Rhinoplasty is a surgical option that has many uses, from repairing sports injuries to refining the shape of the nose. At Legacy Plastic Surgery & Aesthetics in Exton and Lancaster, PA, we use modern techniques to make your surgery and your recovery more comfortable while promoting the best results. Our approach to every surgery is patient-centered. We listen to what you want from your surgery and then make recommendations based on what is best for you. Rhinoplasty can be a good option for patients seeking long-lasting changes to their noses.
A nose job is a surgical procedure that reshapes or reconstructs the nose for functional or cosmetic reasons. It can correct structural issues that affect breathing, repair damage from an injury, or adjust the nasal bridge, tip, or nostrils. With each rhinoplasty, we create a balanced and proportional look while maintaining or improving nasal function.
During this procedure, we make precise incisions on the nose to access the underlying structures. Excess cartilage, bone, or tissue may be removed, while grafts can be added to enhance shape or support nasal function. Every step is planned to achieve the desired shape while preserving the natural integrity of the nose and balancing the end results with the rest of your facial features.
Rhinoplasty is recommended for patients whose facial growth is complete, typically by the late teenage years. Candidates should be in good overall health and free from conditions that could interfere with healing. Non-smokers or those willing to stop smoking before and after surgery have a lower risk of complications, and those with a realistic expectation of the procedure and results are ideal for the procedure.
Before nose alteration surgery, we discuss your surgical goals, medical history, and any medications or supplements you take. We will also review past surgeries, assess potential risk factors, and go over the available options to determine the best approach. With your permission, we may take before photos to evaluate possible results and explain what to expect during your recovery. This will help you plan ahead and understand the likely outcomes to prepare you for a smoother process.
We will have you avoid aspirin, ibuprofen, and any medications that affect blood clotting before surgery. Herbal supplements and over-the-counter remedies can also increase bleeding risk, so only take what your surgeon approves. Smoking and vaping slow healing, so we recommend stopping well in advance.
We can use either local anesthesia with sedation or general anesthesia to keep you comfortable. The decision will be made during the preparatory stages when we can consult you about your preferences and recommend options based on your health history and the extent of your surgery.
Once the area is numb or you are under general anesthesia, we make the appropriate incisions inside the nose and/or across the columella. With both techniques, our goal is to make the incisions as discreet as possible. Once the incisions are made, we will have the access we need to the inner structures such as your bone and cartilage.
With some rhinoplasty procedures, we will need additional cartilage or bone from other areas to support or refine the nasal structure. These grafts are taken from the septum, ear, or rib. For rhinoplasty surgery, grafts can be taken from the patient, known as an autograft, or from a donor, known as an allograft.
Once we access the nasal framework, we reshape the bone and cartilage to achieve the desired structure. This may involve removing a dorsal hump, refining the nasal tip, or straightening a crooked bridge. If breathing concerns are present, this is the phase of the surgery where we can adjust the internal structures to improve airflow.
After making the necessary adjustments, we close the incisions with sutures and apply a splint to support the nose as it heals. Bandages help minimize swelling and protect the area, while internal splints or packing may be placed if structural corrections require additional stabilization. These measures keep the nose secure in the early stages of healing and allow the tissues to settle properly.
Right after surgery, swelling and bruising will be most noticeable around the nose and under the eyes. The first week involves wearing a splint to support the nasal structure. You will come back to the office to have the splint removed. You are encouraged to engage in light walking, such as a trip to the bathroom, right away. Most patients can return to normal, non-strenuous activities after about 10 days. Swelling gradually decreases over the next few months, but subtle changes can continue for up to a year before final results are fully visible.
Keep your head elevated, even while sleeping, to reduce swelling and prevent unnecessary pressure on the nose. Do not blow your nose since this can cause pressure in the nose and disrupt healing—if congestion or a runny nose becomes an issue, you can gently dab the area with a tissue. During the first part of recovery, you may have gauze below the nostrils to catch drainage. This gaze can be changed throughout the day. If you need to sneeze or cough, do so with your mouth open to avoid pressure on the nasal structures.
