How Long Does a Rhinoplasty Take?

If you’ve been busy looking around for the best rhinoplasty surgeon for you, then you may have heard pretty different things at your consults.  One question that patients frequently have is how long the surgery will take.  Answers from surgeons can range anywhere from 1 to 6 hours (or more)! This may seem crazy, so how can this be?

First, rhinoplasty is an art as well as a science. In fact, it is more demanding artistically than any other type of cosmetic surgery.  The length of the surgery obviously depends on what the surgeon feels needs to be done to accomplish the desired outcome.  This depends on a number of factors – what does the patient want corrected? Has the patient had septoplasty?  Is this a revision rhinoplasty surgery? Has there been significant trauma to the nose?  Is there a significant problem with nasal breathing?

Shorter procedures generally rely on limited incisions and trimming away of cartilage.  This works well in patients who have good strong cartilage support and a limited amount of desired change, for example, removing a bump on the nose.  Longer procedures are usually revisions of prior surgeries or major corrections, and use an “open” approach where a small incision is placed at the bottom of the nose. One common procedure that significantly affects a rhinoplasty is whether the patient has had a septoplasty for breathing in the past.  Since many surgeons use that cartilage to achieve the desired outcome, the absence of a septum (after septoplasty) leads many surgeons to seek an alternative source of cartilage.

These sources of tissue for nasal work are called “grafts”.  Grafts are simply tissues taken from somewhere and moved to a new location.  The septum is the most commonly grafted structure. If it is gone, surgeons frequently use either ear cartilage or cartilage from the rib, both of which add complexity to the procedure.  In addition, fat grafts and fascia (soft tissue) grafts are also commonly used.  Grafting is a meticulous process and the more that are used, the longer the surgery.

Ultimately, the length of surgery is not the most important factor in rhinoplasty.  If you are a healthy person, the additional risk of a longer surgery is relatively low.  What is paramount is whether the surgeon will take the time to get the job done right.  Beware of the complex surgery outcome that is promised in 30 minutes!  Most importantly, make sure you have a detailed preoperative discussion with your surgeon so that you are confident that you are on the same page about your goals and expectations for surgery. 

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