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

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.

Can I die from complications of rhinoplasty?

Of course, every surgery carries with an inherent risk. However, as long as the patient in question is healthy and gives us a full run-down of anything (allergies, etc.) which could cause problems, the risk of them driving to my office to do the rhinoplasty has more inherent risks than the rhinoplasty itself.

How much will a tip rhinoplasty cost?

Though the figure varies widely, a typical tip rhinoplasty will run in the range of $6,000-$8,000. However, do not let cost guide you and seek a board-certified surgeon who specializes in these procedures because having to spend for a revision surgery is more expensive than just doing it right the first time.

Can Flonase cause MORE swelling post-rhinoplasty?

In reality, Flonase via its active ingredient fluticasone is expected to reduce swelling, but can cause the opposite reaction in 1/100 or so of its patients. However, I would advise against using any unnecessary sprays and perhaps just sticking with saline. Consult with your surgeon about this, though.

Is Arnica bad prior to rhinoplasty surgery?

On the contrary, we recommend Arnica in our office in the week prior to and after the rhinoplasty surgery as a way to reduce bruising and swelling post-op.

Can a spreader graft fix nasal valve collapse?

Generally, most surgeons will use a spreader graft or even an onlay graft (which strengthens the cartilage more than a spreader graft, but does not really lift or support it) for open rhinoplasties, rather than closed ones. Collapsing nasal valve may be better served with an onlay graft in order to bolster the cartilage wall.

Is the “work-ready” benchmark of 1 week post-rhinoplasty apply to more physically active jobs?

Depending on the degree of modification to the nose and the procedures performed, patients will generally be work-ready within 6 days to 2 weeks post-op. However, 2 weeks is usually the max, unless patients will be doing a heavy amount of exercise in which case, they are recommended to wait 4-6 weeks.

Can I cause an infection by picking my nose post-rhinoplasty?

Generally speaking, patients should take care not to exert any pressure on surgical areas post-rhinoplasty. If the crusting bothers patients that much, they may be better served with saline spray.

Is touching my nose after cast removal safe?

Gently touching the nose will not affect the results. Just make sure not to bump it hard or push very hard as the nasal tissues are still delicate and malleable.

When should the cast be removed post-rhinoplasty?

The cast, which is kept on to reduce swelling and post-rhinoplasty bleeding, should ideally be removed 6-7 days post-rhinoplasty by an experienced surgeon.

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.

Does septoplasty and rhinoplasty get covered by insurance?

As stated in another query, rhinoplasties are strictly cosmetic procedures and are usually not covered by insurance. However, septoplasties (often performed concurrently with rhinoplasties) are functional surgeries which can be used to correct breathing defects and are thus usually covered by insurance providers.

How long is the healing period post-rhinoplasty?

The full healing period post-rhinoplasty takes up to a full year, when all the swelling will eventually dissipate. However, patients will generally recover from surgery within the first few days post-rhinoplasty and will be ready for work within a week. After three weeks, you can even return to light exercise.

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.

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.

My nose is sensitive and clicks following a hit to the face. Is it broken?

These symptoms seem to point towards a broken nose. A CT scan may be necessary and a plastic surgeon should be seen immediately so that the nose can be corrected before it begins to grow in a dysfunctional manner.

Can nasal bones shift back after an osteotomy?

Sometimes, it is possible for a couple nasal bones to shift here and there which is why patients, especially within the first month post-op, should be extra careful not to disturb any areas on the surgical site.

Can I smoke marijuana before/after my rhinoplasty?

My best advice would be to avoid doing this at least 2 weeks before and 2 weeks after surgery.

Can I have an upper lip lift at the same time as my rhinoplasty?

Generally I would remain cautious about this, because traditional upper lip lifts can leave a scar that presents problems when combined with a rhinoplasty.

My swelling has gone down but there is still a bump post-rhinoplasty. What do I do?

For patients without a great deal of swelling, a bump on the nose may unfortunately be permanent and may need to be fixed via fillers.

When can I go diving after a rhinoplasty?

It is advised that light exercise be postponed until 3 weeks post-rhinoplasty and more heavy contact sports be postponed until 6-8 weeks post-rhinoplasty. For diving specifically, due to the risk of potential nose bleeding (and the problems with wildlife that might ensue), I would recommend waiting at least 8 weeks for the nose to fully heal.

How can I reduce my droopy tip?

The tip can often be corrected via repositioning of the depressor septi muscles as well as repositioning of the cartilage at the tip already and cartilage grafts.

