Rhinoplasty surgery is one of the most complex procedures a plastic surgeon can perform, because it deals with the most delicate structures of the face. Over the years, many patients have trusted Dr. Edward J. Gross as a specialist in rhinoplasty, also called a nose job, in the Orlando area. Here, we provide answers to some of the most common questions our Orlando patients ask about rhinoplasty.Request a Consultation
How many rhinoplasties, or nose jobs, does Dr. Gross perform each year?
Dr. Gross consistently performs more than 100 rhinoplasty procedures per year, nearly 10 times the average of a general plastic surgeon.
How long does the rhinoplasty (nose surgery) take, and what kind of anesthetic is used?
Rhinoplasty surgery takes about 2 to 3 hours, depending on the complexity and the condition of the nose. Dr. Gross uses a general anesthetic at Primera Surgery Center. Rhinoplasty is an outpatient procedure, meaning you'll return home the same day. Expect to take a week off from work or school and 2 weeks off from exercising or going to the gym.
How accurate is the computer imaging session?
With more than 2 decades of experience using computer imaging, Dr. Gross produces results that closely match the previews provided on the imaging system. Barring any unforeseen problems, most patients will be very satisfied with the final results Dr. Gross simulates on the computer imaging system. Dr. Gross examines each patient individually and advises each patient about whether their expectations are realistic, based on this comprehensive analysis. We email these images to patients containing a standard disclaimer.
How much does rhinoplasty cost?
At Dr. Gross' Orlando practice, the cost of rhinoplasty surgery depends on what type of procedure he performs as well as other factors. On average, the cost ranges from $7,500 to $8,500 (surgeon fee only), but your costs may differ. Your consultation fee is put toward the cost of your surgery, which also includes VISIA™ skin analysis, all follow-up treatments for a year, and photographs.
Is financing available for cosmetic rhinoplasty?
Yes. Financing can be arranged through CareCredit®.
Is there a lot of bruising afterward, and how long will the swelling last?
This depends on the complexity of the procedure. Typically, our patients can expect to experience some discoloration (bruising) and swelling around the eyes that lasts about 1 week. Dr. Gross' experience and skill minimizes these side effects. "Delicate care in surgery and handling the tissues gently is critical for rapid healing," Dr. Gross says. We prescribe homeopathic arnica to reduce swelling and bruising, and ice and cold compresses can also minimize swelling. You can put frozen peas in a Ziploc® bag and place them on a dry hand towel, and then apply them on your forehead and over the eyes. Keep moisture and water off the tape.
Will I have any pain or pressure during the recovery?
Most patients feel some pressure and congestion during the first 2 or 3 days after surgery, but not significant pain. We prescribe pain medication and saline spray to minimize discomfort.
Will I damage my nose by sneezing after having a rhinoplasty?
No, but please try to sneeze with your mouth open.
I have trouble breathing through my nose; will cosmetic rhinoplasty help my breathing?
Yes, this is possible. Difficulty breathing through the nose is often associated with either a deviated septum or a bent internal framework of the nose. "Most of the time, this results from trauma such as a broken nose, but many of my patients cannot recall an episode where this might have occurred," Dr. Gross says. Another treatable condition is called turbinate enlargement. Careful examination is needed to determine the best course of treatment for each patient. Septal repositioning and turbinate cautery may be recommended. Dr. Gross corrects breathing problems at the time he performs cosmetic rhinoplasty. Keep in mind that Dr. Gross is 1 of only very few doctors with dual board certification and training to handle both the cosmetic and breathing portions of your surgery. Although we do not accept insurance, Dr. Gross may advise you on the benefits of correcting your breathing problems during surgery.
Where are the incisions placed during nose surgery?
Dr. Gross hides most rhinoplasty incision inside the nostril. External incisions may be hidden in the creases where the nose meets the cheek. He may also make an incision under the nasal tip (on the columella) for open rhinoplasty. This incision heals beautifully, leaving no visible scar. Dr. Gross removes external sutures after a week. Sutures inside the nose are removed 10 days after the procedure.
Is it normal to have tiny bumps or uneven edges on the columella incision?
