Rhinoplasty (Cosmetic Nose Reshaping Surgery) – Leesburg, VA

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Introduction

The nose is the central feature of your face and comes in all shapes and sizes.  If you are unhappy with the size or shape of your nose, rhinoplasty is a safe, effective, and time-tested solution that can greatly improve your appearance and the balance of your facial features.

Overview

An attractive face is all about balance and proportion. The nose, located front and center of the face, provides the foundation for this sense of aesthetic balance. With the help of a skilled plastic surgeon, the nose can be reshaped and refined to enhance your natural beauty.

Rhinoplasty, or nose reshaping surgery, improves the shape, size, and symmetry of a person’s nose, bringing it into better proportion with the rest of the face. When performed by a skilled plastic surgeon, nose reshaping can be a rewarding and life-enhancing procedure. Patients often notice that their overall appearance has improved, as the nose they see now looks natural, like the nose they always thought they should have.

There are many reasons why patients might choose to have a nose job procedure. The reasons, however, are unique to each individual. Some of the reasons are more intellectually based while some are more emotionally based. Whatever the reason, you can be sure that Dr. Chang will freely discuss them with you.
 

With a Rhinoplasty:

  • Large noses can be made smaller
  • Small noses can be made larger
  • Button noses can be made more elegant and refined
  • Crooked noses can be made straight
  • Nasal numbs can be flattened
  • Flat noses can be given more volume
  • Nostrils that are too wide are large can be made more narrow


At Aesthetica in Leesburg, VA plastic surgeon Dr. Phillip Chang is expert in and has a love for performing rhinoplasty procedures.    He feels that the nose is the central focus of the face; even mild changes in the nose, whether there is a dorsal hump or whether the nasal tip is too broad, these minimal changes can make dramatic changes and improvements in your appearance; and dramatic improvements in how you see yourself cosmetically can result in dramatic improvements in your self confidence and self-esteem.

 

Ideal Candidates

You are a good candidate for a nose job if you are over 16 years of age and otherwise healthy.   Facial growth and maturity should be complete.

Many patients will seek out a consultation for reasons related to trauma.  Some patients will come in for breathing difficulties.   Most patients, however, have cosmetic concerns about the natural appearance of their nose.  You are a candidate for a nose reshaping surgery, aka a rhinoplasty, if:

  • You think you have a nasal hump
  • You think the nasal tip is too large or bulbous
  • You think the nasal bones are too wide
  • You think the nostrils are large are wide
  • You think the nose is crooked
  • You think the nose is too flat

Common Complaints about the nose and their treatments

Nasal hump  - A nasal hump is one of the most common complaints of patients coming in for evaluation for a nose job.  People usually prefer a straight or a slightly scooped nasal top.  The nasal hump is more of a western or middle eastern feature.  It is made up of bone and cartilage.  The hump is usually taken care of by introducing a rasp through a closed rhinoplasty procedure if nasal tip surgery is not needed and an open rhinoplasty if a nasal tip is required.

Shallow nasal height - A flat nose is often a feature of Asian or in patients of color.  Their nasal bones are shallow and their nasal tips tend to be broad or bulbous.  Non-surgical rhinoplasty can often be useful in these patients.  Injectable fillers, including Juvederm, Voluma, or Radiesse, can be injected directly onto the nasal bone to provide the nose with more height.  Filler can also be delicately placed over the nasal tip cartilages to give the tip more definition and less bulbous.  A more permanent solution would call for a nasal implant or cartilage graft.  Either of these materials can be used to placed over the nasal bones to give it more height.

Bulbous nasal tip  -   A bulbous nasal tip is caused by wide and separated nasal tip cartilages.  A wide nasal cartilage can be made more narrow and separated nasal tips cartilages can be sutured together in the midline. Intercartilaginous and intracartilaginous sutures can be placed to provide more narrowing and more definition.  These delicate maneuvers are better performed using an open rhinoplasty technique where the cartilages can be directly visualized.

Large or wide nostrils-   Wide or flaring nostrils can be treated with a Weir excision.  This procedure takes a wedge out of the base of the nostril arch.  The nostril is brought  into the nasal crease to hide the scar and narrow the circular edge.

