Rhinoplasty (Nose Surgery)

As the central feature of your face, your nose serves to bring the rest of your features into balance. For those who are unhappy with the size and shape of their nose, nose surgery may offer great benefits. For patients seeking nasal surgery, or rhinoplasty, Bellevue cosmetic surgeon Dr. Alex Sobel offers special experience and skill with this procedure.

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What is Rhinoplasty?

Rhinoplasty, commonly known as a nose job, is a surgical procedure that alters the shape, size, or proportions of the nose. Nose surgery can address both cosmetic and functional goals and is deeply rooted in enhancing facial harmony that complements your overall appearance.

What does Rhinoplasty Treat?

The anatomy of the nose is complex, and Dr. Sobel performs rhinoplasty to address various cosmetic and functional concerns related to different parts of the nasal structure. Here’s a breakdown of the nose’s anatomy along with common concerns that Dr. Sobel can address through rhinoplasty:

• Nasal bone: The uppermost structure of the nose, forming its bridge. Cosmetically, Dr. Sobel can reshape or reduce a hump on the nasal bridge and also correct deviations or fractures that may impede breathing.
• Upper lateral cartilage: Located near the bridge, Dr. Sobel can adjust this tissue for asymmetry or irregularities. This adjustment has both cosmetic and functional implications, especially in affecting the nasal valve area and airflow.
• Lower lateral cartilage: Also referred to as the tip cartilage, is primarily involved in refining the nasal tip and correcting issues like bulbous or drooping tips. Functionally, Dr. Sobel can correct malformations in this area that can affect nasal tip support and breathing.
• Septum: The central support structure of the nose, Dr. Sobel can correct a deviated septum which can significantly improve breathing.
• Nostrils: Dr. Sobel can address the nostrils (alar base) by resizing or reshaping wide, flared, or asymmetrical nostrils. Functional concerns in this area are rare.
• Nasal skin: Though not directly modified in rhinoplasty, plays a role in the surgery’s outcome. The thickness of the skin, particularly over the nasal tip, can influence the refinement achievable in rhinoplasty. While not a functional concern, the skin’s characteristics can impact healing post-surgery.
• Turbinates: These structures inside the nose are not typically a cosmetic concern; however Dr. Sobel can reduce enlarged turbinates during rhinoplasty to improve airflow and alleviate nasal obstruction.
• Nasofrontal & nasolabial angles: These angles define the nose’s relationship with the forehead and upper lip. Dr. Sobel can adjust these angles to create a more balanced and harmonious profile, though they rarely present functional issues unless associated with a drooping nasal tip affecting airflow.

How is Rhinoplasty Performed?

Rhinoplasties are performed using either an open or closed technique:

Open technique

The open rhinoplasty technique uses an incision at the columella, the tissue that separates the nostrils at the base of the nose. From this external incision, Dr. Sobel reshapes the nose.

Closed technique

The closed rhinoplasty technique (endonasal rhinoplasty) uses incisions made within the nostrils to augment the nose. Using these internal incisions, Dr. Sobel addresses the cosmetic and functional changes you desire.

In this video, Dr. Sobel debunks the myth that a deviated septum is the sole cause of airway issues and explains how correcting a droopy nasal tip can enhance both appearance and breathing:

Video transcript »

“Nasal septum gets blamed for a lot of stuff, and having a crooked or twisted or deviated nasal septum seems an awfully convenient thing to pin all a patient’s airways troubles on, but it’s really not the case. If it is really quite deviated, then nasal air flow becomes turbulent, and that flow has to go faster, and it causes other structures to collapse more readily. But if it’s not the only answer, what else is going on, particularly with patients with droopy nasal tips or totic tips? If the tip is substantially droopy, what happens is the tip does not have the support it needs, one, to aesthetically look as good as a patient might want it to, but also, the whole structure just isn’t as projected and open. So by rotating the tip up, supporting it, and making sure that it projects the correct amount, will actually lead to a higher performing nasal tip with regards to airflow. Most patients who have had that form of a rhinoplasty will comment, even if they didn’t have breathing concerns beforehand, that even shortly after the procedure, they find that their nasal air flow is better, and they’re breathing in a more relaxed fashion than they ever have.”

Who is an Ideal Candidate for Rhinoplasty?

