Jesse E. Smith, M.D., F.A.C.S
A Dallas-Fort Worth Rhinoplasty specialist, Jesse E Smith, MD, FACS, is not your average plastic surgeon. He is specially trained in facial plastic surgery, a rigorous additional course of study focusing only on cosmetic surgery of the face. He is double board certified in Facial Plastic and Reconstructive Surgery as well as Head and Neck Surgery. Dr. Smith has performed hundreds of rhinoplasty procedures.
What is Rhinoplasty (“Nose Job”)?Preservation RhinoplastyTypes of RhinoplastyRhinoplasty Before & AfterHow Does Rhinoplasty Work?Rhinoplasty CostNon-Surgical RhinoplastyReconstructive RhinoplastyEthnic RhinoplastyRevision RhinoplastyRhinoplasty RecoveryFrequently Asked Rhinoplasty Questions (FARQs)
What is Rhinoplasty (“Nose Job”)?
Rhinoplasty, aka a “Nose Job,” is a surgical procedure to correct the form and/or function of the nose. It can reshape the nose and make it fit better with other facial features. It may also be used to improve breathing function by relieving obstructions in the nasal airway.
The word “Rhinoplasty” comes from ancient Greek:
– rhino – of or relating to the nose
– plasty – to form or shape
Thus “rhinoplasty” means to form or shape the nose. It is a popular procedure as it can fully transform the appearance of the face. Choosing an experienced facial plastic surgeon is essential to getting the most out of a rhinoplasty procedure.
Types of Rhinoplasty
Patients consult with Dr. Smith about rhinoplasty for many different types of rhinoplasty. He offers surgical and non-surgical approaches to suit each patient’s unique needs.
We usually divide the nose into horizontal thirds. The upper, middle, and lower third. These areas can all be adjusted with rhinoplasty. Common adjustments include nasal humps, low and upper thirds, nasal tip, and nostrils.
Each of these areas requires a unique approach and considerations which will be influenced by the other features of your face. During your consultation, you and Dr. Smith will discuss each of these factors and make a plan to achieve your goals.
While many conditions are treated using rhinoplasty, a few of the most common include:
- A bulbous tip on the nose
- A crooked or misaligned nose
- A boxy tip of the nose
- A drooping nasal tip
- A bump along the nasal bridge
- Disproportionally sized and/or misshapen nostrils
Both aesthetic and functional concerns may be resolved with nasal surgery. For instance, Dr. Smith may be able to correct poor breathing associated with a deviated septum or other structural problems.
The main idea behind a preservation rhinoplasty is to modify the nose while preserving as much of the tissue as possible.
This procedure demands the use of advanced surgical techniques. The surgeon will change the shape of the nose by removing small bits of cartilage and bone found under the bridge of the nose. Experienced facial plastic surgeons, like Dr. Smith, can reduce the height of the nose bridge without making changes elsewhere.
Assessing Your Rhinoplasty Needs
While consulting with Dr. Smith about rhinoplasty, there will be a conversation about your needs. There are several things you can expect to discuss, including:
- What your surgical goals are in terms of both breathing and appearance
- Any other surgeries you have had in the past
- The drug allergies, medical conditions, and treatments in your past
- All herbal supplements, vitamins, medications, tobacco, alcohol, and drugs you are using
In many cases, Dr. Smith will also ask additional questions and provide other services. These include:
- Talk about the likely outcome of the surgery as well as potential risks and complications
- Evaluate your current health and any risk factors or health conditions
- Recommend a course of treatment based on your specific situation
- Explains the options to you for nose reshaping
- Discuss all surgical and non-surgical options available to you
- Take photographs of your face
- Measure and examine your face
During the consultation, feel free to ask any questions you may have. It’s a good idea to understand the rhinoplasty process before you have the procedure done. If you feel anxiety or excitement about the potential surgery, you can share that with Dr. Smith.
Dr. Smith has performed thousands of rhinoplasty procedures. Here are a few examples.
How Does Rhinoplasty Work?
There are two broad approaches to rhinoplasty surgery: an open procedure or a closed one.
Open Rhinoplasty: In an an open rhinoplasty, a small incision is made in the columella, the area between the two nostrils, allowing the surgeon access to the nasal cavity.
Closed Rhinoplasty: In a closed rhinoplasty, the entire procedure is performed through the nostrils.
During your consultation, Dr. Smith will discuss which approach is best for your situation and goals.
What to Expect During the Rhinoplasty Process
During surgery, Dr. Smith will make incisions based on the closed or open technique chosen during treatment planning. In either case, bone, cartilage, and tissue will be removed and/or contoured to achieve the desired result.