Wide nasal bones-   Wide nasal bone are made more narrow by breaking the nasal bones at their base followed by pushing them together toward the midline.  This is performed with a very narrow chisel through a very small and almost invisible incision.  Lowering the nasal hump and narrowing the nasal bones are the two major reasons why the external splint is needed after a rhinoplasty.

Hanging columella -  A septoplasty is a procedure to fix a deviated septum.  The septum is the cartilage the separates the two nasal cavities.  The septum is naturally straight but it can deviate with time or after a traumatic injury.  The deviation can sometimes result in closing off of one of the nasal cavities, making it difficult to breath.  If this is the case, the part of the septum that is curved or causing the breathing problem can be removed.

Surgical Technique

The goals of a nose job is to reshape the nose to give a more pleasing appearance.  This is performed non-surgically using injectable fillers or surgically through either an open rhinoplasty technique or a closed rhinoplasty technique.  Most surgical procedures are performed at the surgery center under general anesthesia.  Some minor issues can be treated in the office under local anesthesia

Non-surgical rhinoplasty  - Non-surgical rhinoplasty is a technique that Dr. Chang pioneered in Virginia in 2001.  He is an expert injector who has treated thousands of patients using this technique.  It is ideal for patients with flat nasal bones, small nasal humps, small depressions, and wide nasal tips.  The procedure is performed by strategically injecting fillers and provides immediate results that can last up to 2 years.  In many patients, this procedure allows patients with minor issues to avoid the time, risk, and expense of surgery

Closed Rhinoplasty -  The two major surgical techniques for performing a nose reshaping procedure are the closed and the open rhinoplasty techniques.  aDr. Chang performs both depending on the nature of your issues.  Closed procedures have no visible external scars.  An incision is placed inside the nose and all the work is performed using this incision.  This procedure is ideal for patients who do NOT need work on their nasal tip cartilages.  It is ideal for patients who only need work to either reduce a nasal hump or narrow the nasal bones

Open Rhinoplasty  -   The two major surgical techniques for performing a nose reshaping procedure are the closed and the open rhinoplasty techniques.  Open rhinoplasty procedures are performed using incisions inside the nose that extends to an surface incision at the bottom of the nose on the columella.  This incision is used for patients who require work on their nasal tip cartilages, either to refine the tip, narrow the tip, or to make it smaller.  The nasal bones can also be addressed through this incision.  

Nostril Narrowing ( Wier Excision ) -   This procedure is performed to make smaller a large or flaring nostril

Septoplasty-  A septoplasty is a procedure to fix a deviated septum.  The septum is the cartilage the separates the two nasal cavities.  The septum is naturally straight but it can deviate with time or after a traumatic injury.  The deviation can sometimes result in closing off of one of the nasal cavities, making it difficult to breath.   A septoplasty can be performed to remove the part of the septum that is curved or causing the breathing problems at the same time of your rhinoplasty.

What to Expect

Pain after a Rhinoplasty

Recovery after a nose job depends on what kind of procedures were performed.  Contrary to popular belief, nose reshaping procedures are not particularly painful and most patients will need narcotic pain medication for more than a day or two.  If a nasal hump or osteotomy ( to narrow the nasal bones ) is performed, an external splint is on for 7-10 days.  If a septoplasty is performed, internal septal splints are placed for 7-10 days.  If a septoplasty is not performed, the nosed is packed with a non-stick dressing for 2-3 days.  Some minor bleeding is expected for 1-3 days.  

Return to work after a plastic surgery after a nose job surgery:  

Most patients will  :

  • Most patients will be “mentally capable” of work in 3-5 days
  • External splint ( if needed ) is removed in 7-10 days
  • Internal splint ( if needed ) is removed in 7-10 days
  • Nasal packing is removed in 2-3 days
  • External sutures are removed in 7-10 days
  • Internal sutures are absorbable by may need to be addressed in 7-10 days
  • Clean suture line with peroxide IF there is crusting and then apply ointment 2-3x per day

When will you see the final results of a plastic surgery after nose job:  

Although patients will look presentable almost immediately, final results of nose reshaping are not usually seen for at least 6 months to a year.   This is particularly true of the nasal tip.   The nose will continue to change until the tip cartilage feels soft to the touch.

  • Moderate swelling for up to 3 months
  • Mild swelling for 6-12 months
  • Revisions are NEVER performed except under special circumstances performed until 12 month

What are the risks and complications of plastic surgery after nose job surgery?

