Matthew Bridges M.D.

Facial Plastic Surgeon

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Rhinoplasty (Nose Reshaping Surgery) - Richmond Rhinoplasty Specialist

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Overview

The size and shape of the nose can have a great impact on how a person looks and feels about themselves. Since the nose is a defining characteristic of the face, even small alterations can improve the entire appearance. For this reason, many people (about 500,000 each year) decide to undergo a rhinoplasty, or nose job.  Dr. Matthew Bridges, a Richmond facial plastic surgeon, was trained initially as an Otolaryngologist (Ear, Nose, and Throat) Surgeon. He underwent extensive training in fixing functional problems with the nose, such as difficulty breathing and sinusitis, as well as aesthetic surgery of the nose. Additionally, he completed a very exclusive fellowship in facial plastic surgery with a world renowned facial plastic and rhinoplasty surgeon for the highest level of training in rhinoplasty.  He is therefore fellowship trained and double board certified.   There is truly no higher level of training than this. 

Richmond rhinoplasty specialist Dr. Bridges performs rhinoplasty with 2 important factors in mind at all times:

  1.  Structure – One of the reasons rhinoplasty is difficult is the extreme variability in the anatomy of the nose from patient to patient.  However, everyone, regardless of ethnicity, gender, or size, has the same basic cartilage in the nose.  The person with a “bulbous” tip has the same inherent cartilage structure as the person with a naturally refined tip.   The difference is the shape of the cartilage.  Therefore, better, more structurally sound and natural results can be achieved by maintaining structure and reshaping the cartilage.  Older techniques involve significant reduction/removal of cartilage that can cause problems in the future. Certainly, there are times when some trimming of cartilage is necessary to achieve the aesthetic goals, but Dr. Bridges feels that in general cartilage structure should be maintained as much as possible.
  2. Function – The nose is a functional organ that directs air through the skull and into the lungs.  It helps humidify and warm the air to aid in oxygen exchange.  This functional aspect must be kept in mind during rhinoplasty.  Although frequently the goal of surgery is simply cosmetic change of the nose, the functional aspect of the nose cannot be overlooked.  Some maneuvers used to reduce an overly large nose can cause breathing obstruction unless preventative steps are taken in the surgery.  A slight septal deviation that did not cause a breathing obstruction prior to surgery may be an issue after other areas of the nose are reshaped or reduced.  Therefore, a septoplasty should be done this case.  Dr. Bridges always makes sure that the nose will work well and look beautiful.  

Surgical Technique

Open Rhinoplasty

Many surgeons prefer the open rhinoplasty approach during nose surgery because they can gain a better view and better access to the inside of the nose. The incision using this approach is made on the skin between the nostrils or under. Once the incision is made, the skin is moved back to allow access to the internal structures. The incision lines, which heal nicely leaving barely visible scars, are fairly small and usually measure between 2-3 mm.   Click here and scroll to "base view" for an example of a healed open rhinoplasty scar. Richmond rhinoplasty expert Dr. Bridges performs both open and closed rhinoplasty, depending on the situation. 

Closed Rhinoplasty

The closed rhinoplasty technique is performed through incisions made on the inside of the nose only.  The incisions are not visible after surgery.  Dr. Bridges performs both closed and open rhinoplasty regularly.  The technique chosen is based on the specific needs of the patient. Click here to see an example of a closed rhinoplasty result.
 

During/After Surgery

Rhinoplasty is usually performed under general anesthesia and is always performed in an accredited surgical facility. It is considered an outpatient procedure. After surgery, patients will wear an external splint for about 1 week.  Patients may experience bruising and swelling around the nose and eyes.   Bruising usually subsides over the first few weeks.  Swelling decreases rapidly over the first 3-4 weeks, then slowly over many months. It can take up to a full year for the nose to gain its final contour and softness.  Dr. Bridges rarely uses nasal packing.  Occasionally, small plastic tubes may be placed in the nose if extensive septal work has been done. 

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Rhinoplasty FAQs

Are Surgery Fears Normal?

Yes, and this fear is always elevated when surgery involves the face. However, more than 350,000 people in the U.S. undergo rhinoplasty each year making it one of the most common cosmetic surgeries. One way to help calm your fears is to make sure you find a reputable and skilled surgeon that has extensive experience with nose surgery. 

Will MY Nose be Broken?

Some rhinoplasty patients will benefit from osteotomies, or bone cuts during surgery. This allows maneuvers such as narrowing the width of the nose or correcting an asymmetrical nose. This is a common practice and heals within just a few weeks following surgery.   

What is a Nasal Pack?

Nasal packing is the insertion of gauze and/or cotton packs into the nasal cavity after surgery. These are used to control bleeding, but are not necessary most of the time.  Dr. Bridges uses some type of packing only about 5-10% of the time. 

Is Surgery the Only Answer?

Noses that are too large or too wide, or have a specific deformity may only be able to be enhanced through nose surgery. However, the look of some noses may be able to be enhanced using an injectable filler.   “Injection rhinoplasty” may be an option before resorting to surgery. This is an in-office procedure that can help to soften and camouflage a bump, alter the tip of the nose, and smooth out irregularities.   

Cost of Rhinoplasty?

The cost of rhinoplasty varies depending on what needs to be done in surgery. Sometimes, insurance will cover parts of the procedure, such as septoplasty, if they are performed for functional reasons. The out-of-pocket cost can range about $3000 to over $9000, including the facility and anesthesia fees.

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