Rhinoplasty Nashville

A rhinoplasty, or “nose job” as is commonly referred, can reshape various aspects of your nose such as the tip, the dorsum or bridge, and the nostrils. This is done to create a beautiful and natural result that creates harmony with the rest of your facial features. This surgery can also be performed to improve one’s breathing by alleviating nasal airway obstruction, and sometimes a combination of functional and aesthetic desires are addressed. Regardless, the goal of every rhinoplasty by Dr. Unger is to create an individualized plan, approach, and result uniquely suited to the needs of each patient.

Primary rhinoplasty is accomplished by accessing the bony and cartilaginous skeleton of the nose through carefully hidden incisions, mostly inside of the nostrils. Excess bone and cartilage is removed, and often times cartilage grafts or struts are added to help remodel and strengthen the nasal framework. The skin is then redraped over the improved and restructured framework, which gives the nose its new appearance. The changes may be subtle or dramatic, completely depending on the needs of each patient.

We offer Three Dimensional Imaging using the cutting-edge technology of the Vectra 3D system to simulate the proposed before and after results of rhinoplasty surgery. This gives us a powerful tool, ensuring open communication and creating clear goals for the procedure. It is our desire that the patient have an active role in determining and seeing what the surgical result should be. There are of course limitations to what can be done based on nasal anatomy, history, previous injuries, and natural shape. All of your questions will be answered fully during your face-to-face consultation with Dr. Unger.

Some Common Reasons People Consider Rhinoplasty:

  • Big Tip (Bulbous, Boxy, Amorphous, or Protruding)
  • Drooping or Hanging Tip
  • Dorsal Hump (The bump on your nose seen in profile)
  • Crooked Nose (Angulation, C-Shape, Or even S-Shape to the Bridge or Tip)
  • Wide Nose or Narrow Nose
  • “Nose too Small” or “Nose too Big” for your face
  • Breathing Problems
  • Desire for a more refined nasal appearance, but not perfection.

Common Questions:

Am I a good Candidate? The best candidates are in good health, over the age of 16, and non-smokers. Prospective patients must have reasonable complaints with nasal appearance and/or breathing, coupled with realistic expectations of the result. Desiring improved facial harmony and nasal refinement is the goal. Those seeking perfection are likely not good surgical candidates.

How do I know if I will like the result? We have the cutting edge technology of 3D imaging to both examine a patient’s current nose, and evaluate the surgical simulation in real time. However, the human body is complex and everyone heals differently. There is no way to guarantee a surgical outcome. Only you can determine if you are comfortable taking the risks of undergoing rhinoplasty. We are focused on open communication of goals and desires and take all the time necessary to ensure that patient and surgeon are on the same page with the same plan prior to undergoing a procedure.

How Long Does the Result Last? Rhinoplasty affects the underlying support structure of your nose, and thus results in permanent changes. While there will be some mild changes that may occur with aging, the overall result can be counted on to last for the rest of your life!

Will My Breathing be Improved? As part of your complete consultation and evaluation, any breathing problems or history of nasal airway obstruction will be duly noted and examined. In the majority of cases where there is a component of nasal airway obstruction, even if your goals are mainly focused on cosmetic changes, your breathing will be much improved afterwards. This is because by reshaping and strengthening the nasal framework to create a harmonious and beautiful result, Dr. Unger will also recreate the appropriate architecture of your internal nasal airway.

How Long is the Procedure? The procedure length varies depending on the complexity of your procedure. Primary rhinoplasties typically range from 1.5-3 hours, and average 2 hours. Revision procedures or complex airway procedures can take longer, particularly when cartilage from the ear or rib is required.

What Kind of Anesthesia? Safety is always of the utmost importance. Because this procedure requires involved work on the airway, we employ general anesthesia to ensure the highest level of patient safety, and to ensure complete comfort throughout the procedure.

Where will the procedure be performed? As Maxwell Aesthetics has a State Licensed Out Patient Surgery Center within our office facility, your procedure will likely be performed in this private, safe, state-of-the-art Operating Room within our office. Certain cases, for various reasons, may be performed in an Out Patient Surgery Center of a local hospital.

How Long is the Recovery? You will have some bandages in place for 1-2 days, and a nasal splint for 1 week in most cases. Sutures are removed within 1 week. Any bruising and the majority of the swelling tend to fade away after the first 1-2 weeks, after which time you will likely be ready to return to work or school. The swelling slowly subsides thereafter and usually is minimally visible by 6 weeks, although it takes 6 months – 1 year for the swelling to fully subside to see the absolute final result.

When Can I Exercise Again? For the first 2 weeks you want to avoid heart rate elevation with any strenuous activity as it can cause bleeding or increased swelling. After 2 weeks you can gradually restart an exercise regimen. You want to avoid any activities that require sudden movements of the head or that can cause inadvertent contact with your nose. In addition, movements that require putting you face down or below the level of your heart can worsen swelling and prolong recovery.

Is Rhinoplasty Painful? Patients often find that recovery from rhinoplasty is less painful than expected. While it will be hard to breath through your nose until the bandages are removed, most people find a wonderful improvement in their breathing after that first week. Pain medicine is usually only needed for the first few days after the procedure, but our office is available at all times to ensure you have all of the care and medications you need.

What is Open versus Closed Rhinoplasty? Closed rhinoplasty indicates that all incisions are made inside of the nose. Open rhinoplasty also includes a very small incision across the columella, the bridge of skin that separates your two nostrils. The scar from the open approach is less than 5 millimeters, and is nearly imperceptible once healed. The open approach allows for better exposure to the nasal anatomy. The decision to perform one’s rhinoplasty open or closed is determined by the individual’s needs and goals. This discussion and decision will be part of the face-to-face consultation when the best, individualized plan is created for you.


Click here to view before & after photos for this procedure