Nose Surgery in San Diego
Rhinoplasty is the most commonly performed procedure in facial plastic surgery. The name is a blend of the word rhino (nose) and plasty (to shape). Rhinoplasty is also often referred to as a “nose job”. The goal of rhinoplasty is to create and/or re-shape a nose that looks and feels natural. Rhinoplasty by Dr. Kearney in San Diego and La Jolla, CA, can be performed to meet aesthetic goals or for reconstructive purposes to correct defects or breathing problems.
The History of Rhinoplasty
Rhinoplasty was first developed by Sushruta, an important physician, who lived in ancient India circa 500 BC. He and his later students and disciples performed rhinoplasty to reconstruct noses that were amputated as punishment for crimes. He developed the techniques of forehead flap rhinoplasty which is practiced almost unchanged to this day. This knowledge of plastic surgery existed in India way back in the late 18 century. The first intranasal Rhinoplasty in the West was performed by John Orlando Roe in 1887. In 1898 Jacques Joshep used it for cosmetic purposes to help those who felt that the shape or size of their nose caused them embarrassment and social discomfort.
Video: Dr. Kearney Discusses Rhinoplasty
Why should I get a nose job?
Many features which are not desirable in a nose may be improved through cosmetic surgery. Noses may be made narrower, straighter, longer or shorter. Humps may be removed and the shape, size and angle and definition of the tip of the nose may be altered. Breathing problems caused by a deviated septum may be corrected. Rhinoplasty may be performed at any time after facial growth has been completed roughly ages 15-16 for women and ages 16-17 for men. The ideal outcome in Rhinoplasty is a natural appearing nose with a balance of the rest of the face.
Who is a good candidate for rhinoplasty?
Dr. Kearney’s patients come to him with many reasons for wanting to change their nose with this delicate surgery. Their reasons fall into three categories:
- Appearance — Not liking your nose can really impact your self-confidence. That’s why aesthetics are the reason for most nose surgeries. There are many issues a person can have with his or her nose; these are the most common:
- The nose is out of proportion with the rest of the face
- The tip droops
- The tip is enlarged or bulbous
- There is a bump or depressions on the bridge of the nose
- The sidewalls are depressed
- The nostrils are excessively flared
- The nose is crooked or off-center
- Injury — From getting smacked by a surfboard to bumping into a wall in the dark, impact on your nose can leave it permanently crooked or misshapen.
- Function — Restricted or blocked nasal passages can impact your sleep and your quality of life. Nose surgery can open restricted nasal passages and improve your breathing.
Patients must have finished their facial growth to have nose surgery. For girls (who mature a little faster than boys), this will be at age 14 or 15 at the earliest. For boys, the minimum age is 15.
Dr. Kearney stresses with his patients that they need to want nose surgery for their own personal reasons. This shouldn’t be done for another person or a partner. And it’s important to be realistic about what this surgery can and cannot do.
What is the difference the open and closed methods of rhinoplasty?
In open rhinoplasty, Dr. Kearney makes an incision across the columella, the sliver of tissue between your nostrils. The soft tissue is then lifted upward and off the bone and cartilage. The open method completely exposes the underlying structure, making more dramatic modifications possible. Once the bone or cartilage has been reshaped, the soft tissue is then brought back down.
In closed rhinoplasty, Dr. Kearney makes all of the necessary incisions inside the nose. Obviously, this makes no visible scarring, but it also can limit the extent of reshaping that can be done. If the patient seeks to build up an area of the nose, Dr. Kearney can take cartilage or other material from the septum, the ears, a rib, or synthetic implants can be used. When the patient seeks to shrink the size of the nose, the nasal bones must be broken.
Surgery is usually performed under general anesthesia.
- Incisions are sometimes made inside the nostrils and tiny incisions are also made on the columella, the bit of skin that separates the nostrils.
- The surgeon first separates soft tissues of the nose from the underlying structure, then reshapes the cartilage and bone which causes the deformity.
- In some cases, the surgeon may shape a small piece of the patient’s own cartilage or bone to strengthen or increase the structure of the nose. This is done for cosmetic reasons or to improve breathing and function of the nose.
- In rarer cases, a synthetic implant may be used to reconstruct the nose if the normal structure of the bone and cartilage is badly damaged or weakened. Plastic synthetic implants are often used but cartilage from the septum, ear or rib may also be used.
Can I combine rhinoplasty with other procedures?
Rhinoplasty can be combined with both surgical and non-surgical procedures. Although it will make for a more involved recovery, you could opt for Dr. Kearney to perform a facelift, eyelid surgery, or brow lift in conjunction with your nose surgery. It’s not a time for Botox, as it involves the upper third of the face and there may be some swelling around your eyes. But dermal fillers used down around the mouth area are also an excellent complement.
Nose Surgery Risks
When performed by a qualified plastic surgeon complications are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including:
- Reaction to the anesthesia
You can reduce your risks by closely following your surgeon’s instructions both before and after surgery.
When can I expect to see the full results of my rhinoplasty?
You’ll have to have some patience when recovering from nose surgery with Dr. Kearney. Swelling can linger, and can return later in the day or at night for weeks. It can take up to six full months for a patient to fully realize their new nose, although this schedule varies dramatically with individual patient’s healing rates. But your patience will be rewarded — rhinoplasty is a very satisfying procedure, as patients who have always had issues with features of their nose feel as if their whole facial appearance has improved with their new nose.
Will I have bruising under my eyes after rhinoplasty?
Bruising is pretty much guaranteed after nose surgery because of the tissue trauma. This will be the case whether Dr. Kearney uses an open or closed approach. Your bruising will be the worst from three to seven days after your surgery. It will start as deep purple color and will transition to a brownish orange before fully clearing. It’s likely that some of your bruising may track down and discolor your cheeks. Some of this depends on the extent of changes made with your nose. If Dr. Kearney only worked on the septum and/or the nasal tip, there will be only minimal bruising, if any. Still, heading into this procedure, it’s best to expect bruising.
Nose Job Recovery & Follow-Up
After surgery-particularly during the first twenty-four hours-your face will feel puffy, your nose may ache, and you may have a dull headache. You can control any discomfort with the pain medication prescribed by your surgeon. Plan on staying in bed with your head elevated (except for going to the bathroom) for the first day.
You may go home with a tape or splint on your nose which will usually be removed within a week. You’ll notice that the swelling and bruising around your eyes will increase at first, reaching a peak after two or three days. Applying cold compresses will reduce this swelling and make you feel a bit better. Most of the swelling and bruising should disappear within one to two weeks or so. (Some subtle swelling-unnoticeable to anyone but you and your surgeon will remain for several months.)
How much does a rhinoplasty cost?
The cost of this procedure varies per case. It usually ranges from $6,400 – $11,500.
Is rhinoplasty covered by insurance?
If your nose surgery, whether rhinoplasty or septoplasty (to adjust the septum, the wall inside your nose that divides the nasal passages into a right and left side), is primarily intended to correct issues with function, then insurance is likely to cover the procedure. Of course, some cosmetic adjustments can be made at the same time as structural improvements. If your reasons for this surgery are strictly cosmetic, insurance will not cover it.