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

When is swelling going to be the worst post-rhinoplasty?

The worst swelling after a rhinoplasty occurs at around 2-3 days post-rhinoplasty, after which the swelling gradually subsides after a year or so.

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.

Did tape on my nose post-rhinoplasty cause an overly raised tip?

Not likely. Taping of the nose post-rhinoplasty is more a measure of reducing swelling rather than maintaining the shape of the nose.

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.

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 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.

What does an alar rim graft do?

Alar rim grafts are used to reduce the height of the ala and correct nostril shape and thickness.

What does a nasal valve collapse surgery entail?

Generally speaking, this procedure involves the use of cartilage grafts to strengthen the cartilage on the inner nasal wall and to widen the openings. Collapse of the internal nasal valve requires a spreader graft, which is more intensive. Collapse of the external nasal valve may be alleviated with a smaller graft.

Can cartilage be added to my nose to give it shape?

Absolutely, this can be done with a graft. In rhinoplasties, cartilage grafts are the main types of grafts used and are taken, in order of preference, from the septum, the bowls of the ear (cymba or the cavum), or the ribs.

How can I massage my nose after nasal fracture reduction surgery?

I would advise against massaging the nose after this procedure simply because of the effect it could have on the movement of bones and cartilage in the surgical site.

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 simply use a corticosteroid on my nose to make it smaller rather than going through a rhinoplasty?

Unfortunately, this is not a realistic procedure for the results you want. Steroid injections are used strictly in post-op conditions to reduce swelling, not as a method of primary treatment as they do not reduce cartilage in the nose.

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.

What is a bilateral turbinectomy?

A turbinectomy is a procedure which reduces the size of the nasal turbinates which are curved bony structures on the nose which contain mucous membranes. Enlarged turbinates may block nasal airways and so can be removed (bilateral means removal on both sides of the nose).

Will ear cartilage regrow after being harvested?

Unfortunately, not. However, ear cartilage is usually harvested from the cymba or the cavum (the two central depressions within the ear) where the scars are generally hidden and where removal of cartilage does not significantly affect ear shape.

Can blowing the nose or touching the nose area affect nostril width?

Unless you are a member of certain African tribes who dilate his/her nostrils with nose rings that apply CONSTANT, heavy pressure, it is unlikely that touching the nose and blowing it every now and then will permanently affect nostril width to an appreciable degree.

I have heard of a quick fix nose job in ethnic communities which focuses primarily on nostril width and doesn’t concern itself with osteotomies. Is this an alternative to a traditional rhinoplasty?

Surgeons can reduce the size of the nostrils via an alar base reduction/Weir reduction in which a thin, crescent-shaped patch of skin is removed from the nostril and the hole is stitched. However, it is advised that, before going ahead with this surgery, patients not only choose an experienced surgeon, but also consider whether they truly want to do JUST this surgery. Often, nostril reduction is accompanied by a thinning of the upper nose as well which needs to be done with osteotomies.

Can the nose collapse during rhinoplasty surgery?

Generally speaking, in the case of a competent, experienced surgeon, middle vault collapse of the nose is exceedingly rare. This is usually caused by scar contracture and shrinking of the skin that could affect the middle of the nose and the tip. However, this can be avoided by strengthening the nasal structure with cartilage grafts.

Is it weird to have mucous/nasal drip post-rhinoplasty?

The inflammation caused by rhinoplasty tends to cause excess mucous production that will last for a month or so post-rhinoplasty. Patients need not worry if this occurs.

Can I have a rhinoplasty done with braces?

Given that the rhinoplasty’s main area of attack is on the nose itself, there is no direct adverse effects on the teeth/jaw area from the rhinoplasty. However, I would recommend waiting until the dental correction is done simply because the changes in the jawline and teeth caused by the braces could affect the balance of nose to lips.

Why do surgeons use columellar struts in a rhinoplasty?

Columellar struts are generally sutured in between the tip cartilages in an effort to maintain tip shape and support the tip area in order to prevent excessive drooping post-rhinoplasty.

What is a supratip dip?

A supratip dip is a slight dip in the nose right above the large tip of the nose. It is usually preferred on females because it adds a degree of femininity to the nose.

