Why Should I Choose Dr. Minoli for My Rhinoplasty?
Dr. Minoli has completed extensive training as a plastic surgeon, a facial plastic surgeon, and an ear-nose-throat surgeon (otolaryngologist). He is triple board certified in all three specialties and has collected considerable clinical and teaching experience in all three fields over his decades of work.
Dr. John Minoli offers you years of trusted experience in improving and beautifying your nose: He accounts for nasal proportions in relation to surrounding facial structures and nasal breathing.
He has performed primary or revision rhinoplasty surgery on people from various ethnic, cultural, and racial backgrounds to treat myriad nasal problems — both cosmetic and functional.
As modern medicine offers safer operative and non-surgical methods for nasal reshaping, Dr. Minoli continues to adapt his practice accordingly through extensive surgical education and experience. Dr. Minoli and his staff routinely treat patients undergoing nasal surgery for the first time and those who need revision surgery to improve upon the results of initial nasal operations performed elsewhere.
A consultation with Dr. Minoli may help you further appreciate these highly individualized issues.
Am I a Candidate for Rhinoplasty?
Before undergoing initial rhinoplasty surgery, girls should usually be at least 14 or 15, and boys a bit older. Naturally, Dr. Minoli and his staff will want to be sure that younger patients (and all patients) are sure they want to change their nasal appearance based on their own true feelings and not those of parents, family, or friends.
Of course, if a person is healthy, there is no upper age limit. Sometimes, Dr. Minoli performs rhinoplasty surgery to correct an aging nose or a drooping nasal tip while simultaneously performing facelift surgery during advanced facial rejuvenation cases.
Any one or a combination of the following conditions may indicate that you are a good candidate for rhinoplasty:
- Your nose appears too large for your face.
- There is a bump on your nasal bridge when viewed in profile.
- Your nose seems too wide when viewed from the front.
- Your nasal tip droops or plunges.
- Your nasal tip is thickened or enlarged.
- Your nostrils are excessively flared.
- Your nose is off-center or crooked.
- A previous injury has made your nose asymmetrical.
It is important that you have a clear idea of how you would like your nose to look. During the initial consultation, you may be asked to look in a mirror and point out exactly what you would like to see improved. This will help Dr. Minoli to understand your expectations and determine whether those expectations can realistically be achieved.
Nose Surgery to Improve Nasal Airflow and Breathing
Sometimes, specific breathing problems are related to internal nasal deformities, such as a nasal septum deviation or enlargement of nasal turbinate bones. Internal nasal deformities can be corrected at the same time as the external nasal reshaping.
How Is Cosmetic Nose Surgery Performed?
Dr. Minoli performs rhinoplasty at an accredited ambulatory surgery center in Las Vegas. For your comfort and safety, general anesthesia is administered by a board-certified anesthesiologist. Some patients may be candidates for nasal surgery under local anesthesia, which is performed in our office, but these are very specific settings.
Appropriate prescription medications are provided for pre and postoperative home use (such as antibiotics, muscle relaxants, and painkillers).
Rhinoplasty Incision Options
- A closed approach involves internal nasal incisions but no external ones.
- An open approach involves an external incision across a narrow or creased part of the columella.
Understanding Closed Rhinoplasty
Traditional rhinoplasty incisions are usually made on the inside of the nose (inside the nostrils). This approach is usually referred to as closed rhinoplasty.
Certain patients are candidates for an additional external incision along the external bottom region of the nose (transcolumellar); this approach is usually referred to as an open rhinoplasty. During your consultation, Dr. Minoli can help guide you to the proper approach.
In addition to nasal skin being lifted during rhinoplasty surgery, underlying nasal cartilage and bones are surgically altered. During rhinoplasty surgery, the underlying nasal bones and cartilage are reshaped before the nasal skin is redraped over the nasal bones and cartilage.
Sometimes rhinoplasty involves the use of grafting, a process in which a patient’s own cartilage (from the internal nose, ear, or rib) or fat (from the abdominal wall, buttocks, or thighs) is borrowed from its donor region and then carefully transferred to improve the shape and support of the newly fashioned nose.
Rhinoplasty incisions are expertly sutured for a meticulous final skin closure.
Understanding Open Rhinoplasty
Open rhinoplasty is defined by the external transcolumellar incision illustrated above.
If the base of the nose needs to be narrowed or the nostrils need to be reduced, small skin wedges will be removed at the nostril base. Such incisions are external but still fairly well hidden in the natural crease where the nostril joins the cheek.
