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Nose Reshaping / Rhinoplasty

Nose Reshaping (Rhinoplasty)For many people, a prominent, asymmetric, bumpy or undesirable nose leads to extreme self-consciousness. One of the most common of all cosmetic procedures, rhinoplasty (nose surgery) is used to improve the appearance and possibly the function of the nose.

If you're considering nasal reshaping, the following information will provide you with a good introduction to the procedure.

For more detailed information about how this procedure may help you, we recommend that you schedule a personal consultation with Dr. Kremer.

FAQFrequently asked questions about Nose Reshaping (Rhinoplasty) by Dr. Michael A. Kremer:

What are some of the most common benefits of this surgery?

Rhinoplasty can correct a variety of conditions including an over-sized nose, a hump on the bridge or an undesirable shape of the nasal tip. Both frontal and profile views of the nose are corrected to complement other facial features, and to provide a harmonic balance of proportions.

Rhinoplasty can also be used to correct for breathing problems caused by narrow or partially obstructed nostrils, a deviated septum or hypertrophied turbinates.

Children with congenital cleft lip and palate deformities are candidates for early and repeated nose reshaping procedures in order to enhance their social functioning and integration among peers.

If you are self-conscious about your nose, this surgery can open up new possibilities for changing your appearance and your self-image.

What will happen at the initial consultation?

During the consultation, Dr. Kremer will discuss the changes that you would like to make in your appearance. Because the appearance of your nose is a matter of personal perception and preferences, you will need to discuss your concerns in detail with Dr. Kremer.

Dr. Kremer may also point out other problems areas. For example, some patients who want rhinoplasty also have weak chins or flat cheekbones. In these cases, chin or cheekbone implants might be considered as a part of the operative plan.

A directed physical examination of your nose and other facial features will be done during your visit. This will involve identifying functional as well as cosmetic issues. It is important for you to provide any history of trauma or surgery that you have had to your nose. You should also inform Dr. Kremer of any allergy problems.

Computer imaging is a very useful adjunct to visualizing what you may look like after the procedure. While not a guarantee of results, it is a great benefit in preoperative planning.

How is a rhinoplasty performed?

Rhinoplasty is usually performed under a general anesthetic. Incisions are made inside the rim of the nostrils. Soft tissues of the nose are then separated from the underlying structures, and the cartilage and bone causing the deformity are reshaped.

The exact nature of that sculpting depends on your particular problem, and should be discussed at the consultation. If the nose is being reduced in size, the nasal bones are carefully fractured. Breathing problems may be improved by a procedure called septoplasty, in which the obstructions are removed.

There are two major ways to perform a rhinoplasty: the closed and the open techniques. The open technique includes an incision across the columella, the small skin between the two nostrils. With this type of rhinoplasty, the swelling takes significantly longer to subside. The scar is most often quite small and fades rapidly, however, it may always be visible. The closed technique does not require an external incision, heals more quickly and is associated with less postoperative swelling than the open technique.

Dr. Kremer almost always performs the less aggressive closed rhinoplasty technique.

How long does surgery take?

The procedure usually takes 1.5-2.5 hours, but on rare occasions it may take longer.

Will I need to stay in a hospital?

Not necessarily. This procedure can be performed in the hospital or in an outpatient surgical suite.

How much pain is there?

Surprisingly, there is very little pain after rhinoplasty and most patients require only mild analgesics. A frequently applied nasal packing as well as the postoperative swelling obstruct the nasal airway for a couple of days, which by some Patients is appreciated as unpleasant. In certain patients Dr. Kremer may be able to not insert a nasal packing. Dr. Kremer will decide from case to case.

What can I expect after surgery?

An external splint will be applied and the nose will be packed lightly with a medicated gauze. The stitches within the nose are self-absorbing and do not require removal. No stitches have to be removed.

What is the recovery period like?

Although there is some pain in the first 24 hours, after this there is usually just a feeling of pressure and stuffiness. You will still look puffy and swollen. You should keep your head elevated above the level of your heart for the first few days to reduce swelling. Bruising around the eyes is to be expected, usually peaking around 72 hours and subsiding in 7-10 days.

Cold compresses will help to reduce the swelling around the eyes. You may have a little bleeding too, so you will probably want to change your gauze bandages a few times a day for the first several days.

After 2-3 days, the nasal packing will be removed. After 2 weeks the nasal splint will be removed. You will still need to be careful to not blow your nose for about two weeks. Eyeglasses should be taped to the forehead, off the bridge of the nose, for the first 6 weeks.

You may not be completely back to normal for several weeks. Your nose might be numb, especially if there have been considerable changes made to the tip. You should be gentle when washing your face, and avoid strenuous activity for about 4 weeks.

What is the long term outcome like for most people?

It is common to feel dissatisfied with the appearance of the nose in the immediate post-operative period. At this point, the nose is still quite swollen, and much of the detail is still not visible enough to appreciate. It is wise to take a wait-and-see approach since the elasticity of the tissues, the blood flow, the thickness of the skin and the appearance of the nose will change significantly during the first three months – even up to the first year. It is important to be patient during this period of time. Rushing to perform a second operation during the first nine to twelve months is almost always a mistake.

Many people seem to blossom with positive personality changes after this procedure. A new sense of confidence is the most frequently observed change. Temporary blues after the procedure have also been reported by some patients as rhinoplasty changes the appearance that you've grown accustomed to.

What risks are there, what complications can occur?

Rhinoplasty will provide significant improvements in the appearance of the nose for the vast majority of patients although, in occasional cases, a secondary correction may be required. There are risks with all surgical procedures. You should discuss all benefits and risks with Dr. Kremer.

The information on this web site is only intended as an introduction to this procedure and should not be used to determine whether you will have the procedure performed nor as a guarantee of the result. The best method of determining your personal options is to schedule a personal consultation with Dr. Kremer. He will be able to answer specific questions related to your situation.
  • Be sure to

    • InfoTell Dr. Kremer if you have a history of bad scarring, such as keloids.
    • Tell Dr. Kremer about all medications, herbal supplements or natural supplements you are taking (both prescription and non-prescription)
    • Carefully follow any instructions Dr. Kremer gives you regarding eating and drinking and smoking.
    • Avoid aspirin and aspirin-containing medicines for two weeks prior to surgery.
    • Arrange for someone to drive you home after surgery or after discharge from the hospital.
    • Please inform Dr. Kremer immediately in case you should experience fever or symptoms of an infection after surgery.
    • Please use a cooling mask or ice packs to reduce swelling an discomfort after surgery.
    • Refrain from strenuous physical activities during the first days after surgery.
  • Pre-existing conditions?

    InfoTell Dr. Kremer if you have any of the following pre-existing conditions

    • thyroid problems such as hypothyroidism
    • elevated blood pressure or other circulatory disorders
    • cardiovascular disease
    • diabetes
    • any other serious medical condition(s)
Мюнхенская клиника эстетической и пластической хирургии
Д-р мед. Михаэль Кремер

Мауэркирхерштрассе, 40 - D-81679 Мюнхен (район Богенхаузен)
Тел.: +49 (0) 89 - 55 27 450