Rhinoplasty (Nose Surgery) at Mount Sinai

The nose is the most central and defining feature on the face. Along with its prominent role in facial aesthetics, the nose is the primary organ of smell and functions as a vital part of the respiratory system. At Mount Sinai’s Division of Facial Plastic and Reconstructive Surgery, our goal with each patient’s rhinoplasty (nose surgery) is to create natural, long-lasting results that improve the shape, size, and distinction of the nose.

The facial plastic surgeons at Mount Sinai are double board-certified in Facial Plastic and Reconstructive Surgery and Otolaryngology (Ear, Nose and Throat). Their vast expertise in nasal function, as well as nasal and facial aesthetics mean that your new nose will not only look better, but it will also breathe better. Our surgeons perform both closed/endonasal (without an external incision) and open/external rhinoplasty. Which approach works best for you depends on your unique anatomy and functional and aesthetic goals. We work closely with you to determine which surgical option is most appropriate.

While the majority of rhinoplasties are elective cosmetic procedures, there are also a significant number of surgeries that are performed to improve breathing or repair the nasal structure after an injury. Patients still look like themselves after the procedure, but their facial features are more natural and symmetrical.

About Rhinoplasty (Nose Job) Surgery

Commonly known as a “nose job,” rhinoplasty is one of the most common cosmetic surgeries performed in the U.S. According to the latest statistics from the American Society of Plastic Surgeons, more than 213,000 people receive a nose job each year.

A rhinoplasty changes the shape of the nose by modifying the bone and cartilage of the nasal framework. After accessing the framework through carefully concealed incisions, the bone of the upper portion of the nose is sculpted and smoothed. The cartilage in the lower portion of the nasal framework is then carefully reshaped in order to bring all the dimensions of the nose into harmony. The nasal septum is straightened and reshaped to improve breathing. Any necessary grafts are used to support and contour the final result. 

Rhinoplasty can be used to:

• Change the size and shape of the nose
• Modify the bridge of the nose
• Increase or decrease the size of the nostril openings
• Balance the facial features
• Improve nasal breathing for patients with chronic sinus problems or anatomical problems
• Reconstruct previously injured or disfigured noses from accidents or nasal disease 

Types of Rhinoplasty Procedures

Rhinoplasty typically addresses both the inside of the nose (the septum) and the outside (the nasal framework or skeleton). There are two types of nose jobs: primary rhinoplasty and revision rhinoplasty.

• Primary rhinoplasty: this surgery is performed for the first time to address cosmetic concerns and/or nasal breathing.
• Revision rhinoplasty: this procedure is performed to address concerns or deformities resulting from prior nose surgeries.

Open and Closed Rhinoplasty Techniques

Our expert facial plastic surgeons specialize in numerous techniques including both open (external) and closed (endonasal) rhinoplasty procedures. We will discuss which procedure can help you best achieve your goals during your surgical consultation.

• Closed (endonasal) rhinoplasty: During this closed surgical approach, all of the incisions are made inside the nose. The advantage of this approach is the lack of an external scar and the relatively shorter duration of the operation.
• Open (external) rhinoplasty: Unlike the endonasal option, in this open approach, a small incision is added at the base of the nose to increase the surgical field of vision. This approach allows for better visualization of the nasal anatomy and more complex alterations and grafting to be performed.    

Multidisciplinary Approach: Nasal Sinus Expertise

At Mount Sinai patients have the resources of a large, tertiary hospital at their disposal. Throughout the health system patients have access to a wide range of specialists and subspecialists. For patients with specific concerns related to their nasal breathing, nasal allergies, sinus disease or deformity after cancer treatments, we work closely with Mount Sinai’s widely recognized experts in the Division of Rhinology and Sinus Surgery and Mount Sinai’s Head and Neck Institute. We can even perform combined surgeries when appropriate. 

Combining Procedures: Chin Implants

Some areas of the face are intimately related and often need to be addressed together to achieve the best outcomes. Patients who have rhinoplasty for cosmetic improvements may benefit from cheek or chin implants to improve facial balance. Whenever possible, our cosmetic surgeons combine procedures to reduce recovery time and lower operating costs.

Adolescent Rhinoplasty

Rhinoplasty is a common procedure among teenagers and youth. However, if a nose job is being elected for cosmetic reasons, younger patients should wait until they stop growing and their nasal bone has reached its adult size. Typically, for girls this occurs after puberty around age 15, while boys may need to wait longer until they are 17 or 18 years or older. If the surgical procedure is being performed to correct a breathing problem or repair the bone after an injury, it can be performed before the patient is fully grown.

Before and After Surgery Care

Patients interested in cosmetic treatments at Mount Sinai’s Division of Facial Plastic and Reconstructive Surgery start with an extensive consultation to identify areas of concern and review their goals. Our surgeons then develop an individualized treatment plan. 

Rhinoplasty surgery is usually performed in an outpatient setting under general anesthesia or with a combination of local anesthesia and sedation. Prior to surgery patients are given instructions regarding medications and how to prepare for their recovery. After surgery, patients are usually given a short course of antibiotics and mild pain medication as some mild discomfort may persist for the first few days.

The majority of swelling subsides within the first two weeks, although it may take up to a year for all the swelling to fully fade. Patients should expect to return to work or school within one to two weeks after surgery. We do ask that patients avoid strenuous activities for two weeks after surgery.

Cost of Rhinoplasty

While cost is always a concern, insurance may cover surgery performed to improve breathing (i.e. deviated septum), but it does not cover surgery that is done for cosmetic reasons. We provide patients with expected costs prior to any intervention.