Rhinoplasty

Rhinoplasty NJ or nose job NJ: Dr. Kassir is a rhinoplasty surgeon in NJ and a leading rhinoplasty expert. Find rhinoplasty answers and see results from one of the best reviewed rhinoplasty surgeons in NJ.

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About Rhinoplasty

by Ramtin Kassir, M.D., F.A.C.S. | Learn More About Dr. Kassir

What is Rhinoplasty?

Rhinoplasty, or cosmetic nasal surgery, improves the shape and size of the nose. The procedure can remove a hump, change the shape of the nasal tip, and straighten the nose. The size and shape of the nostrils can be changed. The goal of rhinoplasty is often to achieve better harmony between the nose and the other facial features. Dr. Kassir is a triple board certified surgeon who has performed thousands of rhinoplasty surgeries for his patients and is considered to be one of the best Rhinoplasty surgeons in New Jersey.

Rhinoplasty has become one of the most popular facial plastic surgical procedures in recent years as more and more people seek to change the appearance of their noses. Many are unhappy with the nose they were born with while others have had the shape of the nose distorted from an injury. Disorders of nasal breathing and sinusitis often complicate the situation. A range of techniques are used to fully address the desired change in appearance as well as to improve nasal breathing and correct chronic sinus infections. Sinus surgery, if indicated, is done with endoscopes to avoid any visible incisions.

Rhinoplasty may be performed under general or sedation anesthesia on an outpatient basis. Most health insurance plans still provide some coverage for functional nasal surgery and sinus surgery.

Good Candidates For Rhinoplasty

Are you thinking about having a rhinoplasty surgery? Healthy teenagers and adults who wish to have an improvement in their nasal appearance are good candidates for the rhinoplasty procedure. The decision about having the rhinoplasty operation is a very important and personal one. You should first consult with Dr. Kassir at his surgical clinic in the Wayne, NJ, or Ridgewood NJ office before deciding on the operation. For most patients that undergo this nose job procedure, the results are life changing. Patients describe an increase in confidence and boost in self-esteem. The ideal NJ candidates for rhinoplasty are:

  • You are unhappy with the size and/or shape of your nose.
  • You have breathing problems limited to your nose.
  • You suffered an injury that has altered the look of your nose.
  • You have breathing problems.
  • You are over the age of thirteen.
  • You have good physical and emotional health.

How Much Does a Rhinoplasty Cost in NJ?

Rhinoplasty costs vary by surgeon experience and geography. It can range from $10,000 to $17,000, depending on what is being done. Revision rhinoplasties are on the higher end. Some insurances cover the functional parts of the surgeries (straightening a crooked septum, opening up sinus pathways, etc).

Does Insurance Cover Rhinoplasty?

Insurance may cover some of the functional aspects of rhinoplasty. In other words, those procedures that improve breathing:

  • opening sinus drainage pathways (endoscopic sinus surgery),
  • shrinking large turbinates (turbinate reduction),
  • straightening a crooked septum (septoplasty),
  • valve surgery (placing cartilage grafts to stabilize the breathing passage).

Different Kinds of Rhinoplasty Procedures:

Dr. Kassir performs many different kinds of rhinoplasty procedures in NJ, including:

Revision Rhinoplasty: Revision Rhinoplasty is performed when the initial rhinoplasty procedure is unsatisfactory.

Teen Rhinoplasty: Dr. Kassir is an expert in Teen Rhinoplasty in New Jersey.

Ethnic Rhinoplasty: Dr. Kassir commonly performs African American rhinoplastyAsian rhinoplastyHispanic rhinoplasty, and Middle Eastern rhinoplasty.

Celebrity Rhinoplasty: Dr. Kassir is a leading expert in celebrity rhinoplasty.

What to Bring to Your Rhinoplasty Consult:

  • Your desired surgery date
  • A list of the vitamins, medications, and ointments you use
  • Any medical history, your insurance card (to check for partial coverage), and any reported breathing issues
  • Your own edited photo (any angle you want changed)
  • A portfolio of reference photos and goals that Dr. Kassir can use to craft your digitally edited image
  • Knowledge of Your Financing Options (Private, Care Credit, Alphaeon, Credit Care, or a Combination)
  • Excitement! A new nose can change your life. You make look younger, cuter, happier, and even less tired with the nose that was meant for you. This is exciting and we want you to be just as excited as we are. 

Rhinoplasty: Questions & Answers

I still have problems smelling one month post-rhinoplasty. Is this permanent?

Generally, problems with smelling post-op are the result of swelling in the nose and should resolve gradually within a year post-op.

When is it safe to blow my nose post-op?

