Category Archives: Rhinoplasty

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revision rhinoplasty

How frequently can you undergo a revision rhinoplasty?

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Rhinoplasty is considered to be the most complex and challenging among facial and cosmetic surgeries. The nose is a complex structure of tissues, cartilage, and bones that intersect in different convex and concave degrees. You need the best rhinoplasty surgeon for a nose job because the nose has to be reshaped to make it look better and function well. A surgeon who is not aware of the intricacies of the function of the nose is more like to botch up the nose job than one who does. Therefore, when going for any plastic or cosmetic surgery you should always choose a surgeon who has a history of satisfied clients.

Undesirable alterations in the structure of the nose can cause a difference in how the nose functions and impact how a person breathes. Most expert rhinoplasty surgeons often have a revision rate which can be because of many reasons. Rhinoplasty is surgery; sometimes, there can be complications or unanticipated problems during the surgery that necessitate the need for revision rhinoplasty. These revision rates are generally higher for inexperienced surgeons or those using outdated techniques or needing to understand the patient’s state.

A good nose job has a positive impact on the patient’s life. However, besides being highly technical, a nose job is also a sensitive issue. Revision rhinoplasty is generally done when the patient is not satisfied with the previous rhinoplasty results, but it is a very technically challenging procedure. There is no limit to the number of times one can go in for a revision or a secondary or tertiary rhinoplasty but keep in mind that each comes with its risks and problems. The best revision rhinoplasty surgeon in India will assess you to make sure you qualify for revision rhinoplasty.

How many people get revision rhinoplasty?

On average, the rate of revision rhinoplasties worldwide is around five to ten percent maximum. This is good news, and it means that more and more people are pleased with their first rhinoplasty results. But if you have had a nose job, are not happy with its results, or need additional corrections, here is some more basic information about revision rhinoplasty.

What is revision rhinoplasty?

Revision rhinoplasty uses the same basic techniques as the first rhinoplasty. Only the reasons can be different. The results of a primary rhinoplasty are often unpredictable because the tissue might not heal correctly, and changes in bone or cartilage because of the first surgery. Revision rhinoplasty is used to enhance the nose’s appearance and correct the weakened nasal functions. This is even more difficult plastic surgery than the primary or first rhinoplasty and needs advanced surgical techniques in the hands of the best revision rhinoplasty surgeon in India.

Revision rhinoplasty using dermal fillers

This is a non-surgical option for revision rhinoplasty. Dermal fillers are used to fill in the concave curves and add volume to the nose. These are purely cosmetic treatments and do not have any functional issues. Dermal fillers need to be repeated two years once.

Reasons for opting for revision rhinoplasty

You can opt for revision rhinoplasty, and it can address many issues with your nose, such as

  • Asymmetrical results from the first rhinoplasty: Sometimes, the best rhinoplasty results can be underwhelming because the nose still appears uneven or does not blend smoothly with other facial features. This usually happens because the surgeon’s inexperience when performing rhinoplasty leads to a crooked or disproportionate nose appearance. Revision rhinoplasty can help correct this and achieve a more natural and balanced look that is harmonious with overall facial features.
  • Made up’ looking results: The aim of modern plastic and cosmetic surgery is to ensure that the results look unnatural but blend perfectly. A nose that looks like a nose job is done on it can cause dissatisfaction to many people. A strange look to the nose can be because of too much correction in the first rhinoplasty or scar tissue formation. To correct this a revision rhinoplasty is needed.
  • Not happy with the results: The main culprit is the need for more communication between the doctor and the patient. Patients are often disappointed with the results because they must be briefed about the consequences beforehand. Or sometimes the procedures go differently than expected. For the patients, it is essential to understand that every nose is unique, and getting a celebrity nose does not mean it will suit you. The surgeons need to understand the need to communicate the expected results correctly.
  • Functional issues with the nose: A good nose surgery is one that gives you an aesthetically pleasing nose that works perfectly. Inadequate healing and manipulation of practical aspects can lead to issues with essential nasal functions. Revision rhinoplasty can correct function issues while preserving aesthetic elements.
  • Trauma or injury post-first rhinoplasty: The nose is a delicate structure, and nose reshaping surgery increases its vulnerability. If you have had any trauma or accident that had an impact on the nose, then it can cause the cartilage and soft tissue to be damaged. They are especially delicate first 1-2 years after the surgery. In such events, a revision rhinoplasty can help reinforce the structure of the nose and resolve both cosmetic and functional issues.

Some other factors that affect the first rhinoplasty results are

  • Use of old techniques and equipment
  • Complications during the surgery
  • Not following complete healing instructions

Things that revision or secondary rhinoplasty can do

The most common things that patients seek from nose job revision are –

  • Adding or removing the volume of the nose
  • Changing the tip orientation and size
  • Correcting breathing issues
  • The Disparity in nostril size or shape
  • Asymmetric
  • Crooked nose

Benefits of revision rhinoplasty

Rhinoplasty has many benefits apart from addressing the concerns of the patients, such as

  • A rejuvenated appearance
  • enhanced facial balance
  • Corrections in nasal function
  • Improved breathing
  • Improved confidence in your appearance

How many times can you get revision rhinoplasty, and when?

