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

Can facial exercises post-rhinoplasty hurt the nose after rhinoplasty (e.g. Smiling, lifting the cheeks, etc.)?

This should not have a major effect on the rhinoplasty procedure. However, patients are advised that in the period of a couple weeks post-op, the nasal bones still aren’t fully solidified and should be treated carefully.

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.

Is it bad to bump the nose following rhinoplasty?

It is important that patients keep in mind the fragility of the nose following the rhinoplasty, especially considering the osteotomies (purposeful breaks in the nose) which were likely created during the procedure. Thus, keeping the nose protected is a top priority. By bumping their nose, patients risk septal hematoma (accumulation of blood in the nasal septa) which must be treated in the ER.

Can rhinoplasty be used to widen nostrils?

This procedure is generally less common than using rhinoplasty to narrow the nostrils and typically uses cartilage grafts from the tip of the nose or the ear. Consultation with a surgeon is best, however, to determine a patient’s particular course of action.

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.

How can I minimize skin care complications post-rhinoplasty?

Because the surgical tape and cast applied to the skin in the week after rhinoplasty traps sebaceous fluid within the pores of the skin, it is common for patients to experience acne breakouts in this time period. Having a facial prior to the surgery may be the best way to combat this as it cleans out the pores beforehand.

Is mucus buildup one month post-rhinoplasty normal?

Yes, absolutely. It is safe for patients to begin blowing their nose after about a month post-rhinoplasty, but saline spray can be used prior to this (as long as the splint has been removed).

How long can I wait post-op to fly or exercise?

Two weeks post-op is generally the benchmark to begin exercising again, but ease into your regular exercise regimen and don’t go heavy with the exercise until three weeks post-op. Flying can generally be done a week after the procedure, but it is recommended that patients wait about 10 days to 2 weeks.

Can rhinoplasty make the nose oily?

Normal oil secretion by the skin can be altered because of the trauma to the nose and the cutoff of blood circulation in the area. Post-op, this could result in acne breakouts as oil and other sebaceous fluid becomes trapped in the pores due to the post-op surgical tape.

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

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

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.

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

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

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

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

Why is my nose still the same size post-rhinoplasty?

As I tell many of my patients, the key to success in the post-rhinoplasty period following the rhinoplasty can be encompassed in one word: Relax. Very often, the residual swelling from the surgery, which tends to mostly resolve itself within 3-4 months with some swelling remaining up to 1 year post-rhinoplasty, can make the results of the surgery look much worse than they actually are. Patients are advised to keep this in mind and remain calm.

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.

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.

Is blood work necessary before a rhinoplasty?

It certainly does not hurt to get it done, especially because it may reveal aspects of a person’s health to a surgeon which may impact the surgery itself and the post-op process. Blood tests can help determine if a person has a clotting issue, for instance, or has other potential complication-causing problems. Personally, in my office, I will often have patients obtain blood work before rhinoplasties.

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?

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.

Can shaving the nasal bones reduce the width of the nose?

Theoretically, yes. However, this is a relatively temporary fix and also makes the lower nose look much wider and misshapen. In cases where the bridge is seen as too wide, a full rhinoplasty may be required, complete with osteotomies (which break the bone in a purposeful manner).

What is your opinion of Gore-Tex and silicone in a rhinoplasty?

Personally, I am more partial to avoiding man-made materials during rhinoplasty which can often pop out post-op and, in the case of Gore-Tex, have a high probability of infection. I prefer to use septal cartilage from the patient’s nose or, if that is not available, from the patient’s ear because the body is accustomed to it.

I have a new soft bump on my nose after I broke my nose. What is it?

Harder bumps on a nose subject to trauma are usually an indication of a callus formation (deposition of bone and cartilage in an area). Without an actual examination, it is hard to tell what the bump could be, but the possibilities include a cartilage-dominated callus or even small fluid accumulations (edemas).

How harmful is cocaine post-rhinoplasty?

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

Can I use a Q-tip to clean the inside of my nose post-rhinoplasty?

After a period of a few weeks post-rhinoplasty, patients can begin to clean their nose gently with saline or a hydrogen peroxide/water mixture. However, it is crucial that they remain gentle while doing so, applying a slight rotational, rather than a pushing, motion.

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 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.

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.

How many follow-up appointments are there post-rhinoplasty?

In general, there can be up to 5 post-op visits, the first being at 7 days to remove the nasal splint, the next being at 30 days, then 3 months, then 6 months, then a year (when full results will be more or less apparent).

I have a bump in my nose several months post-rhinoplasty. Why?

Although this may still be residual swelling, it is most likely hard bone tissue which unfortunately must be fixed via a revision rhinoplasty. Talk to your surgeon about your best options at this point.

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.

How do I know when my nose is done developing?