Generally, as long as the nose blowing is not too strenuous, patients can generally blow their nose one week post-rhinoplasty. Until then, it is recommended that patients use saline to break up any chunks which may accumulate in the nose and then use a Q-tip to extract them.

Is light sniffling and nose breathing 1 day post-op fine?

As long as you don’t force either, both of these minor exercises of the nose should not do any permanent damage to the results.

When will cartilage reabsorb after a rhinoplasty?

Cartilage reabsorption in a graft is not ideal as this cartilage was placed in an effort to support the area in which it was placed. Some reabsorption does take place following a year post-op, but not significantly enough where it would cause issues.

How long is a rhinoplasty procedure?

A typical rhinoplasty will take around 2 hours to perform.

Can a deviated septum, if it isn’t broken, be bent back into place?

Unfortunately, no. Cartilage, while being highly elastic and bendable, is not necessarily easily movable (at least in a permanent fashion). Deviated septums can only be corrected with a septoplasty.

Does a crooked nose necessarily mean a deviated septum?

Not necessarily. While a deviated septum could create a crooked nose, problems in the alignment of the underlying cartilage (upper lateral, specifically) or bone may also play a part in creating a misshapen bridge. It is recommended that patients be professionally evaluated in a surgeon’s office.

What are the financing options for an ethnic rhinoplasty?

This is generally up to the discretion of your surgeon of choice. Patients must be advised that rhinoplasties (a cosmetic procedure) are often not covered by insurance, so it is important to discuss financing plans with your surgeon prior to having the procedure done.

How can I fix a hereditary crooked nose?

Any crooked nose (that is, where there is septum deviation), regardless of whether it was caused by injury or by genetics, can be fixed with a traditional rhinoplasty procedure. However, patients should consult with a surgeon and see whether fillers or other non-surgical options could also work for them.

Can a bulbous nose be made smaller?

Absolutely, and this is usually done with an open rhinoplasty. The base of the nose is narrowed and support is brought in via septal or ear cartilage to make the tip sturdier.

When can I return to yoga post-rhinoplasty?

At around 4 weeks out or so, patients can resume light to moderate activity like yoga as long as it is not strenuous and they pay attention to any swelling which may occur (and stop activity immediately once this is noticed).

Does a pixie nose require a rhinoplasty?

It is difficult to say without seeing a patient whether they are in need of a rhinoplasty procedure or not. However, a small, up-turned nose is one which requires a great deal of precision and is best handled by an experienced surgeon. Be careful when choosing your surgeon to find one that is board-certified and has had experience with these types of procedures before.

Is there a way to thin wide nostrils without surgery?

Generally, no. Depending on the width of the nostrils in relation to the rest of the nose, patients may either require a Weir/alar base reduction (if it is just the nostrils that are the issue) or may require a full-on rhinoplasty in which osteotomies are performed in addition to the reduction of the nostrils in order to thin the bridge of the nose as well.

Why does my nose whistle when I breathe post-rhinoplasty?

Whistling in the nose post-rhinoplasty is generally caused by a small opening, usually a minor septal perforation (hole in the septum of the nose). This may have been caused by the harvesting of septal cartilage and should be evaluated by your doctor.

Can pushing the nose in certain directions over time change nose shape?

Highly unlikely. Cartilage is very elastic and bounces back to its original shape, even after repeated pressure.

My nose is runny after rhinoplasty. What should I do?

This is a condition called vasomotor rhinitis which can be resolved with sprays like ipatroprium bromide or atropine. Consultation might be necessary, however, to make sure it is not part of a more serious issue.

Does weight gain impact rhinoplasty results?

No, not at all. Nasal tissue has very little fat, so weight gain or loss will not impact the results of a rhinoplasty.

I delayed my splint removal by a couple of days. Is that bad?

Absolutely not. Surgeons will typically wait for about a week before removing the splint for safety reasons, but delaying it will not impact results at all.

Can I do nasal exercises to maintain the results of a rhinoplasty?

Nose exercises will do nothing to help the form and function of a nose post-rhinoplasty. In fact, it is probably best for patients to move the nose as little as possible.

Should cartilage in my nose “pop”?

If this question is for someone who has not had rhinoplasty surgery, this is typical, as cartilage sections in the nose can slide past one another.

I have breathing problems and a cracking noise in my nose. What’s wrong?

This problem is probably best addressed by an examination in a qualified surgeon’s office. However, pure speculation indicates that this may be an issue of the nasal conchae or caused by septal deviation, both of which require surgical solutions.

Can I fly with a broken nose?

Yes this is fine. I would recommend carrying Afrin spray and applying it 30 minutes prior to takeoff and landing to mitigate the risk of nosebleeds.

I have purple spots on my nose post-rhinoplasty. What should I do?