Yes, the incision flattens after about 2 or 3 months. The bumps subside as swelling goes down. As the scar fades both of these concerns go away.
Where do I get Scarfade® gel?
We provide Scarfade to patients at their 1-week follow-up appointments. You should begin using it on day 14 after surgery.
How long do I use the Scarfade on my incisions?
Start using on day 14 and continue using it for 2 to 3 months or until the gel is gone.
Can I use Neosporin® or peroxide to clean my incisions?
No, never use any product that is not prescribed by your surgeon, especially peroxide.
What about nasal sprays other than saline?
Only use over-the-counter nasal saline spray for the first 2 to 3 weeks. It is important to ask us before using any other nasal sprays, especially nasal steroid sprays. Please do not use Afrin®.
When will I see my final results from surgery?
It takes most patients about a full year for all swelling to subside, especially at the tip. This may take longer following more extensive "tip plasty" with nostril narrowing. Post-op swelling may remain longer for revision rhinoplasty patients or those with previous trauma, thicker skin, or nostril narrowing. However, most patients see pleasing results almost immediately when the cast is removed at the end of the first week. The typical patient returns to work or school at the end of one week with very little sign of nose surgery. "Remember, 90% of the nose swelling is gone at 2 months, which leaves about 1% reduction per month thereafter (for the swelling to resolve). Be patient," Dr. Gross says.
How long will my nose be numb and stiff?
The tip of the nose can be stiff and numb for up to 1 year. Tissue swelling or edema causes the numbing and stiffness.
Will the bump regrow on my nose after my nose surgery?
No, typically the bump will not regrow on your nose; however, we recommend our patients follow strict guidelines to avoid contact sports following surgery and perform compression exercises on the nose to reduce this possibility.
What are internal splints and packing?
Internal splints, aka surfboards, may be needed after septal repositioning. Internal splints stabilize the septum during healing, and Dr. Gross removes them after 1 week. Dr. Gross only uses nasal packing when it's needed to reduce bleeding after the surgery. Patients can remove the packing on their own by simply pulling the string in their noses. This is usually on the second day of recovery and should be done over a sink because some bleeding can be expected.
How long before I can shower?
You may shower 2 days after surgery but avoid getting your nose and face wet. Keep the tape dry and avoid long steamy showers so the tape stays adhered to the skin.
Why are my upper teeth sensitive?
This is normal and temporary after some nose surgeries, especially if Dr. Gross works on your septum. It resolves in 1 week. Over-the-counter pain relief medication such as Motrin helps with this discomfort.
How far should I insert the Q-Tip® to clean my nose?
Generally, about a half-inch or just past the cotton portion of the Q-Tip.
How long will my nose be runny or sniffling?
The nasal drip and sniffling can last up to a year. This is normal during rhinoplasty recovery.
How long do I need the drip pad on under my nose?
We recommend keeping it there the first 2 days after surgery or until the packing is removed.
Is it normal to spit up blood after surgery?
Yes, it is common for the first 2 days and then it subsides.
What is tip plasty?
Any modification of the tip of the nose is considered tip plasty. Dr. Gross reshapes, sutures, and trims the cartilage at the tip of the nose for a more refined tip, making it less round or bulbous. Tip plasty is an advanced surgical technique and requires a great deal of experience and training. Many plastic surgeons don't address the tip because of its complexity and challenges. Dr. Gross often performs tip plasty because it creates more harmonious results. This is also where the art of rhinoplasty comes into play, and Dr. Gross has a very keen eye and sound aesthetic judgment when reshaping and balancing the tip. Weak tips, boxy tips, bifidity, droopy tips, and amorphous tips can be improved with these tip plasty techniques: de-projection, rotation, projection, tip support, grafting, stabilization sutures, cephalic trim, dome binding, and de-fatting.
What is Kenalog®-10 and does it help reduce swelling?
Kenalog-10 is a medical corticosteroid used to treat thickened or asymmetrical areas of the nose after rhinoplasty. It reduces inflammation and scar tissue and helps refine the tip. Dr. Gross usually recommends this at 6 months to a year after surgery, depending on certain factors. He injects it using a very small needle. You typically see results 3 to 4 weeks after the injection, and they last indefinitely. Generally, 2 to 3 injections are needed.
