What Is Rhinoplasty Surgery?

Rhinoplasty is a precise and technically advanced procedure that can improve both the appearance and function of the nose. If there are features of your nose that you would like to change—or if you are having trouble breathing—the procedure can provide aesthetic enhancements and improved quality of life.

Septoplasty may also be included in a rhinoplasty. The septum is the natural segment of bone and cartilage that separates the two air passages inside the nostrils. Injury or genetics can shift the septum out of place and partially limit your ability to breathe. With a septoplasty, we can correct this deviated septum and clear your breathing passages.

Dr. Porter is an industry-recognized rhinoplasty expert, having written book chapters and done research on ideal proportions of the nose, along with a variety of additional innovations with this procedure. If you’d like to learn more about how her expertise can be put to use to create your ideal results, reach out to our Bethesda, Maryland practice today.

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Why See a Nose Job Expert?

Dr. Jennifer Parker Porter, MD, FACS is a fellowship-trained, double board-certified facial plastic surgeon, which means she only performs plastic surgery of the face. She has dedicated her career to mastering the intricacies of rhinoplasty, a complex procedure that changes the aesthetic appearance of the nose. In addition to extensive training and technical expertise, Dr. Porter also offers patients a keenly developed artistic sensibility, enabling her to create truly pleasing results that will enhance their sense of facial harmony.

As with every procedure performed at Chevy Chase Facial Plastic Surgery, Dr. Porter believes that you deserve an individualized approach to your rhinoplasty in Maryland. You’ll enjoy a bespoke treatment plan that is based on your individual needs. By customizing the operation to fit your goals, she will be able to provide the very best results while minimizing your risk of complications.

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The Rhinoplasty Procedure at Chevy Chase Facial Plastic Surgery

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The Benefits of a Rhinoplasty from Dr. Porter

Dr. Porter has spent over 25 years in practice with a primary surgical focus on rhinoplasty; is double board-certified; serves as a clinical associate professor at Georgetown University Medical Center; and has lectured, contributed book chapters, and authored journal articles on rhinoplasty for several medical texts and publications.

Patients consider rhinoplasty both for their cosmetic improvement and their comfort. With this surgery, Dr. Porter can:

  • Remove an unwanted hump or bump
  • Alter a nose to be in proportion with other facial features
  • Narrow the tip
  • Create a very slight swoop or retrousse
  • Lift the nasal tip
  • Make a wide nose narrower
  • Fix a flat or droopy nose
  • Revise large or flaring nostrils
  • Address traumatic deformities
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What Determines the Ideal Nose Job Candidate?

Rhinoplasty results vary depending on each patient’s circumstances, and your procedure will be customized around your existing facial features and cosmetic goals. Once you have decided to undergo the procedure, our Facial Plastic Surgeons will assess your nose structurally and aesthetically by taking the following into account:

  • Pre-existing bone and cartilage structure of your nose
  • The shape of your face
  • Your age
  • The thickness of your skin

Dr. Porter uses this information to construct a treatment plan to optimize your outcome. Cosmetic nose surgery in Maryland should be performed on persons whose facial structure has stabilized. In most cases, it is not a recommended procedure for minors who have not gone through puberty, particularly if they have not completed the growth spurts that usually conclude in the mid to late teen years.

What to Expect for Your Rhinoplasty Treatment

Getting Started

As responsible practitioners, the team at Chevy Chase Facial Plastic Surgery wants to ensure that you get the care you need. We encourage you to start your experience by contacting our office, discussing your concerns and goals, and getting information about the type of improvement rhinoplasty can offer you. While our practice does not take insurance, we can give you the codes to use with your insurer should a portion of the surgery be functional.

Your Consultation

The next step is an initial consultation with Dr. Porter, who will go over your medical history, examine your face and nose, and review digital photographs with you. Most of our patients are excited about this part of the process. Our surgeons will use sophisticated MIRROR® imaging technology to show you what you can expect from your results. As part of treatment planning, she will also aim to create a look that respects your cultural heritage and aesthetic individuality.

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Performing Rhinoplasty Surgery

For revision rhinoplasty, Dr. Porter will determine during the consultation whether the procedure will require cartilage grafts from other areas of the body. This is not necessary in all cases. A majority of revision rhinoplasty procedures involve an external, or open, approach. This is to better visualize the work previously performed.

When you decide that you are ready to move forward, our practice will schedule your surgery. You will return to our offices for a preoperative visit two weeks beforehand so that we can review the surgical plan and answer any other questions you may have. Our goal is for you to enter your procedure with complete confidence and comfort in the decision.

Keeping You Comfortable

Dr. Porter conducts her rhinoplasty procedures at the John Hopkins Surgery Center in Bethesda, SurgCenter of Silver Spring in downtown Silver Spring, Montgomery Surgery Center in Rockville, and at Georgetown University Hospital in Washington, DC. Most of our patients receive general anesthesia so that they can sleep through the entire experience.

