Rhinoplasty

Rhinoplasty, also known as a nose job, is more than a simple cosmetic procedure – it’s a complex surgery that requires the services of a highly skilled plastic surgeon. At Facial Plastic Surgery of Central Texas, individuals can receive a rhinoplasty from a surgeon who specializes in procedures from the collarbone up: Dr. Charles Guy. Located in Waco, Facial Plastic Surgery of Central Texas makes it easier for those throughout the area to obtain exceptional plastic surgery services without needing to travel to Austin or Dallas.

Rhinoplasty, more commonly known as a nose job, is a procedure that alters the shape or function of the nose. Different from other cosmetic procedures, rhinoplasty is not performed to highlight an area of the nose, but rather to subtly adjust the face without making it apparent that work was done.

Surgeons must approach rhinoplasty with the utmost precision due to the nose’s unique structure. At the top of the nose is bone, and at the bottom is cartilage. Depending on the patient’s specific needs and wishes, rhinoplasty can modify the bone, cartilage, skin, or every aspect of the nose. While the changes this procedure makes can be small, they can have a significant impact on the area.

Dr. Guy recognizes the subjective nature of plastic surgery of the nose. What people in one country deem a beautiful nose is not necessarily the same for all cultures. These distinctions may even exist within different regions of the United States.

Dr. Guy consults with each patient to ensure he thoroughly understands their concerns and expectations. From there, he works collaboratively with the patient, and is able to show potential results using 3D Vectra software to ensure best plan of action. He strives to help people achieve an appealing aesthetic while maintaining proper function.

Before rhinoplasty surgery, Dr. Guy will conduct a physical examination to gauge how certain features, such as skin thickness, may impact the results of the procedure. He may also take photographs that can be used to show potential results and to aid in his technique.

Rhinoplasty procedures are conducted in the operating room (OR). Patients can expect the following on the day of the surgery:

• Guy often follows an open approach that entails making a small incision on the skin between the nostrils. While the cut is often unnoticeable, it still requires sutures. These sutures are removed a week after the procedure.
• A cast-like object called a splint is inserted on the outer nose to keep the shape of the nose and manage the swelling in the initial post-operative period. Patients return to the office seven days after the surgery to have it removed.
• When the outer splint and tape are taken away, patients will experience a slight increase swelling.
  • Approximately 60% to 80% of the swelling will dissipate within two weeks.
  • About 90% to 95% of the swelling will disappear in two months.
• Minor side effects may persist for a year, with various durations.
  • Swelling around the eyes may fade sooner.
  • Swelling in the nose when exercising or bending over may continue for months.
  • Numbness of the nose, particularly near the tip, may linger for months before the patient regains full sensation.
• If part of the procedure involves reshaping bones, patients may encounter bruising under the eyes. This bruising usually resolves within two weeks and may change color as it heals.
• Patients will also notice nasal congestion brought on by splints (large pieces of plastic in the nose) from either having a concurrent septoplasty or harvesting grafts from the septum.
  • Nasal congestion tends to improve significantly after the splints are removed during the post-operative appointment one week after the procedure.

The nose may feel different after rhinoplasty surgery. Patients may detect stiffness or small bumps felt deep in the skin. They should not be surprised if it takes time to get accustomed to the way their nose now feels.

Dr. Guy will prescribe the patient an antibiotic and medications for relieving pain. While most people who undergo rhinoplasty surgery take a week to 10 days off work, this is entirely optional.

Although people can seek rhinoplasty services purely to enhance their appearance, this is not the only reason for getting a nose job. Other purposes for this surgery include the following:

• Fixing a birth defect
• Repairing a broken or fractured nose
• Improving breathing ability following a traumatic injury or intensive cancer treatment
• Opening obstructed nasal passages stemming from a deviated or damaged septum

Patients interested in receiving rhinoplasty from a surgeon they can rely on should turn to Facial Plastic Surgery of Central Texas. Dr. Guy is a board-certified plastic surgeon with a longstanding reputation throughout central Texas for treating patients like family, as well as educating them on different procedures and their options. He is joined by a highly dedicated plastic surgery team that shares his passion for patient-centered care.

For outstanding nasal plastic surgery, trust Dr. Guy and his team. Contact us for more information about rhinoplasty or request a consultation today.

Here are some frequently asked questions (FAQs) about the rhinoplasty procedure:

What can a rhinoplasty correct?

Rhinoplasty corrects the shape or size of the outside of the nose. Surgical rhinoplasty can add or take away from the size or even refine the cartilages to improve the aesthetic appearance. Removing humps, narrowing the nose or refining and lifting the tip are some of the most common reasons that a rhinoplasty is sought out. Dr. Charles Guy takes a natural approach to rhinoplasty, using caution to not over-manipulate the nose causing a “surgical look”.

Does rhinoplasty fix a deviated septum?

The septum is on the inside of the nose and is not treated with a rhinoplasty alone. Rhinoplasty corrects issues on the outside. A deviated septum commonly may cause breathing problems for a person. Issues on the outside of the nose won’t necessarily cause breathing trouble and a deviated septum does not necessarily cause an external deformity. Often times cartilage is needed to be taken from the septum in order to shape the nose for rhinoplasty and deviated septums may be corrected.

What is the recovery time for rhinoplasty?