Patients with this condition should contact their surgeon immediately. While it may just be localized bruising, this may also be a sign of unhealthy pressure from a cartilage graft in the skin or decreased blood flow to the area that could result in necrosis of the tissue.

I have redness on my nose post-rhinoplasty. Is it infected?

Redness on the nose surface post-rhinoplasty, especially in the first weeks post-op, are generally the result of irritation of the skin by the nasal tape. However, consultation with the surgery may be necessary if patients feel that irritation of the skin is not the issue.

Is there a problem if my splint is crooked?

The purpose of the splint post-rhinoplasty is to protect the nose and also ensure a decrease in post-procedure swelling. However, even if the splint is crooked, the surgical tape underneath it is probably applied correctly. Consult with your surgeon about this, though.

What should I do about a short nose post-rhinoplasty?

This may simply be a symptom of the swelling which could cause your nose to look bunched up and shorter. However, if this appearance issue does not resolve itself after about a year, it may be the result of an over-shortening of the septum in which case revision rhinoplasty is needed.

Is my nose still supposed to be swollen months post-rhinoplasty?

It is completely normal for swelling, particularly in the tip of the nose, to still be present up to a year post-rhinoplasty.

Should I have the dorsal hump on my nose corrected with open or closed rhinoplasty?

Either approach would work, with the open approach having more bruising and a more noticeable scar. However, it is important for patients to consider whether they also need changes in addition to the dorsal hump (e.g. Droopy tip, etc.) which could better be fixed by the open approach.

Can I remove a dorsal hump/bump via non-surgical methods?

Sometimes, dorsal humps can be disguised via the use of fillers around the hump so that it does not stand out as much as it did. However, this method generally increases the overall size of the nose and thus only works well for those with smaller noses. Those with larger noses will unfortunately require a much larger operation like a rhinoplasty where osteotomies are performed.

Can my nose be made straight in spite of my asymmetrical facial features?

Rhinoplasties can indeed be performed even if the patient can has asymmetrical facial features. However, it is best for these patients to seek out experienced, board-certified surgeons who have a good sense of how to perform these types of procedures.

Why does my upper lip look longer after my rhinoplasty?

Without an in-house examination, this is difficult to assess. Removal of fullness at the base of the nose may cause the illusion of a longer lip, as can the unhinging of some muscles at the upper lip which control movement.

What can I do about blackheads developing on my skin post-rhinoplasty?

Many times, the surgical tape applied post-rhinoplasty will trap sebaceous fluid underneath the skin, prompting acne breakouts. In this case, it is necessary for patients to be gentle in their cleaning, using mild exfoliators and asking their surgeon for advice.

Why was I not taped after my splint was removed?

Taping is simply a measure to safeguard against excessive swelling, and is thus up to the discretion of the surgeon. Patients who do not seem to demonstrate a great deal of swelling may not require surgical tape.

Can I clean out dried blood one day post-op?

Most surgeons will recommend that patients utilize saline solution and apply it to problem areas via Q-tip, and then use another Q-tip to then absorb the remaining crusted blood loosened by the first Q-tip.

Can Alar Base Reduction be done simply on the nostril area?

Yes absolutely. It is possible for this procedure to be done without touching the tip or the bridge of the nose because the incision is made as a crescent shape on the inner wall of the nostril. However, it is rare for patients to expect a reduction in nostril area without reducing anything else, especially the tip.

What foods are ideal after a rhinoplasty?

Hot liquid and spicy foods dilate blood vessels and increase the risk of bleeding post-op, so it is best to avoid these types of food for about 24-48 hours post-op. After this, the swelling will begin to subside gradually and diet will become less of a concern.

When does the splint come off?

Uusally, splints are removed 1 week after surgery.

Why do I have blood in my eyes following my rhinoplasty?

It is a relatively common occurrence for patients to have broken capillaries in the sclera of the eye (the white of the eye) following a rhinoplasty, a condition known as a subconjunctival hemorrhage. Unfortunately, this bleeding tends to last for up to four weeks. However, if bleeding continues past that period or leaks into the iris (colored part of the eye) or affects vision, let the surgeon know immediately.

Could pulling on the tape in an effort to remove it have disrupted my results?

This is probably best answered by the surgeon who performed the surgeon, but as long as there was no ripping of the tape off, there should not be a problem.

How can a patient limit bruising post-op?

Although bruising post-op is generally a consequence of the surgeon’s actions, patients can help reduce bruising by avoiding anti-inflammatory medications like ibuprofen at least 1-2 weeks prior to surgery, applying ice to the surgery site for the first two days after surgery, and keeping their head elevated.

How can I remove a post-rhinoplasty scar?

Unfortunately, scars cannot be permanently removed in the way that patients would like to see. However, they can be mitigated via cortisone injections and, long-term (after the healing process is complete), via laser resurfacing and dermabrasion treatments.