There is a lump on my nostril following rhinoplasty. What is it?

Patients who find a knot forming on the nostril, thus making one of the nostrils look more rounded than the other, may have a bossa of the nasal tip which is a collapse of the lower lateral cartilages upon themselves. This can easily be corrected via revision surgery.

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.

How bad is smoking marijuana within the first week post-rhinoplasty?

Unlike cigarette smoke, marijuana smoke presents no dangers of nicotine, a potent vasoconstrictor which has the ability to cause necrosis of nasal tissue. However, it does have carbon monoxide which limits oxygen to the surgical site and may lead to tissue death there. In addition, the coughing induced by marijuana can lead to internal bleeding post-rhinoplasty.

What type of anesthetic is used during a rhinoplasty?

During a surgery such as this, a top priority among surgeons is the patient’s comfort and safety. Thus, we suit the anesthesia to your needs and wants. Patients can choose from local anesthesia (patient is fully awake and the area is numbed), local sedation (patient is given local anesthetic plus a sedative so that he or she falls asleep during surgery), or general anesthesia (patient is fully sedated and given a breathing tube). Patients with health problems may be recommended for the first two options as general anesthesia puts more strain on the heart and the lungs.

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.

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.

I have a wide nasal bridge. What can I do?

This is generally best taken care of with a rhinoplasty in which medial and lateral osteotomies are performed to lessen the lateral width of the nose and the nasal bones are turned more inward. In cases where patients have a sunken upper-third of the nose, cartilage grafts may also be required.

Are there any side effects of a rhinoplasty?

The most common side effects of a rhinoplasty are relatively mild and include bruising and swelling which dissipates within weeks to months following the procedure. Some much rarer risks include bleeding (which is more of an issue for patients with a history of using blood thinners and NSAIDS), scarring which can be corrected with steroid injections, and potential infections which can be mitigated in the hands of an experienced surgeon.

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

Can rhinoplasty surgery have a negative impact on my breathing?

Generally, in rhinoplasty surgeries, form and function come hand in hand; that is, creating an aesthetically pleasing, well-balanced nose will generally result in a nose where breathing and other functions are brought up to speed as well. Certainly, badly performed rhinoplasties can alter breathing, but the trick to avoid this is to find a surgeon who is qualified and has the proper credentials.

Can pregnancy make my nose swell more after rhinoplasty?

It is common for nasal swelling to occur in women during pregnancy, regardless of whether or not they had a rhinoplasty procedure done. This is due to fluid retention.

How can I tell if I have thick nasal skin?

The best way to evaluate thickness is probably by pinching individual portions of the nose from top to bottom and examining how thickness increases going in this direction. Thick skin is generally relevant in the tip and tends to be rather oily. If the patient easily manipulate the skin over the tip, it is thinner.

How sick do people typically feel after general anesthesia, and how much blood loss is typical?

Because surgeons often use lidocaine mixed with epinephrine in surgical areas to constrict blood vessels, blood loss is typically minimal during these types of procedures. Some blood may escape into the throat and into the stomach, which can cause vomiting and nausea. However, a gauze pack is usually placed in the back of the throat to catch the majority of the blood.

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.

I have pain in the roof of my mouth post-rhinoplasty. Is this common?

This is a relatively common complaint due to the disruption of nerves which occurs when work is done on the septum. As it happens, the palate and the septum share some nerves which are disrupted during the surgery. The subsequent regeneration of the nerves comes with dull throbbing and pain which will resolve itself

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.

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.

Can Laser Septo Control Correction correct a deviated septum?

Unfortunately, no. This is probably another market gimmick designed to dupe less-informed customers.

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.

Is Swelling after Nasal Trauma an indication of permanent damage?

This is a problem that is better addressed on a case by case basis, but generally, I would say that patients who experience swelling after a nasal injury will find that most of their problems will be solved with some ice. However, it is best to go to a qualified surgeon for evaluation in order to check for nasal fractures.

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).

Can I correct asymmetrical cartilage deposits?

It is difficult to answer this question, primarily because it is unclear where the cartilage deposits are. In the simplest case, a tip rhinoplasty can be performed via small incisions through which the excess cartilage will be shaved. However, there may be more complicated procedures which need to be performed.

Are the scars from rhinoplasties too much to handle?

Rhinoplasties come in two main forms: open and closed, with the only difference being that closed rhinoplasties are done via incisions on the inside of the nose (that is, not visible) and open rhinoplasties having more apparent incisions especially on the columella area (the skin between your two nostrils). The incision on the columella in the open rhinoplasty is the only one that has the potential to be apparent, but even these should heal beautifully over time.