In some rare cases, a graft of cartilage taken from the ear and/or rib may be needed for the ideal results. After the nasal sculpting is complete, incisions are carefully closed to offer the best healing.
While it varies by patient and the chosen operation, most rhinoplasty procedures last about two to three hours. Most patients can go home the same day as the procedure. A family member or friend should be present to supervise you at this time.
No matter which procedure is chosen, Dr. Smith uses a delicate surgical approach to ensure any potential scarring is hidden or nearly invisible after healing. This also results in less discomfort after surgery and a shorter downtime/recovery for the patient.
Who Is the Best Candidate for Rhinoplasty?
There is no specific age limit for a rhinoplasty, but most surgeons will only take patients in their late teens and older. Full facial growth should be complete before undergoing the rhinoplasty procedure.
The best candidate will also have other characteristics to ensure impeccable results. This individual will be a non-smoker or someone who has stopped smoking for six weeks or more before the plastic surgery procedure.
Ideal candidates will be in good health and have no specific medical conditions that interfere with healing after the rhinoplasty. In addition, all patients should have realistic expectations about the outcome of the surgery.
Meeting these requirements – and any others put in place by Dr. Smith is something that will be discussed in the consultation period before the procedure is completed.
The average rhinoplasty costs $10,000 to $15,000. Additional fees may be incurred for facility fees and anesthesia fees.
Depending on your procedure, insurance may pay some or all of the cost. Talk to Dr. Smith’s patient coordinator about what insurance may cover.
Non-Surgical Rhinoplasty (“Non-Surgical Nose Job”)
Dr. Smith often uses, at his offices in Colleyville and Dallas-Fort Worth, non-surgical rhinoplasty as an excellent option for minor asymmetries and small defects of the nose such as minor sidewall, hump, upper third, and tip refinement. Non-surgical rhinoplasty is completed with fillers that can give dramatic and immediate results with little to no downtime.
Reconstructive rhinoplasty is usually done for trauma or cancer defects. These procedures may be done all at once, or in stages. These procedures improve both nasal function and the aesthetics of the nose.
Different ethnicities may have different appearances and anatomical variations in their nose and face. Dr. Smith can work to change those variations, or work on keeping those variations while increasing your ability to breathe.
Revision rhinoplasty can be a difficult operation. Dr Smith has done hundreds of revision cases. Many times an open approach is needed to ensure that the underlying anatomy is in the correct position, and that all measurements are correct. Occasionally, rib or ear cartilage grafting may be necessary if all existing nasal septal cartilage has been utilized by other surgeons during previous surgeries.
What to Expect During Rhinoplasty Recovery
Dr. Smith’s number one rule after surgery is to act like you have had surgery. The first two weeks are crucial for healing, so you should avoid heavy lifting and strenuous activities.
Keep all pets and children at arm’s length, as head butts are more common after surgery than you might imagine.
Saline is used every 2 hours while awake after surgery to allow the internal nasal mucosa to heal quickly.
The first three days are the maximal swelling days. Sleeping in a recliner and keeping the nose above the level of the heart greatly assist with this edema. Most of the initial swelling is gone within the first 2-3 weeks. Residual swelling may remain for 3-12 months, depending on the extent of the procedure and the types of incisions made.
Most people take 7-10 days off from work.
The nose is kept dry for the 7-14 days in order to allow the external cast to remain intact. The cast helps shape the nose and resists swelling.
During follow-up visits with the office, we’ll monitor healing and work to make recovery a smooth process. Most swelling improves within a week and many people return to work at that time. The aesthetic outcome will improve gradually and may take up to a year to be fully apparent.
Does Rhinoplasty Hurt?
People tolerate rhinoplasty quite well. While there is pain involved with every surgery, the nose is usually slightly uncomfortable. Pain medicine is prescribed after the operation to keep you comfortable.
Is Rhinoplasty Safe?
Rhinoplasty is safe in healthy individuals. As with all surgeries, the major risks are pain, infection, bleeding, need for further surgeries.
Will I Have Scars?
Scars are minimal for rhinoplasty. They are hidden in the shadows of the nose, or within the nostrils.
What About Rhinoplasty for Men?
Male rhinoplasty is usually done for asymmetric noses, large humps, or breathing issues. Aesthetic rhinoplasty is becoming more common, and can be a helpful adjunct in the overall appearance of the face.
What is the Right Age for Rhinoplasty?
Rhinoplasty can be done on children for some traumatic purposes or for resection and reconstruction of cancer. Otherwise we usually reserve rhinoplasty for those 17 and above. We have done rhinoplasties on people into their 90’s who were healthy.