Avoid heavy lifting, bending over, or strenuous exercise for at least a few weeks since these activities increase blood pressure and may lead to swelling or bleeding. Facial movements like excessive smiling, laughing, or frowning should also be minimized in the early recovery period to prevent unnecessary strain on the surgical site. If constipation is a concern due to limited movement or pain medications, drinking plenty of water, taking a gentle stool softener, and increasing fiber intake can help.
Wear shirts that button or zip instead of pulling clothing over your head to avoid bumping the nose. Glasses should not rest on the nose until healing is further along. When brushing your teeth, move the toothbrush gently to avoid excess movement in the upper lip.
As with any surgery, anesthesia carries some risks, including reactions to medications or breathing difficulties. Temporary or permanent changes in sensation around the nose may occur, and some patients experience numbness that takes time to resolve.
Difficulty breathing can result from swelling or changes in the nasal structure, though most breathing concerns improve as healing progresses. Infection is uncommon but possible, and signs like increased redness, warmth, or excessive/foul discharge from the incision site should be reported. Poor healing can sometimes affect the final shape of the nose, and in some cases, additional revision surgery may be needed if results do not meet expectations.
The cost of nasal surgery depends on the complexity of the procedure, the surgeon's expertise, and surgical facility fees. Additional factors include anesthesia costs, pre-operative tests, and post-operative care. Since each case is different, an in-person consultation is necessary to provide an accurate estimate.
Insurance typically does not cover cosmetic rhinoplasty, but it may provide partial or full coverage if the procedure corrects functional issues like breathing difficulties or a deviated septum. Coverage depends on your specific insurance plan and whether the surgery is deemed medically necessary. Documentation and pre-authorization may be required before approval.
The results of rhinoplasty surgery are long-lasting, with changes in bone and cartilage remaining stable once healing is complete. Minor swelling can take up to a year to fully resolve, and subtle refinements may continue to appear over time. While the nose naturally changes with aging, most structural improvements remain for a lifetime.
Rhinoplasty focuses on reshaping the nose for aesthetic or functional reasons, while septoplasty corrects a deviated septum to improve breathing. In some cases, both procedures are performed together to enhance both form and function. Septoplasty alone does not change the external appearance of the nose.
We perform many nose alteration procedures at our Accredited Ambulatory Surgical Center, located next to our office for patient convenience. Some surgeries take place at local hospitals where Dr. Kim and Dr. Wingate serve as Chief of Plastic Surgery. The location depends on the complexity of the procedure and patient preference.
Finding the right surgeon for nose surgery requires careful consideration of experience, credentials, and surgical expertise. A surgeon who frequently performs rhinoplasty will be more familiar with the nuances of nasal anatomy and the balance between function and aesthetics. Hospital privileges demonstrate a commitment to safety, skill, and adherence to professional standards. Reviewing before-and-after photos and patient experiences can also help gauge a surgeon’s ability to achieve natural-looking results.
At Legacy Plastic Surgery & Aesthetics, our rhinoplasty specialists prioritize both education and individualized care. Dr. Paul Kim and Dr. Gary Wingate have decades of experience in cosmetic and reconstructive procedures. They believe in thoroughly discussing all available options so patients can make informed decisions about their care. With privileges at multiple hospitals and an Accredited Ambulatory Surgical Center next to the office, we offer a seamless experience from consultation through recovery.
Rhinoplasty can improve both the function and appearance of the nose by refining its shape, correcting structural concerns, or restoring balance after an injury. At Legacy Plastic Surgery & Aesthetics, procedures are performed by experienced plastic surgeons who specialize in cosmetic and reconstructive nasal surgery, and we serve all of the surrounding areas including Exton, Lancaster, and Harrisburg. Call (610) 524-8244 (Exton) or (717) 435-9534 (Lancaster) or contact us through our online form.