What could cause tear trough deformity post-rhinoplasty?

This may be the result of swelling and fluid retention (edema) and may be best resolved via filler injections or even a blepharoplasty. A more thorough examination is needed to determine what to do in your particular case.

Should I get a rhinoplasty during high school?

Generally, after ages 15-17 for women and 16-18 for men, rhinoplasty can be done. However, patients in high school should consider whether they are ready for any side-effects and complications from the surgery which could occur including swelling, bruising around the eyes, etc. If not, they could consider having it done before college.

Is there significant risk of smoking marijuana related to the anesthesia?

No, there has not been enough scientific studies to establish any sort of link between smoking marijuana and discomfort/pain following anesthesia. But, why risk it?

How can an ethnic nose be made thinner at the tip?

Quite often, this is done by suturing the nasal cartilages in a more narrow fashion and bringing it cartilage grafts from the septum or the ear for additional support. However, the problem which surgeons often have with ethnic noses is that ethnic noses tend to have thicker skin which does not drape nearly as nicely over skin as thinner skin does. Thus, the results may not look quite as apparent.

When can I play contact sports post-rhinoplasty?

I would recommend waiting 6-8 weeks simply because of the risk which a bump to the nose can have on the results of a rhinoplasty.

Can trauma to the nose cause a dorsal hump?

It is possible for a hit to the nose to cause the development of a small dorsal hump due to the slight separation of the upper lateral cartilages from the bone which can occur. This can be corrected via cartilage grafting. However, it is important to also recognize that trauma to the nose may just create swelling that may look like a dorsal hump, so it is important to ice the area in question and evaluate.

Did hitting my nose 6 weeks post-rhinoplasty cause problems?

It is unlikely that after 6 weeks post-rhinoplasty, any minor hit to the nose caused irreparable problems in the nose’s structure.

What are the chances of developing unsightly scar tissue and other complications post-rhinoplasty?

When done by an experienced surgeon, rhinoplasties do not develop scar tissue to the extent where revisions are necessary. Even when scarring does develop, though, cortisone injections can help. Again, the best way to prevent complications is to seek out an experienced surgeon.

What is the recovery time for a closed rhinoplasty?

This is where patients should learn the distinction between healing time and recovery time. The healing time, that is, the full realization of the results of the procedure and the full reduction of swelling and bruising, of a rhinoplasty is about a year. However, patients are generally work-ready within 7-10 days which I would consider the primary concern regarding “recovery time”.

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.

Can removal of a hanging columella cause the nostrils to appear wider?

Although it may seem like the weight of the cartilage in the columella may help “pull the nostrils back” in terms of flaring, this is not true. In the hands of a good surgeon, a hanging columella can be easily corrected without changing the other aspects of the nose, including width of the nasal bridge/tip.

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.

How long will it do to see the results of alar base reduction?

Unlike traditional rhinoplasties, the results of an alar base reduction should be almost immediate. There may be redness for the first week or so, but swelling and other issues should not be apparent to the extent of a rhinoplasty.

There is dead skin on my nose post-rhinoplasty. Can I scratch it off?

During the first couple of weeks post-rhinoplasty, it is probably best to advise against moving or disrupting the nasal structure in any way. It would be best for patients to ask surgeons for their recommendations in these cases.

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.

How can I fix my hanging columella and how much will it cost?

A hanging columella is treated very simply under local anesthesia in which the surgery basically consists of trimming the columellar cartilage to an appropriate length. It is a very easy procedure that should not cost more than $3000 or so to do.

Is it normal for my nose to twitch post-rhinoplasty?

Patients may experience paresthesias post-rhinoplasty, which is a zapping sensation that occurs when sensory nerves begin to regrow in a trauma-affected area. However, twitching is unusual and should be addressed via consultation with the surgeon.

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.

Can scar tissue be removed post-rhinoplasty?

Technically it can be. However, patients must realize that scar tissue tends to thin over time and surgery with the intention of removing it may cause the formation of new scar tissue and steroid injections may also present complications.

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 happens to excess skin during a rhinoplasty?

Actually, skin is not removed during a rhinoplasty. When performing these surgeries, more skin is undermined than necessary for the area of surgery, so that it can redrape over the skin more evenly. In general, noses during rhinoplasties are not undermined enough where excess skin is a major concern.

How can I reduce swelling post-rhinoplasty?

