The geographic location of the surgeon's practice can greatly affect the cost of rhinoplasty. More affluent cities and neighborhoods, such as Manhattan and Los Angeles, are plastic surgery hubs where some of the best surgeons in the world practice. Meanwhile, these areas also have a higher cost of living, which means higher overhead costs (rent, staff wages, utilities), and that translates to a higher overall price of rhinoplasty.
Many patients choose to combine rhinoplasty with a facelift for dramatic results and an overall more youthful appearance. This procedure can treat creases and sagging skin, particularly around the eyes, cheeks, chin, and mouth. There are several types of facelifts, and patients can choose a mid, mini, or lower facelift to address specific areas of concern. Through carefully concealed incisions, the doctor raises the facial muscles, removes unwanted fat deposits, and trims away extra skin. Following a facelift, patients may look significantly younger.
Doctors realize that most rhinoplasty patients are not eligible for insurance coverage. For this reason, many surgeons offer in-house financing options. With approved credit, patients may be eligible for low-interest or fixed-interest repayment plans. Additionally, many doctors offer significant discounts when patients pay for their procedures in full prior to treatment. Most cosmetic surgery practices accept cash, check, and all major credit cards.
“The biggest difference between the open and closed rhinoplasty is a small incision on the columella (bottom) of the nose,” says Dr. Kent V. Hasen, a Naples, Florida plastic surgeon, in a rhinoplasty Q&A. “This 6 mm incision allows the surgeon to peel the skin of the lower nose back to fully visualize the tip and dorsum of the nose. In the closed procedure, there is not as much visualization since the skin is not peeled back.”
In the initial days after rhinoplasty, it is important that the changes to the nasal tissue be preserved. After closing the incisions made during surgery, a surgeon will place a splint to help retain the new shape of the nose. In some cases, the doctor may also place pieces of gauze, or nasal packing, inside the nostrils. The material will help reduce bleeding and keep the septum in place. The gauze may cause some discomfort. However, it is typically removed within a few days of surgery, and goes a long toward maintaining the results of surgery.
Right now, surgeons follow guidelines that set a maximum extraction limit of 5,000 milliliters of fat (11 pounds) for all patients, regardless of variations in weight or body fat status. But the new study suggests surgeons could use a patient's body mass index (BMI) to determine how much fat extraction is safe. BMI is a rough estimate of a person's body fat based on height and weight measurements.
Patients may require reconstructive rhinoplasty if they have lost all or part of their noses to an accident, skin cancer, or another serious illness. During the treatment, a surgeon rebuilds the nose using skin grafts, flap techniques, and other advanced methods. Due to the complex nature of this procedure, patients may require multiple surgeries over a period of several months. Additionally, reconstructive rhinoplasty is a specialized procedure, and patients should look for surgeons who have extensive experience in this area.
The majority of individuals who undergo nose reshaping surgery are dissatisfied with the appearance of their noses and wish to improve the proportions of their facial features. A smaller percentage of rhinoplasty candidates are patients who deal with discomfort or breathing difficulties due to structural abnormalities or previous nose injuries. The optimal candidates for rhinoplasty are in good general health, understand the risks associated with surgery, and have realistic expectations regarding the surgery results.
Although these side effects will eventually go away on their own, patients can take precautions to minimize their severity and speed recovery. Pain medication can reduce discomfort, and antibiotics can help control the symptoms of sinusitis. Some surgeons may prescribe drugs immediately after treatment. Patients should take these medications as directed. They should always finish each prescription, unless otherwise instructed by their doctors.
During a rhinoplasty the bone and cartilage underneath the skin is modified. In most cases a surgeon will make an incision inside the nostrils or in the septum which is located between the nostrils. The bone or cartilage will be either clipped or bumped up. When a change in the nose is intended to be subtle, a surgeon may collect cartilage from deep inside the nose or possibly from the ear. When the nose is to be altered dramatically, implants or bone grafting may be utilized.
After the patient is sedated, the surgeon creates tiny incisions inside the nostrils or on the columella. Then he or she carefully lifts the skin to access the underlying bone and cartilage. The surgeon can then remove or graft tissues, as needed. Typically, a doctor uses conservative methods to minimize the impact to the surrounding tissues while still achieving the desired results. When the reshaping process is complete, the doctor lays the skin back down over the new contours of the nose and closes the incisions.
Liposuction is often called "liposculpture" because when it is performed by an experienced surgeon such as Dr. Weinberg, the technique is used to sculpt the contoured appearance patients want. Liposuction is often performed along with other cosmetic surgery procedures to fine-tune the results. Dr. Weinberg commonly combines liposuction with the following procedures: