SpaMedica Toronto offers Rhinoplasty surgery to patients who are looking to reshape and reconstruct their nose for aesthetic reasons or after an event or accident.
What is Rhinoplasty?
Rhinoplasty also known as a nose job, is a cosmetic surgery procedure performed on the nose to change its structure, shape and form, as well as on occasion, simultaneously improve the airway flow and function, in order to improve nasofacial balance, function and overall aesthetic appearance.
What makes Dr. Mulholland one of the best Rhinoplasty Surgeons in Toronto?
Dr. Mulholland has extensive experience in cosmetic rhinoplasty procedures and is certified by the Royal College of Physicians and Surgeons in both plastic surgery and has an advanced fellowship in ear/nose/throat head/neck oncology.
Dr. Mulholland spent a number of years performing advanced head/neck oncology, removing extensive tumors and cancers of the face, nose and neck and performing complex reconstructions of these defects, as well as craniofacial trauma including nose fractures and injuries. He is recognized as one of the best Rhinoplasty surgeons in Toronto and Canada.
Dr. Mulholland has spent a number of years treating complex facial fractures, including nasal fractures and advanced facial trauma. His ability to manage the bone and soft tissue deficits of nasofacial fractures provided him with an excellent and unsurpassed foundation for subsequently performing cosmetic rhinoplasty surgeries.
Dr Mulholland showcasing his Nose Job Before and After results to CTV News
Nose Job Procedure in Toronto
In general, the first step during Rhinoplasty Surgery is to gain exposure, either through an internal endonasal approach, or an external approach. Once Dr. Mulholland has adequately identified the anatomical structures, the nose bridge augmentation is performed, followed by fractures of the nasal bones to narrow the bone and make the nose appear more elegant.
The lower part of the nose may then require tip reduction or tip support augmentation or de-bulking the tip. Finally, after the bridge and tip have been shaped, the nostrils may need to be reduced and often, the partition of the nose, or septum needs to be adjusted or partially removed to optimize the probability that there will be no airway obstruction following the nose job procedure.
All these procedures and maneuvers are decided upon in the pre-operative phase, during the computer simulated surgery consultation and can be adapted at the time of the procedure.
There are two broad categories of Rhinoplasty procedures performed at the SpaMedica Toronto Rhinoplasty clinic.
A small incision is made in the base of the nose and the nasal skin is lifted up over the cartilages and bone structure to optimally visualize and reveal the nasal anatomy so it can be structurally changed and stabilized for an excellent long-term result.
The second broad category of type of rhinoplasty procedure is a closed, internal or endonasal rhinoplasty. In a closed rhinoplasty, there is no small incision at the base of the nose, in what’s called the columella, but rather the incisions are placed entirely inside the nose and inside the nostrils.
An internal, or endonasal rhinoplasty, as it is called, saves the patient the small incision in the skin of the partition of the nose (columella), and is excellent for dorsal bridge reductions and some modest tip and airway breathing concerns. It is usually a suboptimal approach for more complex cosmetic rhinoplasty procedures involving extensive or combined changes to the tip of the nose, balancing bridge and tip work or supporting the external valves of the nose and stabilizing all these structures so there is a predictable long-term result following your rhinoplasty.
For the majority of nose jobs, the external rhinoplasty approach, combined with the internal incisions will give you the best possible cosmetic and functional outcome
Figure 1. There are several incision options in performing a nose job. The majority of incisions for are inside the nostrils and inside the nose, where they not visible and these are used in the Endonasal or Internal Rhinoplasty. The External rhinoplasty uses a small incision in the middle of the external partition of the nose called the columella. This small scar is only several mm’s in length and usually heals beautifully and imperceptible and allows Dr. Mulholland to accurately visualize the nose cartilages and bones and to correct more accurately and for greater durability.
The Toronto Rhinoplasty procedures performed at SpaMedica are listed below
Cosmetic Rhinoplasty: This procedure is done under sedation and can incorporate incisions made inside and outside the nostrils. Depending on the problem and size of the nose, different surgical approaches may be taken. Cartilage, soft tissue and bones will be reshaped during this procedure to achieve an attractive and desired nasal shape. For a tailored procedure designed to meet your specific needs there are a variety of cosmetic rhinoplasty options offered by the SpaMedica team.
Injection Rhinoplasty (5 minute nose job): For a simple procedure that can be performed at the SpaMedica office and requires no down time, injection rhinoplasty is a good option for the person on the go, who requires immediate results. With little or no pain, swelling or bruising, a filler can be injected to give you a proportionate and smooth nose.