If a nose needs to be built up, this can be done with nasal cartilage (or cartilage from another site, such as ear or rib). Alterations may be made to increase or decrease the nasal bridge, reduce the size or width of the nose, narrow the nostrils, change the angle between the nose and upper lip, or reshape the nasal tip.
Depending on the surgical technique, a splint may be placed on the nasal bridge to hold the tissues in place until they have stabilized.
Non-surgical Rhinoplasty Techniques
While surgical options are an excellent tool, it is important to remember that non-surgical choices exist. For rhinoplasty, non-surgical injectable neuromodulators, such as BOTOX® Cosmetic and cosmetic dermal fillers, can adjust and treat the nose in specific settings.
Should I Combine Any Other Surgeries With My Rhinoplasty?
In a small number of instances, Dr. Minoli may recommend chin surgery to enhance or diminish the prominence of your lower face in relation to your nose, which can improve overall facial balance in the process. Chin surgery can often be performed simultaneously with rhinoplasty.
How Long Is Primary Rhinoplasty Recovery?
Healing after rhinoplasty is typically slower than in other areas of the body. The amount of time it takes for recovery varies greatly among individuals.
You will be returning to Dr. Minoli’s office regularly so that your postoperative progress can be properly evaluated.
Rhinoplasty Recovery Week By Week
First few days: You should restrict activities and sleep with your head elevated for the first few days. This will help minimize swelling and reduce the possibility of minor bleeding (common during the first night). Generally, the greatest swelling occurs 24 to 72 hours after surgery, but it may take several weeks or months before all puffiness resolves. Fortunately, this should not be apparent to others.
The day after surgery, you will be encouraged to get out of bed for short walks to promote blood circulation. Straining, bending, and lifting must be avoided since these activities may cause increased swelling or bleeding. Even facial washings must be done gently during this early period.
Remember, you must not take aspirin or certain anti-inflammatory medications because those agents could cause more bruising.
First week: You can expect your nose and face to be tender and swollen. As the first postoperative week progresses, so will your sense of independence. You will need to wear the nasal splint for a week or so, during which time you should avoid getting it wet (although efficient showering may be permissible).
External sutures are usually removed in about 5 to 7 days. Toward the latter part of the first postoperative week, you will likely be able to resume driving. Depending on the extent of your rhinoplasty and your general physical condition, you may be able to return to non-strenuous work anywhere from 1 to 2 weeks after surgery.
If any external sutures have been placed during surgery, they are usually removed toward the end of the first week.
Week 2: Bruising and swelling will subside significantly during week 2. At this time, it is usually permissible to wear makeup to help conceal discoloration. Sexual activity and other vigorous activities are also restricted.
Weeks 3 to 5: You can resume most of your normal activities, including mild exercise. The timing of your recovery depends largely on the extent of your surgery and your healing capacity. You may continue to experience mild periodic discomfort and swelling, but severe pain should be reported. Incisions will initially be red or pink, and they may remain this way for many months following surgery, but incisional scars will eventually fade. During the early stages of healing, you will notice puffiness and discoloration, which may be more pronounced in some portions of your nose and face than others. Nasal tip swelling is the most frequent. Do not be alarmed by any unevenness or temporary asymmetry caused by this variance in swelling and bruising; it is perfectly normal.
Week 6: You will begin enjoying the appearance of your new nasal shape within a few weeks. Occasionally, a touch-up may be desired to improve results further, and any additional procedure is typically far less extensive than the original operation.
You will be instructed to avoid direct sunlight during the early postoperative phase and be conscientious about using sunblock to protect your skin long-term. It will be a few months before you can expose your reshaped nose to direct sunlight for lengthy periods.
If your nasal bones are altered, it may take weeks or even months before you can wear glasses without special support or tape.
When Will I See My Rhinoplasty Results, and Are They Permanent?
The goal of rhinoplasty is a nose that looks natural and blends harmoniously with other facial features. Since the healing process is gradual, you should expect to wait up to one year to see the final results of your rhinoplasty surgery.
The results of your rhinoplasty may be dramatic or subtle, depending on how you looked before surgery and the specific goals that you and Dr. Minoli established.
When healing is accomplished, rhinoplasty surgery will enhance the appearance of your nose.
Various healing factors may prolong the final result. Prolonged swelling is typical in the months following surgery. Nevertheless, the results of rhinoplasty surgery are usually permanent — except for possible changes associated with the normal aging processes.
Scars will fade over time. Fortunately, rhinoplasty scars are concealed inside the nose or in natural nasal creases. Occasionally, a touch-up revision may be desired to improve a contour or a scar. The additional treatment can usually be performed under local anesthesia in Dr. Minoli’s office.
