Rhinoplasty

Rhinoplasty NJ or nose job NJ. Dr. Kassir is the best rhinoplasty surgeon in NJ. Find rhinoplasty NJ answers and see results from one of the best New Jersey rhinoplasty surgeons.

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About Rhinoplasty

by Ramtin Kassir, M.D., F.A.C.S.

Do you have any problems breathing through your nose or do you have chronic nose or sinus complaints? Has a prior injury made your nose out of proportion to your other facial features?

Rhinoplasty or nose job surgery, is the surgical procedure that involves changing the shape and size of the nose. Dr. Ramtin Kassir MD performs this procedure for his New Jersey patients that involves reshaping the nasal bones and cartilages to produce a balanced and harmonious nose that blends with the person's facial features.


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 and NYC.

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, 799 Park Avenue, NYC, 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 and NYC 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 fifteen.
  • You have good physical and emotional health.

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 rhinoplasty, Asian rhinoplasty, Hispanic rhinoplasty, and Middle Eastern rhinoplasty.

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


See Dr. Kassir's RealSelf reviews

Rhinoplasty: Questions & Answers

When can I have a facial after a rhinoplasty?

Due to the trapping of sebaceous fluids in the pores due to the surgical tape, it is common for patients to experience acne breakouts post-op. You should be ready for gentle cleaning at around 1 month post-op, but, if the nose is still sore, wait a couple more weeks beyond that.

What can be done to reduce a wide nose?

Depending on what patients define as a wide nose, there are several procedures which can be done to alleviate this problem. Osteotomies can be done to narrow the upper nose, cartilage can be removed from the middle, alar base reductions can be done to reduce nostril width (which is usually the common problem), etc. A more thorough examination is necessary to determine exactly what should be done though.

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

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

Will my smile be normal after rhinoplasty?

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

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.

Can I run 2 weeks post-rhinoplasty?

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

My external splint fell off post-rhinoplasty. What should I do?

If it has not been a week post-rhinoplasty, I would recommend contacting your surgeon immediately. Splints are generally made to stay on for at least a week post-rhinoplasty.

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.

Does my nose spreading (when I smile) get better as the post-rhinoplasty period goes on?

Unfortunately, nostril over-spreading during smiling or even while resting is not something which is fixed by a typical rhinoplasty. Although post-op swelling may contribute to this, patients who are dissatisfied with their nostrils post-rhinoplasty may want to consider alar base reduction.

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

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

How does weight loss/gain affect the appearance of the nose?

While weight loss or gain may affect the appearance of the nose in relation to other structures (as the face gets thinner, the nose takes up a greater proportion of the face and thus looks “bigger”), the nose itself has little fat within it and is not actually affected in terms of size by changes in overall fat for the patient.

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.

Is open or closed rhinoplasty better for tip work?

Generally, I would advise patients to pick the surgeon, not the procedure, as the surgeon’s individual skill is probably the biggest factor as to whether a patient achieves the results he/she wants. However, if you insist on a straightforward answer to the question, I would probably recommend open rhinoplasty for tip work only because it allows for the surgeons to have a greater view of the work they are doing in that area.

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

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

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.

Can the bridge of the nose be narrowed without touching the tip?

Yes this can definitely be done. However, patients must consider whether tip work may be necessary to make all details of the nose proportional to each other.

What is septurbinoplasty?

This term can be broken down into two parts: sept- and turbino-. It is a procedure which corrects a deviated septum (sept-) and corrects for enlarged turbinates (turbino-), both of which can obstruct nasal airways. Correction of these two issues is often determined as functionally necessary and will usually be covered by insurance.

How long does swelling take to subside post-rhinoplasty?

Swelling is variable from patient to patient depending on factors like age, smoking habits, etc. However, as a general rule, 2-3 weeks is the benchmark for when most of the swelling subsides, at which point the remaining swelling will only be visible to the patient and his/her surgeon. The remaining swelling will gradually dissipate in the next 6-12 months.

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).

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).

What can I do for a drooping columella post-rhinoplasty?

A drooping columella can be addressed by removing a small section of skin and cartilage from the area and then simply patching up the area.

Can rhinoplasty be done without anesthesia?

Unfortunately, not simply due to the painfulness of the procedure without anesthesia and the risks associated with it.

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.

I have overprojection and a hard tip following placement of a cartilage graft and a columellar strut. Is that normal?

If the cartilage graft was taken from the rib, this is a perfectly normal symptom as rib cartilage tends to be sturdier compared to septal or ear cartilage. Also, depending on the timeline post-op, this may be a normal part of the healing process and may resolve itself over time.

Should I have an open or closed rhinoplasty?

Patients should generally not concern themselves with the technique of open or closed rhinoplasty as much as the skill of the surgeon, as the results of both are very much comparable in many cases.

Can rhinoplasty fix a short upper lip?

Often, a short upper lip is related to a droopy tip as the depressor septi muscles impact both. Cutting these muscles and releasing the upper lip can help the tip lift up and thus allows the upper lip to show slightly more.

Will my nose rotate upwards as the swelling heals post-rhinoplasty?

It depends where the swelling is. In some patients, there is swelling in the supratip region which weighs down the nose and causes it to droop. The subsiding of the swelling will thus cause the nose to correct itself and rotate upward.

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.

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.

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.

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.

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.

Why was I not taped after my splint was removed?

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

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

When is my nose strong enough to not break after a rhinoplasty?