Revision rhinoplasty is done usually one to two years after the first rhinoplasty because that is the amount of time needed for the nose to heal after the first surgery. The best revision rhinoplasty surgeon will discuss the step-by-step procedure for secondary rhinoplasty, the expected results, and post-treatment care which can be longer than the first one.

Each revision you opt for can have additional complications, and the risk might increase. If you opt for correction too many times, the changes to alter the appearance diminish because the surgeon might need more stable cartilage. Here are some other factors that affect or limit the number of times you can get a revision rhinoplasty done

  • Complexity: The more revisions you have, the more complex it becomes, and the options for alteration become limited. The changes to have dramatic revisions will decrease from the first rhinoplasty itself. This also depends on the type of issue you are seeking treatment for. For example, if your first rhinoplasty is about correcting the deviated septum and the secondary is about tip correction, then the overlap is minimum and hence fewer complications. But if the operation is on the same tissue or area, the results might be less refined.
  • Surgeon: It is always better if the secondary rhinoplasty is done by the same surgeon who does the first rhinoplasty. Most people run to a new surgeon for a revision. But your old surgeon is already familiar with your nose, and he knows what work has he done and therefore will have a better idea and clarity on what needs to be corrected. However, if you are uncomfortable with the old one, do thorough research on a new revision rhinoplasty expert surgeon. Don’t be lured by the overpromising ones. A good revision nose job surgeon can confidently talk about aesthetics and facial symmetry and explain the limitations of secondary and tertiary nose jobs. Ask your new surgeon about their experience in issues and similar styles.
  • Patient: As the patient, it is very important that you fully understand the limitations of your nose and revision nose jobs. You need to adjust your expectations of what is possible or what is not. The more revisions you seek, the more limitations. It is an elective surgery and therefore it is essential always to keep the expectations realistic.
  • Aging nose: Like the rest of us, the nose also ages, and it also affects the results of rhinoplasty. as the nose ages, the texture and elasticity of skin changes, the cartilage weakens, and therefore it is not possible to make drastic changes in the nose, especially in the revision procedures. Often in the second and third revision rhinoplasties grafts or materials needed to be put back in the nose to improve the function and make aesthetic changes.

When revising rhinoplasty, a surgeon’s skin and experience are different. The plastic surgeon might be knowledgeable about reshaping and resizing nose jobs but might need to be experienced in various requests and suitable techniques. Each rhinoplasty needs a customized approach, be it first or revision. Therefore, it is critical to ensure that you are in good overall health and only select the best and most experienced revision rhinoplasty surgeon for revision nose jobs.

How to find a good revision rhinoplasty surgeon?

An excellent and certified plastic surgeon will ensure that the likelihood of a revision is very low, but still, if there is a need:

  • Have an open discussion about your worries and expectations
  • See if the surgeon can show you approximate results using computer imaging.
  • Pay careful attention to the healing process and what you must do.
  • Look through the photo galleries of the procedures done by the surgeon.

Do plenty of research before saying yes to one revision surgeon.

Revision Rhinoplasty cost

The cost of revision rhinoplasty might be slightly more than primary rhinoplasty. This will also vary with whether the same surgeon does the revision rhinoplasty. Some medical centers offer a combination package for a primary and a discount on a secondary rhinoplasty (if needed). The other factors that affect the cost of revision rhinoplasty are the surgeon’s fees, the location of the facility, the post-operative care, and insurance coverage.

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Does rhinoplasty vary with age?

Does rhinoplasty vary with age?

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The nose has many idioms associated with it and all talk about pride. The nose is the prominent feature of the face, and a successful rhinoplasty looks good even as you age. This is only possible when an expert rhinoplasty surgeon does it with outstanding skills. It is a challenging task to create a nose that stands the test of time. Top rhinoplasty surgeons with extensive knowledge and expertise in all types of rhinoplasty techniques are the ones that can do a successful aging rhinoplasty.

There is no limit to the age of cosmetic rhinoplasty, and it can be done even in the teenage as long as the functional components of the nose are fully developed, and you are in generally good health. Generally, the most popular age for rhinoplasty is between 20-29 and in the 40s and 50s.

Many people believe that once they get a nose job done, it will stay the same forever which is a big misconception.

As we age, rhinoplasty gets more challenging, affecting long-term cosmetic results for the patient. Aging changes the appearance and the basic structure of the nose in order to enhance the appearance of the nose suiting the changing facial features.

What does rhinoplasty do to the nose?