I have a crooked nose that is causing breathing difficulties. Is this covered from insurance?

This will most likely be covered by insurance and is usually resolved via turbinate surgery, septoplasty and/or spreader grafts (if the nose is collapsed inward and causes breathing issues).

Can I make my nostrils smaller without surgery, especially after a recent rhinoplasty?

Without surgery, there is no option of reducing nostril size. This procedure consists of taking skin from the inside of the nostril via removal of a crescent-shaped wedge. However, it is recommended that patients wait at least a year post-rhinoplasty to have other changes made on the nose.

Is it bad to have a nosebleed post-rhinoplasty?

Generally, it is advised that patients avoid any strenuous exercise for at least 6-8 weeks post-rhinoplasty simply because of the risk of bleeding caused by increased blood pressure. One episode of nosebleeds is not particularly serious, however, if the patient remains careful.

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.

I have a crooked nose after rhinoplasty. Should I be concerned?

It is recommended that patients not worry about the results of a rhinoplasty until about 3-4 weeks post-op, at which point the majority of the swelling which may skew the appearance of the results will subside. Check again at this point and consult with your surgeon if you are still unhappy.

I removed a dissolvable stitch after a rhinoplasty by accident. Should I be concerned?

Given that stitches will generally dissolve within 5-7 days post-op, there shouldn’t be any problem with accidentally pulling out a stitch. No concern is necessary, but be careful not to remove more.

Should my nose continue to grow in my 20s?

Nasal growth typically ends in a patient’s 20s, but other changes may be responsible for making the nose seem larger. Acne outbreaks and rubbing the nose due to allergies may thicken the nasal skin and changes in the underlying nasal bones and cartilage may cause drooping of the tip.

There is significant swelling in my tip post-rhinoplasty. Should I be worried?

Due to the repositioning of cartilage which occurs extensively in the tip of the nose during rhinoplasty, the tip is one of the most prone areas to swelling post-rhinoplasty. Patients should not be concerned if the tip appears swollen for a longer period of time than other areas of the nose post-rhinoplasty.

Will my tip drop years post-rhinoplasty?

After a rhinoplasty, the nose behaves just like any part of the body in that it follows a natural aging process. Tip drooping is a significant part of the aging of the nose and even applies to noses that have undergone rhinoplasties. Consider this: Rhinoplasties turn back time in terms of nasal aging, but they do not freeze it.

Why do I have breathing problems years post-rhinoplasty?

Although rhinoplasty can lead to a narrowing of the nose in general, it should not lead to excessive breathing difficulties. Problems breathing well post-op can be the result of a range of issues including septal perforation, nasal valve collapse, and others, so consultation with an ENT surgeon is probably your best bet.

How long after a rhinoplasty can I resume kissing?

To be frank, this really depends on how much contact with the nose will ensue during the kissing. Gentle kissing can be done probably around 3 weeks post-rhinoplasty, but more aggressive kissing where contact to the nose is a concern should probably wait until around 6-8 weeks.

How soon after giving birth can I have a rhinoplasty?

Theoretically, a patient can have a rhinoplasty as soon as 3 months afterwards. However, they must consider whether they will have the time or energy for a cosmetic procedure at this time. In addition, as the narcotics used during the rhinoplasty procedure may pass into breast milk, it is important for mothers to pump and store breast milk in anticipation for the procedure.

Do I need to remove my piercings pre-rhinoplasty?

Yes, it is necessary because cauterization during the procedure can cause severe burning of the nasal tissue AND because they present a risk for infection because they penetrate underlying soft tissue, not just the epidermis of the skin.

How is a male rhinoplasty different from a female rhinoplasty?

Generally, the same techniques are done regardless of the sex of the patient. However, the goals are different, as ideal male and female noses are obviously different. Males are usually better suited with a more defined bridge, a greater degree of tip projection, less tip rotation (90 to 95 degrees is suitable), and greater width in the middle of the nose. Females can tolerate more tip rotation, subtle dips in the supratip region, etc.

Can crying after surgery affect nasal development post-rhinoplasty?

As long as the nose was not vigorously poked or prodded during the crying, there is no reason for it to impact your final result.

How long should I not drink alcohol prior to surgery?

