Rhinoplasty is commonly referred to as nose surgery, aesthetic nasal surgery, or a nose job. It is a plastic surgery procedure designed to improve the appearance of the nose. It may also be performed to correct medical problems which inhibit a person’s ability to breathe properly. There are a variety of aesthetic concerns that can be addressed during rhinoplasty. Typical alterations to the nose include changes (either an increase or decrease) in the overall size of the nose, removal of an unattractive hump, reshaping of the nasal bridge or tip, adjustments in the angle between the nose and upper lip, and a decrease in nostril width.
Any surgery performed on the nose has the ability to alter both form and function. When aesthetic nose surgery is performed with the primary intention of improving a patient’s breathing it is considered functional rhinoplasty. Septoplasty, valvuloplasty, and vestibuloplasty are techniques that improve airflow in the nasal passage. Turbinate reduction and osteotomies can also be performed to benefit airway obstruction.
You may benefit from rhinoplasty if you are over the age of sixteen, the cartilage in your nose has stopped growing, and you are in good health. Rhinoplasty candidates must have realistic expectations for the outcome of their surgery and understand the capabilities and limitations of the procedure.
Generally speaking, individuals can undergo rhinoplasty once the cartilage in their nose has stopped growing. This is typically around the age of 14-15 for girls and 16-17 for boys. Each surgeon may set different guidelines for their practice. Dr. Naderi performs nose surgery on individuals who are a minimum of 16 years old.
Dr. Naderi consults with individuals inquiring about rhinoplasty in a private and comfortable setting. A consultation involves taking your medical history, discussing your goals for the appearance of your nose, and conducting a thorough examination. Dr. Naderi will explain the rhinoplasty procedure, including technique, risks, recovery, the facility, anesthesia, and cost. Any and all questions you have will be able to be answered at the time. Effective January 1st 2016 all Primary Rhinoplasty consult fees are still $100, which will be applied towards you surgery.
Rhinoplasty procedures are performed by Dr. Naderi at INOVA system hospitals. INOVA system hospitals include Fair Oaks Hospital, Fairfax Hospital, Loudoun Hospital, and Mt. Vernon Hospital.
Typically, general anesthesia is administered during a rhinoplasty procedure.
After anesthesia is administered, an incision will be made. Incisions made on the inside of the nose are used during endonasal or closed rhinoplasty. Open or external rhinoplasty utilizes a small incision made on the outside of the nose on the skin that separates the nostrils. In some cases both may be used. Bone and cartilage are then repositioned or removed to reshape the nose. The incisions will be closed once the preferred shape is achieved and a splint will be applied to the nose to support the new structure.
On average, the surgical time for rhinoplasty is about 1.5. to 2 hours long.
During rhinoplasty one of two kinds of incisions can be made. The first is placed inside the nose, which is known as closed rhinoplasty or endonasal rhinoplasty. External incisions are made on the outside of the nose in what is referred to as open rhinoplasty. This involves a small incision placed on the skin that separates the nostrils on the underside of the nose. When performing aesthetic rhinoplasty, about 70% are endonasal (closed) procedures. In cases of functional rhinoplasty, 70% are external (open) rhinoplasty.
No visible scars are left by endonasal rhinoplasty since incisions are made inside of the nose where they cannot be seen. A very small scar can occur on the skin between the nostrils when external rhinoplasty is performed, but this fine linear scar is unnoticeable and camouflaged by its location.
Rhinoplasty may involve some discomfort, but it is easily controlled with pain medication. Some patients develop a dull headache and/or experience an ache in their nose. Patients should not feel any severe pain and if they do they should notify their surgeon immediately.
Following rhinoplasty, swelling and bruising around the eyes is very common. Your face may seem more pale than normal at first. Most swelling and bruising will subside during the first two weeks. After one to two weeks, dressings and splints applied during surgery will be removed. Additional swelling can persist for up to a year, but it is very minor and not noticeable to friends and family.
The majority of patients are able to return to work about one week after undergoing rhinoplasty.
It is recommended that patients refrain from exercise for at least two to three weeks after a rhinoplasty procedure. This includes other strenuous activities as well. Contact sports that could risk injury to the nose must be avoided for several weeks.
Endonasal stitches placed inside the nose do not require removal. External sutures made will be removed within three days after surgery.
Every surgery involves some potential risk. About 5% of surgeries will require the need for a minor revision procedure. 1% to 3% percent result in nose bleed. Other risks include adverse reactions to anesthesia, numbness in and around the nose, and difficult breathing. Dr. Naderi will discuss possible complications with you.
