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Because of its location, central on the face, the nose is the predominant facial feature and therefore vital in defining our physical identity. Most patients requesting this procedure have always been concerned about the appearance of their nose. Rhinoplasty is the most challenging cosmetic surgery procedure and demands the highest level of skill, even among experienced plastic surgeons.












Rhinoplasty prices at the Swanson Center of Kansas City include the costs of anesthesia and a licensed on-site ambulatory surgery center.




Reasons to Consider Surgery


• To correct an inherited trait. Most patients have a nose that is too large or too “pudgy.” They would like it to be more refined. Non-Caucasians may wish to have a less ethnic appearance.


• To correct an acquired deformity. The nose may be crooked, sometimes because of an old injury.


• To improve the appearance of the nose after a previous operation. Some patients have had previous surgery, but are still concerned about the appearance of their nose and request additional surgery—called a secondary rhinoplasty.


• To correct nasal obstruction. Patients may experience difficulty breathing due to a blocked airway. This blockage is often caused by a deviated septum. The septum is the structure that separates the two nasal passages. It may be skewed to one side, blocking the passage of air. There are other structures, on the sides of the nasal passages called turbinates. In allergic individuals, these structures are frequently enlarged and can block the passage of air.


It may surprise people to learn that a rhinoplasty is not like sculpting clay (if it were, the operation would be much easier). On the inside, the nose is a delicate framework of cartilages and bones that make up a structure like the frame of a house. The skin is draped across it like shingles on a roof. Changes to the outside appearance of the nose are made by adjusting the underlying framework. Experienced surgeons are cautious not to take out too much of this support system, because doing so may cause parts of the nose to collapse, producing a very visible (“saddle nose”) deformity that is difficult to correct.


A Nonoperated Appearance


The ideal rhinoplasty produces a nonoperated, natural appearance. Everyone has seen actors on TV or at the movies who have had “nose jobs” with a result that looks artificial and unattractive.


In most cases, this is due to overtreatment. Undertreatment is always preferable because the nose still looks natural, and it is easier to go back and trim additional tissue than it is to restore tissue to a nose that has been overresected.


The goal today is to produce a natural look. It is far better to have an imperfect natural look than an imperfect artificial look. Most patients understand this and readily agree. Very few people today are looking for a “button nose.” Neither do they wish to have a concave nasal dorsum that looks like a ski jump. The nose should match the face. For example, an overly narrowed nose looks out of place on a wide face. Unlike most other plastic surgical procedures, ethnicity is an important consideration in rhinoplasty. An overly reduced nose in a Hispanic or an African American patient looks odd. We all know some popular examples!




The surgery is usually done with the patient asleep using IV sedation and a Laryngeal Mask Airway (LMA), similar to other plastic surgical procedures. An anesthesiologist or certified nurse anesthetist monitors the anesthesia, allowing the surgeon to concentrate fully on the surgery. At our facility—a licensed ambulatory surgery center—the procedure is performed without a need for anesthetic gas, intubation, ventilation or paralysis. Patients are asleep, but breathe on their own. This modified general anesthesia enhances patient safety, reduces recovery time, and almost eliminates nausea, which is good news for patients because postoperative nausea is a major source of patient complaints after traditional endotracheal anesthesia. The usual operating time is 1 to 2 hours.