Rhinoplasty in Princeton, NJ

A Quality Nose Job by Specialists in the Princeton area

A rhinoplasty, or nose surgery, is a cosmetic surgical procedure to alter the nose shape. A disproportionately large or unsightly-shaped nose will draw attention away from the other facial features. Understandably, many people from varying locations (including Princeton, NJ) opt for a rhinoplasty to help address these issues. What a rhinoplasty does is re-contour the shape of the nose to fit the patient’s needs. These changes can include:

• reducing the size of a bump on the bridge of the nose
• narrowing the bridge of the nose
• narrowing the tip of the nose
• reshaping the nasal tip

The ideal surgical results after rhinoplasty are a natural-appearing nose that complements and enhances other facial features. The board-certified, facial plastic surgery experts at the Glasgold Group, from Princeton, NJ, specializing in rhinoplasty, revision rhinoplasty, and other related facial procedures.

* Each patient is unique and individual results may vary.

Rhinoplasty Procedure Consultation in Princeton, NJ

The rhinoplasty consultation provides patients with the opportunity to express their desired goals for surgery, to gain an appropriate expectation for the outcome of surgery and to understand the postoperative healing process. Rhinoplasty patients from Princeton, NJ and all over have the opportunity to ask any questions they may have about their upcoming nose job. After the consultation, patients should:

• have a better understanding of the process
• what to expect
• feel comfortable with their plastic surgeon(s)

From the surgeon’s perspective, it is important that we have a good understanding of what changes you hope to achieve through surgery. If there are functional breathing problems that need to be addressed, this will also be reviewed. Provide any history of prior nasal injuries or surgeries, known medical conditions, and medication usage.

After examining the nose and understanding your desires, we will have a discussion about what types of changes should be made and realistic expectations.

Imaging software helps to demonstrate the goal of your rhinoplasty surgery. In our offices in Prince, NJ, we use the Canfield mirror imaging program and 3-D Vectra program. With these imaging devices, we attempt to show a result that is realistic and appropriate for you.

Importantly, imaging does not provide the actual exact result. Instead, it represents a planned goal we strive for and helps patients get a sense of what their new nose will look like. Preoperative imaging also ensures that both patient and surgeon goals are aligned.

Preparing for Rhinoplasty Surgery in Princeton, NJ

Approximately two weeks prior to surgery, patients have a preoperative visit where they meet with a nurse or medical assistant. They will review what needs to be done in preparation for the rhinoplasty as well as the necessary postoperative care. This visit is also an opportunity to review the goals with your surgeon and ask any remaining questions.

Prior to surgery, you will also be reminded to avoid the use of blood-thinning medications such as Motrin, Advil, products that contain aspirin, as well as homeopathic medications or supplements that may have a similar effect. A list of the items will be provided to you at the preoperative visit.

Patients are told to use a prescription topical antibiotic ointment just inside the nostril starting one week before surgery and continuing for one week after surgery. Additional prescriptions will also be provided at the preoperative visit, including pain medications and antibiotics as needed.

Open Versus Closed Rhinoplasty Techniques

Rhinoplasty can be performed through either an open or closed (endonasal) approach. In our practice, almost all surgeries are performed through the open technique. An open approach combines the use of incisions inside the nostrils with an additional small incision that is well hidden in the columella (the skin between the nostril openings). The advantage of the open technique is that it provides better visualization of the underlying nasal structure with the ability to more effectively and precisely re-contour the nose.

Reshaping the upper portion of the nose (aka the bridge or dorsum) involves alterations in the bone and cartilage. When reducing a bump, the bone and cartilage components can be shaved down. In instances where the dorsum needs to be elevated, this can be accomplished either with the use of cartilage grafts or implants. Reshaping the nasal tip requires alterations of the cartilaginous structural components that are responsible for the external appearance of the tip. Depending on the desired changes in the nasal tip, the tip cartilages can be altered by removing excess cartilage that is responsible for a wide-appearing tip, suturing the existing cartilage to change its shape and adding cartilage to strengthen areas that are weak or to create a more defined nasal tip shape.

The addition of cartilage in the nose is termed “cartilage grafting” and is important tool for reshaping the nasal tip. The open technique allows precise placement and suture stabilization of these grafts. The preferred source of cartilage for the grafts is the nasal septum; this involves removing a non-structural component of the septum and creating the necessary grafts from it. When there is an inadequate source of septal cartilage (usually due to patients having prior septoplasty and/or rhinoplasty surgery), auricular (ear) or costal (rib) cartilage can be used.

Your Rhinoplasty Surgery in Princeton, NJ

Rhinoplasty surgery is performed at one of three locations around Princeton:

• our accredited in-office surgical suite
• an out-patient surgery center (University Surgicenter in East Brunswick),
• Robert Wood Johnson University Hospital in New Brunswick

The location of surgery will be determined based on several factors, like the type of anesthesia needed and whether functional breathing issues need to be addressed.

The surgery can be performed under general anesthesia or with intravenous sedation. If the surgery is performed under general anesthesia, the rhinoplasty surgery will be performed at the surgery center or hospital. The type of anesthesia used will be discussed at the consultation and is dependent on the type of procedure being done, the patient’s preference, and the age of the patient.

Length of Rhinoplasty Surgery

The length of surgery is usually three to four hours. After the surgery is completed, patients rest in the recovery room for approximately two hours before they are discharged home. Recovery room time is shorter if the surgery is performed under intravenous sedation.

Patients need to be accompanied by a family member or friend who will drive them home from surgery. Patients must also plan on having someone stay with them until at least the morning following surgery.

Recovering from a Rhinoplasty in Princeton, NJ

After surgery, there will be tape and a small metal splint on the bridge of the nose. Additionally, there’ll be a small gauze pad that is taped under the nostrils. You will be provided extra gauze and instructed on how to replace it. Unlike the bandage on the nose, the drip pad is changed as needed. You’ll be changing the gauze less often after the first few days.

Many patients find that, within 48 hours, drainage has reduced so much that a replacement gauze isn’t needed. The first postoperative visit will be at 6-7 days after surgery, at which time the tape, splint, and sutures will be removed. In most cases, there are just three sutures in the columella that need to be removed. All other sutures are dissolvable. Make-up can be applied once the bandage is off.

Following surgery, there are varying degrees of swelling and bruising. Bruising tends to occur under the eyes and most bruising resolves within 7 to 10 days. The swelling usually peaks a few days after surgery and will then decrease. When patients have their dressing removed, they will be able to appreciate the change in their profile. At one week after surgery, it is common for the nose to look wider than expected on front view due to swelling.

Most patients are comfortable returning to work or school 10 days after surgery. However, this is just an estimated time frame, due to individual variations in healing time. It is important that patients inform us of any significant events they may have scheduled following surgery so that we can adequately discuss their expectations for recuperation and recovery time.

After the first postoperative visit, patients return for their second visit in one month. At this time, patients have experienced significant progression in the healing process. However, there is still some swelling in the nose at this time. Subtle changes and decreases in the swelling will gradually occur over many months.

Patients can return to full strenuous activity three weeks after surgery. Avoid tanning for the first few months as this may lead to nasal swelling. Proper use of strong sunblock is recommended.