Rhinoplasty is a surgical procedure that modifies the shape of your nose. You may consider rhinoplasty if you want to improve breathing, repair injuries, change the look of the nose, or correct defects.

The nose has an upper portion made of bone, and a lower portion made of cartilage. Rhinoplasties alter the cartilage, bone, and skin of the nose to achieve the desired results. Before your procedure, your surgeon will create a customized care plan for you based on your skin, facial features, and desired outcomes. If you are considering a rhinoplasty, talk with your health insurance provider to know your financial responsibilities and their obligations.

As you research your surgical options, you may come across the term reduction or traditional rhinoplasty. These refer to the method that your surgeon will use to perform your procedure. But what is the difference?

What is Reduction Rhinoplasty?

Reduction rhinoplasty is a surgical method that reshapes and reduces the size of large or disproportionate noses. This procedure is appropriate for young patients, as well as for patients looking to straighten and reposition age-related nasal changes.

Reduction rhinoplasties take roughly 30 to 45 minutes and may involve:

• Minimizing or relocating cartilage.
• Raising and supporting the tip of the nose with cartilage grafts.
• Using grafts to contour and lift the nose.

Your surgeon will use either an open or closed approach during your procedure. In an open approach reduction, your surgeon makes an incision between your nostrils. The open approach gives your surgeon access to the tip of your nose and makes it easier to change or remove cartilage and bone. It leaves a small scar, but it is in an undetectable area and usually fades over time. This approach is favored because it gives surgeons a better view of your nasal anatomy, which allows for greater precision during surgery.

In a closed reduction rhinoplasty, your surgeon makes an incision inside the nostrils, which prevents visible scars or bruising. These incisions provide access to structural cartilage and bone to resize the nose.

Despite the approach, a reduction rhinoplasty will always involve detaching cartilage and bone to make the nose smaller. Your surgeon may cut the bridge of your nose to shave down bumps and irregularities. The bones that connect your nose to your cheeks are sometimes moved to make your nose narrower. Your nostrils may also reshape and reposition your nostrils.

What is Traditional Rhinoplasty?

In a traditional rhinoplasty, your surgeon changes several parts of your nose to create a new, proportional one that fits your face. The main goal of a traditional rhinoplasty is to maintain symmetry.

This procedure can fix deviated septums or minimize nasal filtration structures to ease breathing problems, and rarely involve only modifying one section of your nose. For example, eliminating a bump on the bridge of your nose may cause a different part of your nose to become misaligned.

Traditional rhinoplasties also use open and closed approaches. The open approach requires your surgeon to make an incision along your columella. In the closed approach, this external incision is not necessary.

A traditional rhinoplasty is best for you if you are looking to resize or reshape several areas of the nose.

Preparing for Surgery

Before you can schedule your rhinoplasty, you must speak with your surgeon to talk about the factors that determine whether you are a good candidate for surgery. This consultation typically includes:

• Discussion of your medical history, including whether you have a history of nasal blockages, medications you take, and any surgeries you’ve had. Most importantly, your surgeon will identify why you want a rhinoplasty and what results you are trying to achieve.
• An employee will take photographs of your nose from different angles to generate images of the results that you may achieve. Your surgeon will refer to these photos for before-and-after evaluations, during surgery, and for long-term assessments.
• Your surgeon will perform a physical exam that may include laboratory testing. This exam helps your surgeon evaluate the changes you need based on your facial features, nasal anatomy, skin thickness, and cartilage strength.

You will need a friend or family member to drive you home and stay with you for a few nights post-op. Anesthesia can impair your judgment, slow your reaction time, and cause lapses of memory.

After your surgery, you should rest with your head elevated above your chest to curtail swelling and bleeding. You may be congested from swelling or from the splints that are put in your nose during your procedure. Dressings stay on your nose for one to seven days post-surgery, and the splint is removed after roughly one week.

You may also experience swelling or discoloration on your eyelids for two to three weeks after surgery. Do not use cold packs or ice on your nose for swelling. Instead, try to limit your sodium intake. Most of the swelling will resolve within a year.

Risks and Complications

There are general risks with any major surgery, such as infection, bleeding, and adverse reactions to anesthesia. However, rhinoplasty-specific risks include:

• Long-lasting numbness in and around the nose
• Consistent pain, swelling, or discoloration
• Difficulty breathing
• Uneven results
• Scarring
• Septal perforation

In some cases, there is a need for further procedures to fix any mistakes that develop after your initial surgery heals. You may also end up unsatisfied with your new nose. Talk with your plastic surgeon about how these risks apply to you.