What is a Rhinoplasty?
Rhinoplasty is a precise and technically advanced procedure that can improve both the appearance and the function of the nose. If there are features of your nose that you would like to change — or if you are having trouble breathing — the procedure can provide aesthetic enhancement and a better quality of life.
Septoplasty may be included in a rhinoplasty. The septum is the natural segment of bone and cartilage that separates the two air passages inside the nostrils. Injury or genetics can shift the septum out of place and partially limit your ability to breathe. With a septoplasty, we can correct this deviated septum and clear your breathing passages.
Dr. Jennifer Parker Porter, founder of Chevy Chase Facial Plastic Surgery, offers experienced and expert care to patients in need of a rhinoplasty.
Do You Need a Rhinoplasty Revision?
Previous rhinoplasty procedures in your medical history do not preclude you from having the procedure done again. Patients who have had an unsatisfying experience with another plastic surgeon make up about half of the rhinoplasty cases we see at Chevy Chase Facial Plastic Surgery. Most frequently, patients choose to have a revision rhinoplasty because they are having trouble breathing. Dr. Porter can also address cosmetic concerns related to an earlier rhinoplasty.
Revision rhinoplasty tends to be more complex than the initial procedure because of changes that the first surgery makes to the structures of the nose. Dr. Porter can discuss these issues during your initial consultation so that you know what to expect. Previous operative reports are helpful if available. If your nose has been injured or undergone any surgery in the past then you should inform Dr. Porter at the time of your consultation.
During the consultation Dr. Porter will determine whether the procedure will require cartilage grafts from other areas of the body. This is not necessary in all cases. A majority of revision rhinoplasty procedures involve an external, or open, approach. This is to better visualize the work previously performed.
The Benefits of a Rhinoplasty from Dr. Porter
Washington, DC-area patients consider rhinoplasty both for their cosmetic improvement and their comfort. With this surgery, Dr. Porter can:
- Remove an unwanted hump or bump
- Alter a nose to be in proportion with other facial features
- Make a wide nose narrower
- Fix a flat or droopy nose
- Revise large or flaring nostrils
- Address traumatic deformities
Dr. Porter has spent over 20 years in practice with a primary surgical focus on rhinoplasty. She serves as a clinical associate professor at Georgetown University Medical Center and has contributed book chapters and journal articles on the subject to several medical texts and publications.
What to Expect for Your Rhinoplasty Treatment
As responsible practitioners, the team at CCFPS wants to ensure that you get the care you need. We encourage you to start your experience by contacting our office, discussing your concerns and goals, and getting information about the type of improvement rhinoplasty can offer you. Some insurance companies will compensate patients for surgeries that address function. While CCFPS does not take insurance, we can give you the codes to use with your insurer.
The next step is an initial consultation with Dr. Porter, who will go over your medical history, examine your face and nose, and review digital photographs with you. Most of our patients are excited about this part of the process. Dr. Porter will use sophisticated MIRROR® imaging technology to show you what you can expect from your results. As part of treatment planning, she will also aim to create a look that respects your cultural heritage and aesthetic individuality.
For revision rhinoplasty, Dr. Porter will determine during the consultation whether the procedure will require cartilage grafts from other areas of the body. This is not necessary in all cases. A majority of revision rhinoplasty procedures involve an external, or open, approach. This is to better visualize the work previously performed.
When you decide that you are ready to move forward, our practice will schedule your surgery. You will return to CCFPS for a preoperative visit two weeks beforehand so that we can review the surgical plan and answer any other questions you may have. Our goal is for you to enter your procedure with complete confidence and comfort in the decision.
Dr. Porter conducts her rhinoplasty procedures at the Suburban Outpatient Surgery Center in Bethesda and at Georgetown University Hospital in Washington, DC. Most of our patients receive general anesthesia so that they can sleep through the entire experience.
The techniques that Dr. Porter will use during your rhinoplasty will depend on your needs and goals:
- She is skilled in both “open” and “closed” procedures and will advise you about the approach she will use during your consultation
- If you are having rhinoplasty for cosmetic purposes, Dr. Porter will revise internal and external features of the nose to create a more balanced and aesthetically pleasing appearance.
- If you are having surgery to improve problems with breathing, she will work expertly and with precision to rebuild and support the internal structure of the nose.
- Regardless of the goals of the procedure, Dr. Porter will use special techniques in the operating room to minimize bruising so that you can heal more quickly and comfortably.
