Understanding Rhinoplasty: Enhancing Your Beauty & Function

Rhinoplasty, colloquially known as a ‘nose job’, is a surgical procedure designed to reshape or resize the nose. It can be performed for cosmetic reasons, to improve the aesthetic appearance of the nose, or for functional purposes, to enhance breathing. Here at Dr. Haley Carpenter's practice, we specialize in both, ensuring your nose not only complements your facial features but also functions optimally.

Rhinoplasty surgery is truly an art. 

Your nose is a central feature of your face, and when choosing a rhinoplasty surgeon, it's critical to ensure that your surgeon's artistic style and vision matches your goals. 

Dr. Carpenter's artistic philosophy for rhinoplasty is the following:

• Her goal is to give you a beautiful, natural looking result that fits your face
• Whether you want a smaller tip, to get rid of a hump, a dorsal 'swoop' or just a straight profile, Dr. Carpenter wants your nose to fit into your aesthetic and look like a nose you were born with
• Sometimes when a nose has a dorsal hump, is crooked, or has a tip that is disproportionately large, it detracts from your face because a prominent nose can dominate your facial features and draw attention away from your eyes, lips, cheeks, etc. 
• Your rhinoplasty result should harmonize with your facial features, allowing the beauty (or handsomeness) of your natural beauty to shine through
• Dr. Carpenter's goal is not to have an over-done rhinoplasty with a nose that is too small or too pointy (that type of result can also negatively draw too much attention to the nose) - the goal is to have a beautiful nose, but when someone looks at your face, your nose should be so naturally beautiful that it brings out your eyes and your smile

For cosmetic rhinoplasty, there are four major areas we address to bring your nose into harmony with your facial features:

• Upper Vault: This section of your nose consists of your nasal bones. To refine this area, these bones might be broken to allow for narrowing. If they protrude, they can be filed down to reduce the nose's profile, creating a smoother look.
• Mid Vault: Comprised of the upper lateral cartilage and the top of the nasal septal cartilage, this part often causes the nasal 'hump'. By trimming or reshaping these cartilages, we can achieve either a flat or a gentle slope to your nasal profile.
• Nasal Tip: Here, the lower lateral cartilage and the lower portion of the nasal septal cartilage come into play. To refine the tip, we might trim these cartilages or use cartilage grafts from your nasal septum or ear to enhance shape and definition.
• Alar Base: Although less common, if you wish to narrow the width of your nostrils, a weir incision can be made. This incision, hidden inside your nose and in the natural crease between your nose and upper lip, brings the alar bases closer to the midline, subtly refining your nose's base.

While cosmetic rhinoplasty focuses on appearance, functional rhinoplasty addresses nasal airway obstruction. This includes:

• Straightening the nasal dorsum if your nose is externally crooked.
• Septoplasty to straighten the nasal septum inside your nose.
• Inferior turbinate reduction to manage enlarged turbinates that can obstruct airflow. Turbinates are bony structures lined with mucosa inside your nose that help warm, humidify, and filter the air you breathe.
• Spreader grafts to widen the airway.

Functional rhinoplasty can be combined with cosmetic rhinoplasty or performed independently if you're content with your nose's appearance but seek improved breathing. Some insurance companies will help cover the cost of functional rhinoplasty, call your insurance to see if functional procedures are a covered benefit for you. 

After your rhinoplasty, expect:

• A splint over your nose for about one week to aid in proper healing and to help control swelling.
• Silicone splints inside your nostrils, along with prescriptions for nasal saline spray to keep passages clear.
• Antibiotics while internal splints are in place to prevent infection.
• Sutures both external and internal, which will be removed at your one-week follow-up.
• Swelling will be most pronounced in the first few weeks, with final results developing over the course of a year.

At Vitruvian Surgical Institute of Coral Springs, we believe in a personal approach to each patient’s journey. Whether you're looking to enhance your facial harmony or improve your nasal function, Dr.  Carpenter is here to guide you through the process with warmth and expertise. 

We invite you to schedule a complimentary in-person consultation with Dr. Carpenter, where we can discuss your goals, explore your options, and tailor a plan that's just right for you for your rhinoplasty. Let's work together to bring out your natural beauty and ensure you breathe easier. Contact us today to start your transformation at 954-344-4344. 

