Rhinoplasty

As a master of his craft, Dr. Coville’s results speak for themselves.

A RHINOPLASTY IS A SURGICAL RESHAPING OF THE NOSE’S CARTILAGE, BONE, AND SOFT TISSUES TO PRODUCE A NATURAL AND PLEASING APPEARANCE

It is one of the most common of all plastic surgery procedures and can reduce or increase the size of your nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip. It can also correct a birth defect or injury and help relieve some breathing problems. What can and should be done in your case will depend on the consultation with Dr. Fred Coville. During a rhinoplasty, the nose’s height and shape are changed by operating through cuts made inside the nostrils, or occasionally, through a small incision between the nostrils.

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ABOUT RHINOPLASTY

AM I A GOOD CANDIDATE?

WHAT IS THE PROCEDURE LIKE?

ARE THERE ANY RISKS?

PREPARING FOR YOUR RHINOPLASTY

Rhinoplasty can dramatically change your appearance closer to your ideal to improve your self-confidence. However, it cannot change your looks completely or cause other people to treat you differently. Before you decide to have surgery, you must discuss and agree on your goals with Dr. Coville. The best candidates for rhinoplasty are looking for improvement, not perfection. If you’re physically healthy, psychologically stable, and realistic, rhinoplasty may be for you.

Many surgeons prefer not to operate on teenage patients until they’ve completed their growth spurt, around 14 or 15 for girls, a bit later for boys. Reputable surgeons always consider a teenager’s social and emotional adjustment and make sure that surgery is what the individual wants and not just what his or her parents want. Dr. Coville will take the time with you to make sure you are both on the same page.

Dr. Fred Coville performs procedures such as rhinoplasties at one of the private and fully accredited surgery centers on the Southern New Jersey Shore, where he has privileges. The choice of the center will depend on the availability of operating room time, Dr. Coville’s schedule, and your timetable. This procedure is done on an outpatient basis.

Rhinoplasty usually takes 1-2 hours, though, of course, complicated procedures may take longer. The skin of the nose is separated from the supporting bone and cartilage, which is sculpted to the desired shape, using the best technique for your features and facial harmony. The skin is then redraped over the new framework. Rhinoplasty can be performed inside the nostrils or by using an ‘open’ procedure where a small incision is made across the columella, the vertical strip of tissue that separates the nostrils. After surgery, a splint will be applied to help your nose maintain its new shape. Although we try to avoid them, you may also have some temporary packing placed within the nostrils to help control swelling and bleeding.

Choose a well-qualified and experienced plastic surgeon, and any complications are likely to be minor. Because individuals vary significantly in their reactions and their ability to heal, outcomes are never entirely predictable. There are some complications possible with the operation. These include infection, which is rare, and the potential for bleeding. If bleeding is severe and not controlled by simple packing, you may require a return to the operating room.

All patients are advised not to take drugs containing aspirin, ibuprofen, or ginkgo biloba for at least 10 days before their operation as these can alter the clotting of the blood. Just one tablet can affect your clotting for up to 2 weeks. Smoking affects your skin’s blood vessels and decreases the amount of vitamin C in your system. This makes both bleeding after the operation and the risk of skin dying more likely. Dr. Coville will insist you refrain from smoking for at least 6 weeks before and following surgery. Remember, you have absolutely nothing to gain by concealing a smoking habit from your surgeon.

After surgery, small burst blood vessels may appear as tiny red spots on the skin’s surface. Usually, these are minor but can, in some instances, be permanent. When rhinoplasty is performed from inside the nose, there is naturally no visible scarring. Yet, even when an ‘open’ technique is used, or when the procedure calls for the narrowing of flared nostrils, the small scars at the base of the nose are not usually visible. In about one case out of ten, a second minor procedure may be required, for example, to correct a slight deformity. These relatively rare problems are unpredictable and can happen even to patients in the hands of the most skilled surgeons.

Good communication between you and your surgeon is essential. Dr. Coville will ask what you would like your nose to look like, evaluate the structure of your nose and face, and discuss possibilities with you. He will also explain the factors that can influence the procedure’s success, including the structure of your nasal bones and cartilage, the shape of your face, the thickness of your skin, your age, and your expectations. Dr. Coville will also explain the techniques and anesthesia he will employ and provide information about the facility where the surgery will be performed, the risks and costs involved, and any other options you may have. You may find you can achieve your aesthetic goals through combined surgical and non-surgical treatments or even entirely without surgery. You can refer to our section on Aesthetic Medicine to see what non-surgical options might be right for you.

Most private insurance policies do not cover purely cosmetic surgery. On the other hand, it may be wholly or partially covered if the procedure is performed for reconstructive purposes. Check with your insurer, and obtain payment authorization before any surgery. Also, be sure to tell Dr. Coville if you have had any previous nose surgery, or an injury to your nose, even if it was many years ago. You should also inform him if you have any allergies or breathing difficulties, are taking any medications, vitamins, or recreational drugs, or if you smoke. Do not hesitate to ask our staff any questions you may have, especially those regarding your expectations and concerns about the results.

