- What is rhinoplasty?
Rhinoplasty is a surgery to reshape the nose. Over 250,000 rhinoplasties are performed in the United States each year. Rhinoplasty can be used to make the nose smaller, reduce the bridge of the nose, narrow the nose and shape specific portions such as the tip of the nose or nostrils. Rhinoplasty also may be used to improve nasal breathing. Dr. Granzow is Board Certified both by the American Board of Plastic Surgery and also the American Board of Otolaryngology – Head and Neck Surgery (ear, nose and throat surgery) and works carefully to improve both the appearance and the function of the nose in every surgery he performs.
- My nose is too big. Can you make it smaller?
Yes! Dr. Granzow frequently performs rhinoplasty to reduce the size of the nose. He will also carefully address other portions of the nose such as the nasal tip and the nasal bones to achieve a result that appears as balanced and natural as possible.
- What is a standard rhinoplasty?
Because the structure of the nose is quite unique and complex, there is no standard rhinoplasty. Each procedure is different and custom-designed to address every patient’s specific needs within the structure of their specific nose. Because of the huge variation – not only in shape and appearance but also in strength, structure and support of each element of every nose – a careful plan must be created for each procedure and meticulously carried out.
- Is rhinoplasty cosmetic or reconstructive?
Rhinoplasty may be either cosmetic or reconstructive, but most procedures have elements of both. Dr. Granzow will always address the functional/breathing component in every procedure, whether it is performed for aesthetics reasons or not. In functional/reconstructive procedures, Dr. Granzow will specifically review the details of each case with every patient.
- What is Dr. Granzow’s philosophy towards rhinoplasty?
Dr. Granzow takes a very conservative approach to rhinoplasty. He believes in achieving a natural-appearing result and does not like an unnatural or “operated” look. Great care is taken to make changes that fit each individual’s character. A great effort is made to ensure that the nose retains its individual and unique character and that it fits characteristics of each face to provide a harmonious balance for the best overall appearance possible.
- What is the difference between “open” and “closed” rhinoplasty?
Closed rhinoplasty typically describes a procedure in which all incisions are carefully hidden on the inside of the nose. Open rhinoplasty also involves a small incision across the columella, or bottom portion of the nose, which forms the skin and tissue between the nostrils. Dr. Granzow performs the vast majority of his procedures through a closed rhinoplasty approach with the incisions hidden inside the nose. However, in a very small number of specific cases an open approach may be required. This would leave a small incision at the bottom of the nose, which typically heals quite well.
- Is it possible to have a rhinoplasty without having that unnatural or “operated” look?
Yes! The goal of every one of Dr. Granzow’s procedures is to achieve a look, which appears as natural and unoperated as possible. He takes meticulous care both to shape each individual element precisely and also to blend the elements and bring harmony to the overall appearance of the nose. The overall goal is to produce a result that appears unoperated but is a significant improvement from the preoperative appearance.
- Can you improve the breathing through my nose?
Breathing can be improved significantly in the vast majority of cases. Dr. Granzow’s experience in Otolaryngology – Head and Neck Surgery (ear, nose and throat surgery) focused specifically on improvement of the nasal airway and airflow. Dr. Granzow will investigate each portion of the complex nasal airway and specifically address each area that will allow for improvement.
- Where does Dr. Granzow perform surgery?
Dr. Granzow may perform rhinoplasty at either a surgery center or at a hospital, depending upon the needs and wishes of each individual patient.
- Do I have to stay overnight at the hospital after surgery?
No. Almost all rhinoplasty procedures are performed as outpatient surgeries, meaning that patients typically go home after surgery. Arrangements may be made with our office for out-of-town patients to stay at a fine after-care facility or a hotel after surgery if this is necessary.
- What kind of anesthesia is used for surgery?
Almost all rhinoplasty procedures are performed under general anesthesia or heavy sedation, according to the needs and wishes of each patient. We find that most patients prefer general anesthesia in which the patient is asleep during the entire procedure.
- How long does a rhinoplasty take?
Rhinoplasty procedures may take one or more hours, depending entirely on the complexity of the case and the meticulous steps required for an optimal outcome. Dr. Granzow will be able to provide a good estimate for the length of your procedure during your consultation.
- Will there be any nasal packing?
Dr. Granzow carefully closes the incisions with fine dissolving sutures in almost all cases. Therefore, usually he does not use nasal packing. Occasionally technical considerations during the procedure will call for nasal packing but this is quite uncommon.
- What is recovery like?
Patients tell us that the recovery is typically uneventful. We suggest that patients take about a week off from work. Usually there is very little pain or nausea. The nose will feel stuffy after surgery and a small splint will be left in place for one week after surgery. Dr. Granzow takes meticulous care to perform the procedure carefully in the proper tissue planes, and most swelling disappears several weeks after surgery.
- Will I have bruising after surgery?
You may or may not have bruising depending upon the details of your specific surgery. Patients who bruise easily, have thin or fair skin, or require repositioning of the nasal bones will be more likely to bruise than patients who do not. Most bruising resolves around 10-12 days after surgery.
- Will insurance cover my surgery?
Many insurance companies may cover rhinoplasty that is performed for functional reasons, such as to correct a broken nose or to improve the nasal airway. However, insurance coverage will vary considerably according to each insurance company and policy. Our office can assist with insurance issues.
- I understand that Dr. Granzow is a professor at UCLA and a member of the full-time facility. Does he teach rhinoplasty to the residents and fellows?
Yes. Dr. Granzow lectures the residents and fellows at both UCLA and USC and specifically teaches the residents and fellows in both the Plastic Surgery and also the Otolaryngology – Head and Neck Surgery departments at UCLA.
- I have had a rhinoplasty before and I am unhappy with my result. Can this be fixed?
The revision of a rhinoplasty can be quite variable and depends entirely upon the patient’s wishes and anatomy and the procedure, which was done before. Sometimes minor touchups are all that is required and in other cases a major revision of the underlying nasal structures is necessary. Revision of a rhinoplasty typically is more complex and takes longer than a rhinoplasty performed for the first time and the expectation for what could be reasonably achieved may be lower. During your consultation Dr. Granzow will specifically discuss with you what you can and cannot reasonably expect from the revision of your rhinoplasty.
- Can I have other cosmetic surgery at the same time as my rhinoplasty?
Yes. Other procedures may be performed at the same time as rhinoplasty, either on the face or body. A decision about each set of surgeries is made on a case-by-case basis and Dr. Granzow will discuss each option with you in your consultation.
- Why do surgeons sometimes move the chin forward or place a chin implant during rhinoplasty surgery?
Moving the chin forward in specific cases can better balance the relation of the nose to the rest of the face.