Most plastic surgery procedures are not covered by insurance, especially if performed for aesthetic reasons. Cosmetic rhinoplasty will typically not be covered by your insurance, but if the surgery is performed with the goal of improving a breathing problem portions of it may be. Please check with your own insurance provider to find out if and how much of your surgery they will pay for.
Dr. Naderi offers financing for many plastic surgery procedures through CareCredit. Contact The Naderi Center to schedule a consultation and discuss your payment options.
Reconstructive Plastic Surgery Procedures
Rhinoplasty is the Aesthetic or Cosmetic Surgery of the nose
Anyone over 16 years of age who is in good medical health and able to undergo surgery and anesthesia. The ideal patient will have a good realistic expectation regarding the benefits and limitations of Rhinoplasty.
Dr. Naderi encourages his patients to seek several other consultations so they can have a better idea of the different recommendations as well as to be able to gather a list of appropriate questions to ask him during their consultation. This way, each patient gets the most out of their meeting with Dr. Naderi.
Is it absolutely necessary to have seen other plastic surgeons prior to the consultation with Dr. Naderi?
No. You can meet with Dr. Naderi and then if you so choose, you can return for a 2nd or even a 3rd consultation. Dr. Naderi takes as much time as necessary, each and every consultation, in order to make sure that all of his patients’ questions are answered with absolutely no pressure or “sales pitch”.
All primary rhinoplasty consultations with Dr. Naderi are $100. Effective January 1, 2016, Revision rhinoplasty consultation fees are $250. This fee will apply towards your eventual surgery. If you decide not to have surgery, you will still have gained lots of additional knowledge and information by taking advantage of Dr. Naderi’s expertise as a Rhinoplasty Specialist. If there is a functional issue such as breathing difficulties, and you decide to use your insurance company for coverage of the “functional” portion of the surgery, then your insurance will have to be billed for the initial consultation. Some patients choose to not use their insurance even for the “functional” portion of the surgery such as the septoplasty and, in these cases, the entire consultation is again complimentary.
We would like you to arrive 15 minutes early to fill out HIPPA compliant medical information paperwork. After that, you may spend 45 minutes to an hour or more with the doctor until all of your questions have been answered.
Absolutely. Dr. Naderi will show you lots of his “before and after” patient photographs.
Definitely. Digital morphing or imaging is an integral part of your consultation. Dr. Naderi uses the cutting edge United Imaging Marketwise software. It is very important for you to be able to visualize yourself with your new changes and to be able to make comments or voice your concerns BEFORE undergoing surgery.
It depends. Dr. Naderi will see you and examine you and give you a printed quote, which we will honor for up to 4 months. The cost varies depending on your anatomy and the extent of work necessary. Just like one nose does not fit all, so too one price does not apply to everyone. Dr. Naderi will tailor a specific operation for your individual needs. As a general rule, his costs are somewhat higher than other plastic surgeons in the area due to his level of expertise and focus on Rhinoplasty.
Yes. After receiving your quote, we will go over all of your choices with you and guide you through the financing process for cosmetic surgery if you choose this option.
Dr. Naderi is first and foremost a physician and then an artist and surgeon so he is very conservative in his approach to patient care. After thoroughly reviewing your medical history, he will check a quick lab test to make sure you do not have any bleeding tendencies. Select patients will also need a recent EKG. Occasionally, we may ask for a brief letter from your primary care doctor confirming your “clearance” for surgery.
Dr. Naderi has privileges at the top medical centers in Northern Virginia. INOVA Fairfax Hospital, INOVA Fairoaks Hospital, INOVA Loudoun Hospital, INOVA Mt. Vernon Hospital, and INOVA ambulatory surgery center at Countryside are all top accredited facilities with Board Certified Anesthesiologists. INOVA hospitals’ nursing staff were recently given the nations top honor – MAGNET AWARD.
This depends on the extent of work necessary. This may be from 30 minutes to 3 hours or more until the best possible result is achieved. The ‘average case’ takes between 1 ½ to 2 hours total.
Homework! Make sure this is what you want to do and that Dr. Naderi is the Rhinoplastic Surgeon who you want to trust yourself to. Once you are sure of these choices then relax and we will take you through the process step by step.