Before discussing how rhinoplasty varies with age, it is essential to understand what nose surgery or a nose job does to the nose. Most rhinoplasties are reductive, which means the surgeon will manipulate the bones and cartilage to make the nose look smaller. As good as it seems, it tends to fail as one age Because though the bones stop growing as you reach puberty, body tissues change throughout the lifetime.

The nose contains bones, tissues, and cartilage which change shape as you age, and the nose starts to stretch and sag downward. As a result, the structure and skin of the nose lose strength, and with the previous rhinoplasty, the support is already weakened leading to a disfigured nose job. In addition, as the nose ages, the tip might become more extensive, making the nose look wider and heavier.

How does the nose change with age?

As we grow and attain puberty our features begin to take shape a by midlife they are thoroughly and perfectly formed. For example, a nose with the right shape and size during adolescence might seem bulbous, vast, or significant in adulthood. As time passes, the nose becomes different from what you are used to seeing in the mirror in your younger days. The changing shape of the nose also affects the air patterns.

Aging of the nose is a very normal process, but some people like it. This is because the shape and size of the nose matter, and then the rest of the face looks imbalanced and less attractive.

For a successful rhinoplasty, it is necessary to do it in a way that reinforces the structure of the nose to ensure excellent results at all times. This is why aging rhinoplasty has become an essential consideration for both men and women. The initial results are only the first step of having the ideal nose, how your nose will look years or decades after is critical for your appearance and happiness with a nose job over time.

Is the rhinoplasty procedure different for older vs. younger people?

The basic procedure for a nose job remains the same for older and younger people but they aim for different goals. In younger people, the focus is usually on.

  • Reducing nasal humps
  • Strengthening the nasal bridge or narrowing a wide bridge
  • Correct nasal asymmetry
  • Shortening a nose
  • Improving breathing issues, if any

On the other hand, for old people, a rhinoplasty typically focuses on

  • Correcting a droopy tip
  • Shaping a bulbous tip to a narrower appearance.
  • Reducing the size of the nose
  • Correcting breathing and cartilage defects

In both, the surgeon will aim to get the most natural-looking results that don’t show any obvious signs of surgery. The primary considerations for rhinoplasty are improving or modifying the overall structure of the nose structure in a way that compliments the proportions of the face and enhances the functions of the nose. This is done by

  • Modifying nose size with respect to facial balance
  • Altering nose weight and its size and position about the nostrils
  • Correct visible depressions and humps visible on the nasal bridge in the profile view
  • Tip plasty or nasal tip correction to right drooping, upturned, hooked, or enlarged tips
  • Correct large, wide, or upturned nostrils
  • Correct nasal symmetry

Rhinoplasty through the ages

Rhinoplasty, a cosmetic nose job, has recently been popular among youth. Increased awareness and acceptance of nose surgeries have contributed significantly to this. Modern-day nose surgeries are simple, with fewer complications and great results. They also cost less with lower recovery time.

Rhinoplasty in the 20s and 30s

Termed youth rhinoplasty, this type of nose surgery is done to improve the cosmetic and functional appearance of the teen or the young adult’s nose to bring about more facial harmony and a rested look on the face.

A nose that does not ‘fit’ the face can cause significant mental distress in the youth. Studies have proven that many young females feel anxiety and depression because they have a nose like their father or the beak is crooked, and they shy away from class photos or selfies. The results of a youth rhinoplasty last for a long time.

Rhinoplasty in the 40s

By the age reaches the 40s, signs of aging begin to show, and the skin demands extra attention. A nose job at this age is more focused on correcting a droopy tip and humps in the nose. However, care must be taken to ensure the supporting cartilage does not collapse. The surgeon might also use nasal grafts to reinforce the supporting structures.

Rhinoplasty in the 50s

A nose job can be easily tailored to suit a patient of any age. But in the 50s, the skin becomes thicker, so columella or tip manipulation is highly tricky. This is because the surgeon has to make the corrections aesthetically pleasing, and it shows through the skin but still does not weaken the basic structure. Other considerations also come into play in such surgeries, such as whether the patient has underlying conditions like hypertension or diabetes or other medical situations that can increase the risk of surgery.

Other things to consider are the condition and elasticity of the skin. Poor skin quality can cause easy bruising and delay the healing process. Also, the surgeon must consider the patient’s ability to adhere to pre and post-operative needs, quality of nasal cartilage and bone structure, blockages in nasal airways, etc.

How will my rhinoplasty change with the years?

Once the rhinoplasty is done, the actual effects begin to show once the swelling goes down. However, the surgery also initiates the aging process, and thus, most people see a difference in their rhinoplasty results 5-10 years post-surgery. There is no sure-shot way of predicting how the nose will look in the coming years, but here is a list of factors that can influence the results.

