COSMETIC TOWN JOURNAL



Expert Doctor

Types of Rhinoplasty

Posted January 21, 2019

Helen Colen, MD

New York, NY

Types of Rhinoplasty

Rhinoplasty, also known as a nose job, can be performed as a surgical or non-surgical cosmetic procedure in order to change the appearance and functionality of the nose. Some of the reasons a patient might want to make a change in the appearance of the nose include:

  • The nose is too wide
  • It has a bump
  • The tip goes up or down too much
  • The nostrils are not even with each other
  • The patient simply doesn't like the appearance of his or her nose

The choice of surgical or non-surgical rhinoplasty is based on the results desired by the patient as well as the judgment of the doctor. The surgeon will determine which option provides a nose that satisfies the needs of the patient while providing a balanced look with the rest of the face.

Am I a Good Candidate for Surgical or Non-Surgical Rhinoplasty?

The qualities that make a person a GOOD CANDIDATE include:

  • Someone with nasal tip enlargement or drooping
  • A person who is unhappy with some aspect of the appearance of his, or her, nose
  • A patient with a nose that is off-center or not in balance with the rest of the face
  • A person with a nose that has imperfections such as a hump, depression or divot

People that are NOT A GOOD CANDIDATE include:

  • Someone with unrealistic expectations of what can be accomplished by the surgery
  • A person under the age of 16 because there is a chance his, or her, nose has not stopped growing yet
  • The skin or the nasal cartilage does not have structural integrity
  • A person who is having the surgery to make someone else happy

How is Surgical and Non-Surgical Rhinoplasty Performed?

The type of rhinoplasty performed on a patient depends on the issue that needs to be addressed:

Surgical rhinoplasty typically involves trimming various parts of the nose. The surgeon works on the bones of the nose by narrowing them or lowering their height if there is a bump. Adjusting the length of the nose may also be done to make it more compatible with the structure of the face. In other words, structural changes are introduced in order to give it more of an aesthetic appearance.

The surgery can be performed as an “open rhinoplasty” which uses an external incision along the undersurface of the nasal columella (between the nasal openings) to treat the issue. This will also result in a small scar that is generally not noticeable. The other approach is “closed rhinoplasty” which means the doctor performs the necessary work inside the nose. There is no visible scar since there is no external incision and there is less dissection of the nasal cartilage from the underlying tissue.

Non-surgical rhinoplasty is a less invasive procedure that is mostly performed if the problem is the presence of a hump, a divot or a depression on the nose bridge. This problem is corrected by the injection of dermal fillers above and below the section with the imperfection. The amount of filler injected should be just enough to create a nose that looks straight. Non-surgical rhinoplasty is also used to deal with a bulbous nose tip. The doctor will inject the apex of the tip with dermal fillers, instead of injecting the entire tip, so the tip will look smaller and the nose will look slimmer as well. Dermal fillers used for non-surgical rhinoplasty include Voluma, Juvederm and Radiesse.

Non-surgical rhinoplasty is generally safer because it is less invasive. The surgical approach, as long as it is meticulously planned and properly done, is safe but not as safe as the non-surgical method. Non-surgical rhinoplasty is only indicated for certain cases that can be solved through the use of fillers while its surgical counterpart is suitable for more severe nose problems.

What is the Cost of Surgical and Non-Surgical Rhinoplasty?

The cost of surgical rhinoplasty varies according to the type of rhinoplasty performed by the doctor, how much work was done during the surgery, the area of the country where it was performed and if any of the cost is covered by insurance if the procedure is determined to be medically necessary. In general, the cost of surgical rhinoplasty ranges from $4500-$15,000.

When it comes to non-surgical rhinoplasty, patients can expect to pay anywhere from $700-$2000. The final cost depends on the type of filler used by the doctor, where the procedure was performed and if there are any facility fees the patient needs to pay.

Recovery and Downtime

Surgical rhinoplasty requires a longer RECOVERY period than the non-surgical option. After the procedure, there will be swelling and bruising which lasts a couple of days or even weeks. The nose will start to look fairly normal at about six to twelve weeks. Any scarring above, or underneath, the nose may take up to six months to fully heal. The DOWNTIME for non-surgical rhinoplasty is at least one week. There will be some swelling but it will not be as severe as the swelling from the surgical approach. The swelling will go down slowly but it should be completely gone after six weeks.

Results

The final results from both forms of rhinoplasty can be seen after six months. Both techniques produce natural-looking results. Improvements from the surgical approach tend to last longer since it is a surgery and not fillers. Results from non-surgical rhinoplasty last for six to eighteen months while surgical results can last a lifetime if the patient does not suffer any damage or trauma to the nose.

Revision:

There are times when patients are not happy with the results of their surgery and they may choose to have a revision performed on their nose. This is usually not necessary with non-surgical rhinoplasty since the fillers will eventually go away on their own. Some reasons patients want a revision after surgical rhinoplasty are:

Unrealistic expectations

  • Overresection (too much taken off)
  • Underresection (not enough taken off)

Limitations of Surgical and Non-Surgical Rhinoplasty

It is hard to do revisions if the patient is not satisfied with the results. This is especially true for surgical rhinoplasty because the surgeon cannot bring back all of the tissues that have been removed. In non-surgical rhinoplasty, the specialist can do a bit of correction using an enzyme that has the ability to dissolve the dermal filler. If too much filler was used, the specialist can inject the enzyme into the area with excess filler.

There is a limit in the amount of correction that can be made and this is especially true with the non-surgical approach. Non-surgical rhinoplasty can only deal with issues such as humps, dents and bulbous nose tips. Any other issues with the nose are better off with a surgical approach.

Surgical rhinoplasty has a limit to how much skin, fat, bone or cartilage the surgeon can remove. If the surgeon takes out too much of these structures, the result is a nose that looks less than natural.

Risks of Surgical and Non-Surgical Rhinoplasty

There is a chance of scarring in the columella that might not heal well. The columella pertains to the area between the two nostrils. A scar in that area can makes patients very self-conscious.

  • If too much tissue is taken out of the nose, the tip loses its integrity and may become kind of droopy.
  • If too much bone is taken out, the nose may appear too low and look like a “ski slope” nose.
  • If the nose is too thin and the patient’s face is round, the nose may look out of proportion with the rest of the face.

Non-surgical rhinoplasty does not have as many risks because it is simply an injection of dermal filler. There might be some redness or itchiness where the injection was performed but not much more than that in terms of risks.

Consult With a Professional

Patients planning to get a nose job should consult with a rhinoplasty specialist to find out if the surgical or non-surgical approach is the best option for their case. They need to choose a specialist that has a lot of experience in performing both types of rhinoplasty. They should also ask about previous cases the doctor has performed and ask to see “before and after” photos of previous patients. The more information patients have about their options, the better equipped they will be to make a decision about having rhinoplasty.

 

Written by Cosmetic Town Editorial Team- MA

Based on an exclusive interview with Helen Colen, MD in New York, NY

Article Last Updated on January 21, 2019