule a one-on-one consultation.
During this appointment, you will sit down with your facial plastic surgeon to discuss your aesthetic needs and goals. Your surgeon will explain some of the options available to you in greater detail and answer any questions you might have. This is a great time to clear up any concerns you might have about your surgical results, potential complications, or post-operative recovery.
The consultation will also provide your surgeon with a chance to conduct a quick physical evaluation, ask you about your medical history, and verify that you are a good candidate for a safe and successful procedure.
Feel free to ask your facial plastic surgeon any questions you may have about the rhinoplasty process. Here are a few example topics that you might wish to discuss:
- Your facial plastic surgeon’s revision policy. A skilled surgeon is highly likely to produce outstanding results, leaving you satisfied with the outcome of your rhinoplasty. There are occasionally some scenarios in which the patient is not wholly satisfied. Some facial plastic surgeons will have “revision” policies, which outline the basic expectations for any follow-up surgeries. It is always helpful to know what your options are should you emerge from your nose job and not feel satisfied with the results.
- The specific type of rhinoplasty technique. Use the consultation as a chance to talk with your facial plastic surgeon about whether an open or closed rhinoplasty is recommended. Do not hesitate to ask your surgeon for a full explanation of why they would favor one technique over the other.
- Your expectations. One of the most critical parts of the rhinoplasty process is ensuring that you and your surgeon are on the same page about the desired outcome. Be very clear and candid about the results you hope to see, but also open to your surgeon’s guidance, especially if they believe your expectations are not totally realistic. Also, ask your facial plastic surgeon what they can do to help you visualize your results, as many surgeons will have technology that allows them to show you roughly what you might expect at the end of your nose job.
- Recovery from rhinoplasty. Use the consultation to ask your surgeon what you should expect from the recovery period: How long will it take in order for you to see results? How many days will you need to request off from school or work? What will be your pain management options? And what steps can you take to ensure a smooth and expedient recovery?
- Cost. Getting a nose job is a major decision, not just medically but also financially. Before you commit to the procedure, it is always wise to double-check that you know how much it is going to cost and what kinds of financing options are available to you.
Costs and Affordability
How much does a nose job cost, and what are some of the factors that can cause the rhinoplasty cost to fluctuate?
How Much Does Rhinoplasty Cost?
The specific cost of rhinoplasty can vary from patient to patient, from provider to provider, and even from state to state. The best way to determine cost is always to ask for a personalized estimate from your facial plastic surgeon.
For patients seeking a baseline number, the American Society of Plastic Surgery estimates that, in 2019, the average cost of rhinoplasty was $5,409.
Note that this number reflects the surgeon’s fee but may not encompass other necessary expenditures, such as anesthesia, operating room cost, etc.
Will Insurance Cover the Cost of Rhinoplasty?
If you have rhinoplasty done to correct a breathing issue, and if that breathing issue has a clear medical diagnosis (such as an obstructed airway), then having the surgery may be considered a clinical necessity. In these cases, the reconstructive procedure may be covered by your insurance company.
Elective rhinoplasty procedures, wherein the goal is purely aesthetic, will almost certainly not be covered by your insurance company.
Further Considerations About Nose Job Affordability
Remember that if you choose a non-certified surgeon, you are selecting a surgeon with much less training and experience and little accountability. You will face more serious risks to your safety or simply more serious risks of the procedure not turning out well. It is always better to go with a board-certified facial plastic surgeon, even if that means a higher price point.
As for ways to make your rhinoplasty more affordable, always ask your surgeon about the financing options they provide. Most plastic surgery practices will offer plenty of flexibility, ensuring their services are as widely accessible as possible.
Prepping for the Procedure
In the weeks leading up to your rhinoplasty procedure, it is important to prepare your body for the changes that will occur. The following guidelines will help ensure a smooth and fast recovery.
Your plastic surgeon will provide you with a personalized set of instructions. Though, here are some guidelines to abide by as you try to prepare yourself for a nose job.
- Make some adjustments to your diet. One of the most common side effects of anesthesia is constipation, something you can mediate by upping your intake of fibrous foods. Also, make sure you have plenty of iron and vitamin C in your diet, both of which can promote healing. Finally, it is always wise to abstain from alcohol for at least a week before major surgery.
