Rhinoplasty and Revision Rhinoplasty in The Woodlands, Texas, with Dr. W. Marshall Guy

Rhinoplasty is an increasingly popular surgical procedure in the United States. Many patients choose rhinoplasty as a way to achieve a more symmetrical nose and a more balanced facial aesthetic, while others desire a more functional outcome.

Although many surgeons offer rhinoplasty, it takes the knowledge, training, and skill of a true expert to get the right results. Our double board-certified facial plastic surgeon, Dr. W. Marshall Guy, specializes in facial plastic surgery. He strives to provide his patients with the best rhinoplasty and revision rhinoplasty surgeries in The Woodlands and Spring, TX.

 If you would like to learn more about Dr. Guy’s expertise in rhinoplasty and revision rhinoplasty procedures in The Woodlands, TX, we invite you to contact our office today! We are located in The Woodlands and proudly serve the greater Houston area. 

Why Choose Dr. Guy as your Rhinoplasty Surgeon in The Woodlands, TX?

When choosing a rhinoplasty plastic surgeon, it is crucial that he not only is skilled in enhancing the aesthetic appearance of the nose but also appreciates the nose for its primary function: breathing. Before his Facial Plastic Surgery Fellowship, in which he had extensive training in all aspects of the nose from the cosmetic to reconstruction, allergies, sinus and breathing problems, and acute trauma, Dr. Guy also trained in Otolaryngology-Head and Neck Surgery, making him a true nose expert. 

As a board-certified facial plastic surgeon, Dr. Guy knows that obtaining the best result requires improving the nose’s appearance and maintaining its function. Because of this, your existing nasal structure may limit how narrow or refined Dr. Guy can make your nose and still be able to have a successful surgery. If he removes too much support from the nose, it may seem right early on, but it can develop a pinched appearance and obstructions over time. Having a surgeon who appreciates the nose, understands the healing process, and comprehends how the nose evolves with time will minimize many of these risks.

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What are the Benefits of Rhinoplasty Surgery with Dr. Guy?

When you choose Dr. Guy as your rhinoplasty or revision rhinoplasty surgeon, you can expect several distinct benefits:

Rhinoplasty surgery with Dr. Guy can also:


  • Correct the size or shape of the nose
  • Improve symmetry of the face, adding overall facial balance
  • Address breathing issues
  • Reshape nostrils, nasal tip, bridge, or other components of the nose as needed
  • Boost self-confidence, mental health, and self-image
dr. guy facial plastic surgery before and after rhinoplasty

Who is a Good Candidate for Rhinoplasty Surgery in The Woodlands, TX?

While Dr. Guy will ultimately have to decide whether the surgery is safe and will benefit you, there are some general guidelines that you’ll need to meet.

Typically, patients should:

•Be in good health

•Have realistic expectations for the procedure

•Be aware of the potential risks

•Be willing to work with Dr. Guy on developing a surgical plan that is right for them

•Be past puberty to ensure the nose has reached its adult size

•Not smoke or drink excessively

It's Your Time to Look Your Best!

Dr. Guy is a specialist in all areas of rejuvenation and reconstruction for the face and neck. As a double board-certified and fellowship-trained facial plastic surgeon, Dr. Guy knows that everyone ages differently and that there is no one size fits all when it comes to restoring a youthful appearance. From surgical options like a facelift to non-surgical options like Botox® and dermal fillers, there’s never a better time to look your best. 

Revision Rhinoplasty

Revision rhinoplasty is precisely what the name implies, a revision.

One may undergo a revision rhinoplasty for many reasons:

  • The first surgery did not live up to your expectations.
  • The scar tissue formed in such a way that led to an undesirable result
  • Trauma occurred in the postoperative period, which affected the final result.
  • The original goals of surgery were not realistic based on your anatomy.
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Rhinoplasty 3D imaging software helps you see anticipated results

The most common reason for having a revision is based on the facial structure and thickness of the skin. Whatever your reasons are for seeking a revision, you should keep several concepts in mind:

  • You’ll need to wait at least a full year before you can undergo a revision. The nose holds on to swelling more than any other structure. Therefore, if you consider operating before the edema/swelling resolves, you may be left with a suboptimal result.  In addition, the nose needs to reestablish its blood flow, as an early surgery can lead to skin loss and a poor cosmetic result. 
  • Second, the predictability of healing declines with each operation. Therefore, the goals of the operation need to be more clearly defined in a revision rhinoplasty. Because of the unpredictability of healing, there are usually fewer improvements that we can reliably create.

CASE STUDY: This patient in her 20s is a singer and wanted to avoid any treatment that would affect her voice. She was bothered by her inability to breathe as well as the tip of her nose. She was found to have a deviated septum to the left, enlargement of her turbinates, and a poorly defined nasal tip. She underwent a very slight hump removal, placement of a right-sided spreader graft to straighten her septum and prevent the collapse of the right side of her nose, placement of a columellar strut graft to further support her nose, septoplasty, and partial resection of the head of the inferior turbinates. In this3D reconstruction of her before and after photos, you can really appreciate how her septum (the structure separating the two sides of the nose) is no longer protruding in her left nostril. The tip of the nose is also more symmetric as are her nostrils. Her breathing has never been better since surgery and she notes that her singing power has also improved from the increased airflow. She is very pleased.