As a benchmark, try to avoid anything that increases the risk of excessive bleeding during surgery starting 1-2 weeks prior to surgery. This includes alcohol, herbal supplements, fish oil, and non-steroidal anti-inflammatory medicines like ibuprofen

Does swelling fluctuate post-rhinoplasty?

It does not fluctuate really, as much as it subsides gradually. Most of the swelling goes down within the first 10 days, with pretty much all of it disappearing within 3 or so months. Full healing should take place after a year or so.

Can thick skin impact recovery post-rhinoplasty?

At times, it can. Other than the issue of not draping over the cartilage and bone post-rhinoplasty, thick skin also presents other complications including subdermal fibrosis, increased risk of scar tissue, and fluid retention. However, this question is difficult to provide a general answer to and is probably best answered via an in-house examination if a patient with thick skin wishes to have rhinoplasty surgery.

I have a weird smell in my nose post-rhinoplasty. Is it infected?

Although patients will experience mild crusting of blood and mucus post-rhinoplasty, it is rare for it to smell unusually bad unless it is infected. Please consult with your surgeon to evaluate your condition.

What should I do for a flat nasal bridge?

If the flat bridge is from fractures, then osteotomies can be done to narrow a wide nose. If congenital then osteotomies may not be enough and dorsal onlay grafts may be necessary.

Am I developing a Polly-beak deformity? I see swelling right above my tip.

This is best evaluated by a surgeon. However, if temporary pressure via the hand can help in reducing it for a short period of time, it is probably swelling which will subside.

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 does cutting the depressor septi muscles do for my smile long-term?

Over the long-term, these muscles will heal and your smile should come back just fine. However, because cutting the depressor septi prevents the tip from drooping, there will be some loss of sensation in the upper lip area which will cause movement issues in the upper lip (and resulting problems when smiling) for a period of a few weeks.

Can Rhinoplasty be covered by insurance?

Generally speaking, rhinoplasty is considered a cosmetic procedure and will likely NOT be covered under insurance regulations.

Why is my tip drooping post-rhinoplasty?

This may simply be the result of swelling post-rhinoplasty. However, this is best evaluated within 6-12 months post-rhinoplasty.

I’m having dorsal hump removal via rasping. Should I be ready for public presentation in 8 weeks?

Probably. The majority of the swelling will probably have subsided by then.

How should I fix a newly broken nose?

If the nose was displaced during the trauma, a fracture-reduction rhinoplasty may be necessary. However, depending on how soon the corrections take place, the treatment may require re-breaking of the nose through an osteotomy and resetting of the nasal bones. Consult your surgeon about this before proceeding.

What are the things to look forward to during Rhinoplasty Recovery?

1. Pain: There is very little pain; most patients don’t take their pain medicines
2. Swelling: The worst of the bruising and swelling is seen in the first 48 hours. If warranted we give steroids to expedite this process.
3. Packing: More often than not we don’t pack the nose and patients like this.
4. Bruising: The use of endoscopes and tissue glues minimizes bruising. For prevention we have all patients take vitamin C, arnica, pineapple, and bromelane prior to surgery. NO alcohol – this creates swelling in the nose up to several months after surgery!
5. Splint: We take the splint of after 1 week.
6. Activity: You should not exercise for 2 weeks, and not participate in any contact sports for 6 weeks.

Can my rhinoplasty be done with local anesthesia?

Technically, it can be. However, particularly if osteotomies are performed, the sound of breaking bones and the general discomfort of injecting local anesthesia may cause anxiety and discomfort for the patient, so general anesthesia is usually the best option.

How should exercise habits work post-rhinoplasty?

It is generally a good habit to wait at least 6 weeks prior to beginning vigorous exercise.

Will the cartilage graft used in my rhinoplasty soften up eventually?

The reason why patients are often told that rhinoplasties take up to a year or so to fully heal is due to the healing of scar tissue and cartilage grafts which are often used during the procedure to give more support to the tip of the nose. However, if rib cartilage was used, then this may remain noticeably more firm than the rest of the cartilage in the nose (which is why rib cartilage is used as a last resort).

When can I drink after a rhinoplasty?

It is advised that patients refrain from alcohol for at least one week post-rhinoplasty. However, this drinking is to be in moderation, with heavier drinking reserved for at least one month post-rhinoplasty.