Patients can reduce swelling by asking surgeons to apply surgical tape to the area and also practicing good habits such as reducing alcohol/smoking habits, reducing sodium in the diet, and (if swelling is persistent after several months) engaging in light exercise.

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 my concha bullosa taken care of during my rhinoplasty?

Honestly, unless the concha bullosa (which is an air-filled space that may block sinus openings) present problems that could lead to diseases like sinusitis, it is often considered unnecessary to take care of concurrently with a rhinoplasty. However, if it IS symptomatic, then it can be taken care of at the same time as your rhinoplasty procedure.

Is the removal of splints following a rhinoplasty painful?

Nowadays, when the packing used for rhinoplasties is less than it used to be, the removal of splints should not cause any major discomfort for the patient.

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.

Can rhinoplasty alter my singing voice?

Generally, rhinoplasties do little for the nasal airways and instead focus on the cartilage and tissue underneath the skin of the nose, meaning that they should have very little impact on the quality and sound of a patient’s voice. Septoplasties, however, normalize the nasal airways and may change the voice slightly, but this is probably best answered by your surgeon via an in-house examination.

Why should I stop taking Vitamin E prior to rhinoplasty surgery?

Because vitamin E can be a mild blood thinner, it is advised that patients avoid it for two weeks before and after surgery as it exacerbates swelling and increases the risk for hematoma and other post-rhinoplasty complications.

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.

My nose tip looks too round post-op. Should I be concerned?

As surgeons will tell you, the REAL post-op look after a rhinoplasty does not actually form until about a year after the surgery is completed. Minor swelling, particularly in the tip, may exist until then, but it should not be a concern to the patient.

Can wearing glasses cause alterations in your nose shape growing up?

This is unlikely as the glasses only exert very slight pressure.

What does ibuprofen do for swelling?

It is advised that patients avoid taking NSAIDs like ibuprofen simply because of the risks of bleeding which occur as a result of using them.

Is thick skin a problem for rhinoplasty?

Rhinoplasties can definitely be performed on patients with thick skin. However, there may be some limitations. Rhinoplasties work by lifting up the skin, adjusting the underlying muscle and cartilage, and then re-draping the skin. However, the skin needs to be tight in the last step which may be difficult to do for patients with more elastic, thick skin, so extra thinning of the underlying tissue might be needed.

Can I afford a rhinoplasty on a modest salary?

This is probably a question that is best answered by your personal surgeon. The costs of a rhinoplasty is driven by three main factors: operating room time, the surgeon’s individual fee for the operation, and the anaesthesia/individual equipment used. Many offices will have financing options that make these procedures surprisingly affordable.

Does the nose become smaller following rhinoplasty surgery?

Due to the contraction of scar tissue as well as the reduction of residual swelling, the nose does indeed decrease in size over the course of the post-rhinoplasty period to match the expectations (hopefully) of the surgeon and the patient.

I popped a suture in my nose after my rhinoplasty. Is that bad?

Messing up one suture will probably not do a significant amount of damage. However, consult with your surgeon just in case.

Did my rhinoplasty age me unnaturally?

It is unlikely that patients who have a rhinoplasty done demonstrate signs of premature aging (crow’s feet, wrinkles, etc.) that can be traced back to the procedure. Often, loss of volume to the face due to weight loss or other more obvious factors like sun exposure or smoking are to blame for signs of aging, in which case the aging can be disguised via fat grafting and other measures.

Can I perform a rhinoplasty on just one side of my nose?

Unfortunately, given the nature of how a rhinoplasty works, it is impossible to simply just fix “one side of the nose” during the procedure because a rhinoplasty is about balancing the nose and maintain harmonious symmetry.

I am developing a line in the middle of my nose post-rhinoplasty. What is it?

Though it is difficult to say for sure without an in-house consultation, this may be a sign of potential irregularities in the cartilage and bone where osteotomies were performed but the bones did not come together quite as nicely as your surgeon may have hoped. This problem can usually be fixed with fillers or cartilage grafts.

How is the nose shortened during rhinoplasty?

This is up to the discretion of the surgeon. However, some methods can include reducing of the septum, upward rotation of the tip (in the case of longer noses with droopy tips), and modification/elevation of the tip cartilages.

There is still swelling years post-rhinoplasty. Is something wrong?

This may be something that is best evaluated by your surgeon, but the likely cause of this is poor lymphatic drainage and scar tissue which may have accumulated.

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.

I have pain months post-rhinoplasty. Is it infection?

Generally, patients should not experience excessive pain and tenderness post-rhinoplasty and should check for redness, swelling or discharge at the surgical site (could be signs of infection).

