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Nose Reshaping - Rhinoplasty By Dr. Michael Wolfeld New York NYC

Nasal reshaping, or rhinoplasty, is one of the most elegant and complex operations we perform in facial aesthetic surgery. It is a delicate operation performed by Dr. Wolfeld of illusion and balance that produces very satisfying results.  Rhinoplasty (nose reshaping) is a surgical procedure used to improve the appearance of the nose. Some of the indications that you may be a good candidate for rhinoplasty are that your nose appears too large for your face, there is a bump on the nasal bridge when viewed in profile, your nose seems too wide when viewed from the front, the nasal tip droops or plunges, the tip is thickened or enlarged, your nostrils are excessively flared, your nose is off-center or crooked or previous injury has made your nose asymmetrical.  The best candidates for this procedure are men and women who are looking to improve the appearance of their nose, have breathing difficulties, or need reconstruction from a birth defect.

At your initial consultation, Dr. Wolfeld will evaluate your general health, examine your nose, and explain the procedure to you along with the risks of the procedure.  Your nasal reshaping will be planned in detail with Dr. Wolfeld. Each nose surgery is entirely customized according to what the specific problems and goals are for the patient.  During the initial consultation, you may be asked to look in a mirror and point out exactly what you would like to see improved. This will help Dr. Wolfeld to understand your expectations and determine whether they can realistically be achieved.  In evaluating you for a rhinoplasty procedure, Dr. Wolfeld will conduct a routine and painless examination of your internal nasal structures. Your skin quality as well as the size and shape of your nose and its relationship to your other facial features will be carefully studied. In some instances, Dr. Wolfeld may recommend surgery of your chin, making it either more or less prominent, to improve facial balance.  This procedure can be done at the same time as your rhinoplasty.

Your rhinoplasty may be performed in a hospital, free-standing ambulatory facility or office-based surgical suite.  If you are a smoker, you will be asked to stop smoking well in advance of surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery.  Dr. Wolfeld will provide you with additional preoperative instructions.  Nasal reshaping can take from 2-3 hours to perform. It can be performed as a closed procedure or an open procedure.  This refers to how incisions are made. In a closed procedure, the incision is made inside the nose and therefore no scar will be visible afterwards. In an open procedure, the incision is made in the columella, which is the tissue separating the nostrils (that is, it’s the front part of the septum). A small scar will be visible afterwards, but not at all obvious.  Whatever incisions are used to reshape your nose, they will ultimately be very inconspicuous.  The surgical techniques employed will depend primarily on the goals established by you and Dr. Wolfeld.

Alterations may be made to increase or decrease the nasal bridge, reduce the size or width of the nose, narrow the nostrils, change the angle between the nose and upper lip, or reshape the tip.  Sometimes, the position of certain bones may need to be altered slightly in order to make your nose look narrower and straighter.  Dr. Wolfeld can remove a hump using a chisel or a rasp, and then bring the nasal bones together to form a narrower bridge. Cartilage can be trimmed to reshape the tip of the nose or the septum can be sculpted to improve the angle between the nose and upper lip.  If your nose needs to be built up in some areas, this can be done using nasal cartilage, or perhaps bone or cartilage from another site. The skin and soft tissues then redrape themselves over this new "scaffolding."  When your surgery is complete, a splint will be applied to help your nose to maintain its new shape. Nasal packs may also be placed in your nostrils to stabilize the septum.

Following surgery, your face will feel puffy, your nose may ache, and you may also have a dull headache.  You will notice that the swelling and bruising around your eyes will increase at first, and then reach a peak two or three days after your procedure.  Applying cold compresses will help reduce swelling.  The first couple of days after surgery, you should restrict your activities and sleep with your head elevated.  This will help to minimize swelling and reduce the possibility of minor bleeding, which is not uncommon.  Remember, you must not take aspirin or certain anti-inflammatory medications.  Most swelling and bruising should be gone within two weeks or so.  Your nose will be stuffy for several weeks following your surgery.  Dr. Wolfeld will ask you not to blow your nose for two weeks until your tissues heal.  If Dr. Wolfeld places packing in your nose, this will be removed 2-3 days following your procedure.  Within one week all of your dressings, splints, and stitches will be removed.  You should be able to return to work about a week or so following surgery.  Dr. Wolfeld will then give you specific instructions as to when you can resume all normal activities.  You will need to avoid bumping or rubbing your nose or getting it sunburned for at least eight weeks.  You must be conscientious about using a sunblock to protect your skin.

It is important to realize that the amount of time it takes for recovery varies greatly among individuals.  Since the healing process is gradual, you should expect to wait up to one year to see the final results of your rhinoplasty.  You will, however, begin enjoying your new look within weeks of your surgery.  Results of a nasal reshaping procedure can be very dramatic.  The nose is easily visible from every angle, and along with the chin, is very definite in the profile.  If you are interested in discussing your nasal shape and options for improvement, you may schedule a private consultation with Dr. Wolfeld by calling 212-281-1000.

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