  • The techniques your surgeon will use during rhinoplasty.
  • Genetics
  • Trauma or injury to the nose, especially the face.
  • Skin quality and thickness

The best way to keep the rhinoplasty results looking good is to select a surgeon with extensive experience in aging rhinoplasty that can lessen the nose job’s adverse effects. In addition, taking good care of your skin and maintaining good lifestyle choices also help keep nose surgery results for a long time.

Today aging rhinoplasty is a specialty in itself. Modern rhinoplasty is more reconstructive than reductive with the same results, i.e., a more proportionate nose without removing the foundations’ strength. Best rhinoplasty surgeons use grafts to reinforce the areas that can weaken over time to improve the appearance and stability of rhinoplasty over time. If you have also been seeing changes in your previous rhinoplasty, you could consult your doctor for revision rhinoplasty.

Cost of aging rhinoplasty

The cost of rhinoplasty differs by many factors. The primary influencer on the price of nose surgery is the age and genetics of the patient. The second is the change they want to see in the nose. Other factors which cause the cost of rhinoplasty to vary include surgeon experience, primary or revision rhinoplasty, cost of grafts used, the duration of hospital stay, and post-operation care. Your doctor and his team are the best people to brief you about the price and payment plans for rhinoplasty. Some types of rhinoplasties are covered by insurance, and some are not. Therefore you can discuss this with your insurance provider for the same. The main objective should be to get the best procedure done so that the results last decades.

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Questions to ask your Surgeon before Rhinoplasty

11 Questions to ask your Surgeon before Rhinoplasty

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The nose is the central feature of the face; it is right in front and center. Asymmetry or bumps in the nose can alter how your face looks, or if there are any irregularities in the function of the nose, it can cause breathing issues and be very distressing. Rhinoplasty is a simple and fantastic way to get your nose back in shape (in both aesthetic and functional ways) and brings balance and harmony to your features and confidence in your looks. But, of course, rhinoplasty is also done for other reasons such as repairing an injury or just revision surgery.

Since nose surgery is a complex and intricate surgery, it needs delicate handling from the surgeon’s side, and therefore it is natural to expect some nervousness and doubts. Surgery can be a scary experience, especially when making changes to your face. Consequently, you must ask as many questions as possible with the rhinoplasty surgeon and clear all your doubts. It is a known fact that knowing what will happen during the operation can significantly reduce uncertainty and also help the patient plan the surgery. It also makes the patient feel safer and more confident.

 Here is a list of 11 important questions to ask your surgeon before rhinoplasty to make the procedure and recovery more effortless.

1. What are the qualifications and track record of the surgeon?

Selecting a good rhinoplasty surgeon is one of the most critical factors of a successful rhinoplasty surgery. It’s your face and you don’t want to take a risk. Make sure to enquire about your surgeon’s exact qualifications. Are they certified by the concerned agencies? Do they have the additional capability to perform rhinoplasty surgery? Do they have experience in performing nose surgeries and have they done enough surgeries in the past to address your concern? You can also cross-check the surgeon’s accreditation online and get reviews from previous patients. A less experienced surgeon might charge you less, but they will also not get the results.

  1. Can they show you the before and after photos?

Request to see the before and after photos of the previous patients. Any good surgeon or facility will be able to share this information with ease. You can also see back and after pictures of your concern; for example, if you are seeking a tip surgery, then before and after photos of tip surgery of past patients will give you a better vision. This access will also give you an idea of the surgeon’s style and technique.

  1. Do I know what I want, and will I get it from rhinoplasty?

There are very few restrictions on who cannot get a rhinoplasty but your conversation with your surgeon should talk about your expectations. Your face is unique, and every rhinoplasty is personalized after summarizing your medical history, anatomy, and goals. This will help you make an informed decision about what you want and what can be achieved. When going in for the first consultation with the surgeon, take some ideas about what you want and don’t want and some reference photos if you have any. This will create a starting point with the doctor and give him an understanding of what changes are essential for you, and then he can guide you accordingly. Ask your surgeon about 3-D software that gives you a real-time idea of the difference the nose job will make in your facial features.

  1. Does your surgeon have experience in nose reshaping in your ethnicity?

Ethnic rhinoplasty is an essential aspect of a nose job. Each person has some classic facial characteristics depending on their ethnicity. Therefore, what calculations work for a Caucasian nose will not work for an Indian nose? Therefore, before you finalize a rhinoplasty, ask your surgeon about her experience in the context of your ethnic background. This will ensure that the results of your rhinoplasty will be subtle, refined, natural-looking, and aesthetically pleasing. In addition, your surgeon will be able to ensure that your goals align with the surgical results. For this, the surgeon must understand the complex anatomy of the nose and the need to maintain both form and function. Best nose plastic surgeons in India have extensive experience in facial surgical procedures and the artistry to get the most natural-looking results.

