What is Rhinoplasty?
Board-certified surgeons Dr. Paul G. Ruff IV and Dr. Praful Ramineni perform rhinoplasty, also called a nose job, in Washington, D.C. to cosmetically reshape the nose and enhance the overall appearance of the face. This procedure is also used for reconstructive reasons to correct injuries, birth defects, and breathing problems. It is the most common type of plastic surgery performed today.
The meticulous techniques used by our surgeons ensure a beautiful, natural-looking result that can permanently improve the look of your entire face.
Reasons For Nose Surgery
Women and men choose rhinoplasty for a variety of reasons, which often include one or more of the following:
- Reducing or increasing the size of the nose
- Changing the shape of the tip or the bridge of the nose
- Narrowing the span of the nostrils
- Changing the angle between the nose and upper lip
- Correcting birth defects
- Repairing injuries
- Relieving breathing problems
Can I Improve My Breathing Without Changing The Look Of My Nose?
Yes. “Functional rhinoplasty” refers to a version of the surgery that improves the function of the nose without affecting its appearance. This is often performed to remedy a deviated septum and other irregularities that can affect breathing. Although your doctor may need to make very small alterations to the appearance of your nose, its overall size and shape can be preserved. Or, if you have both functional and aesthetic concerns, your doctor can change the look of your nose while improving your ability to breathe. During your consultation, you’ll talk more about the likely outcome you can expect.
Are You A Good Candidate for Rhinoplasty?
The ideal candidates for rhinoplasty are men and women who are in general good health and who have realistic expectations about the procedure. It is best to be at least 15 years of age before considering nose reshaping surgery to ensure that your nose is fully developed and will react well to the surgery.
“All of the staff have been delightful, super informative and helpful, kind and patient. Dr Ramineni has the best bed side manners out of any doctor I have ever met. I have loved all of my interactions with everyone at West End Plastic Surgery!!!” – Dakota S.
Nose Surgery Consultation
Prior to scheduling your nose surgery, you will have an extensive consultation with your surgeon and the team at West End Plastic Surgery. Your plastic surgeon will ask you to detail at length what you want your nose to look like after the surgery. Your nose and facial structure will be evaluated and the surgical possibilities will be discussed with you. The doctor will thoroughly explain the procedure and its expected result and answer any questions you have. If you are unhappy with the results of rhinoplasty by another surgeon, we will discuss the additional details associated with revision rhinoplasty.
Your plastic surgeon and the team at West End Plastic Surgery will:
- Review the various nose surgery options with you
- Clearly discuss the potential risks of the procedure
- Outline in detail how the surgery is performed and what you can expect before, during, and after the procedure
- Provide detailed cost, and payment information
- Answer all your questions
You will be asked to provide:
- Details about your medical history
- A list of all medication you currently take, including over the counter medications such as aspirin, vitamins, and herbal supplements
- Information regarding your tobacco and alcohol use
Primary Rhinoplasty vs Revision Rhinoplasty
Primary rhinoplasty is the first rhinoplasty that a patient undergoes. In most cases, primary rhinoplasty yields ideal, permanent results and is the only surgery necessary. However, occasionally unfavorable results or future trauma can necessitate additional surgery. This is called a revision rhinoplasty. Although both procedures are performed similarly, revision rhinoplasty does require extra care around scar tissue. It’s also vitally important to choose a surgeon who fully understands your desires and offers you realistic expectations about your potential results. Our doctors are skilled at both primary and revision rhinoplasty techniques to give each of their patients the results they envision.
Your rhinoplasty surgery will be performed at the state-of-the-art surgical suite in our Georgetown plastic surgery suite. The surgery can be performed either under general anesthesia or local anesthesia with sedation depending on what you and the doctor prefer. With general anesthesia, you will be completely asleep throughout the procedure. With local anesthesia, you will be lightly sedated and your nose and the surrounding area will be numbed. You will be awake, but will be relaxed and will feel no discomfort. The type of anesthesia used will be discussed with you at your initial consultation.
There are two methods for performing rhinoplasty: the closed technique in which the incision is made within the nose and the open technique in which the incision is made across the two nostrils. The type of surgery to be performed will be discussed with you when you meet with your surgeon. With either technique, the surgery generally lasts from one to two hours.
Once the incision is made, either within the nose or across the nostrils, the skin of the nose is separated from its supporting framework of bone and cartilage. If one of the goals of the surgery is to reduce the size of your nostrils, small incisions are made at their base for this purpose. The bone and cartilage are then sculpted to the shape you and the doctor agreed upon prior to surgery. When the sculpting is complete, the skin is redraped over the new framework of your nose. A splint is applied to help your nose maintain its new structure and nasal packs or soft plastic splints are placed inside your nostrils to stabilize the septum, the dividing wall between the air passages. Sometimes gauze dressings are placed inside the nose.
