Rhinoplasty is sometimes called a “nose job” or “nose reshaping.” Dr. Lafer is a structural rhinoplasty surgeon who employs techniques that maintain and reinforce the structure of the nose with an eye on both form and function. She utilizes both open and closed (“scarless rhinoplasty”) rhinoplasty techniques depending on patient anatomy and surgical goals, but primarily utilizes an open approach. Through various techniques the nasal size, shape, and symmetry can be modified.
A cosmetic rhinoplasty changes the shape of the nose to improve symmetry and create balance.
Patients seek revision surgery for a variety of reasons, but often because they have persistent or new nasal obstruction or aesthetically, they were hoping for a different outcome.
Functional rhinoplasty aims to correct nasal obstruction related to septal deviation, inferior turbinate enlargement and/or valve collapse.
Nasal trauma can lead to a broken nose. This can be a fracture in the nasal bones and/or cartilage and sometimes causes a spicule (a small bony bump on the nose). Trauma can lead to nasal obstruction (difficulty breathing through the nose) and/or cause the nose to look crooked or deformed.
Patients who sustained nasal trauma should be seen right away especially if they have any difficulty breathing through their nose. If there were multiple injuries or loss of consciousness (“black out”), patients should be seen in the Emergency Room. Otherwise, it may be appropriate to be seen in the office setting.
A broken nose can be “re-set” via a closed reduction (no incisions) within 2.5 weeks of the injury. However, children heal faster and therefore have an even narrower window to repair their nasal injury acutely. After the window to reset the nose closes, patients should wait at least 6 months before undergoing corrective surgery, but should be seen by a rhinoplasty surgeon for evaluation.
Nasal obstruction can be from many different causes. One common cause is a deviated septum. The septum is made up of cartilage and bone. A crooked septum can be a result of nasal trauma, congenital (naturally grew that way) or post-surgical. The majority of septal surgery is performed with incisions that are hidden inside the nose and removes portions of the cartilage and/or bone that is crooked and blocking nasal airflow. This type of surgery doesn’t change the shape of the nose on the outside. However, some patients require an open approach to their septal surgery with a more involved septal reconstruction, which may change the external appearance of the nose.
Turbinoplasty or Turbinate Surgery
Hypertrophied (enlarged) inferior turbinates are another common cause of nasal obstruction. Turbinates serve important functions—they humidify and warm the air and filter particles out of the air before reaching the lungs. They can be enlarged for many different reasons. The history and physical exam findings can help determine if you’re a candidate for turbinate surgery.