What Type Of Rhinoplasty Do I Need?

Q: Dr. Eppley, I know rhinoplasty involves a lot of different surgical steps that affect the outcome of the surgery. But there must be different types of rhinoplasties based on whether you change just one part of the nose or different parts. I am trying to figure out what type of rhinoplasty is best for me. 

A: You are correct in your assumption that rhinoplasty involves a lot of different steps and no one rhinoplasty is exactly the same as the other. But there are some basic types of rhinoplasty which affect not only what part of the nose is being changed, but how long the operation lasts and how the length of recovery. I like to think of rhinoplasty as involving three different types which can be described as follows.

Type 1. This is a true tip rhinoplasty where the work lis imited to just the lower alar cartilages. No nasal bone or middle vault cartlaginous work is needed. Also there is no internal septal or turbinate work done. A tip rhinoplasty would actually be done most commonly in revision work for tip asymmetry and/or an adjustment but may occasionally be done as an isolated primary rhinoplasty. This is the quickest recovery of all the rhinoplasties. For the obvious reason I like to call this a TIP RHINOPLASTY.

Type 2.  =  This involves work done to the ip and middle vault cartilages of the nose but does not involve nasal osteotomies. (breaking the nasal bones) It may involve some rasping or smoothing of the nasal bones for minor hump deformities. Septal grafts may be harvested but not overall septal straightening or turbinate reduction most of the time. This collection of nasal procedures I call a RHINOPLASTY.

Type 3.  This is a complete ‘overall’ of the entire nose. It is complete nasal work from the tip to the nasal bones including osteotomies. Always needed when there is a signifincant hump reduction. Will almost always include a straightening septoplasty, graft harvests and inferior turbinate reductions. Because of treating both the internal nasal breathing and external appearance, it is called a SEPTORHINOPLASTY. This will involve the longest recovery of all the rhinoplasties which often causes temporary undereye bruising and nasal congestion and stuffiness.

Dr. Barry Eppley

Indianapolis, Indiana