- Gather supplies. When you are recovering from surgery, the last thing you will want to do is run errands. Stock up in advance on all the supplies you will need, including over-the-counter pain medications, cold compresses, and grocery items. (We recommend having some “soft” food items on hand, at least for the first couple of days after your procedure.) Your facial plastic surgeon will prescribe both an antibiotic and a painkiller; make sure to fill those prescriptions before the surgery.
- Recruit a helper. You will need someone to wait for you during your procedure and to drive you home when it is over. We would also recommend having a spouse, partner, sibling, parent, or close friend who can stay with you for the first 48 hours or so. This helper will be able to assist you with tasks around the house and provide aid should you have an unexpected reaction or side effect.
- Get ready for surgery. Your facial plastic surgeon will likely recommend that you fast for at least eight hours before your procedure. Try to get a good night’s sleep before the procedure, and before you arrive for surgery, take the time to wash your face. Do not apply any makeup.
- Be careful with medication and supplements. Steer clear of aspirin, NSAIDs, vitamin E supplements, and herbal medications for at least two weeks before surgery. These medications can cause bleeding and may impede your healing process.
- Abstain from smoking. Tobacco products of all kinds should be avoided as they impede healing. We encourage patients to stop using tobacco products for at least a month before their surgery and then remain smoke-free throughout their recovery period.
With any specific questions about how to prepare for a nose job, we invite you to talk directly with your facial plastic surgeon.
When your procedure day approaches, you are inevitably going to feel a mixture of excitement and anxiety. This is all perfectly normal. Your excitement stems from the prospect of a more balanced and proportional facial appearance and potentially a new sense of self-confidence. Your anxiety may stem from uncertainty over the final result, trepidation about the recovery process, or some combination of the two.
The most important thing to keep in mind is that you will not see the full results of your nose job for a few weeks. There will be some swelling and bruising following your procedure, making it hard to get a real sense of the outcome. Additionally, your body will require plenty of rest following the surgery, and it will be a while before you can once again do vigorous exercise or lift heavy objects. These factors may cause some frustration or even disappointment but hang in there and be patient with yourself! Patients who get rhinoplasty tend to be elated once they see the results and usually say the whole process was more than worthwhile.
Tips for the Day of Your Procedure
In the meantime, there are a few steps you can follow to ensure a smooth experience on the day of your surgery. Here is what we recommend:
- Arrive at the surgical facility on time.
- Bring any paperwork your facial plastic surgeon instructs you to bring.
- Make sure you have someone with you to drive you home once the procedure is over.
- Wear comfortable clothing that does not need to be pulled over the head.
- Do not wear jewelry or bring any valuables to the surgery.
- Do not take any medications or supplements unless your doctor gives their permission.
What to Expect
Once you are checked in at the surgical center, a nurse will start a line of IV sedation. This ensures that you do not experience any pain or discomfort during the surgery itself, and it also helps you avoid any triggering or traumatizing memories of your surgery. You may also receive nitrous gas to help mediate any anxiety you feel leading up to the procedure.
The procedure itself can take anywhere from one to several hours, depending on the type of rhinoplasty and the scope of work your surgeon is performing. Once your surgery is complete, you will be taken to the recovery room for further monitoring. Around this time, your surgeon will head out into the waiting area to talk with any family members or friends who are there with you, simply reassuring them that the procedure went well.
In the recovery room, a nurse will monitor you and keep an eye on your vital signs. Rhinoplasty is an outpatient procedure, and you should be cleared to head home as soon as the anesthesia has fully worn off. (This may take a couple of hours.)
Recovery from Rhinoplasty
Once you are safely back home, you will need to allow your body plenty of time to rest and recover. Here is a brief guide, letting you know what you can expect from the recovery process.
What Side Effects Can I Expect During Recovery?
During your recovery, you can anticipate some swelling and bruising around your nose, upper lips, cheeks, and around your eyes. These side effects will gradually fade away and should be mostly gone within seven to 10 days. In the meantime, you can use ice packs to help keep the swelling under control.