Before & After Rhinoplasty
For more photos of our patients, please view our photo gallery.
Rhinoplasty Recovery Process
In most cases, rhinoplasty surgery is performed on an outpatient basis and you go home shortly after the surgery. You may be sleepy from the anesthesia and you will feel mild to moderate discomfort so it is important to have someone drive you home after your surgery. You may also want to have someone stay with you for the first few days after surgery.
In the first 24 hours after surgery, your face will feel puffy, your nose may ache, and you may have a dull headache. You can use the prescribed pain medication to alleviate much of this discomfort. You must stay in bed with your head elevated (except for going to the bathroom) for the first 24 hours after your surgery. Most patients are up and around two days after surgery. The swelling and bruising around your nose will increase at first, reaching its peak about two to three days after the surgery. Applying cold compresses will help ease the pain and reduce the swelling and bruising.
Your discomfort level will improve rapidly after the first two days. A little bleeding is common in the first day or so after surgery and you may continue to feel some nasal stuffiness for the first few weeks. If nasal packing was placed in your nose it will be removed within a day or so after your surgery, which will greatly improve your comfort level. All dressings, splints, and stitches are usually removed one week after surgery; however, in procedures that were extensive, it may take two weeks to remove the dressings, splints, and stitches.
You will notice a marked improvement in your discomfort level during the first few weeks after your surgery. You can most likely return to work approximately one week after your rhinoplasty unless your work is strenuous.
What To Expect After Nose Surgery
|Out of Bed||After 24 Hours|
|Gauze Dressings Removed||One to Two Days After Surgery|
|Packing and Splints Removed||Seven to Ten Days After Surgery|
|Stitches Removed||Five to Seven Days After Surgery|
|Back to Work||One Week After Surgery|
|Contact Lenses||As Soon as You Feel Comfortable|
|Driving||As Soon as You Feel Comfortable|
|Strenuous Activity||Two to Three Weeks After Surgery|
|Wearing Your Glasses||Six to Eight Weeks After Surgery|
|Contact Sports||Six to Eight Weeks After Surgery|
Things To Be Aware Of After Your Surgery
- You should not blow your nose for a week or so after surgery to give the tissue a chance to heal. You should make every effort to avoid rubbing, bumping, or hitting your nose for several weeks.
- After surgery small burst blood vessels may appear as tiny red spots on the skin’s surface. These spots are usually minor but can be permanent in some cases.
- When rhinoplasty is performed from inside the nose there is no visible scarring. When the incision is made across the top of the nose or when the procedure corrects flaring nostrils, the scars are minor and are usually not visible within a few weeks of surgery.
- Stay out of the sun to avoid sunburn for at least eight weeks.
- The doctor will schedule regular follow-up visits in the months after your surgery. If anything unusual or troubling develops between visits call West End Plastic Surgery right away.
- Internal swelling subsides very gradually, therefore, the final results of your nose surgery may not be apparent for a year or more.
What Can I Do To Minimize Scarring?
Rhinoplasty isn’t known for creating excessive scarring. “Closed” procedures, which are made through the inside of the nostrils, don’t produce any visible scarring at all, while “open” procedures require only a small incision across the strip of skin that separates the nostrils. Although this incision won’t be noticeable to most people once fully healed, closely following your doctor’s instructions can ensure an even more discreet result. It’s also important to protect the incision from the sun in the days, weeks, and months following surgery. Unprotected sun exposure can cause pigmentation irregularities and a more noticeable result.
How Long Will the Results of Your Nose Surgery Last?
Nose surgery can reshape, resize, and enhance the appearance of your nose. In most cases these results are permanent. Of course, your face, including your nose, will continue to change as you age.
Risks of Nose Surgery
All surgical procedures have some degree of risk, however, major complications from rhinoplasty are unusual. During your initial consultation, your individual risks will be assessed and discussed. As with any surgery, you can help reduce the risks by closely following the pre and post-surgery instructions provided to you. Your surgeon and his staff will be with you every step of the way to ensure a safe and pleasing outcome.
Most likely risks include the following:
- Persistent swelling
- Need for further surgery
Can Rhinoplasty Be Combined With Other Procedures?
Several surgical procedures can enhance your facial appearance and give you a more youthful and less tired look. These include:
Does Insurance Cover Rhinoplasty?
In some cases, your rhinoplasty may be covered by your insurance company. Please contact your insurance provider to confirm coverage. Be advised West End Plastic Surgery does not participate with any insurance provider and you are responsible for the full payment of the procedure. Cost and payment information will be fully discussed with you during your initial consultation.
Schedule a Consultation
Our surgeons are experts in rhinoplasty and will ensure that you have a safe and comfortable procedure and an outcome you are pleased with. To get started, request a consultation online, or call our office at (202) 785-4187 to schedule an appointment.