  1. Open or closed, which surgical technique will be used?

Rhinoplasty surgery can be done using two techniques open or closed. The technique selection depends on the changes you want, the surgeon’s comfort and experience, and your facial framework. The type and extent of reshaping also go a long way in selecting the right approach for your rhinoplasty. There are pros and cons of each technique in terms of outcome and aftercare.

  1. What type of rhinoplasty will give you the desired outcome?

There are different types of rhinoplasties, and each meets another goal. The surgeon can one or more types of rhinoplasties to give you the desired results. The common types of nose jobs include

  • Structural rhinoplasty is done to improve the shape and size of the nose. This is done by removing excessive tissue and bones or adding a graft to replace, reshape, or reinforce the nasal structures. This is usually done in an open approach for better access and manipulation.
  • Preservation rhinoplasty is focused on preserving the nasal tissues and reshaping and repositioning the nose. This nose surgery is done by the best nose plastic surgeons in India to maintain the natural aesthetics of the nose reshaping and improve its appearance.
  • Functional rhinoplasty aims to improve the function of the nose, such as correcting the deviated septum to improve breathing.
  1. What is liquid rhinoplasty?

Liquid rhinoplasty is a non-surgical type of rhinoplasty that can be used to contour the nose shape temporarily. This type of treatment uses dermal filler and surgical threads to treat the structural defects of the nose. Liquid rhinoplasty is popularly used to correct the appearance of a dorsal hump and downward pointing tip. These treatments last 6-12 months and must be repeated for continued results. Liquid rhinoplasty cannot correct any functional defects in the nose, but it is a great way to see the changes a cosmetic rhinoplasty can bring to your face.

  1. What is the revision rate of rhinoplasty patients?

Revision nose surgery is done on patients who are not happy with the results of the previous surgery or need more corrections in the first procedure. The revision rate is usually less than 5% in any good practice. However, sometimes a cosmetic nose job can cause a breathing problem or bring it forward; in that case, further revisions are required to improve the breathing. Ask the surgeon about his particular revision rate.

  1. What is revision surgery?

The healing process varies from patient to patient and sometimes you might not be happy with the immediate results of rhinoplasty, but they improve over time. But what happens when the results don’t give the desired outcome? Then you will require a revision. Keep in mind that you will be making a revision decision only after the effects of the previous ones are clearly visible. Sometimes minor concerns can be resolved even without a revision. Please discuss with your surgeon the eventualities that their facility covers.

  1. What will be my recovery time, and how much time should I take off from work?

This is an important question to ask as the recovery period depends on various individual factors. In some patients, the recovery is in less than six weeks; in others, it might take time because the degree of work done is more. The rhinoplasty surgeon will be your best guide for the norms of recovery and even give you tips to expedite your healing. A general timeline of healing is as follows.

  • Week 1: removal of the nasal splint, but still visible bruising and swelling
  • Week 2: less swelling and bruising
  • Week 4: facial swelling subsidies, the breathing improves and results begin to show.
  • Week 6: The patient is back to regular work and workout life, and bone healing is also done
  • Month 3-4: Results begin to show very clearly. And the area has no pain, swelling, or other abnormal sensations.
  • One year and more: The skin shrinks to the new nose, and the final shape can be observed.

Here is a list of things that can affect the healing

  • Not following doctor’s orders
  • Previous trauma can delay the healing
  • Thick skin, thin skin, etc., are common factors that act as limiting for the surgery.
  1. What is the cost of the rhinoplasty?

An essential part of discussing your surgery is the cost of the surgery. The cost of a nose job varies with many-many factors such as the surgeon’s experience, your expectations, location, the technique used, healing time, etc. Some types of rhinoplasties are covered by insurance while others are considered purely cosmetic surgery. This is why talking to your doctor about the rhinoplasty surgery cost in detail is essential. Make sure you get a detailed breakup of the price and payment plans.

It is essential to keep your expectations realistic post the surgery. The reason for having rhinoplasty should be your own decision and not governed by Instagram celebrities and influencers or the opinion of others. Don’t compare your skin and nose to other models and friends. What works for others may work better for you. Take time to understand the procedure and ask as many questions as possible. Even after the surgery, keep in touch with the surgical team and communicate with them about any accidents or injuries to the nose. This will help in ensuring proper recovery. Attend all follow-up appointments.

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Saddle Nose

How to know if I have a Saddle Nose?

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The saddle nose, pug nose, or boxer nose is a type of nose deformity characterized by a distinct dip or sag in the middle portion of the nose. This ‘saddle’ can be barely noticeable or severe enough to cause breathing problems. However, the saddle nose is clearly visible in the side profile photos and selfies, and people often feel very conscious about it. In severe cases of saddle noses, there can be obvious nasal deformities that alter the shape and function of the nose. Most patients can go through their life with a saddle nose, but corrections become necessary for some.

