Closed Rhinoplasty

Q: Dr. Eppley, I am interested in a closed rhinoplasty correct some tip asymmetry. My questions are:

1. What will be my limitations post op? Can I play sports? Can I blow my nose? What happens if a ball or object hits my nose? Can I go swimming? Etc

2. Is there any possibility that the procedure would produce a more asymmetric nose tip? Or is it guaranteed that I will at least have more symmetry?

3. What will you actually be doing to my nose in order to achieve the more symmetric tip that I want?

4. How long will I have a cast over my nose?

5. What is your policy on revisions?

6. Will my nose have anything foreign in it ?

7. What are some potential complications or risks with a nose like mine?

8. What is your revision percentage for rhinoplasty?

9. About how many closed rhinoplasties have you performed? 

10. Will you only be doing work on the asymmetric side of my nose or do both sides of my nose need work in order to achieve what I want?

11. I attached more realistic before and after photos where I do not use a mirror, but instead just used a morphing app to reduce the hump on the left side of my nose. How realistic is it that you can achieve this result for me?

Thanks in advance!

A: In answer to your closed rhinoplasty questions:

  1. Other than some compressive tapes on your nose for the first week after surgery, there are no physical restrictions…other than common sense ones like no contact sports for the first few months after the procedure.
  2. By removing some of the excessive lower alar cartilage on the fuller side, it would one hard to imagine that the surgical result would the worse than before. The very likely outcome is that the asymmetry would indeed be less.
  3. A cephalic trim of the left lower alert cartilage would be done.
  4. The tapes would stay in place for 5 to 7 days after surgery.
  5. The revision policy is written and is one in which you are already familiar since you have seen and signed that policy paper from your recent surgery.
  6. There will be no foreign materials used in your nose other than resorbable sutures.
  7. The risks of this surgery are exclusively aesthetic…how well does it meet your aesthetic nose reshaping goals.
  8. The usual stated revision rate for rhinoplasty is between 10% to 15% on a national basis for primary (first time) rhinoplasty.  But that number is an average and does not take into account the type or complexity of the rhinoplasty being performed. Your proposed rhinoplasty would be considered ‘not complex’ and in theory should have a lower risk iof revision. But that would depend on the ‘perfectionist’ nature of the patient as that is what drives most revisional facial procedures.
  9. I have performed many closed and open rhinoplasties.
  10. Based on our own imaging, it is presumed that only reduction of the larger side is needed.  But that depends on your nasal tip reshaping goals.
  11. Your imaged results appears realistic and is an achievable goal.

Dr. Barry Eppley

Indianapolis, Indiana