1. Will I Have Visible Incisions?
A closed rhinoplasty avoids making any visible incisions on the skin of the nose.
There are primarily two approaches for performing a rhinoplasty: the closed, or endonasal, approach and the open approach.
In approximately 95% of our patients, we can achieve our results using the closed approach.
This is favorable for our patients as it avoids visible scarring, decreases recovery time, and reduces the time under anesthesia.
This approach is more technically demanding for the surgeon, which is why it’s important to find a board-certified, experienced plastic surgeon to perform your rhinoplasty.
2. How Long Does the Surgery Take?
On average, a rhinoplasty takes somewhere between 45 and 90 minutes, but surgery time varies.
The endonasal (closed) approach allows our surgeries to take less time compared to the open approach, because it reduces the amount of time our patients are under anesthesia.
If we need to obtain alternative sources of cartilage – for example, during revision cases — the surgery may take an additional 15 to 30 minutes.
3. How Long is the Recovery Period?
After surgery, swelling and bruising are normal.
Because of our closed rhinoplasty technique, most of our patients have less swelling and bruising then they would expect.
Our office staff will also discuss natural supplements you can take before and after surgery to reduce bruising.
We usually tell patients that they should rest for one to two days after surgery.
After about two to three days, most people are okay working on their computer, going on walks, and doing light activity.
We remove the splint around one week after surgery. When the splint is removed, most patients go out in public — especially now, given that we are wearing masks during the pandemic.
After about two weeks, patients can gently ease into their exercise routine.
Three weeks after rhinoplasty, we typically tell patients that they have no restrictions (other than participating in activities that will cause them to directly injure their nose).
4. Will I Have Bruising?
Typically, our patients have minimal bruising.
Of course, there are patients who experience more or less bruising than others.
Bruising also depends on what maneuvers need to be performed during surgery.
Bruising underneath the eyes is typically a result of doing osteotomies during surgery, which is where we make controlled breaks within the nasal bones.
If there is not a need for osteotomies, it is unlikely that you will have any significant bruising.
5. Do You Pack the Nose?
We believe this nasal packing is an outdated technique that was a large source of the discomfort patients experienced following their nasal surgeries.
Nobody likes having their nasal cavity packed full of material, and nobody enjoys having the packing removed.
Instead of nasal packing, we place a small, non-stick dressing in each nostril after surgery and our patients can easily and painlessly remove these at their own homes the day after surgery.
At your follow up visit, the only thing we will need to remove is the external splint and tape overlying the skin.
6. Is Rhinoplasty Painful?
This is a very common question that we get asked by our prospective patients.
Almost all our postoperative patients express that the amount of pain they experienced was significantly less than what they expected. Most of our patients only have to take Tylenol to control their discomfort.
Occasionally, some patients will require a few narcotic pain medications in the first day or two after surgery, but this is atypical.
7. Will People Notice That I’ve Had a Rhinoplasty?
One of our ultimate goals is to leave a patient with a natural appearing nose.
We do not want someone with a nose that looks fake and like they’ve had a rhinoplasty.
During our consultation we review imaged pictures with surgically obtainable results so that both the surgeon and the patient can agree on their surgical goals and expectations.
Oftentimes, prior to surgery our patients feel that their nose stands out to other people because of irregularities.
After surgery, our patients are left with a nose that is in harmony with their face.
Of course, family and loved ones that see you regularly may notice that you had a surgery.
8. How Long After Surgery Does It Take to See My Final Results?
Our patients have an external nasal splint that we remove about a week after surgery.
When the splint comes off, our patients can certainly notice changes to their nose, but there will be expected swelling of the nose because of surgery.
After about four to six weeks, the swelling will have gone done significantly.
Ultimately, we tend to expect our patients to see their final results nine to 12 months after surgery once all of the swelling has resolved and the healing process has completed.
9. Can Rhinoplasty Give Me a Symmetrical Nose?
Many patients seeking rhinoplasty have concerns with asymmetries of their nose.
Our goal is certainly to correct these as close to perfect as possible.
We are very critical during surgery and spend extensive time and effort getting the nose as symmetric as possible.
We strive to be perfect, but the reality is that there may be some subtle asymmetries following surgery.
There are factors that cannot be controlled, such as healing and scarring after surgery which impacts the final results.
In our patients, subtle asymmetries are only visible on very close inspection.
10. I’ve Already Had a Rhinoplasty, but I am Unhappy with the Results. Can I Have a Second Procedure?
Since we have been performing rhinoplasty for over 30 years, we see many patients who have had a prior rhinoplasty performed elsewhere who come to our practice to have a revision rhinoplasty done.
Revision rhinoplasty surgeries are a large percentage of our practice.
Revision cases are certainly more difficult, but we are typically able to offer patients surgery to improve their areas of concern.
One of the important aspects that we must consider during revision surgery is if we have enough cartilage for grafting.
If not, we will talk with you about alternative sources of obtaining cartilage — for example, ear or rib cartilage.
Contact Us & Learn More
If you have any further questions about rhinoplasty surgery or would like to arrange an in-person or virtual consultation, please give us a call at 518-786-7000.
About the Author: Dr. Edwin Williams
Dr. Edwin Williams is a double board-certified facial plastic surgeon who founded The Williams Center in 1993. He has performed over 10,000 facial plastic surgery procedures and has pioneered the deep plane facelift. He served on the Board of Directors for the American Academy of Facial Plastic Surgery for over a decade, and served as President from 2015-2016. In 2016, 2017, 2018 and 2019, Dr. Williams earned the Castle Connelly Top Doctors award in New York Facial Plastic Surgery.
Dr. Edwin F. Williams III attended Cornell University in Ithaca, New York where he received a Bachelor of Science degree in 1982. He began medical school at the State University of Buffalo School of Medicine and received his Doctor of Medicine in 1986.
Dr. Williams is actively involved in teaching facial plastic and reconstruction surgery to the residents of the Albany Medical Center and is former Chief of the Section of Facial and Plastic Reconstruction Surgery at Albany Medical Center where he received an academic appointment of Clinical Professor, Department of Surgery.