You will also have a little blood discharging from the nose. This is normal, and your surgeon will provide you with a “moustache” bandage to help catch the drip. The bleeding should fade within two or three days, and when it does, you are free to stop using the moustache bandage.
Most patients will have a little bit of discomfort over the first week. Generally, patients say that the worst of their pain is over within 48 hours. You may use prescription or over-the-counter medications to manage your discomfort, as directed by your facial plastic surgeon.
What About Breathing?
Due to the swelling, you will likely be unable to breathe through your nose. Most patients regain their ability to breathe through the nose within a week’s time, and in some cases, it may take just two or three days. In the meantime, apply Chapstick to dry lips in order to mediate any discomfort due to mouth breathing.
Am I Allowed to Blow My Nose?
Your facial plastic surgeon will strongly advise you to avoid blowing your nose for at least a week, preferably closer to three. Blowing your nose so soon after getting a nose job may irritate the incision site, cause bleeding, or otherwise impede your healing. During this season, be careful to wash your hands often to minimize your risk of catching a cold.
What Can I Eat Following Rhinoplasty?
As you recover from your surgery and from the effects of the anesthesia, there are certain dietary restrictions to keep in mind. Try to keep your diet light and cool, with a focus on soft foods and liquids. Steer clear of hot or spicy foods for at least a couple of days.
Immediately after surgery, you may not feel like eating much; in fact, the anesthesia may make you feel nauseous at the very thought of food. It is okay to go slow on eating for the first couple of days, gradually working your way back up to a normal diet.
How Much PTO Should I Request?
Different people recover at varied rates, but generally speaking, patients feel ready to return to school or work about a week after their surgery. However, if you have a job that requires you to do heavy lifting, you may want to take even more time off.
When Can I Resume Working Out?
Following your procedure, it is critically important to rest as much as you can and to avoid vigorous exercise or heavy lifting. Your facial plastic surgeon will advise you on when you may return to your normal workout, but for most patients, it will be three to four weeks.
Is it OK to Wear Glasses?
You will want to avoid wearing any kind of glasses (including reading glasses and sunglasses). Anything that puts pressure on your nose can ultimately contribute to further swelling or bruising. Switch to contacts if possible, or opt for the lightest possible frames otherwise. Your facial plastic surgeon will let you know when you can wear glasses as normal again.
When Can I Remove the Bandaging?
Most rhinoplasty patients have a splint to hold the nose steady and secure. We recommend keeping it in for about a week unless your surgeon recommends otherwise. Once this splint is removed, you can go out in public without it being obvious that you are recovering from surgery (unless you have major bruising around the eyes).
Additional Tips for Rhinoplasty Recovery
Here are a few additional guidelines for patients to keep in mind as they prepare for an expedient rhinoplasty recovery.
- Sleep with your head elevated. Sleeping flat on your back can be a bad idea, both because it makes breathing more challenging and because it can cause bleeding. We recommend sleeping with your head elevated; use two or three pillows to achieve the elevation you need.
- Remember, you will likely be constipated. Constipation is a common side effect of anesthesia. Try to avoid straining to go to the bathroom, and if you have trouble, use laxatives or stool softeners.
- Take your antibiotics. Your surgeon will prescribe an antibiotic. Take your antibiotic until it runs out. Remember that this is one of the most important ways you can minimize your risk of infection.
- Use steam to help you breathe. Steaming showers can really help clear the airways and get you back to nose-breathing more quickly.
Remember that you are not going to have a clear sense of your rhinoplasty results right away. It may take a full year for the results to truly be “set” before you can get a good look at your new, beautifully proportioned appearance. With that said, you will have a noticeably clear sense of your results within a month or so, as the swelling and bruising subside.
Find Out More About Rhinoplasty in Beverly Hills
If you are considering rhinoplasty, start with finding the most qualified and trustworthy facial plastic surgeon in your area.
If you are local to Beverly Hills, we welcome you to contact Eos Rejuvenation. Dr. Nima Shemirani will provide a one-on-one consultation where you can discuss whether rhinoplasty is right for you. To schedule your appointment, contact our practice at your next convenience.