After the procedure, patients wear a cast on their nose for one week. When an external approach is used, visible stitches are removed in the office a week after surgery. There are splints (pieces of plastic) inside the nose that are also removed a week after surgery. Sutures inside the nose will dissolve on their own.

About 60 to 80% of the swelling will disappear within two weeks, and 90% to 95% will dissipate in two months. When the outer splint and tape are removed, swelling will increase slightly and then slowly go down. Patients might get bruising around their noses and under their eyes, especially if bones are narrowed or moved to the middle during the procedure. Nasal congestion is common from the splints and dried secretions that build up and require nasal saline irrigation. It tends to improve greatly once splints are removed. There are restrictions on activity and exercise that will be discussed and patients need to avoid sneezing through their nose or rubbing there nose from close to 4 weeks afterwards.   Sneezing needs to be done as much as possible through an open mouth. Those who require allergy medication for allergies are able to continue these post operatively in order minimize sneezing.

Patients may notice changes for up to a year or year-and-a-half, but the most significant changes occur within the first two to three months.

Does rhinoplasty cause scarring?

The amount of scarring a patient has depends on the rhinoplasty procedure but is usually very difficult to see. On an open rhinoplasty, the potential visible scar is in the skin between the nostrils. If nostril narrowing is required then scars in the natural folds may also be visible. Dr. Guy also has unique training in specialized techniques to reduce the appearance of scars.

How long do the results of rhinoplasty last?

The results of surgical rhinoplasty are considered permanent. There can be slight changes that naturally occur with aging but usually are minimal.

Are there non-surgical alternatives to rhinoplasty?

Dr. Guy considers all plastic surgery options to meet each patient’s needs. This includes non-surgical alternatives, like liquid rhinoplasty. A liquid rhinoplasty procedure uses dermal fillers to change nose shape and is most commonly used to mask a hump.

How much does rhinoplasty cost?

The price of a rhinoplasty can vary depending on the patient’s needs, if previous rhinoplasty has been performed and overall difficulty of the surgery in order to obtain the results. Patients must schedule a consultation to receive specific pricing information.

Can other procedures be combined with rhinoplasty, for example, eyelid surgery or a brow lift?

Patients can undergo other plastic surgery procedures during a rhinoplasty, such as:

• Upper and lower eyelid surgery
• Brow lift
• Facelift
• Mini facelift

Can I see what I might look like after the procedure?

Yes – Facial Plastic Surgery of Central Texas uses 3D imaging technology to create an image of a patient’s face and show how a procedure might change their appearance.

What should I do to prepare for nose surgery?

To prepare for rhinoplasty, patients may have to adjust their medication regimen. They should avoid medications that increase bleeding and cessation of nicotine products can help improve healing. Dr. Guy will review specific preparation instructions with patients before surgery.

What should I expect during the initial consultation?

Patients should expect to discuss the goals of the procedure with Dr. Guy during the initial consultation.  He may use 3D imaging to help the patient express their goals and discuss what would be required to achieve them.

How many rhinoplasty procedures has Dr. Charles Guy performed?

Dr. Charles Guy has ample experience with plastic surgery and specialized training from the collarbone up. His expertise awarded him Best Plastic Surgeon in Waco by the Wacoan in 2022. This provides peace of mind that plastic surgery services will be up to standards.

Can I see before-and-after photos of previous rhinoplasty patients?

Yes – patients can view before-and-after photos of past patients from Facial Plastic Surgery of Central Texas in the nose photo gallery.

What kind of anesthesia is used for rhinoplasty?

Most rhinoplasty surgeries involve patients going under general anesthesia, where they are asleep for enhanced comfort during surgery.  Some smaller rhinoplasty procedures that only involve narrowing the nostrils may only require local anesthetic, which delivers numbing medications so patients feel no pain.

Will I need to stay overnight in the hospital after the surgery?

Patients typically return home the same day as surgery, so they do not need to stay in a hospital overnight.

What kind of follow-up care will I need?

Once the cast and splints are removed, a patient must rinse their nose regularly. Dr. Guy will prescribe an antibiotic and medication to relieve pain. Outside sutures will need to be cleaned of any dried debris/crusts and constantly covered with a thin layer of ointment.  You will need to be seen in the office 1 week after the surgery to remove the outside sutures and remove the cast and splints.

When can I resume normal activities, like exercise or work, after a rhinoplasty?

Following rhinoplasty, patients should avoid lifting more than 10 lbs. for the first week and 20 lbs. for the second week. After that, there are no restrictions. Avoid sneezing through the nose, and be gentle when blowing the nose for three to four weeks after surgery.

What are the potential risks and complications associated with rhinoplasty?

Patients should prepare themselves for potential risks and complications with any surgery, including rhinoplasty. Dr. Guy and the plastic surgery team use their specialized knowledge of the face and neck to avoid complications as best as possible. He also informs them of potential risks and complications, indicating what to look for and when to call the office.

Should people under the age of 18 undergo rhinoplasty?

Dr. Guy proceeds with caution for those under 18 interested in rhinoplasty. He wants patients and parents to understand how big a decision this is and encourages them to wait, especially for those interested in rhinoplasty for purely cosmetic purposes. Occasionally minors will have rhinoplasty but it is usually associated from deformity from trauma.