Rhinoplasty, primary; complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip

CPT4 code

Name of the Procedure:

Rhinoplasty, primary; complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip Common name(s): Nose Job, Nose Reshaping Surgery

Summary

Rhinoplasty is a surgical procedure to change the shape of the nose. It can address both cosmetic concerns and breathing problems. This specific type involves reshaping the external parts of the nose, including the bony structure and cartilages.

Purpose

Rhinoplasty addresses nasal deformities, congenital disabilities, cosmetic imperfections, and breathing difficulties. The goal is to achieve improved nasal function and a balanced, aesthetically pleasing nose.

Indications

Nasal deformities from injury or trauma
Congenital nasal irregularities
Cosmetic concerns about nasal appearance
Obstruction or difficulty breathing through the nose
Patients with realistic expectations and good overall health

Preparation

Avoid certain medications like aspirin and anti-inflammatory drugs that can increase bleeding.
Stop smoking several weeks before and after the surgery to promote healing.
Preoperative tests like blood work, and in some cases, imaging of the nose.
Follow the surgeon's specific instructions regarding fasting or other pre-surgery protocols.

Procedure Description

Anesthesia is administered (local with sedation or general anesthesia).
The surgeon makes an external incision at the base of the nose between the nostrils.
The skin is gently lifted to access the underlying cartilage and bone.
Bone and cartilage are reshaped to create the desired form. This may include filing down a bony hump, narrowing the nasal bridge, reshaping the tip, or altering cartilage structures.
If necessary, grafts are added to provide structural support.
Incisions are closed, and a splint is placed to support and protect the new nose shape during healing.

Duration

The procedure typically takes between 1.5 to 3 hours.

Setting

Rhinoplasty is usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

Surgeons specialized in plastic or ENT surgery
Anesthesiologists
Surgical nurses
Operating room technicians

Risks and Complications

Swelling and bruising
Bleeding or hematoma
Infection
Adverse reaction to anesthesia
Poor wound healing or scarring
Asymmetry or dissatisfaction with results
Nasal obstruction or breathing difficulties
Revision surgery necessity

Benefits

Enhanced nasal appearance that better fits the facial aesthetic
Improved self-confidence
Corrected structural issues improving breathing
Results may be noticeable immediately but improve gradually as swelling subsides

Recovery

Keep head elevated and avoid strenuous activities for several weeks.
Follow specific care instructions to manage swelling and bleeding, including application of cold compresses.
Take prescribed pain medications as directed.
Attend all follow-up appointments to monitor healing.
Total recovery time can range from several weeks to a few months, with most swelling subsiding after a few weeks.

Alternatives

Injectable fillers for minor nasal corrections
Septoplasty (for internal structural issues without changing the nose's appearance)
No surgical intervention
Each alternative has its own benefits and limitations, often dictated by the specific anatomical and cosmetic goals of the patient.

Patient Experience

During the procedure, patients are under anesthesia and will not feel pain.
Post-procedure, patients can expect moderate discomfort, managed by prescribed pain medication.
Swelling, bruising, and potential congestion are common in the initial recovery period.
Most patients report an increase in comfort and self-esteem as healing progresses and results become apparent.