I have a very pointy tip due to alar cartilage sticking out. What can be done about this?

Patients with this condition may require fascia grafts from behind the hairline on the temple in order to soften the nasal shape. However, this may also be a cartilage issue that can be resolved with a tip rhinoplasty in which the lower cartilages are reshaped to the patient’s liking.

What should I do about an infection post-rhinoplasty?

This is probably best addressed by having an evaluation with your surgeon. He/she will likely take a culture of any drainage which may occur and prescribe antibiotics to fight the infection. Do not try to treat it on your own.

Should I be bleeding after a rhinoplasty?

Some bleeding is generally expected post-rhinoplasty within the first few days, but bleeding in which the dressing is soaked or blood is emerging from the pharynx (throat) is rare. For this, consultation with a qualified ENT surgeon might be necessary. If the bleeding in question is years post-rhinoplasty, it is more likely caused by dryness in the nose, as are most nosebleeds.

Does picking your nose cause changes in nasal structure?

It does indeed. Patients, especially those considering having surgery, must work to stop themselves from obsessive nose-picking which can lead to problems post-rhinoplasty. Obviously, poking yourself in the nose so many times especially post-rhinoplasty will lead to changes in nasal structure.

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.

How can I correct my broken nose?

Correction of a broken nose involves a procedure known as open reduction which involves the creation of osteotomies (controlled fractures) to realign the septum of the nose. In some patients, spreader grafts might be necessary to ensure that the nose does not collapse during or after surgery.

Can the nose be lengthened to reduce the distance between the upper lip and the columella?

Yes, this can certainly be done via the application of cartilage dorsal grafts to weigh the tip down and create the illusion of a longer nose and minor trimming of the columella.

When can I get my septum pierced post-rhinoplasty?

I would suggest not getting it pierced. Because of its importance in breathing and the possibility of cartilage reabsorption after surgery (which can potentially undo the results of the procedure), the septum is best not touched post-op.

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.

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.

Can I use a tampon or pad during anesthesia for a rhinoplasty?

The only risk associated with tampon use during a rhinoplasty procedure is toxic shock syndrome, which is only an issue if you foresee not being able to change a tampon on a regular basis. Tampons themselves should not interfere with the anesthesia in any way.

Why do I have a bulbous, upturned tip post-rhinoplasty?

If this question is posed within a year post-rhinoplasty, both the bulbousness of the nose and the upturned appearance of the tip are probably both due to post-rhinoplasty swelling. These will all be resolved gradually within a year post-rhinoplasty.

Is a growing dorsal hump normal in the 20s?

Probably not, as nasal growth tends to stop soon after puberty (15-17 for girls, 16-18 for boys). This may be the sign of a callus formation, or the buildup of cartilage and bone.

What types of pre-op testing is necessary for a rhinoplasty?

There is no real universal answer for this as it varies from surgeon to surgeon. Often, surgeons will like having blood work because it may reveal potentially complication-causing conditions that patients will either not disclose or forget to reveal prior to the procedure. Again, this is a question best answered by your surgeon.

Why is my columella so swollen after surgery and will it get better?

The tip/columella area is a primary surgical site during a rhinoplasty and will take longer to heal in terms of swelling than other areas of the nose. The swelling will tend to gradually dissipate over the course of a year, but should be generally resolved within 6 months.

Is twilight sedation safe for rhinoplasty?

I generally prefer using general anesthesia during the operation simply because it allows for protection of the breathing airway via endotracheal tubing, minimizes the danger of the patient moving around surgery, etc. However, some surgeons will opt for twilight sedation if they trust their anesthesiologist enough.

Are dark circles under the eyes post-rhinoplasty normal?

This is an indication of blood trapped in the lower rim of the eye, which will eventually dissipate after a period of 6 months or so.

What I can do post-rhinoplasty to reduce scar tissue formation?

Other than staying protected from sun exposure for at least 4-6 weeks post-rhinoplasty, there is little that a patient can do to prevent scar buildup as it is a product of the body’s natural healing process and varies widely from patient to patient. Fortunately, heavy scarring is rare following a rhinoplasty and, in the extreme cases where they do occur, steroid injections have been shown to reduce or even completely mitigate their appearance.