The ideal candidate for rhinoplasty is one looking for improvement, not perfection, in the appearance of their nose. All surgery patients should be in good health, have realistic expectations, and be non-smokers.

How much does rhinoplasty cost in Seattle?

The cost of a rhinoplasty with Seattle cosmetic surgeon Dr. Sobel will range between $7,400 – $11,700, depending on the extent of the procedure needed to achieve your desired goals. We also have financing options available to help make paying for your procedure easy and more affordable.

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Your Consultation

During your consultation, Dr. Sobel will listen to your goals, examine the outside and inside of your nose, consider your age and skin type, and determine which technique would best suit your needs. He will take photographs of all angles of your nose and use those images to explain how nasal bone and cartilage can be sculpted to reshape the nose, contribute harmony to the face, and facilitate better breathing.

What to Expect from Rhinoplasty

Your procedure will take place in Dr. Sobel’s private, accredited surgical suite in Bellevue and will be performed under IV sedation. Dr. Sobel will begin by placing inconspicuous incisions inside the nose where they are well-concealed. Underlying cartilage and bone are then removed, rearranged, or, oftentimes, supported to provide an aesthetic and harmonious structure.

Rhinoplasty Recovery Timeline

Recovery from rhinoplasty is a gradual process and varies from person to person, but there’s a general timeline that most patients can expect:

• Immediate Post-Op (first 24 hours): After the surgery, you’ll be in a recovery room for a few hours. You may experience some grogginess, nausea, or discomfort due to anesthesia and the surgery itself. It’s crucial to have someone to take you home and stay with you for at least the first night of recovery.
• Week One: Bruising and swelling are most noticeable during the first few days and will peak around day 2 or 3 of recovery. You’ll wear a nasal splint to protect and stabilize your nose for about 5-7 days. Expect some bleeding and stuffiness; it’s important not to blow your nose! You can take pain medication as directed to manage discomfort during recovery. Keep your head elevated when you rest and and avoid strenuous activities to help speed recovery. Most patients take one week off from work or school.
• Week Two: Major swelling and bruising will start to subside, but some swelling may persist, especially on the nose tip. You can gradually return to some normal activities at this point in your recovery, but you should continue to avoid strenuous exercise and direct sun exposure.
• One Month: By one month into recovery, most of the swelling has subsided, but subtle swelling can persist. Dr. Sobel will clear you to resume most normal activities, including exercise. Your nose’s shape is more apparent, but you may see more changes in the final shape as the months go by.
• Three to six months: At this point in your recovery, you’ll see subtle refinements in the nose shape, and the gradual decreases in internal swelling will improve breathing. Numbness in the nasal tip, if present, usually improves during this time.
• One year and beyond: Recovery is complete at this point; most patients see the final results of their rhinoplasty around one-year post-op. At this point, the nose has settled into its new shape, with swelling fully resolved. This is the point where you can truly evaluate the final outcome of the surgery.

This timeline is approximate and varies slightly with each patient. Throughout your recovery, you’ll have follow-up appointments with Dr. Sobel to assess your progress and be cleared for certain activities.

Rhinoplasty FAQs

Dr. Sobel serves patients in Seattle, Bellevue, and beyond

Dr. Sobel is triple board-certified in cosmetic facial surgery with vast experience performing nose reshaping surgery. If you have been considering Seattle rhinoplasty surgery, call us or fill out our online form below to set up a consultation with Dr. Sobel.

References »

Crosara PF, Nunes FB, Rodrigues DS, Figueiredo AR, Becker HM, Becker CG, Guimarães RE. Rhinoplasty Complications and Reoperations: Systematic Review. International Archives of Otorhinolaryngology. 2017. doi: 10.1055/s-0036-1586489.

Kalantar-Hormozi A, Ravar R, Abbaszadeh-Kasbi A, Rita Davai N. Teenage Rhinoplasty. World Journal of Plastic Surgery. 2018.

Nellis JC, Ishii M, Bater KL, Papel ID, Kontis TC, Byrne PJ, Boahene KDO, Ishii LE. Association of Rhinoplasty With Perceived Attractiveness, Success, and Overall Health. JAMA Facial Plastic Surgery. 2018. doi: 10.1001/jamafacial.2017.1453.

Parrilla C, Artuso A, Gallus R, Galli J, Paludetti G. The role of septal surgery in cosmetic rhinoplasty. ACTA Otorhinolaryngologica Italica. 2013.

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