All forms of rhinoplasty require incisions, but rhinoplasty can be performed in a “closed” or “open” technique. An “open” technique involves an additional ~5 mm (approximately ¼ inch) incision along the inferior part of the nose known as the columella. This incision typically heals extremely well and is well concealed. The additional incision should not be the main reason to decide between “open” vs “closed” rhinoplasty. The advantage of “open” rhinoplasty is that it permits improved visibility and access to the nose during surgery – this may be more appropriate in many patients to address their nasal appearance concerns. The main advantage of “closed” rhinoplasty is faster healing and resolution of swelling after surgery. During your consultation, Dr. Vaca and you can discuss “open” vs “closed” rhinoplasty in detail to determine which is the better option for you.

This is variable and depends on what is done during surgery to address your individual needs and goals. The surgical procedure can take between 2 and 6 hours, but averages approximately 3.5 hours.

An external nasal splint is typically placed after surgery and removed approximately 1 week after surgery. An internal nasal splint may be placed, depending on how much work is performed on the septum. Most visible bruising resolves in 1 – 2 weeks and patients can typically return to work after this time. The majority of swelling subsides within a few weeks, however, the final appearance of the nose after rhinoplasty will continue to emerge up to 1 year after surgery. Most patients will take pain medication for 1 – 2 days after surgery.

Depending on the patient’s individual concerns and potential breathing issues, the nasal bones may need to be reshaped to straighten the nose, to decrease the width of the nose, or to reconstruct the bridge of the nose if a significant nasal hump is reduced.

“Breaking” the nasal bones is a harsh term. If indicated, the nasal bones are precisely cut, shaped and repositioned to optimize the aesthetic and functional outcome of surgery.

It depends. Insurance will not cover the cost of a rhinoplasty performed for an isolated cosmetic reason. Insurance may cover a portion of the cost of rhinoplasty if you have functional problems with your nose that affect your breathing. Policies on what is potentially covered by insurance can vary between insurance carriers.

The need for using a patient’s rib cartilage is quite rare. Cartilage from the nose itself (typically the septum) is used to help improve the shape of the nose during rhinoplasty – this means that no additional incisions are required on other areas of the body.

Ear cartilage is very rarely used because ear cartilage is curved and unfortunately not useful to help straighten a nose.

Occasionally, and more commonly with revision rhinoplasty, cadaveric rib cartilage may be used to help straighten and improve the shape of the nose. Cadaveric cartilage has a strong track record of safety and longevity. The benefit of using cadaveric cartilage is that it avoids having to harvest the patient’s own rib cartilage and the associated scar, it decreases the length of surgery, and decreases pain and discomfort after surgery.

All surgical procedures carry a degree of uncertainty and risk. Thankfully, the risk of any major complication is rare.

Rhinoplasty incisions typically heal very well. Infection and bleeding are rare but can occur. It is important to avoid strenuous activity, blood thinning medications, and that your blood pressure is well controlled after surgery to decrease the risk of bleeding.

We all have natural asymmetries between each side of our nose and face – some people more than others. After a rhinoplasty, some asymmetries will still exist.

Occasionally, another procedure may be needed to make adjustments to the nose. If this is required, this is usually done at least 1 year after surgery.