Can injury cause the formation of a hump?

This is definitely possible as trauma to a bone-dense area induces the deposition of calcium in that area in the body’s effort to strengthen that particular site of injury.

Can my wide nose be made to look more feminine?

Certainly. Ethnic noses (in which this is often the case) can be made more feminine via reduction of the nostrils and the bridge of the nose as well as alar reduction surgery (to reduce nasal flare).

How long is my tip numb following rhinoplasty?

Generally, numbness in the tip should begin to improve within 6-12 weeks following the procedure, but may take up to a year to fully resolve itself.

How can I combat excessive “nostril show” post-rhinoplasty?

This unintended consequence of a rhinoplasty, which is normally caused by over-removal of tip cartilage and the resulting upward rotation of the lower edge of the nostril, can be addressed with a columellar tuck which reduces the distance from the base of the nose to the columella (thus allowing the nose to seem normally rotated) and an alar rim graft which weights down the nostrils a bit, thus showing the nostrils less.

Are there less complication risks with a tip-plasty as opposed to a full rhinoplasty?

Frankly, there is not a great deal to differentiate between the tip-plasty and the full rhinoplasty in terms of invasiveness, recovery and complication risks. Both carry very minimal risk, most of which is in the anesthesia component of the surgery.

When can I masturbate post-rhinoplasty?

I would wait at least 3-4 weeks before performing any activity which increases heart rate simply because of the risks of hematoma and bleeding due to increased blood pressure.

How can I tell if I have thick skin on my nose or just excess cartilage?

This is probably best evaluated by your surgeon. However, for a rough method of evaluation, you can feel the difference between thick skin and cartilage by feeling your cheek and then feeling your ear. Thick noses can contain a mixture of both, however.

Is the nasal hump made of bone and cartilage?

Normally, it consists of both and is best reduced through surgery.

Can thin skin make a rhinoplasty more difficult to perform?

Generally speaking, I would prefer to do rhinoplasties on thin skin as opposed to thick skin. Thin skin does make the outline of the bone and the cartilage more apparent underneath, but it is much more manageable than thick skin which tends to hide results and make the change less dramatic (although some prefer that).

When does my smile return to normal post-rhinoplasty?

Particularly during septo-rhinoplasties, muscle fibers in the base of the nose and in the upper lip are slightly separated to allow for proper healing of the tip of the nose. Thus, the smile will be a little skewed as the upper lip may not properly elevate. However, this should return to normal within the first few weeks post-rhinoplasty.

What is the cost of a deviated septum plus rhinoplasty surgery?

Again, the costs of a rhinoplasty surgery will vary depending on a number of factors including geographic area, qualifications of the surgeon, equipment used, etc. However, a general ballpark for this type of surgery may entail somewhere between $5000 and $10,000. I would advise patients to place less priority on cost and more on the qualifications of the surgeon, because corrective surgery is often much more expensive than first-time procedures.

Can I workout the day BEFORE surgery?

Yes this should be fine. As long as no workouts are done after surgery and the blood pressure is kept normal, do whatever you want prior to the surgery.

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.

There is some nostril asymmetry following my rhinoplasty. Should I be concerned?

Not at all. Again, swelling is a perfectly normal part of the post-rhinoplasty healing process and will take up to a year to fully dissipate (especially in the tip and nostril area). Therefore, most imperfections seen post-rhinoplasty are merely the result of swelling and will also disappear.

Why can’t I smile properly post-rhinoplasty?

Patients after a rhinoplasty will generally experience a tightness in the nose tip and upper lip area due to post-rhinoplasty swelling and trauma to the nerves in the area, both of which can alter their smile. However, these issues will generally resolve themselves around the 1-2 month benchmark.

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.

My nose is getting bigger. Will rhinoplasty help?

Nasal growth generally stops after a patient reaches his/her 20s. However, acne outbreaks and rubbing the nose due to allergies may thicken the nasal skin and changes in the underlying nasal bones and cartilage may cause drooping of the tip. In this case, rhinoplasty will help with the appearance of a patient’s nose.

Can I take Zyrtec-D prior to my rhinoplasty?

