Question: I’ve seen on message boards where patients looking into revision rhinoplasty mention thin skin. Does the skin become thinner after surgery or are these people who originally have thin skin? How does this affect the surgery?

Answer: Most patients that mention thin skin started with thin skin before they had their rhinoplasty.  Often times after a rhinoplasty that did not turn out as good as they desired, there are areas that are too prominent or areas that have sharp edges that are able to be visible through thin skin and this essentially makes the skin look even thinner.  The nose also has a healing effect where the soft tissue over the cartilage tends to contract around the remaining cartilage and this can also give the appearance of thinner skin than they started with before the rhinoplasty.  Ultimately, there are camouflaging techniques that can be performed in a revision rhinoplasty that will help give the appearance of slightly thicker skin, and there are a variety of techniques that we can perform to help create an overall softer look to the nose. 

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Question: My twin sister and I would like identical nose jobs. Is this possible?

Answer: Yes, if your twin sister, assumingly, has an identical nose as yours then an identical procedure can be performed to give you a nose that would look extremely similar after a rhinoplasty to your sister’s nose after a rhinoplasty.  Obviously, a surgical procedure as well as the healing process cannot be guaranteed to give you identical noses, but they should be extraordinarily close to the point where you would have to literally evaluate standardized photography to be able to tell any difference between the noses, assuming that they started out identical.

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Question: I think of my nose as a sort of Patrician nose. However, there is a slight bump towards the top that I’m bothered by. Can this be slightly improved while leaving the rest of my nose intact?

Answer: We can definitely customize a rhinoplasty to meet each individual’s goals, and I certainly have had many patients who did not want to alter the appearance of the nose in a striking way but more of in a subtle way and that is where computer-generated imaging really helps.  Patients may have an overly large nose with a small hump and though they would like to create a more harmonious nose with the rest of their face, they do not want to lose the overall character of their nose and we, therefore, can customize this not only on a computer screen but also in the operating room so that we ultimately give the patient the nose that they desire. 

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Question: My nose has been broken three times. Is it still possible to correct it?

Answer: Yes, even though your nose has been broken three times, it is absolutely possible to correct it since we can simply manipulate bone and cartilage to bring the nose back into a more natural appearance.

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Question: How long is the cast in place after rhinoplasty?

Answer: I typically leave a splint over the nose for seven days after a rhinoplasty at which point it is removed along with any external sutures if those were placed during the procedure.  Most rhinoplasties that I perform are endonasal, which means that all incisions are on the inside of the nose and, therefore, no sutures would require removal in that case, but the splint is nonetheless placed to essentially push the soft tissue of the nose back down on the underlying bone and cartilage and this helps to improve healing and overall make the nose look better quicker.

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