Rhinoplasty

  • Procedure time: 2-3 hours
  • Recovery time: 2-3 weeks
  • Surgery type: Outpatient

What is a Rhinoplasty?

A rhinoplasty, or a “nose job,” is a procedure that changes the structure and shape of the nose. There are generally two reasons why we perform rhinoplasties. The first is for functional reasons, to help improve breathing in people with nasal obstructions or airway narrowing. The second reason is for cosmetic concerns, when a person wishes to change the shape or size of their nose. Often times when we are performing these surgeries, the goal is to improve both form and function. Either way, it is important to select a surgeon who is well-trained in both functional and cosmetic rhinoplasty. In addition to completing fellowship training in Facial Plastic Surgery, Dr. Gadaleta is also a board-certified Ear, Nose and Throat surgeon. This unique background positions him to have a deeper understanding of the integral relationship between the aesthetic and functional anatomy of the nose.

Indications for rhinoplasty:

  • Desire for aesthetic improvement
    • Removal of dorsal hump
    • Long nose
    • Boxy, bulbous, or wide tip
    • Droopy tip
    • Wide dorsum
    • Wide nostril or nasal base
    • Deviated tip
    • Tip asymmetry
  • Desire for functional improvement
    • Difficulty breathing
    • Deviated septum
    • Nasal valve narrowing

How is it Performed?

There are two main ways that rhinoplasties are performed: opened and closed (AKA “scarless”). Dr. Gadaleta is an expert at both open and closed rhinoplasty. The main difference between the two subtypes of procedure is an incision that is placed within the columella (the bridge of tissue that sits between the nostrils). In closed rhinoplasty, all the incisions are made within the nostrils. This procedure is generally selected when minor changes are needed to the nose, such as smoothing down a slight bump on the bridge. When advance maneuvers are required, especially to adjust the shape and position of the nasal tip, Dr. Gadaleta will often choose to perform the rhinoplasty open. Performing open rhinoplasty allows Dr. Gadaleta greater access to the nasal anatomy, and therefore, more precision in making the subtle changes often required in these cases. Once the desired changes are made to the structure of the nose, the incisions are meticulously closed with sutures and a cast is placed on the nose.

Recovery

The bulk of the recovery occurs within the first 3 weeks following surgery. Typically, patients will experience bruising and swelling, most notably around the eyes. This rapidly resolves over the first 10-14 days. Many patients feel uncomfortable the first few days following surgery; however, severe pain is uncommon. A cast is worn for the first week following surgery and then removed along with the stitches between days 5-7 after the procedure. Once the cast is removed, most patients will be able to resume their normal work activities. By week 3, the majority of the swelling resolves, and a patient can start appreciating the changes made during surgery. Light exercise activities can be re-introduced at this point and, by week 6, all normal physical activities can be resumed. Improvements will be appreciated, both functionally and aesthetically, for the first year after surgery as healing continues to progress.

Goals

Common goals of rhinoplasty include:

(1) to improve the overall shape of the nose and how it balances the rest of the facial features, and
(2) to improve or maintain nasal breathing.

Typical areas of aesthetic improvement involve the nasal bridge and tip. The most common issues that patients would like to address include dorsal humps, nasal deviations, droopy and bulbous nasal tips. Functional improvements are generally made by addressing deviated septums, enlarged turbinates, and nasal valve collapse. Dr. Gadaleta utilizes photographic morphing technology and patient-centered communication strategies to align the patient’s goals with realistic expectations.

Is a Rhinoplasty Covered by Insurance?

Many patients wonder if their rhinoplasty procedure will be covered by insurance. This depends primarily on two factors:

(1) the patient’s specific insurance coverage, and
(2), the type of rhinoplasty that is required.

Making changes to the shape of the nose are considered cosmetic, and are not typically covered by insurance. However, if the anatomy on the inside of the nose is causing restriction of nasal breathing, then the surgery (i.e. a functional rhinoplasty) is often covered by insurance. In cases where there is both functional and cosmetic changes that are desired, typically some of the cost of surgery can be covered by a patient’s insurance. Dr. Gadaleta accepts several of the larger California plans. Please call the office to find out if your insurance plan is accepted!

Rhinoplasty Photos

Schedule a Rhinoplasty Consultation

Reach out today to schedule a rhinoplasty consultation in Palo Alto, San Mateo or Los Gatos with Dr. Dominick Gadaleta. As a board-certified Palo Alto facial plastic surgeon, Dr. Gadaleta’s practice focuses exclusively on surgery of the face and neck. Please contact us using the form below, or call the office most convenient to you. 

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