Saddle nose has cosmetic repercussions too. It can make your entire face look flat. You can quickly identify saddle nose with the following symptoms:

  • The collapse of the nasal bridge cartilage
  • Upward rotation of the nasal tip
  • Obstructions in breathing through one or both nostrils
  • Nasal crusting which becomes chronic
  • A visible horizontal crease in the lower part of the nose that looks like a dent in the nose.
  • Septal perforation
  • Nose bleeds
  • Whistling sound during nasal flow

It is common for people with saddle noses to feel conscious about the dip in the nose, especially during picture-taking times. The excellent news is saddle nose deformity can be easily corrected. However, this repair is a highly specialized procedure as this surgery is different for every patient depending on the indicators and desired alterations.

What causes saddle nose?

The most visible indication of saddle nose is the loss of dorsal height or a noticeable degree of nasal dorsal depression. There can be many reasons for this loss of height. The septum is of the critical parts of the nose and a central one too. It is responsible for the structural integrity of the nose. Any damage to the septum structure causes a sunken appearance of the nose. This causes many cartilage and bone defects. This deformity mainly originates because of

  • Congenital reasons such as Cleidocranial dysostosis, which affect the teeth and bone, and Congenital syphilis, which is an infection passed from the mother to the child
  • Trauma: Direct trauma to the nose can cause the bones to break or damage the cartilage structure. Depression in the nasal bone can also cause saddling or sagging and loss of height.
  • Surgical causes: A prior rhinoplasty, a Septorhinoplasty, or changes in the septal cartilage that are not done correctly or not appropriately healed can also cause nasal deformities such as the saddle nose. Septorhinoplasty in young patients can also cause a collapse of the nasal septum because the septum is weak and collapses as they grow. Removing too much septal cartilage is another reason for saddling.
  • Over reduction of the dorsal hump: Surgical removal of the camel-shaped shape on the nasal bridge can also cause depression in the middle of the nose.
  • Poorly done rhinoplasty to correct nasal contours, which causes over the projected nasal tip, or a supra tip correction, can make the nose appear saddled.
  • Down syndrome
  • Normal variation
  • Infections
  • Illness caused by medical treatment
  • Medical causes such as leprosy, syphilis, recurring infections in the tissues, Wegener’s Granulomatosis, and Relapsing Polychondritis. Syphilis can also cause severe cartilage damage.
  • Accidents
  • Septal hematoma and septal abscess, which cause the normal blood flow to the septum to be obstructed, can also cause a saddle nose deformity.
  • Cocaine abuse: Long-standing use of cocaine leads to a deficit in blood flow in the septum, which causes it to become weak and eventually collapse. The chronic use of intranasal decongestant sprays also causes this safe effect.

Saddle nose rhinoplasty includes both camouflage and reconstruction treatments. In most cases, saddle nose deformity is acquired, and its manifestation depends on individual, racial, or genetic characteristics. Trauma and iatrogenic causes are the two most common causes of saddling.

Types of saddle noses

Treating or correcting saddle nose deformity begins with correctly categorizing its severity. This classification is based on the anatomic issues causing saddle nose and include

  • Type 1 has dorsal nasal depression, but the lower third of the nose has normal tip projection.
  • Type 2 which has moderate to severe depression with a prominent lower third of the nose upturn
  • Type 3 with moderate to severe dorsal depression and loss of tip support, and visible structural deficits
  • Type 4 with severe normal depression and loss of structural support to the entire nose.

Type 2,3 and 4 deformities cause difficulties in breathing too.

Saddle nose rhinoplasty

Depending on the manifestation of the saddling and the investigation into the exact nature of deformity and dysfunction help the surgeon select the best reconstructive options to correct the deformity: these address both the aesthetic and functional aspects.


This is done by taking in the patient’s complete history and doing a physical examination. This helps the surgeon figure out the etiology of the deformity. The doctor will also ask about any history of nasal airway obstructions, past nasal traumas, nasal surgeries, history of autoimmune diseases, etc. if the patient has been using cocaine, then it needs to be investigated too.

The physical examination includes the degree of the location of the saddle, the condition of the nasal septum, the state of nasal valves, and the structural stability of the nasal support structures. Both imaging and diagnostic tools are used for this.


There are two parts to the treatment. One is medical, which is aimed at containing the progression of saddling. Patients suffering from diseases such as Wegener granulomatosis and relapsing polychondritis need the intervention of medical specialists to help improve the condition.

The second part is surgical rhinoplasty or nose job that corrects the saddle nose defects. This nose surgery is done to add or restore strength to the cartilage at the base of the nose. Saddle nose rhinoplasty is one of the most complicated nose surgeries because it requires a carefully crafted graft to be placed in the nose and planning of anatomical reconstruction of the other structures.

In case of mild saddling, getting a proper graft from the septum or conchal cartilage might be possible. However, in case of greater severity of the deformity, the surgeon will recommend taking cartilage from the ribs or using artificial cartilage. In grafts obtained from external sources, the following criteria should be met.

