The purpose of aesthetic surgery is to help you look the best possible.  The goal of aesthetic nasal surgery is to change the features of your nose that you and Dr. Bass agree will improve your appearance in harmony with your other facial features.  Every nose is different in its anatomical structure, including variation in thickness and size of cartilages and bones, thickness of skin, age of patient, shape of the face, heredity and other factors.  For these reasons, the surgical result is never the same in any two patients.  Your facial and nasal features will be evaluated and reviewed with you in detail during the consultation.  Dr. Bass will formulate a treatment plan with you to correct the changes present on his examination and based on your concerns.

Surgical Technique
The rhinoplasty or aesthetic nasal operation is performed through incisions inside the nose which are not visible.  In secondary rhinoplasty (repeat or revisional surgery) or in selected cases of primary rhinoplasty, the procedure is formed through a small incision in the columella, the fleshy column of skin between the nostrils.  This procedure has been termed open rhinoplasty.  Open rhinoplasty allows more precision in adjusting nasal shape in certain patients, especially in more complex procedures .  If this approach would be helpful for your surgery, I will discuss it with you during the consultation.  During the operation, the size, shape and position of your cartilages and bones will be adjusted to provide the changes desired.  In some cases, additional grafts of cartilage, harvested from the septum, ear or rib, are placed.  Cartilage grafting and suturing techniques are used as needed to create as precise a shape to the tip and dorsum as possible.  The particular needs for you as an individual will be discussed in detail during the consultation.  These advanced techniques have helped improve the predictability and control of the procedure.

Day of Surgery
Your procedure will be performed in the office operating room facility.  Local anesthesia with intravenous sedation is used for most operations. The structures of the nose will be numbed with local anesthesia and you will be moderately sedated.  Your nose and the areas around your nose will be numb, whereas with general anesthesia you will sleep during the operation.  In addition, medicines are given to you during the procedure to allow you to be sleepy and relaxed.  Usually, patients do not remember the procedure.  Occasionally, a patient desires or will need general anesthesia depending on the degree of the procedure, which is only provided at the hospital.  This is particularly true for secondary or open rhinoplasty procedures. The operation takes about 1 hour, although this will be longer if additional procedures are to be added.  You will return home after an hour or two of recovery.

After Surgery
You will need someone to accompany you home and provide care for you at home during the first 24 hours after surgery.  A splint is applied over your nose and remains in place for approximately 5-7 days.  This protects your nose and helps minimize swelling.  An Aquecool mask(LINK) is applied to the face during the first 48 hours after surgery to help minimize bruising and swelling.  Small packs may or may not be inserted into your nostrils.  If they are used in your case, they will be removed 1-2 days after the operation.

After surgery you should expect swelling and bruising about the face.  Most of this subsides during the first 1-1.5 weeks.  At that point, most patients are able to appear in public.  Makeup can usually be worn after the splint is removed, masking the small amount of residual swelling and bruising.  Your nose will be congested on and off for several weeks after surgery.  This reaction is normal and slowly subsides.  Once the splint is removed, the nose is visible but does not attain its final appearance for at least 6 months.  This is due to ongoing healing inside the nose which tends to change the shape and position slightly until resolved.  The nasal tip remains swollen the longest and is the last area to reach final appearance.

Before and After Images
In an effort to preserve the privacy of our patients, representative images of Dr. Bass’s rhinoplasty results can only be viewed in the office during a consultation.