Dr. Naderi is a true Rhinoplastic Surgeon and therefore he is highly experienced in all techniques of Rhinoplasty. He utilizes the External approach, also known as the “open” approach, when intricate and detailed “tip grafts” are needed. Dr. Naderi uses the Endonasal or “closed” approach on about 70% of his patients and he is able to achieve excellent results without the extra edema, numbness and healing time that the external or “open” approach involves. Each patient’s nose is different and hence an individual plan will be tailored to best suit each patient’s needs.
The majority of incisions are inside the nose and hidden. With an external approach, a very small incision is made on the columella (the skin dividing each nostril on the base). This allows excellent exposure of the tip for intricate tip grafting. When closed meticulously, this incision heals with no grossly visible scar. Some plastic surgeons are only trained in this technique and “open” all of their noses. Dr. Naderi believes that minimal changes dictate minimal dissection and therefore the endonasal approach is a fantastic technique and a fading art amongst plastic surgeons when only moderate modifications are needed.
Rhinoplasty is surprisingly not very painful at all. You will have some throbbing of your nose the first night but 95 out of 100 patients do not take any narcotic pain medicine beyond the first night.
Most patients go home the same day. Dr. Naderi insists on seeing all of his patients the next day in the office to make sure they are clear on post-op care. Post-op care is very simple and entails cleaning the nostrils with Q-tips soaked in hydrogen peroxide followed by an application of antibiotic ointment to the nostrils with a Q-tip. Ice-cold washcloths to the upper face are encouraged for the first 48 hours and help minimize bruising and swelling. You will be seen back on post-op day 3 – 5 if an open approach was taken to remove the very fine sutures under the nose. If a closed approach was taken then this appointment is not necessary. Then on post-op day 7 the small external splint will be removed and you will be able to see the initial results.
Packing can be uncomfortable and hence Dr. Naderi avoids packing the nose unless absolutely necessary.
We do not want you to take aspirin, blood thinners, herbal supplements such as fish oil, flaxid oil, high dose vitamin E and some other medications which can increase your chance of bleeding. You will be given a complete list of these medications as well as thorough pre- and post-op instructions several weeks prior to your surgery. You will have to refrain from heavy exercise or lifting for about 2 weeks. You will have to avoid wearing heavy glasses on your nose for up to 3 weeks. There are special clips that allow you to wear glasses without pressure on your nose.
Each person reacts differently. Some will have hardly any bruising or swelling and some will have a significant amount. Following Dr. Naderi’s instructions and advice will ensure your best possible outcome.
No! You will start to enjoy your new nose from the moment the splint is removed. You will have swelling and tightness which will improve day by day. After the bruising has cleared, most people will not be able to tell you have had surgery due to the beautiful yet natural results Dr. Naderi is able to achieve. However, with time, as the edema resolves, you will see your nose come into its own and you will like your nose more and more every day. This healing process typically takes a year to complete but 70-90% of the healing takes place in the first 3 months. Also, “closed techniques” allow quicker healing times and less edema.
Dr. Naderi wants all of his patients to be completely satisfied and happy. If certain little irregularities have arisen during the healing process, then he will address these though a minor revision free of surgeon’s charge. He stands by his work and his patients. Anesthesia and hospital fees would have to be covered by the patient. These situations are rare and you and your loved ones can rest assured that he will see you back frequently until everything has healed and you are completely satisfied with your nose.
Dr. Naderi has patients who come to him from all over the world. Our office staff will coordinate things for you and make sure your experience is as stress free and enjoyable as possible.
Many people go back to work or school 2 or 3 days later while still having their small splint on the nose. However, most patient who do not wish to draw attention to themselves will take one week to recover and will take this time off from work until their splint is removed on post-op day #7. After that, women can use makeup to camouflage any remaining bruises and will return to their work or school. Men usually come up with an ingenious excuse for the bruises and return to work or school confidently. However, Dr. Naderi wants you to refrain from heavy activity for 2-3 weeks.
Yes. Although deciding to undergo rhinoplasty and choosing your facial plastic surgeon can be stressful, we want you to do your homework, relax and enjoy the process. Not everyone has the luxury of undergoing elective cosmetic surgery so you should enjoy the process as much as possible and let us guide you step by step.
Dr. Naderi’s office in Herndon, VA is conveniently located near the following:
- Northern Virginia
- Fairfax county
- Loudoun County
- Tysons corner
- Virginia beach
- Great falls
- Montgomery County
- Howard County
- Baltimore, MD
- Chevy Chase
- White Marsh
- Arundle Mills
- Washington DC
- Washington D.C.
- Adams Morgan
- Pentagon City
- North west
- Falls church