Preparation

It is important you follow our instructions on how to prepare for your surgery. They will cover eating, drinking, smoking, taking or avoiding certain vitamins and medications, and washing your face. If you are a smoker, it is especially imperative that you stop at least 4-6 weeks before and after surgery; smoking inhibits blood flow to the skin and can interfere with healing. The longer you stop smoking before a procedure, the better your results will be. Dr. Coville will need you to be honest about your smoking and may even test your blood for nicotine levels if there is any doubt. Be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.

Key Aftercare Points

  • There may be bruising around your eyes following surgery. This will take approximately 3 weeks to settle.
  • The swelling will be evident on and around the nose and can take several months to settle completely.
  • Your throat is likely to feel sore and your nose congested after your operation. Drinking plenty of fluids will help alleviate these symptoms.
  • You will need to sleep on 4 pillows for the first 5 nights and avoid bending to help reduce swelling.
  • It is important not to blow your nose for 2 weeks following the operation. If you feel your nose is running, then sniff rather than blow, and gently dab your nose if necessary. Do not place anything inside your nostril.
  • Depending on the operation’s techniques, there may be stitches on your septum (the part that separates your nostrils). There may also be stitches through the inside of your septum and a soft silicone sheet to support it inside your nose. If so, these will be removed in 4 to 7 days.
  • Your nose may feel numb or stiff after the operation, but this will return to normal within several months.
  • It is wise to wear sunblock and a brimmed hat when in the sun to avoid burning and minimize the appearance of your scars.
  • Depending on your occupation, you may consider returning to work in 7-10 days, bearing in mind the bruising and swelling will not have settled by this stage.
  • For the first month, try to avoid situations where you may knock your nose—for example, dancing and carrying or playing with children. Avoid contact sports for 3-6 months.
  • While we do our utmost to achieve the desired result, we cannot guarantee to make your nose the exact shape you desire. If subsequent revision procedures are required, there may be additional fees.

Read More

LEARN MORE
ABOUT RHINOPLASTY

Rhinoplasty can dramatically change your appearance closer to your ideal to improve your self-confidence. However, it cannot change your looks completely or cause other people to treat you differently. Before you decide to have surgery, you must discuss and agree on your goals with Dr. Coville. The best candidates for rhinoplasty are looking for improvement, not perfection. If you’re physically healthy, psychologically stable, and realistic, rhinoplasty may be for you.

Many surgeons prefer not to operate on teenage patients until they’ve completed their growth spurt, around 14 or 15 for girls, a bit later for boys. Reputable surgeons always consider a teenager’s social and emotional adjustment and make sure that surgery is what the individual wants and not just what his or her parents want. Dr. Coville will take the time with you to make sure you are both on the same page.

Dr. Fred Coville performs procedures such as rhinoplasties at one of the private and fully accredited surgery centers on the Southern New Jersey Shore, where he has privileges. The choice of the center will depend on the availability of operating room time, Dr. Coville’s schedule, and your timetable. This procedure is done on an outpatient basis.

Rhinoplasty usually takes 1-2 hours, though, of course, complicated procedures may take longer. The skin of the nose is separated from the supporting bone and cartilage, which is sculpted to the desired shape, using the best technique for your features and facial harmony. The skin is then redraped over the new framework. Rhinoplasty can be performed inside the nostrils or by using an ‘open’ procedure where a small incision is made across the columella, the vertical strip of tissue that separates the nostrils. After surgery, a splint will be applied to help your nose maintain its new shape. Although we try to avoid them, you may also have some temporary packing placed within the nostrils to help control swelling and bleeding.

Choose a well-qualified and experienced plastic surgeon, and any complications are likely to be minor. Because individuals vary significantly in their reactions and their ability to heal, outcomes are never entirely predictable. There are some complications possible with the operation. These include infection, which is rare, and the potential for bleeding. If bleeding is severe and not controlled by simple packing, you may require a return to the operating room.

All patients are advised not to take drugs containing aspirin, ibuprofen, or ginkgo biloba for at least 10 days before their operation as these can alter the clotting of the blood. Just one tablet can affect your clotting for up to 2 weeks. Smoking affects your skin’s blood vessels and decreases the amount of vitamin C in your system. This makes both bleeding after the operation and the risk of skin dying more likely. Dr. Coville will insist you refrain from smoking for at least 6 weeks before and following surgery. Remember, you have absolutely nothing to gain by concealing a smoking habit from your surgeon.

After surgery, small burst blood vessels may appear as tiny red spots on the skin’s surface. Usually, these are minor but can, in some instances, be permanent. When rhinoplasty is performed from inside the nose, there is naturally no visible scarring. Yet, even when an ‘open’ technique is used, or when the procedure calls for the narrowing of flared nostrils, the small scars at the base of the nose are not usually visible. In about one case out of ten, a second minor procedure may be required, for example, to correct a slight deformity. These relatively rare problems are unpredictable and can happen even to patients in the hands of the most skilled surgeons.

