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Rhinoplasty

Nose surgery, or rhinoplasty, is designed to improve the shape, size, and overall appearance of the nose with the goal of achieving enhanced facial balance. Rhinoplasty is one of the most difficult surgical procedures to perform. The delicate framework of the nose must be manipulated in a manner that not only produces immediate results, but a final outcome that will endure for the patient’s lifetime. Our board-certified facial plastic surgeons, J. David Kriet, MD and Clinton D. Humphrey, MD, excel in rhinoplasty and perform the highest volume of rhinoplasty surgeries in the Kansas City area. From primary rhinoplasties to complex secondary or revision rhinoplasty procedures, our surgeons have the advanced skill and expertise to achieve outstanding results for patients seeking cosmetic and/or functional enhancement of their nose.

What Concerns Can Rhinoplasty Address?

Rhinoplasty can accomplish the following improvements to the size, shape, and function of the nose:

  • Refine the nasal tip
  • Revise the size or shape of the nostrils
  • Change the angle of the nose
  • Straighten or narrow the bridge
  • Smooth a hump or dip
  • Enhance definition and structure
  • Improve breathing

By modifying the nasal shape and proportions, rhinoplasty can bring the nose into harmony with other facial features. Desired changes are often subtle, but many patients remark that their self-confidence and poise are dramatically improved after rhinoplasty surgery. While many rhinoplasty surgeries are performed for cosmetic purposes, rhinoplasty can also correct functional breathing problems and deformities created by previous nasal fractures and/or genetics.

What Can I Expect During a Rhinoplasty Consultation?

For those considering rhinoplasty, we recommend scheduling a consultation with either Dr. Kriet or Dr. Humphrey. During the appointment, your surgeon will complete a thorough physical examination, discuss your medical history, and evaluate your nose. You and your surgeon can identify your areas of concern and the results you would like to achieve with rhinoplasty. If your surgeon determines that you are a good candidate for rhinoplasty, he will begin formulating a customized surgical plan for creating the appearance you desire.

How is the Rhinoplasty Procedure Performed?

Rhinoplasty surgery is performed on an outpatient basis, and patients are typically under general anesthesia during the procedure. Depending on the work being performed, rhinoplasty surgery is sometimes conducted through incisions hidden completely inside the nose (called endonasal, or closed rhinoplasty). More often, internal incisions are combined with a small, well-camouflaged external incision on the columella (the skin that separates the nostrils). The skin is then freed from the nasal framework, allowing your surgeon to sculpt the underlying cartilage and bone into the desired shape (called external, or open rhinoplasty). Once reshaping is complete, the incisions are closed with fine sutures. Rhinoplasty can take between one to three hours based on the complexity of the procedure.

Open Rhinoplasty vs. Closed Rhinoplasty

There are generally two techniques to perform rhinoplasty, with each approach having its own distinct advantages depending on the desired alterations. During open rhinoplasty, incisions are placed within the natural crease of the columella on the undersurface of the nose. This location typically offers maximal visibility of the underlying nasal framework, giving our surgeons a great degree of control when recontouring the nose. For this reason, open rhinoplasty is often effective for revisionary surgery or procedures requiring very meticulous modifications. Closed rhinoplasty utilizes internal incisions, which provide the access point for Drs. Kriet or Humphrey to manipulate the various nasal structures and attain the desired aesthetic. While the closed approach can allow the benefit of minimal visible scarring, this technique is only appropriate in a select number of rhinoplasty cases.

At your consultation, our facial plastic surgeons will explain the different ways of performing rhinoplasty and you will learn which method is the most ideal for your anatomy and cosmetic goals.

Rhinoplasty Alternatives

Revision Rhinoplasty

If a prior rhinoplasty failed to fulfill your goals for nasal surgery or you were simply dissatisfied from the outcome of a prior rhinoplasty, Dr. Kriet and Dr. Humphrey have the specialized facial plastic surgery experience necessary to perform a revisionary procedure according to your original aesthetic desires.

Revision rhinoplasty is an intricate procedure that requires an advanced level of expertise to address the cosmetic or functional issues that may not have been resolved with the initial surgery. As the bones and cartilage have already been operated on, secondary rhinoplasty must be performed with the utmost precision and care, making selection of a skilled revision rhinoplasty surgeon essential. Our facial plastic surgeons will work with you to gain a comprehensive understanding of your cosmetic goals and form a treatment plan to address the concerns that may not have been corrected, or that were exacerbated, by your primary nose surgery. In addition to addressing lingering cosmetic or functional issues, secondary rhinoplasty can also be utilized to treat damage from a nasal injury that was sustained after nose surgery.

