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Rhinoplasty, also referred to as a nose job or nasal reshaping, is a commonly performed surgical procedure that changes the shape of the nose to improve appearance. Dr. Derderian frequently performs rhinoplasty at his practice in Dallas and customizes his approach to each patient based upon the patient’s nasal anatomy and goals for change in their appearance. Aesthetic rhinoplasty can also be combined with reconstructive procedures to improve breathing through the nose such as septoplasty for deviated septum. This page will discuss primary rhinoplasty that is the term used to describe rhinoplasty in a patient who has never had any nasal surgery before. Dr. Derderian also frequently performs both secondary rhinoplasty and cleft rhinoplasty. Secondary rhinoplasty is also called revision rhinoplasty because the patient has had surgery on the nose before and they are seeking additional surgery because they have persistent or new problems after their first rhinoplasty. Cleft Rhinoplasty is performed for patients with an abnormal appearance of the nose due to cleft lip and palate. Cleft Rhinoplasty is widely considered to be the most difficult rhinoplasty to achieve consistently good results.

Derderian’s Goals For Your Rhinoplasty

Your nose in the middle of your face therefore it significantly impacts the harmony and attractiveness of your facial features. People seek rhinoplasty because they want to look better. Perhaps the biggest fear of people interested in rhinoplasty is that their nose will look unnatural after surgery and it will be obvious that they have had a “nose job.” The key to keeping a rhinoplasty subtle is to enhance the nasal shape and proportions to produce a natural appearing nose that fits the patient’s face. When the new nasal appearance looks natural and harmonizes well with the your facial features it enhances your appearance dramatically. People will know that you look better but they won’t be able to figure out why.

Am I A Candidate For Rhinoplasty?

The nose typically stops growing by age 16 years old and surgery should be delayed until after the nose has stopped growing for purely aesthetic rhinoplasty. The best candidates for rhinoplasty are physically and psychologically healthy and do not smoke. Having realistic expectations for what can be achieved from surgery is important. Common reasons why patients seek consultation for rhinoplasty include:
  • Reshape a nasal tip that is poorly defined, wide, drooping or upturned
  • Improve the profile of the nose by removing bumps or dips in the bridge
  • Change the size and shape of the nose to improve facial balance
  • Straighten a crooked nose
  • Change the size or shape of the nostrils
  • Improve breathing through the nose
It is important that the patient has a clear idea of what improvements they want for their nose and have realistic expectations for what can be achieved with rhinoplasty. Dr. Derderian will discuss these specific goals in detail at your consultation and will develop a surgical plan tailored to the agreed upon plan.

How Is The Surgery Performed?

Dr. Derderian prefers to use an open versus closed approach to rhinoplasty because the open approach allows direct visualization of the nasal cartilages. Open rhinoplasty requires a small incision in the columella (the skin between the nostrils) through which the skin of the nose is elevated off of the underlying cartilage and bone. This incision typically heals with an imperceivable scar. Closed rhinoplasty is a technique that avoids the incision in the columella, using only incisions inside the nose to uncover the cartilages. This takes avoids the scar in the columella, but it requires surgical maneuvers to be performed blindly or without complete visualization of the nasal structures. Dr. Derderian believes that the control that the open approach affords more precise change during surgery that is important to achieve consistently good results. The duration of surgery will vary somewhat from patient to patient. Typically the procedure takes 2-3 hours. During surgery the skin is elevated from the underlying cartilage and bone. A variety of maneuvers are used to reshape the nose. Graft material is frequently harvested from the nasal septum to be used for support in reshaping the nose. If needed, septoplasty is performed to help with breathing. After the desired changes in shape are achieved the nose is closed with fine stitches. At the end of surgery soft splints may be placed inside your nose to support the nasal septum. Tapes and a splint are placed on the outside of the nose over the nasal bridge to support and protect the nose for 7 days. After recovering from anesthesia you will be taken home the same day as surgery by the family or friends who bring you to the hospital.

What is the Recovery Period?

Minimal activity is recommended for the next week. Most patients take a week off from work or school. Oral pain medication is used for 2-3 days. Splints and sutures are removed after 7 days. No vigorous activity is allowed for 3 weeks. After 3 weeks normal cardiovascular exercise and non contact sports may be resumed gradually. No restrictions on activity after 6 weeks. The majority of swelling subsides within a few weeks after surgery, but it typically takes one year for your new nasal contour to fully refine. During this time, your nose will look normal but you may notice gradual changes in the appearance of your nose as it refines to a more permanent outcome.

What Does Rhinoplasty Cost?

Cost may include:
  • Anesthesia fees – cover the anesthesiologist, their staff and medications
  • Hospital or surgical facility costs – covers the operating room, staff and equipment
  • Surgeon’s fee

Why Choose Dr. Derderian?

It is critical to have an experienced surgeon perform your rhinoplasty. During his residency Dr. Derderian had extensive training in primary and secondary rhinoplasty at New York University and at the Manhattan Eye, Ear and Throat Hospital (MEETH). After completing his residency, he did a fellowship in craniofacial surgery (complex skull and facial reconstruction) at the University of Pennsylvania. Dr. Derderian is board certified by the American Board of Plastic Surgery. He frequently performs primary, secondary and cleft rhinoplasty in his practice in Dallas. He has been invited yearly as an instructor at the world renowned Dallas Rhinoplasty Symposium since arriving in Dallas in 2011.

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