Rhinoplasty

Rhinoplasty in San Antonio with Dr. barrera

Want to get a nose job in San Antonio? Rhinoplasty or nose job surgery can help improve the cosmetic shape of the nose as well as improve breathing. Do you experience difficulty breathing, or would you just like a straighter, more refined nose? Rhinoplasty is a surgery where the cartilage and bone of the nose are reshaped and reconstructed. It may involve correcting a functional obstruction to improve breathing (septoplasty) and reshaping the tip, middle vault, and bony pyramid of the nose to correct a deviation or refine the nose.

Is rhinoplasty surgery right for you?

Dr. Jose Barrera, MD has been rated by his peers and patients as a Top Facial Plastic Surgeon in Rhinoplasty Surgery by Realself.com. He has performed over 700 rhinoplasty operations and is a specialist in revision rhinoplasty. He is an expert in rhinoplasty surgery.

In nasal surgery consultation, Dr. Jose Barrera, MD will discuss improvement in nasal obstruction, congestion, fixing a crooked nose, and refining the nasal tip, bridge, and profile.

Every year half a million people seek consultation to enhance the appearance of their nose. Some are unhappy with the nose they were born with or the way it has aged. Others have suffered a traumatic injury which causes disfigurement or an inability to breathe appropriately. Before considering nose surgery, it is important to understand the anatomy and function of the nose. Dr. Barrera will evaluate your nasal function and address your top cosmetic concerns during your rhinoplasty consultation. A proper facial analysis balancing medical expertise and your specific concerns will be performed.

What is rhinoplasty?

Rhinoplasty means cosmetic surgery to change the shape of the nose. The operation involves accessing the bone and cartilage framework supporting the nose through incision inside the nose and the area of the skin separating the nostrils.             

The prominent or deviated cartilage or bone is reduced, augmented, or replaced allowing the surgeon to sculpt the cartilage and reduce bumps on the nose. The tissues are redraped and a temporary splint is placed for one week. A splint may be placed inside the nose to maintain stability that permits nasal breathing postoperatively. We perform rhinoplasty in San Antonio, Texas at top rated hospitals.

Before & After Photos

Can you give me someone else’s nose?

Rhinoplasty is a personal decision. The uniqueness of the nose is as unique as the individual. The goal of the operation is not to replicate someone else’s nose, rather it is to provide balance with the rest of the face and improve function. Skin type, ethnicity, and age are all important factors when discussing nasal surgery. Following a consultation with Dr. Jose Barrera, MD, a joint decision will be made based on your desires, any functional concerns, patient photographs, and realistic expectations. 

Click here for more FAQS.

How much does a nose job cost?

The cost of a nose job varies depending on surgeon, revision rhinoplasty cost, rhinoplasty anesthesia, and facility prices. Rhinoplasty cost in San Antonio is approximately $7450 as reported on Realself.com. Revision rhinoplasty cost San Antonio price averages $9500. If a septoplasty or rib cartilage is required the revision nose job will cost more.

Will insurance pay for my rhinoplasty?

Rhinoplasty may be covered by insurance when a septal deviation, narrowing, or swelling inside the nose from the turbinates causes significant obstruction. In addition, recurrent and chronic sinus infections may affect the function of the nose. A thorough evaluation is necessary to understand this condition. A septoplasty, balloon sinuplasty, sinus surgery, or turbinate reduction may be performed at the time of cosmetic rhinoplasty. Nose surgery for purely cosmetic purposes is not covered by medical insurance.

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What to expect after the surgery?

You will be  monitored in the post anesthesia recovery area until you are well enough to be discharged home. The majority of patients do not feel excessive pain after the surgery. You will be given analgesic pain medications and antibiotics. It is important to irrigate your nose with saline after the operation for the best results. Some patients develop swelling and bruising around the eyes after the operation. Any external sutures and splints are removed after 5 – 8 days. Activities such as heavy lifting, running, blowing your nose, excessive exertion,  or sun exposure are prohibited after surgery. Follow-up care is crucial as postoperative swelling and bleeding can occur after the surgery. It is important to keep your followup appointment with your surgeon.

In consultation Dr. Barrera will discuss improvement in nasal obstruction, congestion, fixing a crooked nose, and refining the nasal tip, bridge, and profile.

FAQS: WHAT TO ASK DURING YOUR Rhinoplasty CONSULTATION

Your rhinoplasty consultation with Dr. Barrera, a board-certified and double fellowship-trained facial plastic surgeon, is a great time to learn more about the procedure, Dr. Barrera, and realistic outcomes. Before your consultation, we suggest you compile a list of questions to ask. If you are unsure of what to ask, Dr. Jose Barrera can help. Here, Dr. Jose Barrera, MD, San Antonio facial plastic surgeon shares important questions to ask during your consultation.

