What is a Rhinoplasty (Primary Rhinoplasty)?
Because the nose is such a predominant feature of the human face, it’s unfortunate that a person can feel dissatisfied with his or her nose. Every morning it’s right there looking back at you in the mirror. Rhinoplasty, the clinical term for nose surgery, can change your nose, removing imperfections or simply making it more proportional with the rest of the face.
Rhinoplasty is one of the original cosmetic surgeries, first performed in the United States in 1887. The surgery involves making incisions to access the underlying bone and cartilage. Depending on the patient’s goals, Dr. Cilento may remove some bone and cartilage, or tissue may be added. Once he has altered the underlying structure of the nose, the skin and tissue is re-draped over the new structure.
Nose surgery is a delicate procedure, and Dr. Cilento takes great pride in his ability to give his patients the nose they’ve wanted. This procedure can really change a patient’s self image.
Goals Of Rhinoplasty
- Modify the bridge
- Open breathing passages
- Reshape the tip
- Remove a hump
- Reshape or resize the nostrils
- Repair an injury
- Reshape or resize the nostrils
- Increase or decrease size
Rhinoplasty can involve modifying skin, cartilage, bone, or all three.
How the Rhinoplasty Procedure works
Rhinoplasty is performed with one of two methods: closed or open. During your consultation, Dr. Cilento will discuss which method he believes fits your needs, but this will be a joint decision.
In open rhinoplasty, an incision is made across the columella, the sliver of tissue between your nostrils. The soft tissue is then lifted upward and off the bone and cartilage. The open method completely exposes the underlying structure, making more dramatic modifications possible. Once the bone or cartilage has been reshaped, the soft tissue is then brought back down.
In closed rhinoplasty, Dr. Cilento makes all of the necessary incisions inside the nose. Obviously, this makes no visible scarring, but it also can limit the extent of reshaping possible. If the patient seeks to build up an area of the nose, Dr. Cilento can take cartilage or other material from the septum, the ears, a rib, or synthetic implants can be used. When the patient seeks to shrink the size of the nose, the nasal bones must be broken.
Am I a Candidate for Rhinoplasty?
When a patient comes to us exploring the possibility of nose surgery, there are usually three main purposes: cosmetic issues, injury repair, or to improve function.
Cosmetic — If a person feels her nose is too bulbous or there’s a bump on the bridge, it can be a real issue. Here are common aesthetic reasons patients seek to make some changes:
• Their nose is too big or too small.
• The nose droops downward.
• They have overly flared nostrils.
• The nose isn’t proportional with the rest of the face.
• There is a prominent bump on the bridge.
• The nose has a bulbous tip.
• The nose is too wide or flat.
• Their nose is crooked from a prior injury.
Injury — People often injure their nose, but don’t always opt to correct it. Things like touch football games or even simply bumping into an unseen wall in a dark room can alter the look and the function. Dr. Cilento can correct both the appearance and the function.
Function — Some people are born with nasal passages that are too narrow. Restricted airflow can lead to snoring and even sleep apnea. Functional Rhinoplasty can open constricted airways and vastly improve breathing function.
Recovery after rhinoplasty
When your surgery is complete, your nose will be packed and Dr. Cilento will place a splint on it. This splint will stay in place for about one week. We’ll provide a cold compress to help minimize swelling, but there will be swelling and bruising. This is inevitable with the degree of tissue trauma as a result of rhinoplasty. For the first week, it will be necessary to keep your head elevated as much as possible, even when sleeping. The area around your eyes and nose will be bruised and swollen usually for 10-14 days.
If you wear glasses, they will need to be taped to your forehead for up to seven weeks to keep any pressure off of your nose. Any strenuous exercise or lifting that increases blood flow to the face needs to be strictly avoided for a number of weeks. Dr. Cilento will discuss your particular restrictions at length with you, giving you a timeframe to return to your typical exercise and activity routines.
Primary Rhinoplasty: This young woman wanted a nose that fit her face more. After much discussion we settled on a smaller tip and dorsum with a slightly more turned up appearance.
Rhinoplasty & Nose Surgery Philosophy
I happen to believe that rhinoplasty is the most challenging procedure in the head and neck. No two noses are exactly alike and likewise, no two rhinoplasties are exactly the same. I knew this at the beginning of my journey which is why I sought out the greatest rhinoplasty surgeons in the world to train me. Although this surgery is difficult, I also believe that it is the most rewarding procedure.