What Determines an Ideal Candidate for a Rhinoplasty?
Rhinoplasty results vary depending on each patient’s circumstances. Once you have decided to undergo the procedure, Dr. Porter will assess your nose structurally and aesthetically by taking the following into account:
- Pre-existing bone and cartilage structure of your nose
- The shape of your face
- Your age
- The thickness of your skin
Dr. Porter will use this information to construct a treatment plan to optimize your outcome. Cosmetic nose surgery should be performed on persons whose facial structure has stabilized. In most cases it is not a recommended procedure for minors, particularly if they have not completed the growth spurts that usually conclude in the mid to late teen years.
The Recovery Process
After rhinoplasty, you will spend about an hour recovering at the hospital before heading home with light nasal packing. We will see you back at CCFPS the next day where we will remove the packing, and for the next week, you will use salt water nasal spray on a daily basis. If you have a cast and sutures, Dr. Porter will remove them one week after surgery.
Nine to ten days following rhinoplasty, most patients are comfortable socializing and returning to work. Eighty percent of the swelling should subside within one month, and if you have had rhinoplasty to improve your ability to breath, you should notice a difference by this point. Cosmetic patients should see the final result of their procedure after about one year: a more refined and aesthetically appealing nose that fits naturally with their other facial features.
Rhinoplasty Frequently Asked Questions
What Are the Functional Benefits of Rhinoplasty?
Rhinoplasty is about more than just cosmetic appearance. Rhinoplasty can be performed in conjunction with functional techniques. There are a number of functional benefits incorporated with rhinoplasty patients and beyond. For example, many patients have trouble breathing through their nose because of a defect in their nasal valves. These valves might have narrowed due to old age or trauma, or a person could have been born with narrower-than-usual nasal valves. Whatever the case, this limits the flow of air to the lungs, preventing the person from taking a full breath through their nose. During a rhinoplasty, Dr. Porter can help to open up these airways through grafting techniques and repairing cartilage in the nose.
Functional rhinoplasty can provide patients with some of the following benefits:
- Ability to breathe better, especially when working out or sleeping, as the airways are wider
- Improved well-being, as the patient may be receiving more oxygen than they are used to
- Improved appearance, as removal of cartilage can sometimes change the appearance of the nose for a sleeker, refined look
Functional rhinoplasty differs from cosmetic rhinoplasty because these functional improvements are the main goal of the treatment. Cosmetic rhinoplasty, on the other hand, is done solely to increase a person’s aesthetic appearance. In many cases, those who seek functional rhinoplasty may also see a change to the shape of their nose, as Dr. Porter will have to remove some cartilage to widen the airways. However unintended this benefit is, it’s still a nice bonus for patients.
What Is the Difference Between Open Rhinoplasty and Closed Rhinoplasty?
While open rhinoplasty and closed rhinoplasty are two separate approaches, in the end, they provide the same, long-lasting results for patients.
An open rhinoplasty involves making a small cut in the skin between the nostrils, called the columella. Then, Dr. Porter can lift the skin out of the way and visualize the underlying structure of the nose to begin the procedure. A closed rhinoplasty, on the other hand, only involves incisions inside the nose, so the patient won’t have any visible scarring. Closed rhinoplasties are appropriate for patients that want hump removal or need changes to the nasal tip.
While Dr. Porter will have a better view of the nose with an open rhinoplasty, the procedure can leave patients with a small scar underneath their nose. On the other hand, a closed rhinoplasty eliminates scarring but makes the procedure slightly more challenging if more drastic changes are desired.
Before deciding on whether or not an open or closed rhinoplasty is appropriate, Dr. Porter will perform a full examination on each patient. She’ll ask them about their treatment goals and take a look at the current structure of their nose to decide which procedure would provide results that align closest with their expectations. In general, patients who are having moderate work done on their nasal bridge can benefit most from closed rhinoplasty, while patients who are having work done on their nasal tip (such as the removal of a malformed or bulbous tip) or other extensive reshaping are best suited for an open rhinoplasty.
Rhinoplasty – What Should I Expect?
A wide range of aesthetic goals can be met at our cosmetic surgery practice. Surgeon Dr. Jennifer Parker Porter is one of the area’s best in cosmetic nose surgery, and can alter the size of your nose, change the shape of the tip or the bridge, adjust the width of the nostrils, or alter the angle of the nose in relation to the upper lip. Rhinoplasty can remove a hump and improve nasal disproportion. In addition to achieving cosmetic improvements, the procedure can also be employed to correct problems resulting from nose injuries and can help relieve certain breathing difficulties.
