Provider: Ronald J. Caniglia, M.D., F.A.C.S.
 Rhinoplasty, or nasal surgery, is a plastic surgery procedure designed to reshape the nose by altering its size, shape, angles and/or proportions. Rhinoplasty can safely be performed on men and women beginning in their early to late teens and throughout life. The best candidates are those with good motivations and realistic expectations.
Dr. Caniglia performs rhinoplasty surgery at the Plastic Surgery Center at Kierland (PSCK). Located in the Caniglia Center in Scottsdale, Arizona, the PSCK is an AAAHC-accredited, state- and Medicare-licensed outpatient surgery center. Most rhinoplasty surgeries are performed on an outpatient basis, with the typical surgery taking between one and two hours to complete. Surgical times will be longer for extensive reconstructive rhinoplasties if multiple grafts are needed.
Dr. Caniglia performs all of his rhinoplasty procedures under local anesthesia with intravenous sedation (deep twilight sleep). With this form of anesthesia, the patient feels no discomfort and remembers nothing from surgery. Furthermore, patients feel more alert and refreshed after surgery. All patients are monitored by a board certified anesthesiologist who is present at all times before, during and after surgery.
There are two approaches to rhinoplasty surgery: the closed approach and the open approach. Both approaches utilize incisions hidden inside of the nose. The only difference between the two is that with the open approach, there is an additional small inverted "V" incision hidden at the base of the nose. This external incision is of negligible importance as the scar is nearly imperceptible.
Working through incisions hidden for the most part on the inside the nose, the skin overlying the nasal tip and dorsum (hump) is elevated. The tip cartilages are the first to be evaluated. The tip cartilages are reshaped, thereby reducing or enlarging the size of the tip. The tip can also be turned up or down depending on whether the nose needs to be shortened or lengthened. The shape of the nostrils are also addressed, either narrowing or reducing the flare as needed. Next, the bridge of the nose is often lowered. In some cases, however, it will need to be raised up. The width of the bridge is also evaluated and narrowed if necessary through controlled incisions in the nasal bones, performed on the inside of the nose. Once the tip and bridge of the nose are in good aesthetic harmony, the incisions are closed with tiny sutures and a thin splint is applied externally to the nose. In most cases, internal packing can be avoided, making recovery virtually painless.
There is often very little discomfort following rhinoplasty surgery, especially when internal packing is avoided. With a skilled rhinoplasty surgeon and proper surgical technique, bruising is kept to a minimum. Many of the stitches dissolve on their own, however some may require removal after 7 days. The external splint is also removed on postoperative day 7. Many patients return to work once the splint is removed. However, Dr. Caniglia prefers that his patients wait two weeks before resuming heavy strenuous activity or exercise.
Though very rare, potential complications associated with rhinoplasty may include bleeding, infection, asymmetry and breathing difficulties. If a secondary procedure is necessary to refine the results, it is best to wait a minimum of one year from the surgery date. Selecting a qualified and experienced facial plastic surgeon can help to ensure the best possible rhinoplasty result while minimizing your risks. |
