Your plastic surgeon's experience and reputation make the greatest difference in the cost of rhinoplasty. Here in Manhattan, it is possible to undergo the procedure for as little as $3,000 when it is performed by surgeons-in-training, supervised by senior surgeons. Meanwhile, there are experienced surgeons who are not performing as many rhinoplasties as they would like, and may be willing to perform the procedure for $5,000 to $7,000. However, if rhinoplasty is your surgeon's specialty, this can provide the best chances of achieving the results you desire. His or her fees will reflect that, and depending on where the practice is located, the total cost of surgery can be upwards of $15,000.
With modern technology, patients can actually get a picture of the results of their rhinoplasty surgery. Digital imaging technology allows surgeons to construct 3-D virtual models of a patient's face and the future appearance. It is important to note, however, that while this 3D model will serve as a guide for the surgeon, there is no guarantee that the nose job will yield those precise results.
Before anything else, the surgeon determines a patient's candidacy for rhinoplasty. He or she takes the patient's health history, asks about medications and whether the patient smokes, and addresses other concerns. It is important for the patient to be honest with the doctor. Withholding certain information could increase the risk of surgical complications.
A revision rhinoplasty is a complicated surgery, because the surgeon now has to contend with thick scar tissue—which makes it difficult to raise the skin and soft tissue off the cartilage. “Plus, we often need to reconstruct part of the nose, so we need to take cartilage from other sources,” says Dr. Miller. Surgeons say that the minimum amount of time to wait before you can do revision rhinoplasty, even if there is an obvious problem, is a full year.
Case 87: This young woman had broken her nose and was noticeably crooked with poor nasal breathing. In addition, she disliked her nasal hump and length. She preferred an aesthetic with a slight supra tip break to soften her profile. Beyond straightening and improving her breathing, you can see how we were able to remove the nasal hump and lift her tip to transform her look while still looking completely natural.
As stated above, these complications are unlikely. However, patients can take steps to reduce their risks even further. First, they should choose a qualified surgeon, according to the guidelines listed above. Selecting an outstanding doctor, who maintains proper safety standards, can minimize the chances of infection, perforation, and other difficulties. An experienced surgeon can also ensure aesthetically pleasing results.
Dr. Richard Rival, a rhinoplasty surgeon in Toronto, has both certifications. While board certification is an essential prerequisite, make sure your surgeon has extensive experience performing the procedure and does so on a regular basis. Ask to see photos of previous patients. While these photos will likely show only the "best results," you will able to determine whether the surgeon is able to produce the improvements you want by paying attention to cases in the photo gallery that are similar to yours.
Once your bone and cartilage have been resculpted, your surgeon pulls the skin back down and stitches it along the open-rhinoplasty incision across the columella (the tissue that links the nasal tip to the nasal base). “When done properly, that incision is extremely hard to see, once it’s healed,” says Dr. Miller. With a closed procedure, the incisions are made inside your nostrils, so there’s no visible scarring, and the sutures are usually dissolvable.
Like facelift surgery, brow lift surgery eliminates sagging skin and reduces deep creases. However, brow lifts specifically target the forehead and the area between the eyebrows. The doctor creates an incision along the hairline or the crown of the head. Then he or she lifts the underlying muscles to reduce frown lines, vertical creases, sagging eyebrows, and hooded brows.
Case 60: Facial aging can be hard on someone who is naturally thin by creating a more severe and skeletonized appearance as facial fat is lost. A combined approach was used to create a beautiful transformation, including a trichophytic brow lift, lower lid tightening, and facelift along with a conservative rhinoplasty to straighten and balance her nose. Notice how the eyes are opened up and facial hollows are smoothened without the surprised look that can accompany over-aggressive lifts. You’ll also see that incisions are hidden within the hairline and natural skin creases making them almost invisible.
However, it’s not without real risks. A liquid nose job should be done only by a skilled plastic surgeon with extensive knowledge of facial anatomy, using only hyaluronic-acid-based fillers. Misplaced filler can cut off blood flow and cause skin necrosis (tissue death). If it’s caught quickly, the hyaluronic-acid filler can be dissolved by a doctor, using an injection of hyaluronidase. But because this risk is serious, fillers have not been approved by the U.S. Food and Drug Administration for use in the nose.
The minimum age for rhinoplasty depends on both physical and emotional maturity. It's important to wait until your facial growth is complete, which is approximately at age 14 or 15 for women and in the late teens for men. There is no upper age limit for rhinoplasty, as long as you are in good general health. Many women and men come to Dr. Rival for nose surgery in their 40s and 50s.
Tobacco use slows blood flow throughout the body. Because oxygen cannot reach the incision sites very quickly, smokers may face a longer recovery and a higher risk of infection and unfavorable scarring. Although smokers are not automatically disqualified from rhinoplasty, they should quit the habit for at least two weeks before and two weeks after the surgery.
"Sometimes, a good reputation is well deserved, and sometimes it's merely hype and marketing," Dr. Naderi said. "There are reality show plastic surgeons who charge high fees, for example, based on their television exposure and publicity. Then, there are well-known plastic surgeons in the field who focus mainly on nose surgery and are true specialists."
It's the anticipation. We all tend to worry about new things we are unfamiliar with, and rhinoplasty surgery is one of those things. If you've never had surgery before, it's not unusual to be nervous and worry about every little detail. Will it hurt? Will I be in pain? When rhinoplasty is performed using a general anesthetic, you won't remember the procedure and you won't feel a thing. Most patients wake up after surgery realizing there was nothing to be scared about – and feeling silly for having worried at all.
Revision (secondary) rhinoplasty is a cosmetic surgery that is performed when a patient is not satisfied with the outcome of his or her initial procedure. In some cases, patients may be unhappy with the appearance of their noses, while others may experience functional difficulties after surgery. Additionally, a patient may need a secondary procedure if he or she suffers traumatic injury following the first nose reshaping surgery.
A nose job can be done in a private surgical suite, an ambulatory surgical center or a hospital. A hospital is the most expensive setting, while a private surgical suite is the least expensive. Most people can have the work done in a private office or ambulatory setting, which is an outpatient procedure. Should you choose to stay overnight in a hospital and undergo an inpatient treatment, it would significantly increase the overall nose job cost.