You will return to Dr. Minoli’s office for follow-up care at prescribed intervals so your progress can be evaluated. This postoperative period typically spans the first year following surgery and certainly beyond if needed.
Primary Rhinoplasty FAQ
What will my rhinoplasty consultation with Dr. Minoli be like?
Your consultation will include a discussion about your overall goals. You should come to a consultation with Dr. Minoli prepared to discuss your medical history, including conditions like diabetes, high blood pressure, or heart disease. If you plan to become pregnant in the near future, you should discuss this too.
Dr. Minoli will want to know about your current medications and previous nasal surgeries (including nasal injury repair). Dr. Minoli will also ask whether you breathe through your nose with difficulty, suffer from stuffy nasal allergies, or chronically use nasal sprays. Complete information is important for proper decision-making.
Dr. Minoli will also examine your nose and adjacent facial structures. Your skin quality (as well as the size and shape of your nose and its relationship to your other facial features) will be studied carefully. Pre-existing scars will also be evaluated, as scarring from previous rhinoplasty surgery may limit your results. Dr. Minoli will conduct a routine and painless examination of your internal nasal structures.
How should I prepare for my nose surgery?
We want to make your surgical experience as easy and comfortable as possible. If you are a smoker, you will be asked to stop smoking before surgery. Aspirin, certain anti-inflammatory drugs, and an array of supplements (such as fish oil, flaxseed oil, garlic supplements, green tea, and vitamin E) can cause increased bleeding, so you should avoid taking these medications and supplements before surgery. Dr. Minoli will provide additional preoperative instructions.
If your rhinoplasty surgery is being performed on an outpatient basis (as usual), be sure to arrange for someone to drive you home and stay with you at least the first night following surgery.
What will the day of my rhinoplasty surgery be like?
Your rhinoplasty surgery will likely be performed in a free-standing ambulatory facility, although some patients are candidates for rhinoplasty surgery under local anesthesia in our office.
Medications are administered for your comfort during and after the surgical procedure. Dr. Minoli and your anesthesiologist will discuss your anesthesia options and determine the type to be used. Options include local anesthetic injections, intravenous sedation, and general anesthesia. For your safety during the operation, various monitors may be used to check your blood pressure, pulse, and circulating oxygen.
When the surgery has been completed, you will be taken into a recovery area, where you will be closely monitored. If you do experience discomfort, this can be controlled by pain medication. You can return home under adult supervision after a few hours of recovery room monitoring.
A splint is placed on your nasal bridge to hold tissues in place until they have stabilized. The splint will shield your nose from accidental bumps and protect it while you sleep.
For the first night after surgery, you may have a small bandage underneath your nose (mustache dressing) to absorb postoperative nasal secretions. In addition, nasal packing or soft internal nasal splints are used inside the nostrils.
Will your insurance help cover the cost of rhinoplasty surgery?
Rhinoplasty (nasal reshaping) surgery is typically a cosmetic procedure and, as such, is not covered by most insurance companies. Under certain circumstances, insurance coverage may be available. For example, if a patient has an obstruction to nasal breathing due to a structural deviation inside the nose — corrective nasal surgery may be needed (which could include naso-septal reconstruction and inner-nasal turbinate bone surgery).
Many factors determine your eligibility for coverage, including the specific terms of your insurance policy. A letter of predetermination may be required by your insurance company before surgery. Dr. Minoli and his staff will discuss these matters with you.
What are the risks of rhinoplasty?
Surgical risks and potential complications are best discussed personally with Dr. Minoli and his staff. Fortunately, significant complications from rhinoplasty surgery are uncommon.
Every year, many thousands of people have their noses reshaped and experience no significant problems. However, anyone considering nasal surgery should be aware of both the benefits and the risks.
These risks include the following:
- Prolonged discoloration
- Reactions to anesthesia
- Painful or unattractive scarring
- Contour irregularities
- Need for further surgery
- Unsatisfactory results
Minor irregularities can sometimes arise (in certain instances when incisions have not healed in an ideal way). Still, office-based postoperative treatments are usually available to help minimize these problems if they occur.
Contact Dr. Minoli and See the Nose You’ve Always Wanted
Please remember that the relationship with our staff does not end when you leave the operating room. Please contact us if you have any questions or concerns during your recovery or need additional information.
Supported by a
Dedicated and Skilled Team
Even with Dr. Minoli’s accomplishments and training, he couldn’t do this without his dedicated team, led by his wife, Anita. Together, they have built a family practice based on compassionate and personalized plastic surgery care.