Rhinoplasty

Rhinoplasty, commonly known as a nose job, is a surgical procedure performed to enhance the appearance or functionality of the nose. It is one of the most commonly performed cosmetic surgeries worldwide. Rhinoplasty can address various concerns, such as altering the nose’s size, shape, proportion, bridge height, tip position, or correcting breathing difficulties.  Understanding the balance of form and function requires excellent training and significant experience to be able to provide high quality results. Dr Rubach has exceptional training and over 27 years of experience. Dr Rubach initially trained in a surgical residency in ENT Head and Neck Surgery to develop the skills necessary to manage the functional breathing aspects associated with nasal surgery. Following this he completed an intensive fellowship in Facial Plastic and Reconstructive Surgery at University of California, San Francisco focused entirely on facial surgery. He is double board certified in ENT Head and Neck Surgery and also Facial Plastic and Reconstructive Surgery.

Here is an overview of the rhinoplasty procedure:

1. Consultation: The process begins with a consultation with a qualified facial plastic surgeon. During this consultation, we will discuss your goals and expectations for the surgery. Dr Rubach will evaluate your nasal structure, skin quality, facial proportions, and overall health to determine the best approach for your individual case.
2. Anesthesia: Rhinoplasty is typically performed under local with IV sedation in our in office based Joint Commission Accredited surgery center. This approach provides a comfortable patient experience with minimal risks for post operative nausea or vomiting and a quick anesthesia recovery. Patients are often discharged home 30 to 45 minutes following the procedure.
3. Incisions: There are two different approaches that are used for rhinoplasty, Incisions inside the nostrils (closed rhinoplasty) or at the base of nose  (open rhinoplasty). The choice of incision technique depends on the complexity required for the procedure with the open approach being the most common.
4. Reshaping the nose: The underlying bone, cartilage, and soft tissues of the nose are then accessed through the incisions. The surgeon may remove or reshape the cartilage and bone to achieve the desired aesthetic outcome. This can involve reducing or augmenting the nasal bridge, refining the nasal tip, narrowing the nostrils, or correcting asymmetry.
5. Septoplasty (if needed): If you have a deviated septum causing breathing difficulties, then a septoplasty may be performed at the time of the rhinoplasty to straighten the nasal septum and improve breathing.
6. Closing the incisions: After the necessary modifications are made, the incisions are closed with dissolvable sutures or stitches that will be removed during a follow-up appointment.
7. Recovery: You will be provided with specific post-operative instructions. The initial recovery period typically involves wearing a nasal splint or cast to support the nose’s new shape and minimize swelling. Some swelling, bruising, and discomfort are common in the first few weeks, but these effects gradually subside. Typically, Dr. Rubach’s rhinoplasty patients do not experience significant post operative pain, however pain medication is provided if needed. Social activities may be resumed at 7 to 10 days following the procedure. It may take several months for the final results to become fully visible as the healing process continues.
8. Follow-up appointments: Typically post operative patients are seen at one week, one month and 3months following the procedure.
9. Dr Rubach utilizes computer imaging at the time of the consultation to ensure that patient expectations are aligned with the surgical expectations. A digital photo is taken and the proposed changes are visualized prior to any surgical procedure.  This is an essential tool when considering cosmetic changes to the nasal structure.