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Choosing the Right Nose Job Technique

The techniques that Dr. Porter uses during your rhinoplasty will depend on your needs and goals:

  • She is skilled in both “open” and “closed” rhinoplasty procedures. During your consultation, she will individualize your approach based on your goals.
  • If you are having rhinoplasty for cosmetic purposes, Dr. Porter will revise the internal and external features of the nose to create a more balanced and aesthetically pleasing appearance.
  • If you are having surgery to improve problems with breathing, she will work expertly and with precision to rebuild and support the internal structure of the nose.
  • Regardless of the goals of the procedure, Dr. Porter will use special techniques in the operating room to minimize bruising so that you can heal more quickly and comfortably.
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The Recovery Process

After rhinoplasty, you will spend about an hour recovering at the recovery room before heading home with light nasal packing. In many cases, we will see you back at our welcoming Bethesda, Maryland office space the very next day, where we will remove the packing. For the next week, you will use salt water nasal spray on a daily basis. If you have a cast and sutures, these will be removed one week after surgery.

Nine to ten days following rhinoplasty, most patients are comfortable socializing and returning to work. Eighty percent of the swelling should subside within one month, and if you have had rhinoplasty to improve your ability to breathe, you should notice a difference by this point. Cosmetic patients should see the final result of their procedure after about one year: a more refined and aesthetically appealing nose that fits naturally with their other facial features.

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Rhinoplasty FAQ

What are the functional benefits of rhinoplasty?

What is the difference between functional and cosmetic rhinoplasty?

What is the difference between open rhinoplasty and closed rhinoplasty?

What should I expect from the surgery?

How will my nose job procedure be performed?

How does the computer mirror® imaging system work?

How long is the recovery period following a rhinoplasty procedure?

When will I enjoy my final results?

How does rhinoplasty differ for patients from different ethnic backgrounds?

What are the functional benefits of rhinoplasty?

Rhinoplasty is about more than just your cosmetic appearance. Rhinoplasty can be performed in conjunction with functional techniques. There are a number of functional benefits incorporated with rhinoplasty patients and beyond. For example, many patients have trouble breathing through their noses because of a defect in their nasal valves. These valves might have narrowed due to old age or trauma, or a person could have been born with narrower-than-usual nasal valves. Whatever the case, this limits the flow of air to the lungs, preventing the person from taking a full breath through their nose. During a rhinoplasty, Dr. Porter can help to open up these airways through grafting techniques and repairing cartilage in the nose.

Functional rhinoplasty can provide patients with some of the following benefits:

  • The ability to breathe better, especially when working out or sleeping, as the airways are wider
  • Improved well-being, as the patient may be receiving more oxygen than they are used to
  • Improved appearance and the removal of cartilage can sometimes change the appearance of the nose for a sleeker, more refined look

What is the difference between functional and cosmetic rhinoplasty?

Functional rhinoplasty differs from cosmetic rhinoplasty because these functional improvements are the main goal of the treatment. Cosmetic rhinoplasty, on the other hand, is done solely to increase a person’s aesthetic appearance. In many cases, those who seek functional rhinoplasty may also see a change to the shape of their nose, as your surgeon will have to remove some cartilage to widen the airways. However unintended this benefit is, it’s still a nice bonus for patients.

What is the difference between open rhinoplasty and closed rhinoplasty?

While open rhinoplasty and closed rhinoplasty are two separate approaches, in the end, they provide the same long-lasting results for patients.

An open rhinoplasty involves making a small incision in the skin between the nostrils, called the columella. This enables your surgeon to lift the skin out of the way and visualize the underlying structure of the nose to begin the procedure. A closed rhinoplasty, on the other hand, only involves incisions inside the nose, so the patient won’t have any visible scarring. Closed rhinoplasties are appropriate for patients that want hump removal or need changes to the nasal tip.

While Dr. Porter will have a better view of the nose with an open rhinoplasty, the procedure can leave patients with a small scar underneath their nose. On the other hand, a closed rhinoplasty eliminates scarring but makes the procedure slightly more challenging if more drastic changes are desired.

Before deciding on whether or not an open or closed rhinoplasty is appropriate, Dr. Porter performs a full examination on each patient. She will ask them about their treatment goals and take a look at the current structure of their nose to decide which procedure would provide results that align closest with their expectations. In general, patients who are having moderate work done on their nasal bridge can benefit most from closed rhinoplasty, while patients who are having work done on their nasal tip (such as the removal of a malformed or bulbous tip) or other extensive reshaping are best suited for an open rhinoplasty.

What should I expect from the surgery?