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Your Rhinoplasty Recovery with Dr. Guy Facial Plastic Surgery

One of the biggest concerns that patients have regarding rhinoplasty involves the use of “packing.” By understanding the nose’s anatomy, Dr. Guy avoids the use of nasal packing to allow for a more pleasant post-operative recuperation. Most patients are able to return to work or school within a week of surgery. Those not performing any rigorous activity may return even sooner. Dr. Guy will explain all of this with you at the time of consultation.

We will go the extra mile to make sure you are comfortable after your surgery. Dr. Guy will be fully available if you have any issues and will call you once daily after your procedure.  Our team will also provide you with a book that fully outlines the procedure, and also includes a comprehensive list of instructions for the best postoperative care.

If you would like to learn more about rhinoplasty and revision rhinoplasty with Dr. Guy Facial Plastic Surgery, feel free to reach out to our friendly staff today! Be sure to check out our gallery and our reviews to see our many satisfied patients!

Rhinoplasty FAQs — Answered by Dr. Guy

For most nose surgeries, the best option is going to be general anesthesia, so you don’t feel anything.

There will be some mild discomfort and some drops of blood from the nose for a day or so. Overall most plastic surgery patients will be off of prescribed pain pills within about 24-48 hours. 

You should have an idea of what bothers you about your nose. We will use 3D software to help demonstrate what surgery can accomplish. 

Read the provided material regarding what to expect before, during, and after. Then, simply be ready to relax and enjoy the experience.

Relax and take it easy. It is essential not to be too active in the first few days to minimize swelling and bruising. 

With any procedure there are 6 generic risks. These include

  • Pain, although usually minimal
  • Bleeding, which will happen for a day or so
  • Infection, which is low with noses
  • Scarring, although even with the open approach, the incision is nearly imperceptible
  • Need for repeat operations
  • Asymmetry

Specific to rhinoplasty include the following:

  • Sensation of nasal firmness, since with preservation rhinoplasty, we use sutures and grafts to help stabilize the nose
  • Nasal obstruction, which is very rare
  • Nasal collapse, which is even rarer and is only a risk if a septoplasty is also performed
  • Decreased sense of smell, which would only occur if less airflow takes place.

Smoking always negatively affects healing. It is important to minimize all sources of nicotine leading up to surgery and the week after to provide for the best healing. 

It takes about one week to recover from a rhinoplasty. 

Most people can return to work within a few days, as long as it isn’t manual labor. There will be a splint on the nose, so if you don’t want anyone to know, then take the week off. 

I recommend waiting 2 weeks to minimize swelling and the risk of bleeding.

Every nose is unique. We use a customized plan with input from the patient and the use of 3D imaging software to help come up with the ideal nose for your face. As a result, your nose will be unique as opposed to a cookie-cutter nose. 

For most people, there is minimal discomfort. The swelling from surgery that causes some nasal obstruction is usually more bothersome than actual pain. 

If the nose has deviations or collapse, a rhinoplasty can help to support and open the nose to improve breathing. This often is covered by insurance. 

This is best assessed with an in-person examination. If there is a deviation sufficient to cause decreased airflow, then a septoplasty would usually be recommended. 

This refers to the approach.  An open approach offers the most visibility and involves a small incision between the two nostrils. The closed approach makes all incisions within the nose; this helps to minimize swelling afterward, but visualization can be limited.

There is no set age, but teenage patients should not have been growing in height for the previous year.  The reason is there are growth plates in the nose, and if operated on while growing, it can affect the development of the nose. 

I don’t use any nasal packing. In my opinion, that is an archaic approach to rhinoplasty that is terribly uncomfortable. To avoid packing, there are stitches placed in the nose and sometimes some small splints that still allow for airflow. 

Revision rhinoplasty is more difficult for a few reasons. The first is that scar healing is less predictable. Most look perfect at the end of the surgery, but the previous scar tissue can affect how the nose ends up, although this is usually subtle. Second, because many other surgeons use more ablative approaches to nose surgery, many of the normal structures may be absent and need to be built up again. 

Besides improving breathing, rhinoplasty can provide a huge boost to self-esteem by making the nose more harmonious with the face.

3D computer imaging is a guide to help direct the surgery. Although results cannot be guaranteed, the use of software does provide a realistic final result for most patients. 

In certain instances where there is a functional problem affecting breathing, rhinoplasty may be covered by insurance. This is not common. 

We operate at an outpatient surgical center for your comfort and convenience. 

Yes, Dr. Guy can also enhance your nose using dermal fillers. This approach is much more limited in what it can achieve, and it is also not permanent. Ask Dr. Guy if you are interested in learning about a non-surgical nose job.