I have an asymmetrical nose from squeezing blackheads. What can be done?

It is unlikely that simply squeezing a nose caused any major form of nasal deformity. However, if the nose is indeed asymmetrical, the patient have a consultation with a board-certified, plastic surgeon to determine what can be done.

When can I play soccer post-rhinoplasty?

Patients can conceivably begin playing contact sports at a period of 6-8 weeks, with most surgeons suggesting waiting until the first 8 weeks simply because of the risk of bumping/breaking the nose in contact sports like football or soccer.

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.

After taking off the cast, my nose ballooned up. Is that normal?

This is absolutely normal. Patients will often find that the swelling which was kept down by the cast returns with a vengeance when the cast is removed. However, they should not be concerned as the healing process over the next three weeks post-rhinoplasty will cause this swelling to die down.

My nose is growing downwards and affecting my smile. What can I do?

What may be interpreted as nasal growth past the age of 20 or so (when nasal growth actually stops) is rotation of the tip of the nose downwards due to gravity and aging. This can be corrected via a tip-plasty in which the depressor septi muscles which cause nasal drooping are partially released and the tip is lifted, sometimes via a cartilage strut.

How to choose your Rhinoplasty surgeon

You should inquire about the following when choosing a surgeon:

1. Credentials: Is he a Board Certified Facial & Plastic surgeon? Is he aslo an ENT? How long has he been in practice? First and foremost you need someone who is well trained.
2. Gallery of Work: When you see their before and after gallery does it impress you? There are no guarantees, but the past is a great predictor of the future. You should consider whether the surgeon has experience with your ethnic type.

3. Simulated results: Computer technology allows the surgeon to virtually adjust your nose. This will show you the philosophy that shapes the surgeons style. Pay attention to how your surgeon describes what he would like to do.

3. Reputation: What does their previous/current patients say? Read some reviews and testimonials about the surgeon and their work.
4. Talents: Is your surgeon artistically inclined ? You want a surgeon who can not only manage the technical aspect, but that they will give you the best looking nose possible.

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.

What causes scar tissue buildup post-rhinoplasty?

Patients must realize that the rhinoplasty procedure, even if done by the most skilled surgeon, does cause a great deal of trauma to the nose. Scarring is simply one method the body uses to heal the wounds caused by this operation.

Can touching the nose affect its shape over time?

Constantly touching the nose may lead to minimal changes in nose thickness, stretching of the nostrils, etc, but not to any noticeable extent.

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.

How long do sutures take to dissolve post-rhinoplasty?

Typically, external rhinoplasty sutures can be removed after 7 days by the surgeon or will dissolve in that period. However, internal rhinoplasty sutures may take several weeks to dissolve.

Can I get a rhinoplasty at age 14?

As I addressed in another query, it is recommended that patients wait until their nose is fully developed before choosing to go ahead with rhinoplasty. Timing for a rhinoplasty after ages 15-17 for women and 16-18 for men is the ideal.

Can rhinoplasty be done under local anesthesia?

It depends on the procedure. In our offices, we generally like to use general anesthesia to protect the patient’s airways, but tip rhinoplasties (which only work on the very bottom of the nose and do not involve the breaking of nasal bones) can be done under local anesthesia.

I had an indentation in my nose post-Kenalog injection. Is it permanent?

Unfortunately, this may be a permanent defect that can only be corrected via the use of fillers. Kenalog and other steroid injections are normally used for thicker skin, but can erroneously be used for thinner skin causing it to become overly delicate (which is what I believed happened here).

Is nose cracking normal post-rhinoplasty?

This is a very unusual symptom, not at all common. I would recommend seeing a board-certified surgeon immediately to check what the issue might be. It may be the sign of a re-broken 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.

Does “Beauty Lift High Nose” work?

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 a nose be made longer?

The nose can be made to appear longer via downward rotation of the tip or the introduction of extension cartilage grafts. However, this is a much more complicated procedure than shortening of the nose and so must be done by an especially well-experienced surgeon.

Can I correct allergies with rhinoplasty?

It is true that the lining of the nose swell and thicken in response to allergies and this can block the nasal passages, leading to congestion and other allergy symptoms. A rhinoplasty can help make the air space bigger so that the tissues have to swell more to cause symptoms, BUT this will not help the condition of the allergies.

Can I have rhinoplasty in India and achieve good results?

It is highly recommended that patients looking to go abroad to have surgeries done take a second look at this idea and perhaps err on the side of caution and choose a surgeon closer to home. While there may be wonderful doctors abroad, it is important that, should something go wrong in the post-rhinoplasty phase, the surgeon who treated you also be able to evaluate you.