I have a wide nose. I heard about an osteotomyâ€”will that help? And will you break my nose?
A wide nasal bridge can occur from trauma or more commonly from hereditary features within a family. By performing the needed osteotomies to narrow the bridge, this can be corrected. The nasal bones are carefully reset or fractured in a controlled fashion to close the wideness of the bridge (after the necessary excess bone has been removed). Dr. Gross performs osteotomies routinely in both primary and revision nose surgery and has a great deal of experience with this maneuver. Additionally, a refined and narrowed nasal bridge that matches the tip is aesthetically more pleasing. Controlled osteotomies result in a narrower and straighter nose, which is less traumatic than breaking the nose. Once the nasal bones are cut, they are repositioned, and a cast is applied at the end of surgery. The key here is experience.
What are internal splints and what are they used for?
Internal splints are occasionally placed during surgery to correct a deviated septum or to keep the nose straight during healing. These are made of a thin Silastic® sheeting and are also known as "surfboards." They are removed in the clinic at the 1-week visit.
What are turbinates, and what do they do?
Turbinates are nasal membranes that warm, humidify, and clean the air we breathe through the nose. When they become chronically swollen or congested, the nasal breathing is obstructed. When this occurs, it is best to cauterize and permanently shrink them. Turbinate cautery is performed during rhinoplasty and improves long-term breathing.
What is cartilage grafting? Will I need it?
The nose needs structural integrity for proper form and function. When it has been weakened by injury, prior surgery, by hereditary features, or from birth defects, support must be added. This is done by harvesting cartilage from within the nose, or when not available, from behind the ear. Cartilage grafts are then placed to shore up weak areas of the nostril, lift the tip, or open the air passages. They are also used to cushion areas of the nose and to soften any sharp edges. Dr. Gross performs cartilage grafting in more than half of the cases he operates on. "This adds a bit more time and complexity to the operation but results in long-term stability and successful outcomes," he says.
What are compression exercises?
These are fingertip compressions of the nose bridge and tip that are recommended following cast removal. Compression exercises reduce swelling, straighten the nose, and maintain symmetry. They should be performed 2 or 3 times a day for 2 minutes each. Dr. Gross and our staff will review this after the 1-week follow-up visit. We'll instruct you on how to do the compressions, but you can also watch Dr. Gross' YouTube channel for an instructional video.
What about nasal taping?
We use 3M Micropore Tan Surgical Tape 0.5" wide. Please ask a staff member for help or watch this video.
What type of cast will I have over my nose?
A nasal cast is made of aluminum and foam held in place with Steri-Strips™. You must keep the cast and tape completely dry for the entire week.
Will I be able to breathe with the cast on my nose?
Yes, but expect some stuffiness for 2 to 3 weeks after the surgery while the airflow improves.
Why does my nose look crooked or twisted with the cast on?
Try not to judge the results of your surgery prematurely. The local anesthesia, swelling and cast can create an illusion, and swelling can be uneven.
Why are my eyes tearing up?
Rhinoplasty causes the nose and tear ducts to swell, which results in tearing. This resolves on its own after 1 or 2 weeks.
Can rhinoplasty damage my sense of smell?
No. Patients typically regain their sense of smell after 1 or 2 weeks after swelling subsides and the airflow improves.
When can I wear glasses after rhinoplasty?
Wait 2 weeks before wearing glasses or sunglasses.
Can I get BOTOX® immediately after having rhinoplasty?
No, you should wait at least 3 months.
What kind of sports can I play after rhinoplasty?
Dr. Gross recommends avoiding all sports for 3 months after surgery and to not participate in contact sports for 6 months.
What other activities should I avoid?
- Swimming: 3 months
- Snorkeling: 3 months
- Scuba diving: 6 months
- Riding roller coasters: 3 months
- Skydiving: 1 year
- Flying: 10 days
How long before I can get a face-down massage?
Wait at least 3 months. You should also wait 3 months before scheduling a facial.
"I prefer individualized treatment of each segment of the nose to give a balanced, refined look without compromising function."