I would advise against it because of one of the ingredients in Zyrtec-D known as pseudoephedrine which is a stimulant that can increase blood pressure and heart rate, thus creating a slightly increased risk of bleeding during and post-surgery. Contacting your surgeon and the anesthesia department of the hospital where you will be having this procedure done is the best option here.

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.

Why has my swelling not gone down months post-rhinoplasty?

Again, as I answered with many of my patients, swelling especially in the tip and nostril area following a rhinoplasty will resolve itself almost completely after a year post-rhinoplasty, with most of the swelling being gone around 3-4 months post-rhinoplasty. It is key that patients remain calm and wait out the results.

Is a long nose only shortened by rotating the tip?

It depends on the nose which the surgeon is starting with. This type of technique is ideal for patients who have the combination of a droopy tip and a long nose. However, if the tip is normally rotated, there is no need to mess with it and the issue would be better resolved by shortening the septum and bringing the inferior tissues upward. Consultation with a surgeon is probably the best way to determine a patient’s course of action here.

When can I start smoking following surgery?

Though I would rather patients quit smoking entirely after surgery, I would wait at least 4 weeks post-rhinoplasty to begin again. Cigarettes contain nicotine and carbon monoxide, the first of which is a vasoconstrictor and causes tissue death in the surgical area by limiting blood flow and the second of which decreases the blood’s oxygen capacity and also causes tissue death.

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.

Will a nose job affect my smile?

The cutting and stretching of nerves around the tip and the upper lip/teeth during a rhinoplasty will definitely cause a general numbing of the area, particularly if the surgery in question was a revision rhinoplasty where extensive cutting of scar tissue occurred. However, these symptoms are very temporary and will probably dissipate within 2-3 weeks post-rhinoplasty.

Can caving in the middle of my nose be corrected non-surgically?

Often, patients with indentations in the nose are dealing with irregularities in the underlying lower lateral cartilage tissue, problems which can only be addressed via a full rhinoplasty procedure. Fillers have shown to be ineffective in these scenarios and only provide temporary relief for the issue at hand.

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.

Should I tell my friends and family about my rhinoplasty?

This is generally a matter probably best decided by the patient. However, it is my opinion that true friends and family will support you, regardless of the decisions you make and how they feel about it. I have found that many family members tend to be supportive of the patient’s decision and even those that aren’t will generally not be so outspoken as to openly challenge the decision and try to cancel the surgery.

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.

Is it possible for rhinoplasties to cost less than $1000?

If performed by residents at a university hospital, rhinoplasties can be done with minimal cost to the patient. However, given the difficult nature of the procedure and the inherent risks in appearance if the rhinoplasty turns out badly, it may benefit the patient to find a more experienced surgeon in spite of the extra cost. After all, fixing a bad job often incurs more costs than doing it right the first time.

Can a nose bump be fixed under local anesthesia?

It truly depends on the size of the bump. While small bumps can be removed by rasping under local anesthesia, larger bumps, which carry the risk of open-roof deformity if removed by rasping, require osteotomies which are difficult to really perform under local anesthesia. General anesthesia might be more suitable for this reason, and because of the protection offered by the endotracheal tube (can block blood and other fluids from getting into the lungs during surgery).

What part of the ear is cartilage harvested from in a rhinoplasty?

Generally, surgeons will look for cartilage grafts in the septal area as a first resort and will only use grafts in the ear when this is not available. However, if ear cartilage is harvested, it is taken from the central depression in the ear called the concha where the incisions are well hidden either from the cymba (the top part of the depression) or the cavum (the lower part of the depression).

I have a lump on my nose tip post-rhinoplasty. What can I do?

Unfortunately, depending on how the bump is situated, this may be a possible reason to have a revision rhinoplasty. This may be a bend in the domal cartilages in the tip that can only be fixed via a revision procedure.

Why do I have a hard tip following rhinoplasty?

A hard tip following rhinoplasty is most likely caused by residual swelling or scar tissue which may have formed, as well as cartilage grafts which may have been used during a patient’s rhinoplasty procedure. As I mentioned in previous queries, the tip of the nose undergoes the greatest proportion of the swelling post-rhinoplasty, so healing takes a while in this area.

How delicate is my nose in the first days post-rhinoplasty?