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.

Will insurance cover fixing my broken nose?

Generally, surgeries which work to improve the quality of life (in this case, the goal is improving breathing) tend to be accepted readily by insurance. However, if the septum is not deviated and breathing is not an issue, the surgery will only be counted as an aesthetic/cosmetic one and will NOT be covered by insurance.

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.

How can I clean the outside of my nose post-rhinoplasty?

It is important that, when a patient’s surgeon gives him/her the OK to begin cleaning the outside of the nose, they remain gentle. Generally, patients will use sterile solution like alcohol on gauze/cotton.

How can I correct my bulbous tip and upturned nose?

Correction of the bulbous tip would be the easier problem and can be solved by thinning the lower lateral cartilages in the tip and stitching them together to create a narrower defined tip. An upturned nose is more difficult and can be corrected in several ways, including the use of grafts or weakening the suspension elements of the nose and repositioning/securing the tip in a more preferable position by suturing the tip cartilages to the skin.

What is the proper icing technique following a rhinoplasty?

Patients are advised to speak with their own surgeons regarding this matter. However, one method which I have seen is to use a disposable glove and fill it with ice at the fingertips, letting the finger parts of the glove rest on either side of the nose and the palm part rest on the forehead.

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.

Will the Medpor nasal implant hold for a lifetime?

In my experience, it is usually best for support to be introduced into the nasal region via natural cartilage grafts from the ear or the septum. It is not clear whether the Medpor nasal implant will work for a particular patient, but the best chance of success involves grafts from the body.

Why is there a transverse crease in my upper lip?

Often, creases in these areas are caused by repeated motions of the muscles, much in the same way that laugh lines or crow’s feet developed. Mild solutions like Botox or Dysport may provide relief.

Does the nasal tip drop after rhinoplasty?

Of course, after the surgery, the nose ages just like the rest of the body and drooping does occur. However, this only occurs at a gradual rate and is unlikely to look unnatural. For patients concerned with the possibility of an upturned nose following surgery, it is important to recognize that there will be significant swelling in the columella region (the bottom part of the nose where the incision was made) that will cause upward rotation of the nose, but this will dissipate over time.

Why can’t I have the smaller nose which I want?

It is important for patients to recognize that, sometimes, a nose can be reduced to the point where it is simply not natural-looking in relation to the rest of a patient’s facial features. We as surgeons have a responsibility to not only fulfill a patient’s needs, but to stay realistic. Think of this way. We do not substitute one nose for another, but rather modify existing noses and correct defects. We maintain your original nose but tweak it, rather than giving you a new one.

My nose looks bigger post-op. Why?

It is perfectly normal for swelling to be apparent for up to a year post-op, so residual swelling particularly on the tip area several months post-op is perfectly normal and should not be a concern. Your surgeon did not do “anything wrong”.

Can oily skin damage my rhinoplasty results?

Absolutely not. Oily thick skin may be more difficult to conduct a rhinoplasty on simply because it is less elastic and tends to not drape as tightly around the newly positioned cartilage and bone, thus making the results look less apparent and dramatic. However, no damage can be incurred with this type of skin.

How long does it take for dissolvable stitches to dissolve?

Generally, dissolvable stitches will dissolve at an average of around 3 weeks post-rhinoplasty.

What are the preferential sites for cartilage harvesting in a rhinoplasty?

Generally, surgeons will prefer to use septal cartilage as a first resort, followed by ear cartilage from the cymba or cavum (top and bottom parts of the central depression within the ear). Rib cartilage is used as a last resort when these two sources are depleted, simply because of the invasiveness of cutting into rib tissue.

What is an alar base reduction?

The alar base reduction is a surgical procedure performed on patients with an excessive wide nasal base and/or excessive nostril flares. In this procedure, thin crescent-shaped wedges are taken out from the nostril and the resulting hole is stitched up, thus reducing the nostril size.

I have VERY WIDE swelling on my nasal bridge post-rhinoplasty. Is this actually swelling or something more serious like bone growth?

This is best evaluated, after approval by your surgeon, by applying pressure on one side of the swelling for about 1 minute or 2 and examining how deep of an indentation this created. If the indentation was deep, then it is most likely swelling. If this is the case, then lymphatic drainage may be the issue in which case massage of the area may help. If the indentation created was shallow, then it may be bone tissue in which a revision rhinoplasty is needed at least 6 months after the original procedure.

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