A wide range of aesthetic goals can be met at our cosmetic surgery practice. Our facial plastic surgeons are some of the area’s best in cosmetic nose surgery and can alter the size of your nose, change the shape of the tip or the bridge, adjust the width of the nostrils, or alter the angle of the nose in relation to the upper lip. Rhinoplasty can remove a hump and improve nasal disproportion. In addition to achieving cosmetic improvements, the procedure can also be employed to correct problems resulting from nose injuries and can help relieve certain breathing difficulties.

How will my nose job procedure be performed?

There are two basic methods for performing cosmetic nose surgery, the open method and the closed method. At our Bethesda, Maryland rhinoplasty center, Dr. Jennifer Parker Porter has extensive experience with both methods. During an open rhinoplasty procedure, your surgeon will make a small incision along the columella. The columella is the strip of tissue that separates the nostrils. An open rhinoplasty tends to leave a tiny scar, but the scar is hardly visible because it is strategically placed in an area that is usually in shadow. If a closed rhinoplasty procedure is performed, then the sites of the incision will all be internal rather than external.

Our surgeons prefer to use the closed technique for the majority of their procedures, reserving the open technique for patients undergoing revision rhinoplasty, patients increasing their tip definition, or patients correcting an overall structural problem such as a crooked nose. The closed rhinoplasty procedure works best for patients with thin to medium skin thickness, while the open procedure is often the more suitable option for patients with increased skin thickness. There are benefits associated with both methods, and a comprehensive consultation is the only way to be certain about which method would be most appropriate for your specific rhinoplasty needs.

How does the computer mirror® imaging system work?

The computer is able to transform a photograph of your face into an image of what you might look like following rhinoplasty. During your cosmetic surgery consultation, this photographic image can be manipulated based on your aesthetic preferences and any suggestions that Dr. Jennifer Parker Porter may have in accordance with her extensive experience as a rhinoplasty surgeon. The computer imaging system is a communication tool that allows you to more clearly express the desires you have for your nose’s ultimate appearance. In turn, it enables your surgeon to show you exactly what is possible using the most recent advances in rhinoplasty surgical techniques and technology so that you can enjoy more realistic expectations for the outcome of the procedure.

How long is the recovery period following a rhinoplasty procedure?

Recovery time from cosmetic nose surgery can vary. Our rhinoplasty experts usually recommend that a patient reserve seven to 10 days for their initial recovery. The cast and stitches, if any are present, will be removed approximately one week after surgery. Sometimes patients are fitted with a nose splint to stabilize the septum, the wall dividing the nasal passages. If present, this is also removed after about a week.

Bruising is common following the procedure. Shortly after any postoperative dressings have been removed, many patients feel strong enough to resume light activities, such as having dinner with friends, driving, or going to the movies. Remember, however, that a complete recovery after cosmetic nose surgery will take time and patience.

When will I enjoy my final results?

The final results of your cosmetic surgery will not be apparent for up to a year after rhinoplasty is performed. You should avoid strenuous activities for at least four weeks and avoid excessive direct sun exposure to help ensure a smooth recovery. Complications associated with the procedure are rare and usually minor. The risk of complications can be greatly reduced by adherence to our detailed post-operative care instructions.

How does rhinoplasty differ for patients from different ethnic backgrounds?

Our surgeons have written several book chapters on this topic and, through the years, have treated many patients from a variety of ethnicities. Whether it is African American Rhinoplasty, Asian Rhinoplasty, or Rhinoplasty for patients of Latino descent, each patient is approached on an individual basis.

Our surgeons frequently find that the external approach is the preferred surgical approach because of the thickness of the skin and the desire for increased definition of the tip. The external approach allows for further contouring that will become apparent as the nose heals. Additionally, the healing time to reach the final result in the “ethnic” rhinoplasty patient is usually on the order of one and a half years. Although there are obvious changes early on, this extra time is the ideal time for refinement. Visit our offices in Bethesda, Maryland for your consultation, and we’ll be happy to share our collection of before-and-after photos to show you exactly what you can expect from your rhinoplasty surgery.

Book Your Consultation with Dr. Porter

With rhinoplasty, Dr. Porter produces natural-looking results that will be in harmony with your existing features, enhancing your sense of facial harmony in a way that preserves your natural good looks. Rather than looking different, you’ll look like an enhanced version of yourself. Dr. Porter carefully considers the functional aspect of these procedures, so she can improve or maintain your ability to breathe properly. 

Your outcomes will reflect your personal aesthetic vision, thanks to the impressive skill offered by our doctors and their collaborative approach to the consultation and patient education process. Ready to learn more? Reach out to Chevy Chase Facial Plastic Surgery in Bethesda, Maryland and speak with a helpful member of our team to set up your initial consultation today.

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