The size and shape of the nose can greatly influence a person’s appearance and self-confidence. As a defining facial feature, even subtle changes to the nose can enhance overall facial harmony. Each year, about 500,000 people choose to undergo rhinoplasty, or a “nose job,” to achieve their desired look.
Rhinoplasty in Richmond, VA
Richmond's Top Rhinoplasty Surgeon
Matthew Bridges, MD, FACS, a Richmond facial plastic surgeon, was trained initially as an otolaryngologist (ear, nose, and throat surgeon). He underwent extensive training in fixing functional problems with the nose, such as difficulty breathing and sinusitis, as well as aesthetic surgery of the nose. Additionally, he completed a very exclusive fellowship in facial plastic surgery with a world-renowned facial plastic and rhinoplasty surgeon for the highest level of training in rhinoplasty. He is, therefore, fellowship-trained and double board-certified. There is truly no higher level of training than this. Dr. Bridges is Richmond's top rhinoplasty surgeon. He frequently sees patients from out of town who seek his expertise.
Rhinoplasty Videos
Surgical Technique
Richmond Open Rhinoplasty
Many surgeons prefer the open rhinoplasty approach during nose surgery because they can gain a better view and better access to the inside of the nose. The incision using this approach is made on the skin between the nostrils or under. Once the incision is made, the skin is moved back to allow access to the internal structures. The incisions consistently heal very well, leaving barely visible scars. Click here and scroll to "base view" for an example of a healed open rhinoplasty scar.
The trade-off of the improved visibility during surgery afforded by the open approach is that this technique is more invasive and requires more dissection, leading to more prolonged swelling after surgery. The internet is full of patients worrying about nose swelling many months after open rhinoplasty. It is true that it can take one year or longer for swelling to resolve after open rhinoplasty. This is somewhat unique to the open approach in that with the closed, or endonasal, approach, the swelling fades much faster. For this and many other reasons, Dr. Bridges now performs exclusively closed rhinoplasty. This is an evolution of technique over his years of surgical practice.
Richmond Closed Rhinoplasty
The closed rhinoplasty technique is performed through incisions made only on the inside of the nose, so they are completely hidden. Separate small incisions are made to access different parts of the nose, such as the tip and bridge. A more accurate way to refer to this technique is "endonasal rhinoplasty." Dr. Bridges performs endonasal or closed rhinoplasty exclusively. Click here to see an example of a closed rhinoplasty result. Dr. Bridges is skilled in advanced closed or "scarless" rhinoplasty techniques.
Closed rhinoplasty is a surgical art form that requires the highest level of understanding of nasal form, function, and aesthetics. Only with years of practice can this surgical approach be mastered. Most surgeons perform only open rhinoplasty because the closed approach can be intimidating. Most surgical training programs teach only the open approach, which has made the closed approach somewhat of a dying art. Being a master of his craft and always seeking the best results for patients, Dr. Bridges has honed his techniques over many years to be able to offer this rhinoplasty approach to Richmond nose job patients.
Dr. Bridges transitioned to performing exclusively closed rhinoplasty around 2016. The main reason for the switch is the ability to see the changes made to the shape of the nose on the operating table in real time much more accurately with the closed approach. See here for an example of what Dr. Bridges sees on the table with this technique. From a patient's perspective, the recovery process is much easier with the closed approach, with results seen much earlier than with the open approach.
During/After Surgery
Rhinoplasty is usually performed under general anesthesia and is always performed in an accredited surgical facility. It is considered an outpatient procedure. After surgery, patients will wear an external splint for about one week and may experience bruising and swelling around the nose and eyes. Bruising usually subsides over the first few weeks, but if bruising is prominent, Dr. Bridges provides Sciton BBL laser treatments to break up the bruises. Swelling decreases rapidly over the first 3-4 weeks, then slowly over many months. The nose can take up to a full year to gain its final contour and softness. This is more true of the open approach, as previously described above. Dr. Bridges does not use nasal packing. Occasionally, small plastic tubes may be placed in the nose if extensive septal work has been done.
Rhinoplasty FAQ
Are surgery fears normal?
Will my nose be broken?
What is a nasal pack?
Is surgery the only answer?
How much does rhinoplasty cost?
Are surgery fears normal?
Yes, and this fear is always elevated when surgery involves the face. However, more than 350,000 people in the U.S. undergo rhinoplasty each year, making it one of the most common cosmetic surgeries. One way to help calm your fears is to find a reputable and skilled surgeon with extensive nose surgery experience. Rhinoplasty is one of the main focuses of Dr. Bridges' practice. He is the Richmond rhinoplasty expert.
Will my nose be broken?
Some rhinoplasty patients will benefit from osteotomies or bone cuts during surgery. This allows maneuvers such as narrowing the width or correcting an asymmetrical nose. It is a common practice and heals within just a few weeks following surgery.
What is a nasal pack?
Nasal packing involves inserting gauze and/or cotton packs into the nasal cavity after surgery. These packs are used to control bleeding, but they are not usually necessary. Dr. Bridges almost never uses packing in the nose for rhinoplasty. He occasionally places soft silicone tubes if extensive septal work is required.
Is surgery the only answer?
Noses that are too large, too wide, or have a specific deformity may only be able to be enhanced through nose surgery. However, the look of some noses may be enhanced using an injectable filler. 'Injection rhinoplasty' may be an option before resorting to surgery. This in-office procedure can help soften and camouflage a bump, alter the tip of the nose, and smooth out irregularities.
How much does rhinoplasty cost?
The cost of rhinoplasty varies depending on what needs to be done in surgery. Sometimes, insurance will cover parts of the procedure, such as septoplasty, if they are performed for functional reasons. The out-of-pocket cost can range from $4000-$10,000+, depending on the complexity of the surgery, whether insurance is involved, and whether previous surgery has been performed. Facility fees and anesthesia charges add additional costs.