Patient goals and desires are at the forefront of any rhinoplasty surgery. Undergoing a rhinoplasty surgery is life changing for many patients. Dr. Barrera feels that every face is a masterpiece. Our journey is to architect the structural components of the nose and seek to create a personal masterpiece that is unique to the patient.

Rhinoplasty causes minimal pain. Dr. Barrera is pioneering a combination of medications that avoid narcotic use and accelerate healing. Swelling is common with rhinoplasty. Therefore, nasal splints are often used during the healing process to minimize swelling.

Rhinoplasty can address the nasal valve or collapsibility of the nose. By improving the nasal airway just 2 millimeters, we can achieve a 62% increase in airflow. When performed in combination with a septoplasty and turbinate reduction, further improvements in the internal nasal airway and congestion can be achieved.

A septoplasty is required when in the course of a rhinoplasty structural support of the dorsum, or nasal tip of the nose, require additional cartilage. In addition, a deviated septum may be causing nasal obstruction. Improvement in nasal breathing can be achieved with a septoplasty in combination with a rhinoplasty. We call this operation a septorhinoplasty.

An open or closed rhinoplasty are terms to describe the approach the nasal surgery. An open approach utilizes an inverted V incision and skin or vestibular incision to “open” the nose and expose the underlying cartilage or bone. A closed rhinoplasty uses skin and cartilage incision to deliver the underlying tip cartilages and approach the dorsum of the nose.

Rhinoplasty can be performed as young as 14 years old in patients with a traumatic nose deformity or as old as 80 years of age. There is no “right” age to undergo rhinoplasty. Patients who are bullied as a teenager may be a candidate to improve their self-esteem. Others have a traumatic deformity causing nasal obstruction or external deformity. Others see their nose as a cosmetic focal point for which they desire refinement.

Dr. Barrera does not pack the nose during recovery of rhinoplasty surgery. We utilize small silastic splints called Doyle splints or Rutter Splints, which can secure the internal lining and minimize swelling.

In revision rhinoplasty, there has been a removal of the underlying cartilages or bone that result in a collapse of the internal or external structures of the nose. This can promote abnormal scarring or misshapen nasal tip cartilages. Revision rhinoplasty is completely restorative and combines both reconstructive as well as cosmetic techniques. A primary rhinoplasty focuses on refining the nasal tip and dorsum of the nose to achieve harmony and balance during the first operation. A revision rhinoplasty often takes longer to perform. The cost of revision rhinoplasty is increased due to the length of the procedure, the need for cartilage, and additional anesthesia to achieve the desired result.

Benefits of rhinoplasty surgery include improved aesthetics and refinement of the nasal tip, dorsum, bridge, and nose to lip shape. Other benefits include improvement in the architecture or foundation of the internal nose. These benefits include improved breathing, decrease in snoring, decreased fatigue, and improved support and symmetry. Some patients may even be able to smell better after rhinoplasty surgery by improving nasal congestion and airflow.

Computer imaging can benefit the rhinoplasty patient by showing what can be achieved with the profile of the nose. Computer imaging has limitations pertaining to the frontal view of the nose, as the computer has difficulty focusing on the multiple contours of the nose. Computer imaging is not a guarantee of the final result in rhinoplasty surgery.

Rhinoplasty is considered a cosmetic procedure by most insurance carriers. However, there are unique cases when rhinoplasty surgery can be covered. Regarding cleft lip and nose deformity, revision rhinoplasty may be considered a covered benefit when it causes significant nasal obstruction due to the birth defect. In addition, patients with severe traumatic deformity may require a closed nasal reduction of the nasal fracture during the first two weeks after injury. After two weeks, a closed nasal reduction is not achievable due to the fusion of the fractured nasal bones.

The rhinoplasty procedure may be performed at Texas Center for Facial Plastic and Laser Surgery. The Texas Center has received full accreditation from the American Association for Accreditation of Ambulatory Surgery Facilities, Inc. (AAAASF). Dr. Jose Barrera is the only facial plastic surgeon in San Antonio to achieve the highest level of accreditation. This accreditation demonstrates to patients and prospective patients that Dr. Barrera and his staff are committed to ensuring their complete safety and satisfaction at all times. If an insurance procedure is performed at the same time that requires overnight observation, Dr. Barrera may elect to take the patient to Christus Alamo Heights Hospital or Methodist Hospital.

