Board-certified surgeon Dr. Paul G. Ruff IV 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.
Dr. Ruff, and the staff at West End Plastic Surgery in Washington, D.C. 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 to meet with Dr. Ruff, or call our office at (202) 785-4187 to schedule an appointment.
Why Choose Rhinoplasty?
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
- Reparing injuries
- Relieving breathing problems
Before & After Rhinoplasty
For more photos of our patients, please view our photo gallery.
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.
Your Consultation With Your Plastic Surgeon
Prior to scheduling your nose surgery you will have an extensive consultation with Dr. Ruff and the staff 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, Dr. Ruff will discuss the additional details associated with revision rhinoplasty.
Your plastic surgeon and his staff 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
Paul G. Ruff IV,
Personalized, compassionate patient care is the foundation of West End Plastic Surgery's philosophy. Our board-certified surgeon, Dr. Paul G. Ruff IV embraces innovative techniques to ensure our patients get the best treatments available.Meet Dr. Ruff Request a consultation
How Rhinoplasty Is Performed
Your rhinoplasty surgery will be performed at the state-of-the-art surgical suite in our Georgetown plastic surgery office. 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 Dr. Ruff. 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 is 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 picks 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.
What to Expect During Rhinoplasty Recovery
|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|
Immediately After Your Surgery
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.
The First 24 to 48 Hours After Your Surgery
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.
The First Two Weeks After Surgery
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. Here are some other things to take note of during the first few weeks after your surgery:
- Most of the swelling and bruising you experience will disappear within about two weeks of the surgery.
- Your stitches will be removed seven to ten days after surgery.
- You can wear your contact lenses as soon as you feel comfortable doing so.
- You should be extra careful and gentle when washing your face and hair and applying makeup for the first two to three weeks after the procedure.
- Strenuous activity should be avoided for at least three weeks after your surgery.
Resuming Your Normal Routine
Everyone heals at different rates and you are the best judge of when you are ready for certain activities, but the following are general guidelines:
- You can most likely return to work within a week of your surgery.
- You can resume driving as soon as you feel comfortable doing so.
- You can most likely return to your physical exercise program within three weeks of your nose surgery. Our patients are encouraged to plan an exercise program and discuss it with the staff prior to resuming exercise.
- You can wear your contact lenses as soon after surgery as it feels comfortable. Glasses, however, cannot be worn for at least six to seven weeks after your surgery. Until then, they must be taped to your forehead or propped on your cheeks until your nose heals completely.
- Your nose will feel stuffy for several weeks; talk to the doctor about using nasal sprays to help with this condition.
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 Are Possible Side Effects or Risks?
All surgical procedures have some degree of risk, however, major complications from rhinoplasty are unusual. During your initial consultation with your plastic surgeon and his staff of West End Plastic Surgery 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
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.
Questions You May Have
Are there other procedures that could be done along with rhinoplasty to enhance the overall appearance of my face?
Several surgical procedures can enhance your facial appearance and give you a more youthful and less tired look. These include:
Will my insurance coverage pay for my 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.
Are there alternatives to rhinoplasty?
There are currently no non-surgical alternatives for correction of the deformities or concerns treated by rhinoplasty.
For more answers to common questions about rhinoplasty, visit our Rhinoplasty FAQ page.