  • They should be noncarcinogenic.
  • Nonallergenic
  • Nonimmunogenic
  • Non-destructive to the adjacent tissue and be bio integrable
  • Non-resorbable for durability
  • Easy to mold, remove and work with
  • Should feel similar to the actual cartilage and have the same strength
  • It should be readily available
  • Cost-effective
  • Zero extrusion rate.

The suitability of the graft will depend on the degree of saddling. The choice of material and type of reconstruction plays an important role and saddle nose deformity correction. There is no one ideal nasal implant. Each implant has its only successes and failures; your doctor will be the best one to decide which will suit your problem.

Rhinoplasty for saddle nose corrections takes about 2-3 hours to complete. The grafts are carefully shaped and sterilized first. Then the surgeon will make an incision along the columella of the nose and lift the skin. Finally, the graft is placed, and other structural corrections are done per the treatment plan.

Who can get saddle nose surgery?

A healthy patient bothered by the saddle nose opts for this rhinoplasty surgery. However, some persons with contraindications include

  • Patients with autoimmune conditions in whom the damage can be continuous
  • Intranasal drug abusers who have failed sobriety
  • Unhealthy patients and those with a poor risk profile, such as schizophrenia patients.
  • Patients who have unrealistic expectations

This rhinoplasty is also not recommended for people who

  • I have had some previous rhinoplasties
  • Have a history of smoking
  • Are 16 years or younger
  • Patients who are likely to experience nasal trauma such as boxers, martial artists, etc.

Saddle nose surgery recovery

Mild swelling and bruising are expected after the surgery but will decrease in 10 odd days. You should take great care of your nose and avoid blowing or sneezing through it. Don’t try to touch the nose too often or pull or tug at it. The full results appear as the skin heals, and you can see complete healing in one year of surgery.

Saddle nose surgery cost

Saddle nose surgery is one of the most challenging nose deformities to correct for the surgeon. The correct surgical approach is essential, which can have a physiological impact on the patient. The cost of saddle nose surgery in India depends on the graft type used and the surgical approach used.

Other factors that influence the price of this type of rhinoplasty are the surgeon’s expertise, the hospital cost price, the location of the clinic, and the post-operative consultations. Since it is mainly done for functional reasons, the cost of saddle nose rhinoplasty is usually covered by insurance.

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How Long Does Rhinoplasty Surgery Take?

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Do you ever look in the mirror or examine your selfies and feel that the shape of your nose does not look right with respect to the rest of the face? Does your nose look long in the photos or tilt in one direction or does the tip look fat and boxy to look it? Of you felt lately that you are not able to breathe freely through the nose and have been breathing through the mouth? If this all sounds familiar then the answer to all your problem is a simple rhinoplasty.

Rhinoplasty or the nose job can be a life-changing experience for many. The nose is not only essential for our being but its symmetry has the ability to enhance our natural beauty without appearing too made up. Knowing that they are looking good gives a healthy boost to a person’s morale and self-esteem. Rhinoplasty is one of the most commonly performed plastic surgery but it is still a surgery and it is quite natural to want to know all about it, like how much time will it take, what is the recovery time, etc. It helps the individual be more confident and comfortable.

A Nose job is a safe and successful procedure and it can take anywhere from about 1 to 3.5 hours to complete the surgery. Every patient has a unique set of facial features, and needs and expectations from the surgery. One individual’s nose job can be done in less than one hour while the other’s might take longer.

Basic rhinoplasty is done to manipulate a person’s nose to change its appearance and/or improve its function. It helps in a to of things such as sinus relief, correcting defects caused because of injury or trauma, broken nose, congenital birth defects such as cleft lip and so much more. The surgeon works with the bones and cartilage in the nose to get the desired function and appearance. In cosmetic rhinoplasty, the focus is entirely on correcting the shape and structure of the nose without disturbing the functions, and in functional rhinoplasty, the main aim is to improve breathing and sinus. Rhinoplasty is done because of

  • Personal preference
  • Health concerns
  • Facial injuries

Individuals who are in good health condition and above 18 years of age and are not addicted smokers and done abuse alcohol are the most suitable candidates for rhinoplasty. The use of tobacco and drugs increases the risks of more tissue damage and delayed healing. A nose job is a very intricate procedure and should only be done by an experienced, trained, and accredited professional. A practiced rhinoplasty surgeon will take under two hours to do a primary rhinoplasty whereas a less specialized or experienced surgeon can take up to 5-6 hours.

What affects the time rhinoplasty takes?

How long the rhinoplasty takes is a question whose answer is dependent on many factors. The two most specifics that affect the duration of rhinoplasty surgery are nasal structure and function.