• For the first week after surgery, you will have a splint on the outside of your nose, and most likely on the inside of your nose as well. You will also have sutures on both the outside of your nose on your columella and inside of your nose. At your first postop appointment 1 week after surgery both splints and your outside sutures will be removed. The sutures on the inside of your nose are dissolvable and will fall out on their own
• Aggressive head of bed elevation: If you have a lazy boy chair or a reclining sofa this is the best place to sleep, as you can control the level of elevation. If not, plan to sleep on as many pillows as you can tolerate, or consider getting a wedge pillow to sleep on. Keeping your head elevated at night helps keep the swelling down and expedites your healing. 
• Nasal drainage: After rhinoplasty, it is normal to have bloody drainage from your nostril for the first several days. If this is coming from the front, you can create a nasal drip pad using a mask and gauze to collect the drainage. You might also experience bloody postnasal drip. If this is the case, drink lots of water and consider taking your Zofran, as swallowing blood can make you feel nauseous
• Antibiotic: You will be prescribed an antibiotic to take twice daily after surgery. If you run out of this medication before your nasal splints are removed, call the office for a refill.
• Ointment: You should put ointment on your external incision 3 times a day, and more often if necessary to keep moist. This provides an optimal healing environment for your scar, and prevents formation of scabs along your suture line. Additionally, if the incisions inside your nostrils are irritating you, you can also put the ointment on a Q-tip and gently rub inside your nostril. For the first 3 days after surgery, you should use the antibiotic ointment that was prescribed to you. After that, switch to a plain ointment like Aquaphor (preferred) or Vaseline. The reason that you switch to a plain ointment is that antibiotic ointment can irritate the skin if used for too long. Make sure you apply ointment the day of your first postop appointment, as that will make removal of the sutures more comfortable.
• Sneezing and blowing your nose: Sneezing or blowing your nose can increase the pressure around your nose and can cause postoperative bleeding, either under your nasal skin or inside your septum. If you have to sneeze, try sneezing with your mouth open if possible, and avoid intentionally blowing your nose–just wipe beneath your nose if you have any nasal drainage.
• Nasal spray: If you have internal nasal splints, these are silicone splints placed inside your nostrils to support your septum as it heals. The splints have passages to allow airflow, but those passages can become clogged with dried blood or mucus. To prevent this, use a nasal saline spray every 1-2 hours while awake to keep these passageways patent. Use a nasal saline spray that has a pump/mist handle (ie, don't use a Neti pot or a nasal spray that comes out in a stream).
• Showers and face washing: avoid getting your face wet for the first week. You can gently wipe your face, avoiding the nose area, with facial wipes. Take tepid (only mildly warm) showers - that is because showers that are too steamy can cause the tape on your nasal splint to moisten and fall off prematurely. You can wash your hair, just keep your face dry. The day of your first post operative appointment you can take a hot, steamy shower - that will loosen your dressing and make removal more comfortable. After your splints are removed you can take steamy showers again - this will help your breathing and clear out any remaining mucous in your nose. In the first 2 months after your nasal splints are removed you can let warm soapy water wash over your nose, but don't scrub or put pressure on your nose as your cartilage and bones are still healing.
• Icing: You can put ice packs over your eyes if they are swollen after the surgery, but do NOT put ice or hot packs over your nose. 
• Trauma: avoid nasal trauma for at least 2 months after surgery. Your bones are healing and trauma can damage your nose and alter your cosmetic result. No contact sports or sports with balls that could strike your face (basketball, soccer, etc., etc.). If you do have nasal trauma, contact the office right away, as you may need Dr. Carpenter to 're-set' your nasal bones to make sure they stay straight. 
• Bruising and Swelling: this is normal after rhinoplasty. In addition to a swollen nose, bruising and swelling under your eyes is common. Swelling is highest the first 2 weeks after surgery. Paradoxically, swelling sometimes increased the 2nd week after surgery, after your external splint is removed. After your first appointment for splint removal, be sure to continue head elevation to minimize your swelling. The majority of your swelling will be gone after the first month, but it can take a whole year after rhinoplasty for your final result. 
• Taping: After your external splints are removed, Dr. Carpenter may instruct you to perform taping of your nose. The purpose of this is to control post operative swelling, and to get the nasal skin to heal down tight to your nasal cartilage, giving you your most refined result. 
• Activity: no heavy lifting over 10 lbs or strenuous activity for 4 weeks after surgery. Avoid bending over to pick things up (bend at your knees instead). These activity limitations are to minimize your swelling and prevent post operative bleeding (a hematoma), which can happen if your heart rate or blood pressure are elevated in the early healing phase. Walking as far as you'd like is okay and encouraged to stay active. After 4 weeks, Dr. Carpenter will provide instructions on how to ease back in to your normal activity routine. 
• Call with any questions or concerns: If you have any concerns after your surgery, Dr. Carpenter wants to hear about them. We want your healing and surgical experience to go smoothly and you to be in comfort.