At Texas Center for Facial Plastic and Laser Surgery, we have a private anesthesiologist that provides general anesthesia for our patients undergoing rhinoplasty surgery. General anesthesia may also include “Twilight” anesthesia utilizing propofol.

Immediately following rhinoplasty surgery, you will be attended by our private nurse and anesthesiologist to ensure that there is minimal pain and nausea. You will have an external splint and a small guaze dressing under your nose that can be removed in a couple of hours. The six weeks after rhinoplasty surgery are critical for your successful healing.

  • Nasal Drip Pad:

    Your drip pad will be necessary for the first 48 hours and possibly a few days after that. If you experience heavy bleeding out of your nose after your surgery, please call our hospital immediately. Take a 4×4 sponge and fold it corner to corner and tape it to your face with non- latex tape available from a pharmacy.

There are several steps to prepare for your rhinoplasty consultation:

  • If medical clearance is required, please obtain clearance from our medical provider.
  • An EKG or stress test maybe necessary if over the age of 50 years.
  • Bring your medication list to the appointment for review.

  • Consider your goals for the surgery and Dr. Barrera will review these with you.
  • If a functional component is necessary to correct a deviated septum or address sinus or nasal airway concerns, please bring your insurance card and schedule a separate insurance visit.

Dr. Barrera performs both cosmetic and reconstructive surgery. Therefore, two different visits may need to be scheduled to fully address all your concerns as well as authorize your insurance company for medically necessary procedures. Schedule your consult here.

Preparing for rhinoplasty surgery day can be stressful. Patients who experience anxiety may have a sense of worry anesthesia or pain. Dr. Barrera has performed over 1,000 rhinoplasty procedures. We want you to feel comfortable and confident prior to your procedure, so please reach out to us if you need additional help or further instructions. In general, do not eat after midnight the day of your procedure. Bring your medications with you. Ensure that you have transportation to and from the facility from a trusted friend or family member.

Start using nasal saline immediately after surgery every 4 hours while awake for the first two weeks. Be sure to irrigate a minimum of four times daily until Dr. Barrera tells you that you can go down to twice daily. You should irrigate your nose for at least three months after surgery since ciliary motility is impaired three months post-op. Irrigation replaces the normal function of your nasal cell function.

There are several risks of the rhinoplasty procedure that Dr. Barrera will discuss with you. In general, persistent swelling, nasal scarring, decrease smell, decreased sensation of the nose for several months, and early return of nasal hump or bump can occur during the recovery process. Assymetry can also occur although steps are taken to minimize asymmetry or deviations. If a septoplasty is performed at the same time, a septal perforation is an uncommon risk.

For temperature, more than 101 degrees or bleeding, call our office at 210-468-5426 during daytime or evening hours or the Emergency Room if experiencing an emergency. Call our clinic to schedule your follow appointment in approximately 1 week for removal of sutures and nasal splints.

We advise against smoking after a rhinoplasty. Smoking can increase the risk of bleeding and persistent swelling after surgery. Please refrain from smoke during the first 6 weeks after surgery.

Rhinoplasty cost in San Antonio varies depending on the surgeon, the facility, and the anesthesia cost. On average, a primary rhinoplasty costs $7450 in San Antonio as determined by Realself.com and a revision rhinoplasty cost in San Antonio is approximately $9500. Cost also increases if a septoplasty has to be performed at the same time or if additional cartilage is necessary for the rhinoplasty such as costal or rib cartilage and ear cartilage.

 Recovery time after rhinoplasty can be broken up in stages:

  • The first week the patient will wear a nasal cast and/or nasal splint.

  • The cast and splints will be removed after one week.
  • The nose will be swollen for up to one year after surgery with 90% of the swelling resolving after 12 months.

Patients generally return to work after 10 days. However, early return to light duty is possible. Speak to Dr. Barrera about your return to work after rhinoplasty surgery plans.

You can return to a light workout three weeks after a rhinoplasty procedure. Please keep your activities to a minimum for the first 48 hours after your surgery since you are at an increased risk for a severe nosebleed. Slowly increase your activities back to normal over the next few weeks.

Dr. Barrera Presents For the AAFPRS Webinar series On Nasal Tip Support in Rhinoplasty

Best of 2020 San Antonio ENT Doctors

Delighted and humbled to have been chosen #bestof2020 in San Antonio. Thousands of Bexar County physicians and hundreds of dentists were asked which of their peers they would refer for inclusion in S.A. Doctors and Dentists: Best of 2020.