Is twilight sedation preferable to general anesthesia for rhinoplasty?

Both methods can be used for rhinoplasty. However, twilight sedation has been shown to produce less post-rhinoplasty nausea. However, in this procedure, patients are not given a endotracheal breathing tube which is up to the patient’s discretion.

Is “Nose Secret” an effective rhinoplasty replacement?

Many gimmicks like these work to simply temporarily compress nasal tissues, but do not lead to any substantial changes. There is no substitution for professional work when it comes to optimizing nasal structure.

Can I simply just have a nasal hump removed rather than having a full-on rhinoplasty done?

Unless the nasal hump is small, it is probably best to having a full-on rhinoplasty simply because of the risk of open roof deformity (shaving off a larger bump leaves a hole that can only be filled with osteotomies that force the nasal bones inward). In addition, removing the nasal bump without having tip work done also makes the nose look unintentionally longer as well.

When can I wear makeup after a rhinoplasty?

Because of the inherent difficult in keeping the splint dry when there is makeup next to it, it is recommended that patients wait until the splint is removed (1 week post-rhinoplasty) before applying makeup.

How can I prevent swelling post-rhinoplasty?

To prevent swelling post-rhinoplasty, patients are advised not to drink alcohol or smoke or engage in behaviors which will result in altered blood flow to the surgical area. They are also advised to sleep with their head elevated and keep ice on the surgical area for the first 2 days post-rhinoplasty.

Should I get an inferior turbinate reduction in addition to my rhinoplasty to help with breathing?

This procedure can certainly be beneficial for those undergoing rhinoplasty because it helps clear the airways, not to mention that due to its functionality (necessity), it is generally covered by insurance.

Can a nasal rinse be used post-rhinoplasty?

Nasal rinses can start to be used one week post-rhinoplasty, but patients must remain gentle with them.

How is a crooked nose corrected?

There are generally two types of crooked noses: one which starts normal but is made crooked by trauma and another which is naturally crooked. The first is resolved with correction of the septal deviation and alignment of the nasal bones, while the second may require additional steps like support via cartilage grafts.

Can I do a nostril reduction post-rhinoplasty?

Yes, this simple procedure can be done after a rhinoplasty under local anesthesia. However, it is probably best for patients to wait at least 9-12 months before deciding to undergo any revision/additional procedures.

Can I smoke post-op?

Nicotine in cigarettes is a powerful vasoconstrictor (causes narrowing of the blood vessels) and must thus be avoided in order to speed up the healing process post-op. It is recommended that patients wait at least 4 weeks or so post-op to resume smoking again, but not doing so is even better.

Can I re-break my own nose in order to straighten it?

This is highly inadvisable as patients often do not know the precise motions which are required to set the nose in a perfectly straight manner. It is recommended that patients with a deviated nose go to a professional to have it fixed.

How much does a hump filing cost?

It is difficult to determine the cost of reducing a hump because patients will have different requirements. Small humps will require smaller procedures, but typically, the cost to reduce a hump is synonymous with the cost of a rhinoplasty which will cost in the neighborhood of $8000-$10,000.

Can you change the shape of your nose non-surgically?

Unfortunately, changing the shape of your nose requires movement and repositioning of the underlying skeleton and cartilaginous structure. Fillers and other non-surgical tools will typically only camouflage defects like a dorsal hump, etc by filling it areas around the defects.

How can I correct an over-upturned nose?

This can be corrected via an incision within the nose that will free up the tip and allow it to drop down naturally. Additional reinforcements may be needed in the form of cartilage grafts at the base of the septum. Trimming the cartilage near the tip of the nose may also provide the loss of support and thus the derotation which is desired.

Who or what determines what kind of nose is possible for me during rhinoplasty? Can I get any nose I want?

The type of nose which you get post-rhinoplasty depends on your surgeon’s skill and what you bring to the table (existing nose, genes, etc.). The goal of surgeons is to modify an existing nose and correct for any defects which bother/inconvenience a patient, not substitute one nose for another. Giving your surgeon pictures of what your ideal nose, although not always possible to recreate exactly on the face of a patient, will give him/her a good idea of what you want.

Can an alarplasty be done alone?

Certainly, as long as the rest of the nose looks proportional. However, this is usually not the case as patients usually need other procedures to make everything look harmonious on the face. The cost for one alone will generally range from $2,000-$4,000.

How bad is Rhinoplasty Swelling?