Results After The rhinoplasty procedure
A good result in rhinoplasty can completely change a person’s image. Because the nose is the central and most prominent feature of the face, a well-executed rhinoplasty will draw less attention to a person’s nose-not more. Many patients tell me after rhinoplasty that they receive many compliments on their eyes. When the nose is less prominent, other features come to the foreground…
It is important for you as the patient to understand that there is no such thing as a ‘perfect’ surgical result. Nowhere is this more evident than in rhinoplasty. As a patient, you should be very skeptical of any surgeon that promises perfection or treats the outcome as a foregone conclusion. In skilled hands there is an excellent chance of success, however, rhinoplasty is one surgery in which there is an element of unpredictability. This is why the postoperative period is so critical, a time when the patient must adhere carefully to a strict regimen.
I require a more personal relationship with my patients
In order to go to surgery with a patient, a fundamentally closer more personal relationship has to exist. It is important to be completely comfortable with your surgeon and to understand what is required of you as a patient. However, I emphasize to patients that I will always be there to address their concerns. Following surgery, I make myself available to patients continuously via phone, text and with multiple office visits. I believe when questions are answered early, fewer problems develop.
I also request that patients have at least two preoperative visits before a decision is made to proceed with surgery. This gives the patient a second opportunity to ask any remaining questions. It also gives me an opportunity to clear up any misconceptions that the patient has about their surgery. Rhinoplasty is an elegant operation that requires a tremendous amount of finesse and skill. With a well-executed plan, precise surgical technique, and adherence to a strict post-operative routine, a patient can expect a pleasing result.
Most surgeons consider rhinoplasty to be the most complex surgery in the head and neck. Therefore, it is vital that you find a surgeon that is capable and experienced in the art of rhinoplasty. With all of the information available on the internet it is much easier to find a competent surgeon these days if you know what to look for. There are three attributes a surgeon must have in order to join the ranks of elite rhinoplasty surgeons: training, certification and experience.
Attributes of good rhinoplasty surgeons, according to Dr. Ben Cilento
Although there are several different roads that lead a physician into plastic surgery, only a solid underpinning in head and neck surgery provides the necessary skill set to make a truly excellent facial plastic surgeon. You should check to see that your surgeon initially trained in a field that focuses on the area of interest and nowhere is this more important than in the nose. Furthermore and perhaps most important of all is completion of a fellowship in facial plastic and reconstructive surgery. This is the time when a good surgeon becomes great under the watchful eyes of experienced mentors.
It is always good to have basic certification in general medical societies. However, a physician certified by the prestigious American Board of Facial Plastic and Reconstructive Surgery (ABFPRS) has passed rigorous scrutiny by a panel of experts and is certified to be competent in plastic surgery of the face, head and neck. This extra certification is only given to those plastic surgeons who have the appropriate training and experience to qualify.
Lao Tzu once said that even the longest journey begins with the first step. This is true in every hobby or profession and I believe that a good surgeon continues to learn during his whole career. However, it is important to make sure that the rhinoplasty you are getting is not your surgeons first. There should be good before and after pictures and plenty of previous patients with good outcomes to peruse.
Your consultation is only the first step…
Dr. Cilento developed a love for rhinoplasty sometime during his intensive training in head and neck surgery. He has always sought out the best people in the world to train him and it was this training combined with his extensive experience in the military and in academic medicine that has created his unique style and approach to rhinoplasty. Because of his experience and expertise, Dr. Cilento is often sought after by patients who have had surgery elsewhere and desire a revision surgery. Finally, his background in nasal research and head and neck surgery taught him to appreciate the functional aspects of nasal surgery. Maintaining or improving nasal breathing after cosmetic or functional rhinoplasty is of primary importance.
Dr. Cilento’s initial consulting process is designed to answer most questions up front. He will provide detailed explanations of the required post-operative care you will need.
There are the general risks that accompany any surgery: anesthesia reaction, infection, bleeding, poor wound healing, scarring, and changes in skin sensation. Specific to this procedure, the patient may have difficulty breathing, skin discoloration and continued swelling, possible perforation of the nasal septum, or unsatisfactory final results. If further changes are necessary, revision surgery may be an option.
Schedule a Consultation
To learn more about rhinoplasty surgery in Houston, please call 346-413-9313 to schedule a consultation with Dr. Ben Cilento at our office in Spring, TX. You can change your life with nose surgery and you can take the first step by speaking with us.