Primary Rhinoplasty

The term primary rhinoplasty (primary nose job) is reserved for noses that have not had any prior surgery or trauma. The distinction is noteworthy since it guarantees that the internal anatomy is not scarred or otherwise altered.

Most often primary rhinoplasty is accomplished by manipulating existing nasal anatomy through reshaping, reducing, or augmenting the key structures. When additional strength is needed for weak underlying structure, I prefer to use septal cartilage as a graft to regain the structural support necessary to attain the desired result.

The results from rhinoplasty continue to change for well beyond a year following surgery. Detail in the nasal bridge is usually seen by 3-4 wks post-op but the subtle changes in the tip go on for much longer. Because of this healing sequence and the long time before the final outcome can be confidently assumed, revision following rhinoplasty (secondary rhinoplasty) should be postponed for a year in most cases. My revision rate following primary rhinoplasty is less than 5% and is generally limited to the smoothing of small irregularities at the junction of the bone and cartilage along the bridge. I now keep my patients in night time compression of the bridge of their nose using a silastic gel strip secured with micropore tape. This is applied for the first six weeks after surgery and has greatly reduced post-op swelling and the occurrence of these healing irregularities.