Septoplasty Surgery: Designed specifically to straighten the nasal septum, this procedure can help reduce nasal obstructions which often result in chronic sinus problems, and airflow impediments. For a significant reduction in surplus bone or tissue causing a deviation, Septoplasty surgery can provide much needed relief.
Anesthesia during the procedure
Many rhinoplasty patients have concerns that they will be aware of the surgery and want to be reassured they will have a “full anesthetic”. Because of the nature of the surgery and the need for weakening the bones of the nose, there may be some nasal fluids that flow back into the throat and these must be prevented from entering into the lung. Therefore, general anesthesia with throat protection is used during rhinoplasty procedures, unless the work is only on the soft tissue of the tip, which can be performed under local anesthesia.
An anesthesiologist, fully-trained and certified with an excellent reputation and work history, will meet you on the day of surgery and provide the level of anesthesia that is appropriate to your case and you will not be aware of anything during your rhinoplasty surgery.
There is also local anesthesia instilled and injected into the nose once the general anesthesia has fully taken effect, so there will be additional protection against feeling any pain. The local anesthesia helps to minimize bruising and swelling and also minimizes inter-operative and post-operative pain for the patient.
Figure 2. A RhinoplastyToronto patient who underwent a reduction rhinoplasty with the reduction of a strong bridge, shortening of a nose, septoplasty and de-projecting the over projected nasal tip.
There are multiple complications that can occur following a nose job procedure. Small irregularities may occur from shifting bones following surgery and this can generally be adjusted with simple molding. The external scar on the columella generally heals imperceptibly, but can occasionally be visible. There is a risk of compromised breathing after making the nose smaller and more attractive, so a complimentary septoplasty, or reduction of the partition is often performed to increase the airflow to compensate for the reduction in the actual size of the nose.
There are many other potential complications, most of which are very rare, following any cosmetic surgery, including a nose job. Dr. Mulholland and his operative team will review thoroughly the risks and benefits and recovery of your surgery at the time of your consultation.
After Care Instructions
Most patients will go home following their procedure with internal packing in the nose to minimize the risk of bruising in the first few days and a cast on the external portion of their nose. Patients return on day three to have the small sutures under their nose, which are used for the external rhinoplasty approach, removed. On this day, the nasal packing is also removed.
The first three days are impossible to breathe through the nose with the nasal packing and you will be a “mouth breather”, but, once the packing is removed, free air exchange can occur easily through the nose again
The cast is usually removed on day seven and all sutures are out by day seven. Most patients can look quite presentable on day seven, with some minor to moderate or significant bruising under the eyes.
The nasal bridge aesthetic improvements following the surgery start to look very good by week two or three and the nasal tip looks presentable by week six. Overall, the aesthetic improvements for the rhinoplasty occur gradually and over time. The final nasal tip result is not achieved till one year after the procedure, but approximately 70% to 80% of the improvement is visible at seven months.
Is there any maintenance required following my rhinoplasty procedure?
There is no maintenance required following the procedure. Simple care and attention not to traumatize the nose is all that is required.
What kind of results can I expect following my rhinoplasty procedure?
You will undergo three-dimensional computer imaging and simulation of your nose surgery prior to your actual nose job. This will give you a better sense of what kind of nose job and nose appearance can be achieved. This computer-simulated procedure will be done at the time of consultation, so that Dr. Mulholland can assess your level of expectations and ensure that the proposed surgery that he outlines on the computer screen will meet or exceed your expectations.
How can I know if I am a candidate for a nose job?
Please out the appointment request form or “ask a question” form and upload up to 3 photos for Dr. Mulholland to review.
How long does the Rhinoplasty procedure take?
The procedure, whether it’s augmenting the bridge, reducing the tip, reducing the bridge or improving function generally takes Dr. Mulholland approximately 90 minutes to perform. Patients need some post-operative care for the first few hours, until they can be picked up and go home.
The cost of Rhinoplasty or nose job reconstruction surgery depends upon the severity of the aesthetic involvement and nose reshaping. In general, the cost of a nose job in Canada for a well-trained Rhinoplasty surgeon can vary between $5,000 – $9,000. For secondary, or “corrective rhinoplasty” (nose job that has been done before) it costs $15,000, depending on the physician you’re seeing, their level of experience, speed and accuracy.
To discuss insurance policy and health coverage, book a consultation with a SpaMedica medical specialists who will be willing to talk you through payment process at our plastic surgery clinic.
To schedule a consultation for your 3D imaging and rhinoplasty assessment by Dr. Mulholland, simply call 877-695-2835 and a SpaMedica client service representative will schedule your appointment. Alternatively, you may fill out the online appointment request form and a client service representative will get back to you within one business day to organise your Toronto Rhinoplasty consultation.