Rejuvenation Rhinoplasty

Rejuvenation rhinoplasty addresses specific features of the aging nose that require correction. The overlying nasal skin is elevated, the droopy tip of older age is rotated upwards, the tip is refined if bulbous, and the bump of the bridge lowered. Less change is often desired, and therefore created, in rejuvenation rhinoplasty than in rhinoplasty done in younger age groups. A rejuvenation rhinoplasty can be performed with either an open or closed approach.

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The Skinny

avg. recovery: 2 weeks
permanence: Is permanent
application: Surgical Procedure
surgical: Yes
cost: $5000 - $10000

About the Procedure

A rejuvenation rhinoplasty, while typically minimal in scope, provides patients maximum return for a youthful appearance. As we age, the loss of collagen and elastin as well as the forces of gravity cause the skin to droop. This droopiness, alongside the loss of volume in the lips and cheeks, can make the nose appear longer or larger. A rejuvenation rhinoplasty will commonly only address superficial aspects of the nose such as the tip or excess skin, while leaving inherent structures such as the septum intact. A rejuvenation rhinoplasty, much like a primary rhinoplasty, can be performed with either an open or closed approach. If an open approach is used, an incision will be made at the columella, just beneath the tip of the nose. The nose will then be retracted backwards, dissecting the nose cartilage with care being taken to not incise the medial crura, the cartilage that separates the nostrils. The flap will be raised off of the nose for maximum exposure and work can now be done to reshape the nasal tip, bridge, nostrils, or septum repair. Once completed, the flap will be redraped over the bone framework and external contouring and shaping is completed. The incision will be closed with sutures and an external splint or cast will be placed over the nose. If a closed approach is used, incisions will be made on the inside of the nose. The nasal structure will not be exposed which means decreased visualization for the surgeon, however postoperative scarring will be hidden and discreet. The addition of an endoscope may be used during a closed rhinoplasty to increase visualization. When repair has been completed, sutures will close incisions and an external splint or cast will be placed over the nose.

The goal of rejuvenation rhinoplasty is to achieve facial harmony by changing the shape, size or angle of the nose in older patients. Rhinoplasty can also be used to correct breathing problems resulting from irregularities inside the nose.

Concerns

Rejuvenation Rhinoplasty addresses concerns such as:

What to Expect

Rejuvenation rhinoplasty addresses specific features of the aging nose that require correction. Typically, the overlying nasal skin is elevated, the nose tip is rotated upwards and refined if bulbous, and the bump of the bridge lowered. Here is a quick guide for what to expect before, during, and after a rejuvenation rhinoplasty.

Before Treatment

Stop taking blood thinning medications for 2 weeks
Stop smoking 2 weeks before and after surgery
Limit sun exposure for 2 weeks
Do not eat or drink anything 6 hours prior
Purchase all recovery items beforehand

During Treatment: Closed Technique

General or local anesthesia with sedation
Incisions made on the nasal membrane in varying locations to access different parts of the nose
Nose is reshaped and refined
Sutures to close incisions
External splint or cast will be placed over the nose

Recovery Notes

Following surgery, an external splint is applied for 1 week. Facial bruising and swelling as well as teeth numbness is common which resolve within 1-2 weeks. Nasal swelling will last longer and dissipate over the next month. Older patients will typically have a prolonged recovery period. The nose will continue to heal over the next 1-1.5 years. Makeup may be worn once the cast is removed. Depending on the surgical technique, normal activities may be resumed as soon as a few days postoperatively.

Ideal Candidate

The ideal candidate for a rejuvenation rhinoplasty is older, is in good health, and typically only wants to address specific features of the aging nose such as excess skin or a droopy nasal tip.

Not Recommended For

Rejuvenation rhinoplasty is not recommended for candidates with cardiac or pulmonary conditions due to potential risks of complications with anesthesia used.

Side Effects

Side effects from a rejuvenation rhinoplasty may include numbness, nosebleeds, scarring, swelling, bursting of small blood vessels on the surface of the skin, permanent nerve damage, and under-or over- correction that necessitates revision rhinoplasty.