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Rhinoplasty, Nasal, Facial & Reconstructive Surgery

Rhinoplasty, one of the most performed plastic surgeries in Washington D.C., is designed to enhance the appearance of the nose. Given its central position on the face, the size and shape of the nose significantly influence an individual’s overall appearance. A face can be transformed with this most sought-after nose surgery, expertly crafted to enhance an individual’s unique beauty and redefine their profile.

Rhinoplasty can be performed for several reasons:
– Dissatisfaction with the natural appearance of the nose
– Distortion of the nose caused by injury or trauma
– The desire to improve nasal function for better breathing

Rhinoplasty Considerations

Rhinoplasty is a surgical procedure designed to enhance the appearance and/or function of the nose. While rhinoplasty is generally not an emergency procedure, it can significantly improve your appearance and potentially enhance your physical health by facilitating easier breathing.

Generally, it is straightforward to determine who is a good candidate for rhinoplasty. A patient who is in good health, has legitimate concerns about the appearance of the nose, and has aligned expectations with their surgeon is most likely to benefit from rhinoplasty surgery.

Rhinoplasty Before and After

Washington D.C. Rhinoplasty Surgery Details

The rhinoplasty procedure begins by accessing the bone and cartilage structure of the nose. This is achieved through a combination of incisions made inside the nose and along the strip of skin separating the nostrils (this skin is called the columella). The underlying bone and cartilage are then reshaped by reducing, adding, or modifying tissue to create the desired structure.

In certain cases, cartilage from the ear may be used to reconstruct the nose, necessitating additional incisions on the outer part of the ear. If the nasal tip is too large, the cartilage in that area can be reduced or adjusted using sutures. If the nose has a “hump” on the bridge, it can be reduced and contoured. In cases where certain areas of the nose are too small, cartilage or soft tissue grafts can be added to improve proportions. Additionally, the angles of the nose relative to the upper lip or forehead can be altered by further sculpting the nasal framework.

After the desired shape is achieved, the tissues are redraped over the new structure, and the incisions are closed with dissolvable sutures inside the nose and removable sutures on the outside. A small plastic splint is then placed on the exterior of the nose to minimize swelling and help maintain the new shape during healing. Soft, absorbent material may also be used inside the nose to stabilize the septum, the dividing wall between the air passages.

Potential Rhinoplasty Complications

In most cases, rhinoplasty successfully achieves the desired aesthetic outcome. However, potential complications can include, but are not limited to: infection, bleeding, swelling, scarring, numbness, skin discoloration, nasal obstruction, noticeable or palpable irregularities, asymmetry, dissatisfaction with the cosmetic results, personality changes, and psychological difficulties following surgery—even when the procedure is technically successful. Additionally, there may be allergic or adverse reactions to substances used during the operation.

Goal alignment with your plastic surgeon is essential. You want to be sure to select a rhinoplasty surgeon like Michael J. Reilly, M.D. who routinely performs the surgery, and one whose results are like the aesthetic you’re looking to achieve. It is also recommended that patients go home and take time to digest the discussion about surgical technique, post-operative recovery, and altered images. It’s a big decision and it’s important that the patient is properly educated and informed to make the decision to undergo surgery.

Is Rhinoplasty Covered by Insurance?

Rhinoplasty performed solely for cosmetic purposes is typically not covered by insurance. However, if any part of the surgery is intended to improve nasal function or correct a traumatic nasal deformity, it may be partially or fully reimbursable.

Whether rhinoplasty is covered by insurance depends on the specific reasons for the surgery:

  • Medical Reasons: Rhinoplasty that is performed to correct breathing issues, repair a deviated septum, or address nasal deformities from injury or trauma is often deemed medically necessary. In such cases, insurance may cover part or all the procedure.
  • Cosmetic Reasons: If the rhinoplasty is done purely for cosmetic purposes, such as altering the nose’s shape or size to enhance appearance, it is typically not covered by insurance.

