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In 2004, cosmetic surgeons performed 166,187 "nose jobs," a small decrease of 4 percent since 2003, according to the American Society for Aesthetic Plastic Surgery. During rhinoplasty, the surgeon can alter the size, shape, and angle of the nose to enhance its appearance. The procedure may also be performed to correct breathing problems, chronic congestion, and deformity caused by injury, disease, or birth defect. Depending on the desired results, the surgeon makes incisions to either remove bone or cartilage or to add tissue or a synthetic filler (for instance, to reshape the tip or bridge of the nose). Nasal packing and a splint will help support the newly shaped nose as it heals. Surgery lasts one to two hours. Rhinoplasty requires either general or local intravenous anesthesia. It is usually performed as an outpatient procedure, but may require a one-night stay in the hospital or surgical center.
Pain Level/Recovery Time: The doctor will remove the surgical packing from inside the nose within a few days. The splint and bandages will be removed after about a week. Patients can expect puffiness around the eyes; the nose will remain bruised and swollen for about two weeks. (Some subtle swelling will remain for several months.) Cold compresses, head elevation, and pain relievers will help reduce swelling. Most patients can return to their usual routines within seven to 10 days. Strenuous activities should be avoided for several weeks. The final results may not be apparent for a year or more as the nose heals.
$4,047 (national average for surgeon's fees).** Average surgeon's fee for rhinoplasty may vary by region:
For New England (CT, ME, MA, NH, RI, VT) and Middle Atlantic (NJ, NY, PA): $4,451 For East North Central (IL, IN, MI, OH, WI) and West North Central (IA, KS, MN, MO, NE, ND, SD): $3,723 For South Atlantic (DE, DC, FL, GA, MD, NC, SC, VA, WV): $3,844 For East South Central (AL, KY, MS, TN) and West South Central: (AR, LA, OK, TX): $3,885 For Mountain (AZ, CO, ID, MT, NV, NM, UT, WY) and Pacific (AK, CA, HI, OR, WA): $4,289
** Note: These averages for surgeon's fees are provided by the American Association for Aesthetic Plastic Surgery, Inc. These figures do not include fees for the surgical facility, anesthesia, medical tests, prescriptions, splints, packing, or other miscellaneous costs related to surgery. In addition, most insurance companies do not cover the cost of rhinoplasty unless it is being done to correct impaired breathing or deformity due to disease or trauma.
Rhinoplasty results are permanent. You should discuss your expectations with your doctor in advance. Age can be a limiting factor. To avoid complications and alterations in the results, rhinoplasty should only be performed on an individual whose nose is fully developed (by age 15 or 16 in females and 17 or 18 in males). Overall, complications of rhinoplasty are usually minor and infrequent when the procedure is performed by a qualified plastic surgeon. Possible complications may include infection, nosebleed, or a reaction to anesthesia. You can reduce some of these risks by carefully following your doctor's advice before and after surgery. In about one in 10 cases, a second procedure may be performed to correct a minor deformity. These cases are unpredictable and may occur even in the hands of a highly skilled surgeon.
Donna, 46, Pittsburgh
Donna, a secretary, always disliked her nose. "It was kind of like a hook," she recalls. "It always made me uncomfortable when people looked at me from the side." So last April, after saving up for the $5,000 fee, she decided to take the plunge for plastic surgery. "When I don't like something about myself, I try to change it," she says.
On the day of her rhinoplasty, Donna's three daughters accompanied her to the doctor's office. About 2 1/2 hours later, they were already driving her home. Donna doesn't remember a single detail about the procedure, which was performed under local anesthesia. But she fondly recalls the recovery. "I couldn't believe I wasn't in pain," she says. "I didn't have a headache; my nose didn't hurt; my face didn't hurt. That afternoon, I was sitting at the table having tea." The next day, despite some swelling and bandages covering her nose, she went grocery shopping. The splint was removed after a week.
"For about three weeks, I had a greenish, purple bruise under my eye," Donna says. "But it was minimal. I put on special makeup and you couldn't tell."
She now loves her new nose; the bump is gone and it's less wide. "My sister thinks I'm crazy," Donna says. "But I've always felt that anything I can do for myself that will make me feel good about myself, I'm going to do." Two of Donna's daughters have inherited her original hook. She's told them that if they decide to get nose jobs, they can. "But they have to pay for it themselves," she says.
To Learn More: Visit the Public Site section of the American Society for Aesthetic Plastic Surgery's Web site. Or call their toll-free referral line at 1-888-ASAPS-11.
Check out the Learn section of BeautySurg.com, the "cosmetic surgery supersite."
For a rhinoplasty tutorial, visit FacialSurgery.com.
For physician referrals, call the American Society of Plastic Surgeons referral service at 1-888-4PLASTIC or visit them online. Click on "Learn about Procedures" to find out more.