Firstly, there is no average cost for a nose job (rhinoplasty) as there are no average noses and different effects are desired. I always advise patients that I need to see them first, assess their needs and then plan the appropriate combination of procedures for them.
Most importantly, your nose must harmonise with the rest of your facial features especially the chin. A small petite nose will look insignificant and lost in a broad, strong face. A higher and sharper nose will not work for a small, backward sloping chin. You could end up looking like a bird! Balance and proportion is the key so I often combine a rhinoplasty with a chin augmentation.
You won’t get a perfect nose from just inserting a silicone implant (the “thing” you mentioned). In most cases, it can give a smooth and higher bridge. Other times, it can add sufficient shape and projection to the tip. However, it can also enlarge the tip as a result of pushing the nose’s natural cartilages outwards. So, these cartilages would have to be removed at the same time which is an additional procedure. If the implant is not customised to the face it can look very artificial.
An implant also does not influence the width of the nose, the nostril size or the thickness of the lower nose’s rounded fleshy sides. To slim noses, a wedge of tissue is removed from the base of the nose and the nostril floor as well as some fatty tissue from the nose tip. This is done either through closed incisions within the nostrils or via a tiny incision made at the bottom of the nose.
One of the problems is that over time, a “capsule” or fibrous sheath develops around the implant making the tip bulky or crooked. To slim and define tips I reshape their own natural cartilages and reinforce with additional cartilage from the inner nose or the ear. This complex procedure takes longer but results are aesthetically pleasing with no capsule. Moreover, the tip will gradually become softer and more natural. Over thinning the skin damages the delicate circulation and results in swelling and prolonged recovery.
Recovery from solid silicone nasal implants takes about one week for the swelling and bruising to subside. For additional procedures such as tip thinning or nostril width reduction, the swelling can last up to two weeks and external scarring visible for several months. If in some cases, the bones at the side of the nose need to be broken in order to slim down the overall shape of the nose, you may have “black eyes” for up to three weeks. I prefer to do a composite rhinoplasty where I use the patient’s own cartilage for the tip but a modified implant for the bridge and remove tissues from the side of the nose at the same time.
*Price depends on approach, quality of implants and degree of customisation. Healing takes five to seven days. Looks natural in three weeks.
*Includes tip thinning, cartilage modification, additional grafts, narrowing bones, bridge implant, skin and alar thinning and nostril narrowing. Looks natural in six to 12 weeks.