Rhinoplasty Boston

A nose that is too large, wide or crooked can be the most prominent feature on your face.  Rhinoplasty (nose job) can change the shape and size of your nose, improve the function of your nose and restore balance to your face.  Newer techniques allow modifications of the various parts of your nose including the tip, the nostrils and the top of the nose resulting in a more natural pleasing nose.

There are many reasons why we may seek treatment of our nose. Reasons can range from a small bump in the nose to a large disproportioned nose that is out of balance with the rest of the face.  The features that one dislikes may have been present all of one’s life or have presented with changes associated with aging.  Traumas in the past to the nose may also give rise to shape issues.

The goal of rhinoplasty (nose job) is to create a nasal shape that is in harmony with the rest of the face.  I strive to create a nasal shape that is natural appearing, not the overly-operated appearing nose.  Probably the best nose is one that is pleasing on your face and attracts more attention to your eyes and lips.  The nose should not be the focus of the face.

In order to create most of the changes to the appearance of your nose, the underlying structure of the nose is altered.  I often use the analogy of a tent with its frame and covering.  The skin of the nose is like the covering of the tent and the nasal bones and cartilage make up the framework.  By altering the underlying bones and cartilage with various surgical techniques and incisions within the nose, the skin re-drapes to the new framework.  Those with relatively thin skin of the nose may show these changes a bit more readily than those with thicker skin.

There are two general types of rhinoplasty.  Closed rhinoplasty refers to techniques in which incisions are kept within the nose.  Open rhinoplasty refers to a type of technique that in addition to the internal incisions, a small incision is used at the base of the columella- that vertical part of the nose on the bottom that separates the right and left nostril.  This leaves a scar there but fortunately it is minimally visible.  This technique is used when certain precise changes to the tip of the nose are made.

A rhinoplasty is usually a collection of small techniques depending on the type of change desired.  A bump may be filed down, a full tip thinned, nostrils changed and more.  Cartilage grafts may be used.  These are small pieces of your cartilage that may be added to the tip of the nose or bridge of the nose.  Sometimes cartilage grafts are used to stiffen a collapsing sidewall of the nose that impedes breathing.  These small shaped pieces of cartilage are usually taken from within the nose itself- sometimes it is necessary to use ear cartilage.
I am often asked if ones nose must be broken.  Technically even filing down a bone is considered breaking it but if you have a crooked nose from a previous trauma, the bones may require significant fracture and resetting into a better position.  Usually one wears a small plastic splint for about 6 days following rhinoplasty.  Packing the nose is rarely necessary.  Mild bruising if any may last 1-2 weeks.

A good consultation is always in order to determine the desired changes with rhinoplasty, options for techniques and expected outcome.  Sometimes computer mockups may assist in the discussion of possible changes.  Although most changes are seen quickly, full healing may take up to a year.

Occasionally chin augmentation is performed at the same time to provide better balance to your face.  Dr. Volpe will discuss your options and reasonable expectations with the outcome of your surgery.

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