How Is a Cosmetic Nose Surgery Procedure Performed?
There are two basic methods for performing cosmetic nose surgery, the open method and the closed method. At our Maryland rhinoplasty centre, Dr. Jennifer Parker Porter has had extensive experience with both methods. During an open rhinoplasty procedure Dr. Jennifer Parker Porter will make a small incision along the columella. The columella is the strip of tissue that separates the nostrils. An open rhinoplasty tends to leave a tiny scar, but the scar is hardly visible because it is strategically placed in an area that is usually in shadow. If a closed rhinoplasty procedure is performed then the sites of incision will all be internal, rather than external. Dr. Jennifer Parker Porter prefers to use the closed technique for the majority of her procedures, reserving the open technique for patients undergoing revision rhinoplasty, patients increasing their tip definition, or patients correcting an overall structural problem such as a crooked nose. The closed rhinoplasty procedure works best for patients with thin to medium skin thickness, while the open procedure is often the more suitable option for patients with increased skin thickness. There are benefits associated with both methods and a comprehensive consultation with Jennifer Parker Porter, MD, is the only way to be certain about which method would be most appropriate for your specific rhinoplasty needs. Visit us to see a collection of rhinoplasty before and after pictures.
How Does the Computer Mirror® Imaging System Work?
The computer is able to transform a photograph of your face into an image of what you might look like following rhinoplasty. During your cosmetic surgery consultation, this photographic image can be manipulated based on your aesthetic preferences and any suggestions that Dr. Jennifer Parker Porter may have in accordance with her extensive experience as a rhinoplasty surgeon. The computer imaging system is a communication tool that allows you to more clearly express the desires you have for your nose’s ultimate appearance. In turn it enables Dr. Jennifer Parker Porter to show you exactly what is possible using the most recent advances in rhinoplasty surgical techniques and technology so that you can enjoy more realistic expectations for the outcome of the procedure.
How Long Is the Recovery Period Following a Rhinoplasty Procedure?
Recovery time from cosmetic nose surgery can vary. Our rhinoplasty expert usually recommends that a patient reserve seven to 10 days for their initial recovery. The cast and stitches, if any are present, are removed approximately one week after surgery. Sometimes patients are fitted with a nose splint to stabilize the septum, the wall dividing the nasal passages. If present, this is also removed after about a week. Bruising is common following the procedure. Shortly after any postoperative dressings have been removed, many patients feel strong enough to resume light activities, such as having dinner with friends, driving, or going to the movies. Remember, however, that a complete recovery after cosmetic nose surgery will take time and patience. The final results of your cosmetic surgery will not be apparent for up to a year after rhinoplasty is performed. You should avoid strenuous activities for at least four weeks and avoid excessive direct sun exposure to help ensure a smooth recovery. Complications associated with the procedure are rare and usually minor. The risk of complications can be greatly reduced by adherence to Dr. Jennifer Parker Porter’s post-operative care instructions.
How does Rhinoplasty differ for patients from different ethnic backgrounds?
I have written several book chapters on this topic and, through the years, have treated many patients from a variety of ethnicities. Whether it is African American Rhinoplasty, Asian Rhinoplasty, or Rhinoplasty in patients of Latino descent, each patient is approached on an individual basis. Frequently I find that the external approach is the preferred surgical approach because of the thickness of the skin and the desire for increased definition of the tip. The external approach allows for further contouring that will become apparent as the nose heals. Additionally, the healing time to reach the final result in the “ethnic” rhinoplasty patient is usually on the order of one and a half years. Although there are obvious changes early on, this extra time is the time to refinement. Visit your best clinic for plastic surgery in Chevy Chase MD. We’ll be happy to share our rhinoplasty before and after collection of satisfied procedures.
Book A Consultation
With rhinoplasty, Dr. Porter produces natural-looking results that are in harmony with each patient’s features. She carefully considers the functional aspect of procedures to improve or maintain proper breathing. Outcomes reflect the patient’s personal aesthetic vision, based on our doctor’s skill and on the collaborative and extensive consultation that makes up treatment.
Talk with an experienced facial plastic surgeon about your options with rhinoplasty. Schedule a consultation online with CCFPS or by calling us at (301) 652-8191.