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Nose Surgery

There are several types of nose surgeries that The Graivier Center offers.

Rhinoplasty reshapes and resizes the nose to achieve an aesthetic goal.

Septoplasty corrects structural abnormalities like a deviated septum or crooked nose.

Nasal fillers are used to add subtle changes and correct asymmetries of the nose. 

When to Consider Nose Surgery

  • If you are unhappy with the shape, size or angle of your nose
  • If your nose is too large, too small or not in proportion to the rest of your face
  • If you have breathing problems resulting from irregularities inside your nose
  • If you have a nasal hump or a nasal tip that is drooping, too elevated or wide

Nose Surgery Consultation

During your consultation, Dr. Graivier will inquire in detail about the areas of your nasal appearance that bother you. You may bring pictures of noses that you like to the consultation, but your anatomy may not make it possible to achieve those results. Dr. Graivier will examine the external and internal parts of your nose. He will also determine if you are having nasal airway obstruction and if this needs to be dealt with at the time of rhinoplasty. You will then have pictures taken and a digital imaging program will allow you to show Dr. Graivier what you would like your nose to look like.

It is imperative that you make your desires known to Dr. Graivier during your consultation. The digital images will be printed for you to take home before making final decisions as to your desired nasal appearance. Keep in mind that the final result after surgery is often better than the altered images.

Nose Surgery Complementary Procedures

It is a common practice for patients undergoing nose surgery to combine several procedures at once that will offer complementary or enhanced results. At The Graivier Center, we will take the time to walk potential patients through all of the risks and benefits of each surgery, whether you choose a single treatment or multiple treatments.

Patients undergoing nose surgery can elect to combine the following procedures for enhanced results:

Rhinoplasty Surgery

If you are unhappy with the appearance of your nose, rhinoplasty surgery can reshape and/or resize your nose using some of the most modern technology in cosmetic surgery available today. Rhinoplasty can remove the hump on the bridge of the nose, reshape the tip, narrow the nostrils, reduce or increase the overall size of the nose, increase the angle between the nose and the upper lip and offer many other improvements.

Many factors have to be considered in making sure a patient’s expectations are reasonable. These would include the thickness of the nasal skin and the underlying support structures of the nose. A person with very thick nasal-tip skin will not have the same result as a patient with a very thin tip where cartilage can be seen underneath the skin. In addition, many people wish to retain the ethnic quality of their nose while changing a specific area.

Unless a congenital or traumatic nasal deformity has occurred, insurance will not cover this procedure. Surgery for nasal airway obstruction due to a deviated septum or an enlarged inferior turbinates is often performed at the same time as a rhinoplasty. These procedures may be covered by insurance. Sinus surgery may also be performed at the time of a rhinoplasty.

The operation is done in as an outpatient procedure, usually under general anesthesia. The surgery can be done through either an “open” or “closed” approach. The open approach entails an incision on the columella, which is the area between the two nostrils. This approach leads to better exposure of the nasal tip cartilages and is often used in patients with asymmetric tips or overly bulbous tips. In the closed approach, the incisions are on the inside of the nose. If the nostril bases are to be narrowed, there will also be an incision along the edges of the nostrils. These incisions heal extremely well and are barely perceptible in the future.

If the width of the nose needs to be narrowed, then the nasal bones will need to be fractured, which will cause more bruising and swelling than in those patients in whom fracturing is not necessary. If this is necessary, an external splint will be placed after the surgery, which will remain for six days. Dr. Graivier has developed a less traumatic technique to lessen bruising and swelling. If nasal packing is necessary, Dr. Graivier uses a small amount of absorbable material, which usually goes away on its own. A nasal drip pad will also be placed and usually needs to be changed several times in the first 36 hours.

Closed Rhinoplasty is used for minor nose reshaping. Incisions can be made within the nose. The skin of the nose is then separated from the bone and cartilage, which forms its supporting framework. Once exposed, bone and cartilage can be removed, reshaped, augmented or rearranged to achieve the desired new shape.

Rhinoplasty Recovery

During your nasal surgery, an external splint will be placed on the outside and absorbable packing will be placed inside your nose. The  splint will protect and support protect the new structures during the initial healing. An absorbable packing will be placed on the inside.  The splint is removed after one week.  

While initial swelling subsides within a few weeks, it may take up to one year for your new nasal contour to fully refine. Your nose will look good after one week, but swelling and some bruising may still be present. Your nose will look very good after four weeks, but will continue to improve over one year. During this time, you may notice gradual changes in the appearance of your nose as it refines to a more permanent outcome. 

You will be given specific instructions that may include:

  • How to care for the surgical site
  • Medications to apply or take orally to aid healing and reduce the potential for infection
  • Specific concerns to look for at the surgical site or in your general health
  • When to follow up with The Graivier Center

Septoplasty

Not all nasal surgery is performed for cosmetic reasons. A septoplasty corrects structural abnormalities like a deviated septum or crooked nose, which can lead to breathing problems, chronic stuffiness and postnasal drip. Straightening the nose and septum and opening up the internal portions of the nose can also be performed. This procedure can be performed at the same time as a rhinoplasty.

A deviated nasal septum is a displacement of the bone and cartilage that divides your two nostrils. During septoplasty, Dr. Graivier will straighten your nasal septum and reposition it in the middle of your nose. During your septoplasty consultation, Dr. Graivier will carefully consider your symptoms, such as breathing difficulties, along with the physical structure and features of your nose.

Nasal Contouring with Fillers                        

Nasal fillers can be used to add subtle changes and correct asymmetries of the nose. Dr. Graivier is the acknowledged “World Leader” in pioneering these techniques. Dr. Graivier has written the chapter on Nasal Contouring with Fillers and has been commissioned to produce training videos from The American Society of Plastic Surgeons.  

Patients who have never had nasal surgery or patients with previous nasal surgery can use nasal fillers to smooth areas and add contour to the nose. This treatment is beneficial for patients who are unsatisfied with the appearance of their nose, but need only minor improvements to achieve their desired look.

Fillers are especially helpful in the top of the nose, the nasal tip and even the sides of the nose. They can also be used to assist breathing and give structural support in some cases.

The injection only takes a few minutes and is done with topical anesthesia. The results are immediate and swelling resolves usually within six to 12 hours. You will have input into the appearance of your nose and you can request changes at the time of your injection.

Fillers in the nose tend to last longer than most other areas, often for nine months or longer. You will be asked to return to The Graivier Center four weeks after your injection to see if more filler is needed.

While nasal fillers are an affordable option for nasal contouring, please keep in mind that they do not offer permanent results.