Good communication between you and your surgeon is essential. Dr. Coville will ask what you would like your nose to look like, evaluate the structure of your nose and face, and discuss possibilities with you. He will also explain the factors that can influence the procedure’s success, including the structure of your nasal bones and cartilage, the shape of your face, the thickness of your skin, your age, and your expectations. Dr. Coville will also explain the techniques and anesthesia he will employ and provide information about the facility where the surgery will be performed, the risks and costs involved, and any other options you may have. You may find you can achieve your aesthetic goals through combined surgical and non-surgical treatments or even entirely without surgery. You can refer to our section on Aesthetic Medicine to see what non-surgical options might be right for you.

Most private insurance policies do not cover purely cosmetic surgery. On the other hand, it may be wholly or partially covered if the procedure is performed for reconstructive purposes. Check with your insurer, and obtain payment authorization before any surgery. Also, be sure to tell Dr. Coville if you have had any previous nose surgery, or an injury to your nose, even if it was many years ago. You should also inform him if you have any allergies or breathing difficulties, are taking any medications, vitamins, or recreational drugs, or if you smoke. Do not hesitate to ask our staff any questions you may have, especially those regarding your expectations and concerns about the results.

Preparation

It is important you follow our instructions on how to prepare for your surgery. They will cover eating, drinking, smoking, taking or avoiding certain vitamins and medications, and washing your face. If you are a smoker, it is especially imperative that you stop at least 4-6 weeks before and after surgery; smoking inhibits blood flow to the skin and can interfere with healing. The longer you stop smoking before a procedure, the better your results will be. Dr. Coville will need you to be honest about your smoking and may even test your blood for nicotine levels if there is any doubt. Be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.

Key Aftercare Points

  • There may be bruising around your eyes following surgery. This will take approximately 3 weeks to settle.
  • The swelling will be evident on and around the nose and can take several months to settle completely.
  • Your throat is likely to feel sore and your nose congested after your operation. Drinking plenty of fluids will help alleviate these symptoms.
  • You will need to sleep on 4 pillows for the first 5 nights and avoid bending to help reduce swelling.
  • It is important not to blow your nose for 2 weeks following the operation. If you feel your nose is running, then sniff rather than blow, and gently dab your nose if necessary. Do not place anything inside your nostril.
  • Depending on the operation’s techniques, there may be stitches on your septum (the part that separates your nostrils). There may also be stitches through the inside of your septum and a soft silicone sheet to support it inside your nose. If so, these will be removed in 4 to 7 days.
  • Your nose may feel numb or stiff after the operation, but this will return to normal within several months.
  • It is wise to wear sunblock and a brimmed hat when in the sun to avoid burning and minimize the appearance of your scars.
  • Depending on your occupation, you may consider returning to work in 7-10 days, bearing in mind the bruising and swelling will not have settled by this stage.
  • For the first month, try to avoid situations where you may knock your nose—for example, dancing and carrying or playing with children. Avoid contact sports for 3-6 months.
  • While we do our utmost to achieve the desired result, we cannot guarantee to make your nose the exact shape you desire. If subsequent revision procedures are required, there may be additional fees.

Read More

WHAT IS RECOVERY LIKE?

For the first 24 hours after surgery, your face will feel puffy, your nose may ache, and you may have a dull headache. Prescribed pain medication can control this. Plan to take it easy with your head elevated for the first few days. You’ll notice swelling, and bruising around your eyes will increase initially, peaking at 2-3 days. Cold compresses will reduce swelling and make you feel better. Initially, you’ll feel a lot better than you look.

Most of the swelling and bruising should disappear within 2 weeks, although some subtle swelling—unnoticeable to anyone but you and your surgeon—will remain for several months. Some bleeding is common in the early days, and you may continue to feel some stuffiness for several weeks. You will probably be asked not to blow your nose for a week to allow the tissues to heal. If nasal packing has been used, it will be removed after a few days, and you’ll feel much more comfortable. By the end of 1 week, all dressings, splints, and stitches should be removed.

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WHAT RESULTS CAN I EXPECT?

When the swelling subsides and your new nose emerges, you can expect a better facial balance to your features and an overall improved reflection. It’s likely the aspects of your old nose that bothered you caused a great deal of insecurity. When those concerns are gone, your confidence will increase, and your comfort in social, professional, and personal situations will become significantly more noticeable. For many Cornerstone Plastic Surgery & Aesthetic Medicine patients, rhinoplasty has been one of their best investments, and many wonder why they waited so long in the first place.

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Dr. Frederick Coville

Frederick A. Coville, M.D., Cornerstone Plastic Surgery’s Owner and Medical Director, has been an Aesthetic and Reconstructive Plastic Surgeon for over 25 years. He firmly believes each of us possesses an inner “Foundational Beauty.”

As a student of beauty all his life, he calls upon his naturally artistic eye and God-given talents as a surgeon to deliver the results you demand. Dr. Fred likes to say, “It’s my job to help you find Your Beautiful!”

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Dr Frederick Coville Plastic Surgeon Atlantic County