One of the most popular procedures in the United States, primary rhinoplasty refers to a first-time nose job, as opposed to a secondary or revision procedure. It’s performed to reshape and resize the nasal structure, so it fits in with your other features and achieves a more attractive facial appearance.
There are countless reasons why men and women of all ages choose to undergo a primary cosmetic rhinoplasty. Some of the most common ones include:
A nose that’s too large or small for your face
A nasal bridge with a hump or bump
An abnormally wide nose
A protruding, overly large, bulbous or drooping nasal tip
Flared or pinched nostrils
A crooked or asymmetrical nasal structure
Preparing for your primary rhinoplasty
Your satisfaction with your primary rhinoplasty relies heavily on how your plastic surgeon prepares for your procedure. As such, Dr. Rahban spends a substantial amount of time with you prior to surgery, discussing the imperfections you’d like addressed and reviewing your expected results.
When patients are unhappy with their appearance following a nose job, it is often due to a miscommunication with their surgeon. Dr. Rahban avoids this by getting crystal clear about your vision before the procedure even begins. The two of you will go over every step of the procedure and he will make numerous illustrations in order to make certain you truly understand what will be done.
While he may use images of various noses to help you understand ideal shape, size and profile you should consider, he is opposed to computer morphing of the patient’s own nose, aka Photoshop. He feels that this tool is better for the surgeon than the patient, as it is used to “close the deal.” Understandably, patients’ greatest apprehension is what they will look like, and the Photoshop image is very misleading and as such has “results may vary” all over it. This will only create a false sense of security, and when your nose looks nothing like the image, you will be sadly disappointed.
The best predictor of what your nose will look like is looking at numerous before and after pictures of your surgeon’s work. If you like 70% of their work, the two of you are likely on same aesthetic page. Dr. Rahban will offer his guidance regarding which nose will appear the most natural, and he’ll make sure you’re both on the same page before scheduling your operation.
What to expect during your primary rhinoplasty
There are two main approaches to the primary rhinoplasty: the open approach and the closed approach.
With open rhinoplasty, Dr. Rahban will create an incision along the columella, which is the cartilage that separates your nostrils. From there, he will lift the skin to expose the underlying nasal structure, where he will reshape and resize your nose.
With closed rhinoplasty, Dr. Rahban will make incisions inside the nose only, through which he will reshape the nose.
In general, he is a strong proponent of the open approach, as he believes it gives him the greatest accuracy and control of the underlying structures, reserving the closed technique for minor changes. Both of these techniques are very effective, and the right one for you will depend on the shape of your nose and your aesthetic objectives.
Once the incision has been made, Dr. Rahban will very precisely remove excess cartilage and bone as well as reshape your native nasal structure to create a new nose that is objectively more attractive and in better balance with your face. Dr. Rahban believes in what he terms is a reconstructive rhinoplasty as opposed to the standard mill reductive rhinoplasty.
Most surgeons who don’t do a lot of rhinoplasties tend to do a quick surgery where the main objective is to remove structure like cartilage and bone. Therefore, it should not come as a surprise that these noses tend to collapse with time and lead to the classic “done look” and difficulty breathing. Almost all of his revision cases are due to this type of rhinoplasty.
During a reconstructive rhinoplasty, Dr. Rahban uses cartilage, usually from the septum, to add reinforcement to the refined structure he has created. Like a building, your nose will need support to keep it looking natural over time. Your nose will not only be more refined but more importantly strong and long lasting. This type of rhinoplasty takes more time and expertise, hence why few surgeons use this technique.
Throughout the surgery, Dr. Rahban will be referring to images of your nose and his notes to make sure he achieves an outcome that is in alignment with what you discussed pre-operatively. Most importantly, he will use a conservative approach to avoid overcorrecting your nose – ensuring that your results appear very natural. Once the procedure is complete, he will close the incisions meticulously to ensure that your resulting scars are as faint and imperceptible as possible.
After your rhinoplasty, you can expect the first week to be the key during your recovery period. You will need to treat the area very gently to avoid harming your new nasal structure and interrupting the healing process. To that end, you’ll be advised to wear buttoned shirts, sleep with your head elevated, eat soft foods, take baths rather than showers, and avoid salty food and blowing your nose. In addition, you’ll need to carefully change the gauze outside your nose as directed by Dr. Rahban.
Throughout this initial period, it’s normal to experience some swelling, bruising and stuffiness. Though uncomfortable, these effects are only temporary and should subside as you continue to heal. Rhinoplasty is generally not considered painful, but instead could be described as uncomfortable. With that said, certain side effects are not normal and require immediate medical attention. If you experience a high fever, severe bleeding, a significant injury to the nose or a considerable increase in pain that cannot be relieved with your prescribed medications, you should contact Dr. Rahban immediately.
About one week into your healing process, you’ll return to Dr. Rahban’s office for your first post-operative appointment. During that meeting, he will remove any internal and external dressings so he can evaluate your nose, assess your progress and ensure that you’re healing properly. He will also answer any questions you may have about your recovery and provide you with additional aftercare instructions as needed. Depending on how swollen you are, he may apply tape on your nose to help the swelling resolve more quickly. From that point on, you will be seeing him several more times, as the healing process takes up to one year and he is a very hands on surgeon.
Come in for a Consultation with Dr. Rahban
When Dr. Rahban does a consultation with a prospective patient, he wants it to be two things above all others: thorough and honest. He will find out from
you just what you want from cosmetic surgery. And he will tell you honestly if you can get the result you want, and how he can best help you do so.