Swelling after rhinoplasty varies depending on the what and how much work was done on the inside of the nose. Our general advice to patients is to expect that 80% of the swelling subsides after 2 weeks, and 90% after 2 months. Healing will be complete by about a year after the procedure. We have patients avoid any type of medications that may thin their blood (aspirin products, garlic, vitamin E, etc), and have them supplement with Vitamin C, arnica and other homeopathics prior to the surgery. It is very important to avoid alcohol before and after the procedure. If necessary we can give steroids to reduce excessive swelling post operatively.

My nostrils close when I breathe through my nose. What’s wrong?

These symptoms may be attributed to nasal valve collapse which can be corrected via spreader grafts that are harvested from septal cartilage or, in rare cases, ear cartilage.

How long will my nose feel stuffed up post-op?

Easier breathing will generally come 10-14 days post-op and will continue to improve for 6-8 weeks afterwards.

I removed blackheads from my nose by squeezing it post-rhinoplasty. Did I damage anything?

Unless the manipulation occurred within the first few days post-rhinoplasty, there is little to worry about for patients who did this. Temporary swelling may occur, but this is nothing to worry about. However, I would recommend against squeezing them in the future because it could cause bacterial infection.

What is the best material for nasal implants?

Your own cartilage, particularly septal cartilage (or ear cartilage, if not enough of this is available), is the best choice for implant as it mitigates a lot of the risks of silicone, Gortex and other implants including movement, warping (twisting out of shape), infection, etc.

Will a bulbous nose that developed during pregnancy return to normal?

It is unlikely that, especially after a year since the pregnancy was completed, bulbous noses which developed in those nine months will return to normal. At that point, any corrections will have to come from rhinoplasty.

What is the difference between twilight sedation and the sedation caused by general anesthesia?

Generally speaking, the major difference between these two procedures is the presence of a endotracheal breathing tube in the general anesthesia route which helps secure the patient’s airway. In twilight sedation, the patient breathes on his/her own. Either practice is generally safe.

There is a bad smell in my nose post-op. What is wrong?

A nasty smell inside the nose following surgery may just be the result of dried, crusted blood development or extraneous mucous which infiltrated the area, both of which are perfectly normal post-op conditions that can be corrected with saline spray. However, a consultation with a surgeon may be advised in order to evaluate for a possible infection.

Is the cost of a rhinoplasty reduced if only the tip is reshaped?

If patients require ONLY work on the tip, then yes, the cost of rhinoplasty can be reduced and a tip-plasty can be performed. However, it is rare for patients to just require this procedure as reduction of the tip often requires reduction of the nasal bridge and other areas of the nose in order to keep the proportions of all the facial structures in check.

Is it safe to cough and sneeze post-rhinoplasty?

It is recommended that patients, when sneezing or coughing post-rhinoplasty, use their mouth as much as possible in order to relieve unneeded pressure from the nose. Especially during the first week, take care not to blow your nose if not necessary.

Can a wide, flat nose be fixed via rhinoplasty?

A wide, flat nose is typically among certain ethnic communities, particularly those of East Asian or African-American ancestry. Cartilage grafts from the septum or the ear will often help adjusting the nose in order to give it more “height” and protrusion and this can be done during a rhinoplasty.

Why is my tip so stiff 6 months post-rhinoplasty?

Especially if cartilage grafts were introduced, it is normal for stiffness to remain post-rhinoplasty for up to a year due to the trauma which the tip of the nose in particular undergoes during the procedure.

Why does the skin thicken after a rhinoplasty?

Unnatural thickening of the nose, other than from swelling, may be caused by the buildup of scar tissue underneath the skin, particularly if the patient has had multiple rhinoplasties. This can be solved by cortisone or Kenalog injections.

Is there a higher risk of ear cartilage warping over time, as opposed to septal cartilage?

Surgeons conducting a rhinoplasty often like to use septal cartilage because it is thicker, straighter, and stronger than ear cartilage which is thinner and tends to be used more for revision rhinoplasties.

What is the difference between silicone and Gore-tex implants?

Both silicone and Gore-tex implants are synthetic, with the former being constructed from siloxane molecule chains and the latter being composed of polytetrafluoroethylene. Gore-tex, while tending to shrink over time (unlike silicone, which is stabilized via a capsule), is also stabilized by the surrounding tissue, but tends to be more difficult to remove if infection occurs. I prefer personally to use the patient’s own cartilage as a first resort rather than these synthetic materials.

Would I know if I accidentally pulled out a stitch post-rhinoplasty?

While pulling out stitches by accident does not always cause pain, it is probably best for patients to speak with their surgeon if they suspect that a stitch was pulled out. Removing one stitch accidentally will not necessarily cause any damage, but evaluation will not hurt.

My nose is upturned after surgery, almost unnaturally. Will it come down?

Patients who experience an upturn in the tip of their nose post-op most likely had a surgeon who overcorrected the original condition. However, this is not a concern as the tip should come down within 2-3 weeks after surgery. It is also possible that the upturn may be caused by swelling which is perfectly normal post-op and should come down within the same period of time.

