Please click here to get our latest COVID-19 updates
The nose is the focal point of the human face, and many patients are dissatisfied with their appearance because they don’t like their nose. They feel it is a distraction, so that other people are staring there first and not seeing their eyes or their smile.
Rhinoplasty is a cosmetic procedure in which a plastic surgeon reshapes the nose to improve contour, profile, size, proportion and overall appearance. It should take away the distraction and leave a beautiful, natural result.
Patients commonly want their nose to be a little more straight, flat, thin, small, narrow or proportionate. During this nose surgery, the surgeon may add or subtract tissue and use sutures to achieve these desired effects. Many individuals are shocked that a series of such small changes can make such a dramatic improvement. Dr. Donaldson and Dr. Sieffert are known for creating natural results that “blend in” with the rest of the face.
The nose may be considered in three basic parts: the bridge (dorsum), the tip and the deeper airway/breathing structures. The most common deformities of the bridge include a prominent bump and excessive width. The tip is most often too bulbous, wide, long, downturned, upturned or “crooked.” Some patients have one or two of these features, others have them all; regardless, there are safe, well-established surgical techniques for their correction, while preserving or improving the deeper airway mechanics at the same time. Dr. Donaldson and Dr. Sieffert combine surgical skill with artistic sensibility to achieve safe, beautiful results.
Rhinoplasty may be performed at the same time as other cosmetic procedures for convenience, and a more comprehensive effect. The most common are:
Breast and body enhancements are possible, too. These combinations allow complex, multi-factorial goals to be achieved in a single operation.
Rhinoplasty may be a great option if you have always wished your nose were a different size or shape. This assumes realistic expectation. Those seeking perfection, or expecting to find professional or romantic success because of rhinoplasty, are generally not good candidates. If you have specific complaints due to underlying anatomy that can be realistically addressed, rhinoplasty will likely help.
You may not be a good candidate for rhinoplasty if you suffer from certain health conditions. Dr. Donaldson or Dr. Sieffert will review your medical history during your consultation to determine whether further studies or referrals are necessary. You may need to stop taking certain medications before surgery as well. Rhinoplasty can be performed on teenagers or adults after physical growth is complete and emotional maturity is established.
Rhinoplasty can correct the blockage of nasal pathways, making it easier for patients to breathe. This is called functional rhinoplasty. This procedure can also be used to straighten a deviated septum and fix other nasal issues. If you are undergoing functional rhinoplasty, Dr. Sieffert can make cosmetic adjustments at the same time.
During your consultation, Dr. Donaldson or Dr. Sieffert will listen carefully to your goals and assess your expectations. Tell the surgeon exactly what you dislike about your nose, and he will help determine and explain the best correctional approach. Share all of your aesthetic goals with Dr. Donaldson or Dr. Sieffert, because they may be able to perform multiple procedures on the day of your operation for your convenience.
Your medications and medical history will be reviewed to make sure you are a good candidate. Dr. Donaldson or Dr. Sieffert will be happy to address any health concerns you may have and make referrals as necessary to ensure safety.
Your consultation is an opportunity to learn as much as possible about the procedure, but also to get to know your surgeon and our team. Our friendly staff will be happy to show you around the office and answer any questions you may have about our practice. We can also go over cost and financing options for your convenience.
You should ask Dr. Donaldson or Dr. Sieffert any questions you may have about your current health or medications, your goals and expectations, the operative plan, the pre-operative preparations and post-operative management, your recovery and possible complications. Feel free to ask questions about the surgeon’s experience, training and credentials, as well as specifics about the surgical center, the anesthesia staff and nursing team. Some examples of important questions to ask are:
Make sure to ask Dr. Donaldson or Dr. Sieffert about possible outcomes, so you know exactly what to expect before you make any decisions. This will ensure that you and your surgeon are on the same page about what you want done and what can be done.
Before your procedure, you may have to stop taking certain medications. Dr. Donaldson or Dr. Sieffert will make this decision along with your current doctors. Avoid taking aspirin, ibuprofen and supplements such as vitamin E and fish oil in the time leading up to surgery, as these medications can increase bleeding.
It is also crucial that patients quit smoking and using other tobacco products before surgery, because nicotine greatly increases the chance for healing complications.
Before your surgery day, it’s best to prepare a recovery area within your home. Make sure to have plenty of juices and other liquids on hand, as hydration is important to the healing process. Have button-up or loose-necked shirts, as pulling clothing over your face may cause pain and disrupt bandages. You will also need to make plans for the day of surgery. You will need someone to drive you home after the surgery, and someone to stay with you for a night or two to help with everyday tasks.