You can count on Michael J. Reilly, M.D. and team to work closely with your insurance provider to determine your coverage eligibility.

Rhinoplasty Recovery

Most patients are unaware that while approximately 90% of the swelling after a rhinoplasty surgery subsides within six weeks, the complete healing process of the procedure can take up to a full year. In some instances, the nose may initially appear slightly over-lifted, but this will gradually settle into its final position. Overall, recovery from a nose job is manageable for most people and typically doesn’t cause significant disruption to daily life. However, as with any surgery, it’s important to understand what to expect at each stage of the recovery journey to maintain peace of mind.

About Michael J. Reilly, M.D.

  • Double board-certified in Head & Neck Surgery and Facial Plastic & Reconstructive Surgery
  • Exceptional training including medical school at the University of North Carolina at Chapel Hill, head & neck surgical residency at Georgetown University, and facial plastic surgery fellowship at the University of California, Los Angeles
  • Associate professor of facial plastic and reconstructive surgery in the Department of Otolaryngology – Head and Neck Surgery at MedStar Georgetown University Hospital
  • Groundbreaking research on how surgical intervention can change the way a person is perceived by others, featured on NBC’s Today Show
  • He is well-known as the recent “Face of Rhinoplasty/Nasal Surgery” in Washingtonian Magazine, and routinely performs cosmetic rhinoplasty in conjunction with other functional nasal or sinus procedures
    Dr. Reilly has performed over 1,000 rhinoplasties, with an average of 100 a year
  • Washingtonian Top Doctor 2016 – 2023
  • Dr. Reilly is a founding board member of The Foundation for Facial Recovery, a non-profit organization dedicated to improving the lives of patients living with facial paralysis

Washington D.C. Rhinoplasty Post-op FAQ

What do I do if I have to sneeze?

If you need to sneeze in the rhinoplasty postoperative period, please leave your mouth open and let the rush of air come out of your mouth.

When can I blow my nose?

No nose blowing or straining for two weeks after rhinoplasty surgery unless otherwise directed by your physician.

How and when do I use the saline spray?

It is a good idea to use two sprays of saline in each nostril at least four times per day following this surgery. This will help prevent large blood clots from forming that may block your breathing and contribute to more postoperative discomfort.

Is it normal for my teeth to be numb?

Yes, after rhinoplasty surgery it is normal for the front teeth and the nasal tip to suffer some numbness. The nerve that provides sensation to this area is often transected during the surgery, and it frequently takes up to 6 weeks or more for the sensation to fully recover in this area.

What do I do if the cast on the outside of my nose falls off?

Do not worry if the external cast falls off—it is essentially there as a reminder to be gentle with it and not to hit it. However, the tape that is underneath the cast will remain in place until the first postoperative visit and will continue to hold the structure in the desired location during the postoperative period.

How much bleeding from my nose is normal?

The average amount of time that a patient experiences bloody or blood-tinged mucus drainage from their nostrils after this procedure is about 2 days. However, the range of normal is anywhere from one day to a full week. As long as there is not a steady flow of active bleeding from the nose, then continue to use the nasal “drip pad” provided to you at the time of surgery and the drainage will continue to slow and ultimately stop, almost always within one week.

What is the plastic I can see and/or feel inside my nose?

These thin sheets of plastic are called silastic splints and they are held in place with a suture to keep your septum stable in the postoperative period. The suture and the splints will most likely be removed at your first postoperative visit.

When can I expect to get back to work?

We recommend taking a full week off of work or school to adequately rest and recuperate from your rhinoplasty procedure. We will see you in the clinic one week after your surgery to ensure everything is healing properly and to remove any packing or splints. Depending on your occupation and the ease of your recovery, you may be feeling up to returning to work after that first week. However, you should expect to take it easy for the first two weeks after surgery by avoiding heavy lifting or strenuous exercise, and you should avoid any contact sports for six full weeks.