Rhinoplasty by Dr. Osborn

Cosmetic Facial Surgery in Medford

Rhinoplasty is a commonly performed procedure used to reshape the nose in order to improve breathing, balance the nose with the face, and normalize the contours of the nose. People may notice shapes or contours of the nose that they do not like. We can help you identify the underlying structure and come up with a solution to create harmony between your face and your nose.

What is Rhinoplasty?

Rhinoplasty is surgery. That may seem like an obvious statement, but with social media and marketing making it seem as though it is a simple procedure it does require recovery and healing. The only way to heal properly is to treat this as safely as possible. With this procedure comes different forms of healing and depends on the patient and their tissue. Making sure your procedure is fit to you is why you want a surgeon with training, experience, talent, and passion.

I have done hundreds of rhinoplasty procedures over the last 10 years. About half of them are done with other procedures like reconstructive jaw surgery to balance the profile simultaneously. One of my favorite things to do is to read about rhinoplasty and the different approaches that surgeons take. An indicator of experience is the ability to take what others are doing and incorporate it into your own approach and technique. We also critically assess our outcomes and learn from every case.

Who is a candidate?

There is a wide range of candidates for Rhinoplasty some include a dislike of the appearance of the shape and Medical reasons such as trouble breathing. Nasal growth is usually done before the age of 16, and most of our patients are over 16, though we assess each case individually.

Common Reasons For Evaluation

Dorsal hump

Long nose

Short nose

Tip excess

Airway Collapse and asymmetry

Surgical Approach

Most of my career I have performed open rhinoplasty, but recently I have uncovered a renewed passion for closed techniques. Most surgeons do one or the other with an almost cult-like devotion to the one. I am one of the very who is trained in both and have routinely incorporated them into my clinical practice. I would do my primary rhinoplasty open and revision rhinoplasty closed. It was in reading a book by Mark Constantian, MD that I realized that my ability to visualize in surgery was the same, the end goal is the same, but the recovery is substantially different from the closed approach, patients recovering far faster. If you are interested more about open vs closed, you can read more in our blog post.

Surgical Planning

We perform a comprehensive history and examination of your facial features, proportions, and nasal exam. We are going to assess your goals for treatment, nasal function, history of trauma or allergies and formulate a surgical plan. We encourage patients to bring photos of noses that they like. It helps us identify a common language, frames your goals for an outcome, and allows me to explain how structure relates to appearance. We will discuss what we can achieve with surgery, the surgical process, and stages of recovery. We invite an open and frank discussion about the process as it helps prepare everyone who will be part of the process. No matter what, we are going to take great care of you.

This is an example of part of the planning process. Blue indicates where reduction will be performed, brown is augmentation. Overall, we are going to reshape and rebalance the nose with what is available surgically. Rhinoplasty must be a fusion of techniques to remove and replace in order to balance best with the features of your face. Simulation programs can be helpful, but often paint a picture that is not possible. We are happy to discuss with you how we plan every case in order to achieve your goals.

Adjunctive procedures:

Recovery

Most of the recovery from rhinoplasty takes place in the first 1-2 weeks. There will be moderate discomfort, for 2-3 days, and significant swelling and bruising for the first 7-10 days. For most patients, splints will be placed in the nose and a cast outside. These are removed at the first postop visit 6-8 days after surgery. Immediately after splint removal, the ability to breathe will be improved. For the first 2-3 months, the nose will seem stiff. It takes months for all swelling to resolve and over those months, there will be variation in the location of the swelling. By 12 months, most of the swelling is gone and the final result can be appreciated. We encourage patients to be patient and not hyper-focus on swelling, contour, or the variations that will occur over time. We like to follow our patients closely and can do most of this by online meetings.

Insurance

Your insurance company may pay for all or part of the costs associated with your surgery if it is performed as a result of nasal obstruction. It is recommended that you check with your carrier to determine if there is coverage and we are happy to help in the process.