Generally, nasal bones will be stable enough not to move easily following a month post-rhinoplasty.

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.

Long-term cocaine use caused a hole to develop in my nasal membranes. What can I do?

First of all, it is important that patients who are serious about achieving a permanent solution to this type of problem lay off cocaine, which is a major vasoconstrictor (narrower of the blood vessels). Vasoconstriction of the nasal membrane blood vessels causes nasal membranes to die, thus leading to the development of holes, etc. Reconstructive nasal surgery may be done with the use of grafts but the chance of success is much lower than typical rhinoplasties.

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.

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.

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.

Can I make the bridge of my nose lower and flatter (Asian nose)?

A typical “Asian” nose can indeed be crafted via a shaving down of the bridge, especially the radix (the top part of the bridge), and conducting osteotomies to realign the nasal bones in an appropriate manner.

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.

My nasal tip is still swollen. Why?

Patients will often find that residual swelling is pronounced particularly in the tip. This is generally a pretty heavy surgical site during the rhinoplasty procedure and will be subject to the greatest proportion of the swelling. Regardless, patients need not worry as residual swelling gradually dissipates over the course of a year.

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 bad is Rhinoplasty Swelling?

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

Is reduction of my bulbous tip going to a problem with my thick, oily skin?

For patients with rhinophyma (excessively large sebaceous glands which cause the nose to appear large), it is important to recognize that the results of a rhinoplasty will not be as dramatic as a rhinoplasty on a patient with thinner skin. However, sebaceous glands can be reduced with a CO2 laser procedure, which can help with the results of the rhinoplasty a little bit.

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.

How can I treat a ski-slope nose and upturned tip post-rhinoplasty?

Patients who have these conditions after a rhinoplasty will most likely be in need of a revision rhinoplasty where cartilage grafts are reintroduced to give more support to the tip and fillers are introduced to augment the bridge.

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.

When will I be work-ready following a rhinoplasty?

I would say that patients will generally be presentable a week to ten days following a rhinoplasty.

Is vomiting after a rhinoplasty common?

The most common causes of post-rhinoplasty vomiting are blood dripping into the stomach and complications with general anesthesia. This occurs probably in around 1/10 of most rhinoplasty procedures, but it is important to recognize that these symptoms will only last for about a day or two.

Can I laugh or smile following a septorhinoplasty?

Of course! Patients are told to avoid strenuous activity like exercise for 6 weeks or so post-rhinoplasty, but smiling and laughing does not go under this category.

My stitches aren’t dissolving one month post-rhinoplasty. Why?

Generally, these stitches should not last longer than a week or two (absorbable). Evaluate with your surgeon to have them removed.

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 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

When is alcohol consumption post-rhinoplasty fine?

Alcohol in moderation should not a problem at around 3 weeks post-op.

How soon can I use nasal irrigation or sprays post-rhinoplasty?

This is probably best addressed by your surgeon. However, I would advise against nasal irrigation because it creates too much pressure in the nasal region that can lead to disrupted healing of nasal incisions.

When should I blow my nose post-rhinoplasty, and why shouldn’t I do it before then?

Blowing the nose prematurely can result in bacteria getting into the internal incision sites. In addition, pushing on the nose during the blowing process may cause shifts in the cartilage and bone which the surgeon worked so hard to avoid. Patients can safely blow their nose 1 week or so post-op.

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.

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.

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.

How long is the time period from consultation to surgery?

This really depends on the surgeon’s schedule, the patient’s schedule, and the need to obtain medical clearances.

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.

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 do I get natural rhinoplasty results?

The best tip for achieving a natural rhinoplasty look is first to find an experienced surgeon that is board-certified in plastic surgery AND specializes in these types of procedures. The second tip is to not set your expectations unrealistically high. Very often, patients will come in demanding a “Kim Kardashian nose” or something like that when it is impossible for me as a surgeon to make it look natural. What rhinoplasties do is essentially modify an existing nose to correct defects, not substitute one nose for another. Our goal as surgeons is to simply enhance the nose you already have.

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

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

Should cartilage in my nose “pop”?

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

Are uneven nostrils normal post-rhinoplasty?

As I tell my patients, it is key that they remain patient in the post-rhinoplasty period. The first few weeks post-rhinoplasty will be accompanied by a great deal of swelling and bruising that will skew the appearance of the surgical results and make them look significantly worse than they actually are. It is best to wait at least 6-8 weeks to evaluate for asymmetry.

What kind of stitches are used in rhinoplasty?

There are two main types of stitches that are used in rhinoplasties: dissolving and non-dissolving. Stitches which are placed inside the nose will dissolve over the course of a couple months, while external stitches are non-dissolving and will typically be removed within a week post-rhinoplasty.

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.

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.

What is the difference between open and closed rhinoplasty?

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

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

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

My nasal implant is showing and stretching my skin. Should I keep it in?

This is a common complication with nasal implants, and the best course of action would probably be to have the nasal implant removed before it impedes blood flow, extrudes through the skin, etc.

How is rhinoplasty different for Hispanic patients than other patients?

In general, Hispanic patients tend to have thicker (oilier) skin than Caucasian patients, broader faces and wider nostrils/nasal bridges, weaker cartilage, and a greater proportion of nasal humps. With all these considerations, it is important that surgeons understand the aesthetic goals of their Hispanic patients and tailor their surgical goals to their patient’s needs.

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