What are some alternatives to surgery?

Although strategies for nasal beautification are not as effective or long-term as a full rhinoplasty, they can be good short-term fixes. The main alternative to surgery is the use of fillers like Restylane or Radiesse which camouflage defects by filling in areas around the site of defect. But, these must be used judiciously because, otherwise, the patient risks having too much filling in areas where it is not necessary.

Do non-surgical fillers have long-term effects?

Surgical fillers have been FDA approved for use on the face for wrinkles, but surgeons have been using them for a long time for nasal injections (off-label use, of course). I am not aware of any particular diseases which result from the use of fillers, but there have been reports of patients who are unhappy in the long-term with the use of fillers and would rather have rhinoplasties done to correct the original problem.

Can I travel to Mexico to have a rhinoplasty done?

It is my recommendation to have a rhinoplasty done as close to home as possible. While there may be perfectly competent surgeons in Mexico, there is a chance for potential complications and issues in the post-rhinoplasty period which are best addressed by going to the surgeon who performed the procedure in the first place. This may prove difficult if the surgeon is in another country.

Is raising the nasal bridge a risky procedure during a rhinoplasty?

It is not a risky procedure and can be done via the use of the patient’s own cartilage and/or fillers/implants. However, it is important for patients to make sure that their entire nose remains in balance and is also proportionate to the rest of the face.

I have a clogged ear sensation post-rhinoplasty. Why?

This is mostly likely to temporary swelling in the back of the nose which is connected to the throat and the ear via the Eustachian tube in the pharynx. This will resolve itself within a week.

What is the difference between open and closed rhinoplasty?

The main factor which distinguishes the open and closed rhinoplasty procedures is the presence of an incision in the columella, the skin between the nostrils on the underside of the nose (the open form has the incision, while the closed form does not). This incision is rather conspicuous and patients will often opt for the closed form which makes incisions inside the nose, thus leading to no visible scars.

Can nasal valve collapse cause sinus infections?

The collapse of the nasal valves will not directly lead to sinus infections, but their effect on airflow to the sinuses can indirectly lead to sinusitis.

What can I do about an indentation on my nose post-Kenalog injection?

Unfortunately, this is not an issue that will resolve by itself. Steroid injections may have weakened the tissue and caused it to collapse, an issue which can only resolved by injecting fillers like Restylane into the area.

What is tip refinement?

Tip refinement is, to put it in general terms, the re-contouring and re-shaping of the nose tip for better appearance. This usually involves the addition/removal of cartilage from the tip and the suturing of the results, in addition to the use of cartilage grafts for people with thick skin to heighten the nasal tip.

My nose should be healed years post-rhinoplasty, so why do I still experience some swelling when I consume alcohol and/or cigarettes?

This is nothing to worry about. After a year post-op, the nose is more or less fully healed. Therefore, the swelling which occurs when cigarette smoke is in the air is probably more of a sign of inflammation or slight allergy due to the irritation of cigarette smoke. Minute swelling can also be caused by alcohol which is a vasodilator that causes the nose to become thicker (“drinker’s nose”).

Is a crooked nose more costly or painful to fix?

Not at all. The procedure of a rhinoplasty often entails osteotomies if necessary, that is, the purposeful breaking of the nasal bones to ensure their correct repositioning. Therefore, there is no additional cost and the “pain” is no more than a traditional rhinoplasty, which is basically none at all.

What should I do if I get an infection post-rhinoplasty?

Serious infections following a rhinoplasty are exceedingly rare. However, when they occur, they are very easily treated like any other infection, with antibiotics and careful monitoring by the surgeon.

Can I have fractured cartilage in spite of a negative X-ray?

Definitely. X-rays only show fractures in hard tissues such as bones and not soft connective tissue, like cartilage. Evaluation by a surgeon is probably the best avenue to determine whether cartilage is indeed fractured.

Is rhinoplasty necessary to correct for a minor dorsal hump?

This is probably best evaluated by a surgeon’s examination. However, sometimes, rhinoplasty may not be necessary as injectable fillers can disguise the bump in question.

Can I remove excessive cartilage without an osteotomy?

This can only be answered on a case-by-case basis. If the excess cartilage in question is around the tip, a tip-plasty can be performed without osteotomies. However, extra wideness on the bridge of the nose or any areas other than the tip will most likely require a careful breaking of the nose which only an osteotomy can provide.

What is the cost for rhinoplasty in the LA area?

Of course, given the increased overhead costs in big cities like Los Angeles and New York, costs for procedures in these areas will cost more than they will in other parts of the country. As such, a rhinoplasty in these areas will generally hover in the $8000-$10,000 area.