The reason why surgeons will almost always apply a splint in the first week post-rhinoplasty is because of the delicacy of the nose in this period. Small forces, even a slight hit with a towel, can have large impacts simply because the cartilage underneath the skin has been shifted, so patients are advised to be careful.

Can I get a rhinoplasty surgery in Pakistan?

As I have said before, there are good surgeons and bad surgeons everywhere and people may benefit from saving costs via surgical tourism. However, if patients wish to go abroad to have surgery done, I would advise them to be wary only because any complications that may arise in the post-op period may be best addressed by the surgeon who did the procedure in the first place.

I had bad acne breakouts following removal of the tape. What should I do?

This is especially common due to the blockage of sebaceous glands on the skin by the tape. Common acne regimens should be fine to help alleviate this.

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.

Can the nasal tip be reduced via rhinoplasty?

Patients with a bulbous nose (wide) can easily have this defect correct via rhinoplasty. However, they should also take care to consider additional revisions in the bridge of the nose to ensure that the corrections made at the tip will not look disproportionate.

I have small, hard bumps on my nose post-op.

Generally, hard bumps on the nose post-op are the results of swelling due to the instruments used in osteotomies (controlled breaks in the nose made to correct the nasal deformities). Patients should consult with their surgeons upon seeing these bumps, just in case they are the results of other issues, but should generally not be concerned.

Can rhinoplasties affect my singing voice?

Correction of a nasal septum deviation during rhinoplasties will definitely cause a change in the voice, the extent of which can vary, due to change in airflow and the subsequent effects it has. However, unless the septum is being manipulated, it is unlikely that other types of rhinoplasty would affect the voice in a noticeable manner.

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.

My nose is far too triangular (bridge is too straight) following my rhinoplasty. What can be done?

This is somewhat unusual, as most patients favor a straight, less bumpy nose. However, patients can have this issue corrected via cartilage addition to the area or even injectable fillers.

How long will breathing be difficult post-rhinoplasty?

Especially during the first several weeks post-rhinoplasty, swelling in the nasal area and crusting of blood and mucus will cause congestion of the nasal airway and thus inhibit breathing. This swelling will begin to subside, however, and will improve after 2 weeks.

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.

I have minor bleeding in my nose post-rhinoplasty. Why?

Though this is probably best addressed by your surgeon, bleeding within the nasal wall post-op may just be the result of aggravation of a suture. This is best addressed by consulting what to do with the surgeon and NOT touching the aggravated site anymore.

Can I use silicone for nose bridge augmentation?

Most surgeons, including myself, would prefer to use the patient’s own cartilage either from the septum or the ear as this has the largest potential for long-lasting results.

Can I shower after my cast was removed post-rhinoplasty?

Patients can shower after the splint is removed one week post-op. However, they are advised not to apply too much pressure while cleaning the nose.

How do I ask my doctor about getting a rhinoplasty in addition to my septoplasty?

This is very simple as both procedures are often performed concurrently, although the septoplasty will be covered by insurance and the rhinoplasty will most likely not be. However, check if the surgeon has experience with both surgeries and is board-certified.

When will my ear recover if cartilage was harvested from it during the rhinoplasty?

Patients can sleep on the ear in question within a week or two after the cartilage is harvested, but it may continue to be mildly painful for around 3-4 months, after which it heals completely.

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.

Why did I have an infection one year post-rhinoplasty?

An infection post-rhinoplasty can have many causes, including an infected implant, introduction of a foreign body, etc. When an infection occurs, patients are advised to look for the cause by having any mucus or discharge cultured and to take the antibiotics which are recommended by their surgeons.

Are rhinoplasties necessarily obvious?

It is important for patients to recognize that, as surgeons, our goal is to modify an existing nose and correct defects during rhinoplasties, rather than substitute one nose for another. If the surgeon you chose was competent, the rhinoplasty should enhance your overall appearance and give your face a degree of greater harmony.

How can I get rid of bruising under my eyes post-rhinoplasty?

Unfortunately, other than the tips which your surgeon probably gave you (avoiding blood thinners like aspirin, not smoking, etc.), there is little else that you can really do to reduce bruising as it is part of the body’s natural healing process.

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