All surgeries come with risks, but those associated with rhinoplasty are generally mild. The most common risk is nasal swelling, which can block your nasal passages and make it difficult for you to breathe through your nose. Swelling generally goes down within the first week or two, but it is not uncommon for swelling to persist.
As with all surgeries, infection, bleeding and complications with anesthesia are possible, although they are uncommon.
Make sure to address any concerns you have with Dr. Donaldson or Dr. Sieffert before the surgery. They will be happy to go over possible complications with you before hand.
Depending upon each patient’s goals, a “closed” or “open” rhinoplasty may be selected. During closed rhinoplasty, incisions are made inside the nostrils and the nasal bones, cartilage and soft tissues are often manipulated without direct vision. Dr. Donaldson prefers an open rhinoplasty for most patients, because the addition of a 2-4 millimeter incision across the skin of the columella (strut between the nostrils) allows reshaping under direct vision. This subtle difference has improved predictability and reproducibility for most surgeons and has become the most popular approach in the United States.
Typically, during rhinoplasty, the skin is lifted away from the underlying cartilage and bone. Many precise surgical maneuvers are then possible, depending upon the goals of the operation. If there is a bump on the bridge of the nose, then the cartilage and bone are filed down so it becomes straight and flat. If it is too wide, then the nasal bones are brought closer together. If the tip is too big and round, then fat and cartilage are often removed and sutures are placed to help make it more narrow. If the nose sticks out too far, then the cartilage is collapsed upon itself and sutured to set it back.
Dr. Donaldson and Dr. Sieffert perform rhinoplasty on an outpatient basis under general anesthesia. The patient goes home with a small, skin-colored external cast or splint in place and there is no internal packing except in rare circumstances. The cast or splint is removed after one week, and discomfort is controlled with oral medication. External sutures are removed at one week as well, and internal sutures dissolve.
While no surgery is pain-free, recovering from rhinoplasty is relatively easy. Pain and headaches tend to resolve after the first few days, and Dr. Donaldson or Dr. Sieffert will prescribe pain medication to help ease the symptoms. Rest, head elevation, ice and homeopathic remedies such as Arnicare will aid recovery, too.
You may have noticeable swelling and bruising, including bruising under your eyes and on your upper cheeks if the nasal bones are manipulated during surgery. The majority of swelling and bruising subsides progressively over one to two weeks, but it may take longer for the micro-swelling to go down. Dr. Donaldson or Dr. Sieffert will make further recommendations before surgery to help with post-operative bruising.
The most common side effect of rhinoplasty is congestion. The swelling often causes difficulty in nasal airflow that can be annoying for patients. This should go away in the first week or two, but may last longer. Everyone is different, and recovery time will depend on your body. However most patients take about a week off before they resume normal activities. Your splint or cast will remain on for one week, depending on how your nose is healing. Many individuals feel up to going to work after a few days, but prefer to wait until bruising and discoloration has subsided.
Swelling will obscure the final results for some time. The majority of the swelling should be gone in the first few weeks, but it can take up to a month. The final result, however, is not established until a full year has passed and the underlying anatomy has adjusted to the surgical changes.
As an experienced board certified plastic surgeon, Dr. Jeffrey Donaldson is known across the Midwest for his cosmetic surgical skills and artistic sensibility – an important combination for rhinoplasty. Voted one of America’s Most Compassionate Doctors, he shows each patient the individual focus and attention they deserve. Dr. Donaldson places a great emphasis on patient education and will strive to make sure you are fully informed, confident, and comfortable before proceeding to surgery.
Dr. Donaldson was named one of America’s Top Plastic Surgeons in 2013 and one of the Columbus Forty Under 40 in 2014. He is a member of the American Society for Aesthetic Plastic Surgery as well as the American Society of Plastic Surgeons, and he is a Diplomate of the American Board of Plastic Surgery.
If you’re ready to take the next step toward rhinoplasty, call or email our office in Columbus, Ohio. A friendly staff member will be happy to answer your preliminary questions and set up a consultation. Your consultation provides the perfect opportunity for you to customize your procedure and learn about Dr. Donaldson and our office. We will be happy to share our practice philosophy and answer every one of your questions.
To schedule a consultation or learn more about rhinoplasty, contact our office today.