Why is my nose still bulbous 2 years post-rhinoplasty?

Especially in thicker-skinned individuals, this could very easily be caused by the maturation of scar tissue which can contract and thus pulls the nostril sides downward, giving the appearance of a bulbous nose. Unfortunately, the only alleviation for this condition comes in the form of a revision rhinoplasty. Steroid injections would help initially when the scar was beginning to form.

I’m coughing up bloody phlegm after my rhinoplasty. Am I dying?

Especially in the case of a combined rhinoplasty and septoplasty/turbinate reduction, patients can expect to cough up bloody phlegm in the weeks post-rhinoplasty. However, this should not be an ongoing problem and should correct itself soon afterward.

Is congestion 1 month after my rhinoplasty normal?

Yes, congestion can last as long as two months post-op and can be combated via the use of saline spray, at the discretion of your surgeon.

There is hollowing under my eyes post-rhinoplasty. Did I do something wrong?

Likely not. This is probably just residual swelling. Give it time to heal.

How long does a nose job last?

Ideally, patients will only require one rhinoplasty within their lifetime. Subtle changes will occur over time: the tip of the nose will begin to descend gradually, because the new nose ages with the rest of the body. However, such changes are subtle and will not require additional surgeries.

Do all surgeons use splints and packing post-rhinoplasty?

Generally, surgeons will use splints in the first week post-op not only to protect the delicate nasal tissues immediately after the surgery, but also as a reminder for patients to be extra careful in the first few days post-op. Packing has generally gone by the wayside due to discomfort/breathing issues felt by the patient and has given way to internal splints.

How does an injection rhinoplasty work?

Injection, or non-surgical, rhinoplasty is not a true rhinoplasty in the sense that the underlying cartilage and nasal bones under the skin are not manipulated in any way and the changes are thus more subtle. Instead, during these procedures (which generally last around 10-20 minutes), temporary injectable fillers like Restylane or Juvaderm are placed in the skin to add fullness into areas and influence nasal contouring.

Why is my nose still growing at age 30?

Generally, nasal growth should cease when a patient is in his/her mid-20s. Continuous growth afterwards may be attributed to rhinophyma which is excessive growth of sebaceous glands around the lower third of the nose, but may also be just the general loss of elasticity in the skin that causes the nose to droop.

Can I have a rhinoplasty with a cold?

Generally, it is best for the patient to be as healthy as possible prior to an elective surgery like this. Many surgeons will not risk a bacterial infection during a rhinoplasty as there is a possibility for complications.

Did I make a mistake by waiting too long to fix a broken nose?

Not fixing a broken/deviated nose immediately does not necessarily make it impossible to correct the original defect, but it definitely makes it more difficult. Nasal fractures are best treated within 10-14 days of the original injury before the nasal bones begin to reset in the newly established manner.

When does smell and taste come back after a tip-plasty and turbinate procedure?

Taste and smelling will generally be disturbed, particularly if work was done around the septum, for a period of a couple of months to a year. Speaking to an ENT might be the best option for figuring out how to hasten this process.

How can I fix a broken nose tip?

Generally, the tip is composed of a great deal of cartilage and thus may be prone to fracture. These types of injuries are generally only treatable with a rhinoplasty procedure.

Can steroid injections help if I have a hard tip following surgery?

Steroid injections about a year or so post-op can definitely help with any residual swelling and can soften up the tissue in problem areas, but have your surgeon complete these procedures.

Will taping my nose down after a rhinoplasty help bring it down?

Swelling at the tip can derotate the nose (rotate it upwards). I would not touch the results and wait for the swelling to subside.

What is this bump on the inside of my nose post-rhinoplasty?

At long periods of time post-rhinoplasty (a year or so), bumps on the inner wall of the nose will most likely be scar tissue which can alleviated with the help of steroid injections or a simple excision under local anesthesia. However, short-term bumps may be sutures that need to be taken out or swelling that will dissipate by themselves.

There is a visible graft on my nose post-rhinoplasty. What can I do?

Sometimes, grafts can become apparent after a period of a few months post-op. Eventually, they tend to contour themselves out over time, though. However, bring it up to your surgeon to see what he/she has to say.

Will my smile be normal after rhinoplasty?

In most cases, patients are expected to make a full recovery following a rhinoplasty, so it is probable that patients experiencing smiling difficulties will find their concerns alleviated. Patients may find that the separation of the muscle fibers between the base of the nose and the upper lip during certain procedures like septorhinoplasties may reduce smiling capabilities, but these issues will eventually resolve themselves.

How harmful is cocaine post-rhinoplasty?

