Getting the New Nose You Want with Modern Techniques

Rhinoplasty (nose surgery) is one of the most common plastic surgery procedures performed, yet one that has the potential for a noticeable or operated-on look.  How can patients ensure that they get the nose they want and not an artificial-looking nose?  Here are the 8 things to know in order to get the new nose you want:
1) Know what changes you want:  The more clearly a patient can identify what features he or she wants 
changed, the easier it is to communicate with the surgeon.   Think about whether you want to change the top of the nose (a large bump or wide nasal bones), the tip ( too droopy or wide), or both.  Patients who are overly obsessed with their nose appearance, but cannot clearly define what they want changed, could be disappointed by surgical results.  

2) Know your surgeon:  Perhaps no plastic surgery operation requires as much experience to perfect as rhinoplasty.  Yes, experts agree it can be tougher to master than facelifts, eyelid surgery or breast surgery.  Select a surgeon with a proven track record in rhinoplasty surgery.  Make sure they have top-notch training credentials and a board certification recognized by the American Board of Medical Specialties (such as the American Board of Plastic Surgery).  Be comfortable with their personal manner, their office environment and the office staff. 

3) Know what your expected outcome may look like:  Do not be afraid to ask your surgeon to review photos of previous patients with similar noses. See a computerized simulation of your own photos.  While simulated results and other patient photos will not give a perfect representation or guarantee of your outcome, it will give you an idea of the kinds of results your surgeon can and hopes to achieve.  If the pictures do not seem ideal to you, let the surgeon know your thoughts, or seek another opinion.

4) Know your operating facility:  While patients are often busy focusing on aesthetics, safety should always come first.   Any surgery with anesthesia has serious risks and must be performed in a certified hospital or ambulatory center.  For surgery performed in a physican's office, make sure that the operating room is certified by a recognized agency (JCHO, AAAASF, AAAHC) and that the surgeon has a transfer arrangement and admitting privileges at a local hospital.  The surgeon should also have credentials at the local hospital to perform the same surgery performed in the office.

5) Know your airway: Rhinoplasty surgery typically can result in improved airflow for patients who suffer nasal obstruction.  Let your surgeon know about any allergies or breathing issues or previous nasal injuries. Deviations of the nasal septum, enlarged turbinate glands and an overly narrow middle nose can all contribute to reduced airflow. These conditions can often be improved with surgery.  In some cases, such as allergic rhinitis, surgery may not fully help.  In rare instances, surgery can worsen airflow.  Discuss these important matters in advance with your surgeon.

6) Know your insurance:  Alterations of nasal shape is considered cosmetic surgery and is not covered by insurance policies.  However, severe breathing obstruction and significant recent nasal injuries may be covered by your plan. Talk to your insurance plan and your doctor.  If a portion of the surgery is covered by insurance (such as a deviated septum repair), the cosmetic part of the operation will still be subject to out-of-pocket payment.  Total fees for Rhinoplasty from top surgeons, including operating room and anesthesia, can vary from about $8,000 to $16,000. Ask what happens if you have a complication or a result that needs some additional treatments or tweaking.
7) Know who is not a great candidate for rhinoplasty surgery:  Some patients can have an excessive degree of worry over the appearance of their noses. Some degree of being self- conscious about a noticeable deformity is normal.  If negative feelings about your nose intrude into your thoughts frequently, or are out of scale to the level of deformity, then surgical changes may not help your self-image issues.  Additional pre-op counseling or therapy may be needed. 
8) Have patience:  While the initial result from surgery is noticeable in a week or two, swelling and skin changes can occur that take many months to fully resolve. 
Talk to your surgeon about all these important issues beforehand. Then, you can feel secure that you have done all you can to make sure your results are in line with your expectations.

To learn more contact Dr. Michael S. Suzman.

Dr. Michael S. Suzman operates at the Rye Ambulatory Surgery Center in Westchester County, NY, is the Chief of Plastic Surgery at The White Plains Hospital, is on staff at  Greenwich Hospital in CT, and serves as a clinical instructor in surgery at Weill Medical College of Cornell University in Manhattan, NYC, Division of Plastic Surgery. 

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.