Nasal Reconstruction

If the trauma suffered from an injury or accident is extensive, a nasal reconstruction procedure may be a more appropriate treatment for your needs. Nasal reconstruction typically differs from rhinoplasty and revision rhinoplasty because of the extent of facial trauma experienced—in many cases, the procedure is recommended after undergoing cancer removal surgery or a major injury. Nasal reconstruction can correct breathing problems and improve nasal function, as well as repair more complex damage to the framework of the nose. This may involve techniques like skin or cartilage grafting, or facial scar revision. Each patient’s surgical plan will be developed based on the most optimal approach to address their injuries and unique needs.

Septoplasty

Septoplasty is a variation of nose surgery specifically designed to straighten the septum, which is the strip of bone and cartilage that separates the nostrils. When the septum is misaligned or deviated, some patients may experience obstructed breathing and restricted airflow. Septoplasty is performed to repair the septum, remove blockages, and allow patients to breathe easier. This can be completed at the same time as cosmetic rhinoplasty if desired, or be pursued as a standalone procedure.

What is Recovery From Rhinoplasty Like?

After surgery, a protective splint is applied to the nose and remains in place for one week. Bruising and swelling around the nose and eyes is very common and usually improves over the first couple of weeks of recovery. Some patients may experience minor swelling that can persist for up to a year, depending on their skin type. Discomfort is generally quite mild and readily treated with medication. Within about a week after surgery, the surgeon will remove stitches and the protective splint. Most patients return to work within five to seven days.

Rhinoplasty Results

Dr. Kriet and Dr. Humphrey have helped many rhinoplasty patients attain the nose shape and profile they have always wanted. Our surgeons’ training and experience in reconstructive facial plastic surgery has also allowed them to successfully restore proper breathing and nasal function for patients suffering from structural abnormalities and/or traumatic nasal injuries. If you are considering rhinoplasty, our facial plastic surgeons have the specialized skill and expertise to help you achieve optimal results from your procedure.

How Long Does Rhinoplasty Last?

Rhinoplasty from our board-certified facial plastic surgeons can achieve results that last a lifetime. The internal nasal framework is permanently recontoured, and the outcome should continue to improve as swelling subsides. It may take up to one year for the nose to look fully refined. While results from nose surgery can be very enduring, selecting a qualified facial plastic surgeon to perform your rhinoplasty is essential to enjoying long-lasting results. In general, those who specialize in facial procedures are able to provide the highest standards of safety and care, minimizing the potential need for a revision rhinoplasty.

How Much Does Rhinoplasty Cost?

Depending upon the qualifications of the facial plastic surgeon as well as the customized treatment plan, the cost of rhinoplasty will vary. On average the cost of a rhinoplasty ranges between $6,500 and $8,500. However, there are a number of variables that can influence this price and impact the final cost. Factors that commonly affect the price of the procedure include the complexity of the changes desired, whether or not cartilage grafting is needed, and if the patient has previously undergone rhinoplasty. Fees for the facial plastic surgeon, the anesthesiologist, and the surgical facility will also be included. At the end of your preliminary consultation, Dr. Kriet or Dr. Humphrey will be able to provide you with a personalized quote based upon your unique needs and goals.

Will I Have a Scar After Rhinoplasty?

While every surgical procedure typically leaves some type of scar, rhinoplasty offers the benefit of little to no visible scarring. This is possible due to the strategic incision placement from our facial plastic surgeons, yielding virtually undetectable post-surgical scars. Depending on which rhinoplasty procedure (open vs. closed) is best for your cosmetic goals, the nasal framework will be accessed either through an incision made internally, or on the undersurface of the nose. The internal incision for closed rhinoplasty is not visible to outside observers and the open incision is placed along the base of the columella, typically blending into the natural crease.

Can I Get a Rhinoplasty Without Surgery?