Because cocaine acts as a powerful vasoconstrictor, it decreases blood supply to nasal tissues and thus inhibits the healing process and even causes these tissues to be necrotic and die. I would highly advise AGAINST using it simply because of hearing cases where patients run into an array of issues post-rhinoplasty, including septal perforations.

It has been almost a year since my rhinoplasty. Why is my tip still hard?

At this point, it is still normal to have some swelling from the rhinoplasty still present in the tip. However, unless a graft was placed in that area, it should have at least a small degree of give. If not, evaluate with your surgeon your best course of action.

How long does numbness after rhinoplasty last?

Typically, numbness following rhinoplasty is a common symptom and resolves itself within 8-12 weeks following surgery. However, it may take as long as a year or two before symptoms resolve themselves completely. Patients will know when the nerves regenerate because they are usually accompanied by itching and brief, shock-like sensations

Does any real healing take place after a year post-op?

At one year post-op, patients should generally be close to their final results or should be there already. Patients with thick skin may take a little longer to fully heal and reveal their final shape, however.

How much is dorsal hump removal?

Dorsal hump removal is generally a component of rhinoplasty and thus the costs of it will be very much in line with that of a typical rhinoplasty. As stated before, geographic area, equipment used, and other factors deeply impact the cost of these procedures, but an average rhinoplasty will run somewhere in the area of $5,000 to $10,000.

How visible are the scars from a nose job?

In closed rhinoplasties, all incisions are made within the nostrils and thus the scars that form are generally imperceptible unless Weir reductions are also done to reduce nostril size. Open rhinoplasties, however, will also make use of an incision at the columella (the thin strip of skin between the nostrils) which risks more apparent scarring. However, in the hands of an experienced surgeon, even this scar will heal nicely.

What can be done to improve a typical “East Asian” nose?

The most common complaints I hear from East Asian patients is that they have low definition on their nasal bridges and their tips. The nasal bridge issue is often solved with the help of grafts/implants which make the bridge more prominent, while the tip projection is improved with cartilage grafts in a tip-plasty procedure.

Why is my nose tip still crooked post-rhinoplasty?

Swelling in the tip, the hardest-hit area in terms of trauma, tends to persist for about a year and can distort the appearance of results. Please be patient in evaluating your results.

Can I run 2 weeks post-rhinoplasty?

Any activity which increases blood pressure (even light exercise) can present a problem in terms of swelling. I often recommend to my patients that they refrain from running until at least 3 weeks post-rhinoplasty.

Is the bulbous nose which I have post-rhinoplasty a sign that I need to do a revision rhinoplasty?

Even months post-rhinoplasty, the nose can still have a good deal of swelling which skews the appearance of the final results of the surgery. My best advice to patients post-rhinoplasty is not to worry too much about the appearance of the nose until at least 8 months post-rhinoplasty.

Do rhinoplasty results really take a year to show?

In general, full healing (that is, full dissipation of the swelling from the procedure) will take up to a year to heal properly. However, the bruising and swelling which results varies widely depending on if osteotomies were performed, the type of rhinoplasty performed, etc. The majority of the swelling, however, in most cases will resolve itself within 4 months and the nose will generally be presentable to the public without significant issues within 1-2 months.

Can rhinoplasty correct asymmetrical nostrils?

Asymmetrical nostrils may be the result of an uneven septum which can easily be corrected with a rhinoplasty procedure. However, in the case that they are not, rhinoplasties can correct them still, but the procedure is much more difficult and involves the cutting away of skin from the nostril area.

I have bumps on my nose almost a decade post-rhinoplasty. Is it scar tissue developing years after my procedure?

It is unlikely that this is scar tissue. More likely, this is caused by the thinning of the skin with aging that makes the results of the rhinoplasty more apparent years after the procedure has been performed.

I am experiencing dry nostrils and burning post-rhinoplasty. What’s wrong?

This may be the result of a suture which has not been removed yet. I would consult with your surgeon to make sure everything is okay.

Should I bring pictures of my ideal nose to my surgery consultation?

I don’t see how this could hurt you. However, it is important for patients to recognize that the goal of surgeons is to match the nose we create to the face and create overall harmony, meaning that a certain celebrity’s nose may not match up with a patient’s face and may not be advisable. However, it does give the surgeons a good idea of what the patient wants and expects.

Why do I have nasal bumps which I didn’t have before? I am a teenager.

During puberty, certain areas of the body tend to expand more than others, these areas including the nose. Bumps may form at this time, but cannot be removed except via rhinoplasty at the appropriate age (15-17 for women and 16-18 for men).

Why is there tape on my nose post-rhinoplasty?

This is merely for the purpose of reducing swelling.

How long does congestion last post-rhinoplasty?

Congestion usually clears up within 6-8 weeks of a rhinoplasty and tends to get better gradually.

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