As with any surgery, there are associated risks.  Only you can decide whether a plastic surgery after nose job can achieve your goals and whether the recovery and risk profile are acceptable to you.  National statistics show that revisions after nose reshaping is required in 10-20 percent of all patients.  Fortunately, most revisions are minor.  The most common complications are problems with delayed healing, infection from the stitches, minor tissue loss in areas of delayed healing, and widened or thickened scars and the need for more surgery.  

Although infrequent, the risks and complications of plastic surgery after nose job can include

  • Bleeding, hematoma, or bruising
  • Asymmetry
  • Infection particularly from the absorbable sutures
  • Change in sensation
  • Widened or thickened scar especially in patients of color
  • Delayed wound healing or tissue necrosis
  • Under-correction or Over-correction
  • Unsatisfactory results that may require additional procedures.  Patients are responsible for any associated facility fees.  

Frequently Asked Questions

How much does rhinoplasty cost?
The cost of rhinoplasty varies based on what technique is used and how complex your procedure is. Before estimating costs, Dr. Chang will listen to your concerns and goals to help develop your custom treatment plan. When this is done, he can discuss costs for the facility, anesthesia, and more. For your best results, it's important to focus on selecting an experienced surgeon, like Dr. Chang, instead of the lowest cost. To help make your surgery easy to afford, Aesthetica Cosmetic Surgery & Laser Center accepts several payment methods and our office can help you find low-interest financing.

The cost of a plastic surgery after nose job surgery depends on the type of surgery.  Cost should be only a small factor in choosing the plastic surgeon.  The prices listed below are subject to change.  Combined procedures ar often discounted dramatically.  Facility center fees are only estimates

  • Surgeon’s fee - Open rhinoplasty - $7,500.
  • Surgeon’s fee -  Closed rhinoplasty  - $6,500
  • Surgeon’s fee - Nostril reduction  - $2,000
  • Surgeon’s fee - Cartilage graft from the ear - $2,000
  • Surgeon’s fee - Septoplasty  - $2,000
  • Surgery Center Fees -   $ 2,000ish
  • Combined procedures are usually discounted
  • VIP Members may have a discounted rate

Will my insurance cover functional nose surgery?
Although rhinoplasty for cosmetic reasons is not paid by insurance, functional rhinoplasty that is medically necessary to improve your breathing may be covered. If you may be applying for reimbursement from your insurance, please tell Dr. Chang in your consultation. We can help you submit any needed information and paperwork to your insurance to process your claim.

Are there nonsurgical options to change my nose?
If you want to smooth lumps and bumps on your nose, a wrinkle filler (like Restylane or Juvéderm) might be an option. A filler can temporarily improve minor imperfections, which might help you decide to get a rhinoplasty. Nose surgery is better for larger changes, long-lasting results, and to adjust the internal structure for better function. At your consultation, Dr. Chang can tell you more about nonsurgical nose reshaping.

What about ethnic rhinoplasty?
Ethnic rhinoplasty is about improving the nose while still keeping your cultural identity. This is often a concern if you are African-American, Asian, or Middle Eastern. In your consultation with Dr. Chang, you can talk about what you want to keep and what you want to change. This will allow him to personalize your treatment plan to give you your best results.

Can I combine nose surgery with other facial surgeries?
Some patients think about combining rhinoplasty with another procedure, like cheek or chin augmentation. Having multiple surgeries for a dramatic result can be reviewed during your consultation with Dr. Chang. Once he understands your goals, he can help you choose which procedures will be in your custom plan. Rhinoplasty can help your whole face appear more balanced, so you should wait to see your results before getting another procedure.

Your Best Nose

Nose surgery is a great option to address the distaste you might feel when looking in the mirror at your appearance. If you're dissatisfied with the size and shape of your nose or if you suffer from breathing problems, nose surgery may help. Nose surgery is a popular cosmetic procedure with very high success rates. Plastic surgeon Dr. Chang aims to improve your nose so your entire face appears more attractive and proportionate. Even minor adjustments can lead to an impressive difference. We encourage you to get in touch with Aesthetica Cosmetic Surgery & Laser Center in Leesburg, VA and schedule an appointment.

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*Individual results are not guaranteed and may vary from person to person. Images may contain models.