In some cases, the appearance of the nose can be refined using non-surgical dermal fillers, such as those found in the JUVÉDERM® and Restylane® product lines. The use of hyaluronic acid-based dermal fillers to adjust the shape of the nose is often referred to as a “liquid rhinoplasty,” a minimally invasive alternative to nose surgery that can allow patients to achieve temporary enhancement without anesthesia or downtime. Utilizing these volumizing, the nasal bridge can be straightened, bumps and depressions can be smoothed, and the nasal proportions subtly refined.

While a liquid rhinoplasty can be effective for special occasions or other temporary engagements, the treatment is limited in the scope of what it can achieve. Fillers typically cannot address concerns about the angle of the nasal tip or adjust the dimensions of the nostrils. Furthermore, non-surgical treatment is not capable of correcting breathing problems or a deviated septum. In general, the non-surgical technique does not achieve the same quality of results as a surgical rhinoplasty; however, dermal fillers may be able to provide some degree of aesthetic improvement, depending on your concerns.

Choosing a Top Rhinoplasty Surgeon

There are several ways you can research a prospective plastic surgeon’s credentials to determine whether they are the right person to achieve your unique cosmetic goals. The following tips can help you attain a thorough understanding of a plastic surgeon’s training before your initial consultation:

  • Enlist a facial plastic surgeon. You can tell the difference between a cosmetic surgeon who simply offers facial procedures and a facial plastic surgeon by checking whether they are certified by the American Board of Facial Plastic and Reconstructive Surgery.
  • Learn about their educational background and fellowships. Individuals who have completed a facial plastic surgery fellowship have specialized training that not all physicians undergo.
  • See before-and-after photos. A facial plastic surgeon’s patient gallery can be an excellent indication of their work, as well as the types of results that are possible with rhinoplasty.
  • Check whether they have any professional affiliations. Those who belong to local or national organizations, such as the American Board of Otolaryngology and the American Academy of Facial Plastic and Reconstructive Surgery, are typically well-versed in evolving plastic surgery techniques and technology.

Dr. Kriet and Dr. Humphrey would be happy to evaluate your concerns and discuss the best approaches to attain the desired shape, size, and contour of your nose. Please call our office at (913) 871-9785 to schedule a consultation. Our plastic surgeons also offer virtual consultations for patients who would rather attend their appointment from the comfort of their own homes.

Additional Rhinoplasty FAQs

How can I reduce swelling after rhinoplasty?

Swelling is an expected part of the rhinoplasty process and can last for several months after your procedure. That said, there are several ways to reduce inflammation and achieve a smoother recovery period while the face heals. Excessive salt intake often aggravates swelling, so a healthy diet of protein- and antioxidant-rich foods—such as leafy greens, fruits, vegetables, eggs, and healthy fats—can help decrease fluid retention and discourage further inflammation. In addition, taking care to avoid very hot environments can accelerate the healing process, as swelling often exacerbates with heat. Try to refrain from eating very hot or spicy food, taking excessively hot showers, and exposing the facial tissues to humidity. You should also avoid exercise in the early postoperative period. Drs. Kriet and Humphrey will discuss when you may resume your exercise routine.

When can I blow my nose after rhinoplasty?

You should avoid blowing your nose for at least two weeks after surgery—some cases in which a deviated septum was corrected may require a longer period of cessation. Feeling congested after rhinoplasty is a normal response to the swelling of nasal tissues, but forcefully blowing the nose before it reaches an appropriate stage of healing can cause bleeding, internal damage, and possibly an altered final outcome. Drs. Kriet and Humphrey will inform you when it is safe to blow your nose again according to the details of your unique procedure.

How long after rhinoplasty can I wear glasses?

Eyeglasses should not rest on the nasal bridge for four to six weeks. We will be happy to show you how to safely adjust your glasses during the healing period. Contact lenses can be worn during the healing process, if needed or desired.

How do I clean my nose after rhinoplasty?

After surgery, you can clean the nose without disrupting the healed tissue by using a saline rinse or spray to irrigate the nostrils and keep the nasal lining from drying. To more thoroughly clean the inside of the nostrils, a cotton-tipped swab coated with Vaseline can be utilized to gently moisten and lubricate just inside the nasal rim. Take care to avoid putting excessive pressure on the soft tissues of the nose, as the internal bones and cartilage will be delicate.

Dr. J. David Kriet and Dr. Clinton D. Humphrey can address any questions or concerns you may have during a consultation. For more information about rhinoplasty, or if you would like to schedule an appointment, please contact our practice today.

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