  1. The first thing that the surgeon check is the condition of your nose, the skin type, etc. Is this your primary rhinoplasty or the secondary one?
  2. The second step is to discuss the goals of rhinoplasty. Are you looking to rectify the appearance of the nose or are there any functional needs as well.
  3. The third thing affecting the time taken by the nose job is the number of procedures that need to be. Cosmetic and functional rhinoplasties can often be combined together.

Factors affecting how long a rhinoplasty operation lasts

In plastic surgery, it is not about how quickly but the emphasis is on how well it is done. Efficiency is what takes prime importance. This is because, after two to two and a half hours of surgery, the swelling and bleeding start to work against the surgery. Rhinoplasty length can never extend beyond 5 hours at any time. Let’s look at the factors that come into play for it


Since rhinoplasty is an invasive surgery, anesthesia becomes a must. Though it does not affect the outcome of the procedure it does affect the length of the surgery. The anesthesia that is used in rhinoplasty is a low-level one. The longer the operation the more the anesthetic and it can lead to longer waking up time and some disorientation and grogginess during the day. Another factor is the type of anesthesia used. For most surgeons the preferred combination is local plus a low dose of general anaesthetic. This does not affect the recovery time post-nose job. In the case of non-surgical rhinoplasty, only a local numbing cream is applied before injecting the fillers and it has no downtime.


In cases of trauma or injury to the nose or in reconstructive rhinoplasty the surgeon might need to harvest the cartilage from other parts of the body such as the ear or rib to get a suitable graft and it can increase the surgery time. Additional tissues somethings become necessary to get the finest results. These requirements often come when performing rhinoplasty to correct a round or plunging tip, correct the nasal bridge, straighten the crooked nose, or lengthen or widen the nose. The first choice of harvesting is the nasal septum in case of septum correction and improve breathing and preventing sinus infections. The next choice is cartilage from the ear. In such cases, the incision is done in the back of the ear in line with the natural curve. Rib cartilage is used when the surgeon needs a large piece of cartilage. It is then shaven in thin slices and most used to raise the nasal bridge. It is not very time-consuming but adds to the length of the surgery.

Open vs closed rhinoplasty

This is the surgeon’s choice. Open rhinoplasty takes more time than closed rhinoplasty. Close rhinoplasties are done in less severe cases and are often referred to as a patient-favored technique. The reason is that the incisions are placed inside the nose and no scarring is visible outside. Open rhinoplasty on the other hand gives a more approachable view to the surgeon and makes it easier and more precise to place cartilage and tissue grafts. It is a primary choice when significant manipulation is required. The incisions are made on the outside of the nose and then closed with sutures so some scarring might be visible. Open rhinoplasty can add 20 extra minutes to the operation than closed rhinoplasty.

Experience, style, and preference of the rhinoplasty surgeon

Rhinoplasty sounds simple but to get good results you need expertise. Closed rhinoplasty can restructure the nasal architecture and even improve breathing without visible incisions or marks and only ultra-experienced surgeons can meet this mark. For new surgeons, closed rhinoplasty can become a challenge. Therefore how much actual experience the surgeon has gained makes it possible for him to do the surgery quickly and without risks. The skill and judgment of the surgeon matter the most when it comes to gaining the nose that you always wanted. Going to an inexperienced surgeon as a cost-cutting measure can run a risk of doing more damage. A skilled surgeon will understand the challenges of your nose and work quickly and efficiently to meet your specific needs.

Complexity of the rhinoplasty surgery

This has the most effect on the amount of time your surgery will take. For breathing issues such as septoplasty, turbinate reduction, etc time taken can be longer, whereas some cosmetic changes can be done easily as an outpatient procedure. The nose is a delicate structure comprising cartilage, skin, and bone and it needs great expertise to get good results.

The length of rhinoplasty surgery also includes other factors such as time taken to prepare the patient for the surgery, inducing the anesthesia, disinfecting, instrumentation, and monitoring, etc. A change to one part of the nose can affect the rest of the nose and the face. The surgeons aim to preserve the function and keep the scarring to minimal and still bring out the finest and most natural new look for the nose.

About Dr. Debraj Shome

Dr. Debraj Shome- Facial Plastic Surgeon in Mumbai, India

Dr. Debraj Shome – Founder, The Esthetic Clinics, is a top facial plastic surgeon. Dr. Shome is currently a Consultant at the best Mumbai hospitals like Saifee Hospital, Breach Candy Hospital, Nanavati Hospital & Apollo Spectra Hospital in Mumbai, India. He has 40+ research papers in the best international journals, numerous presentations at conferences & many awards such as “Best Plastic Surgeon in Mumbai”, “Best Plastic Surgeon in India”, Best Cosmetic Surgeon in India”, “Best Cosmetic Surgeon in Mumbai”, “Breakthrough Innovator in Facial Plastic Surgery” etc. A celebrity plastic surgeon, Dr. Shome believes plastic, reconstructive & cosmetic face surgery can allow you to lead a more fulfilled life….Read more

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