Generally, when it comes to noses, there is no “magic number”. However, it is generally safe to consider rhinoplasty at ages 15-17 for girls and 16-18 for boys.

When can I swim post-rhinoplasty?

It is acceptable for patients to go back in the pool after a month or so post-rhinoplasty, but take care not to bump your nose on anything. I would, however, postpone swimming in the ocean to 8 weeks because of the risks of a bleeding nose and the subsequent problems which could occur with sharks and other wildlife.

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 should I do about scabs inside my nostrils post-op?

Nasal vestibulitis (the development of scar/scab tissue in the nostrils) is a common occurrence post-op, especially for patients with a history of seasonal allergies. It is suggested that patients with this condition see their doctors, who may suggest applying OTC hydrocortisone with a Q-tip to site of scar development (this will generally fix the problem within a week).

What is a revision rhinoplasty?

A revision rhinoplasty refers to a rhinoplasty procedure which is used to correct the results of a previous rhinoplasty which had a negative impact on the patient, functionally and cosmetically. Unfortunately, given the high degree of difficulty inherent in a rhinoplasty procedure, it tends to have a relatively high rate of revision (8-10% of cases require revision). As a result, patients should be careful in choosing their surgeon and make sure they have all the proper qualifications and experience to do the 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).

Can rhinoplasty be used to reduce nostril size?

Yes this can be done with an alarplasty in which a crescent-shaped wedge of skin is taken out from the nostril via an incision inside the nostril tissue and the resulting hole is closed up to reduce nostril size. However, this is a rather difficult procedure with great potential for asymmetrical results, so work with a surgeon who is very competent and has a history with these procedures.

Why is wearing glasses a problem post-rhinoplasty?

Especially during the first few weeks post-rhinoplasty, it is important that patients refrain from wearing glasses because of the pressures which they exert on the nose. At this stage, the nose is still very delicate and, if osteotomies were performed, is still recovering from being broken, so any external pressures may cause irreparable shifts in the bone.

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.

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.

I had septal cartilage harvested to build my tip, but now it’s too long. What can I do?

Chances are the surgeon who built your tip add a cartilage graft. To return to the preoperative stage, the graft can be easily removed.

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).

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.

Can heavier glasses deform the nasal bones?

It is unlikely that heavier glasses will necessarily deform nasal bones, especially in a nose which has not undergone rhinoplasty. Patients can try going to lighter frames and see what occurs, however, if they are curious as to what could happen.

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.

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).

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.

I have a sore red bump inside my nostril. What is that?

This is most likely your inferior turbinate, a shelf of tissue and bone, which is often cauterized during a rhinoplasty and can swell up post-op.

When will I see the final results of a rhinoplasty?

The full results of a rhinoplasty will manifest themselves generally after about 1 year post-rhinoplasty, but patients should generally have an idea about how they should generally look at 6 months (anything afterward is simply refinement of the existing product).

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 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.

How can one reduce nose size without excess skin?

In reality, thick skin is more difficult to manage and drape over a newly created cartilage foundation than thin skin because it is more elastic and willing to stretch. Therefore, reduction rhinoplasty is considerably more difficult under these circumstances because, while skin does contract, thick skin does so far less.

Will I experience empty nose syndrome after a rhinoplasty and turbinectomy?

Both of these procedures were likely performed to correct a breathing defect. If by empty nose syndrome (which is not a real condition) you mean that the turbinates have been fully removed, this is not likely unless your surgeon went hyper-aggressive on the turbinate removal —- which is not medically advised at all. I would not worry about this.

Is Nose Right a scam?

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.

How long can I use saline rinse post-rhinoplasty?

Saline rinse is generally advisable for the first 2 weeks post-rhinoplasty simply to clear crusting blood and excess mucus deposits within the inner wall of the nostril. However, it is best to follow your surgeon’s recommendations regarding nasal cleaning post-rhinoplasty.

Does rhinoplasty improve sinus reactions?

Normal airflow through the nose is essential for sinus function (sinuses are air chambers within the facial skeleton). Therefore, a deviated septum or any other obstruction to normal air flow can be corrected with rhinoplasty and this procedure can improve sinus function. However, patients must evaluate whether a blocked airway is actually the cause of their sinus issues, because any other cause will not be fixed via a rhinoplasty.

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 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.

What can be done to resolve cartilage shifting post-rhinoplasty?

Cartilage shifting post-rhinoplasty can be disguised with the use of fillers, but a more permanent solution would be to introduce cartilage grafts.

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.

Is it strange to have extensive bleeding and oozing days post-rhinoplasty?

Given the freshness of the trauma endured by the nose during rhinoplasty, it is perfectly normal for patients to experience bleeding and oozing. Patients should contact their surgeon and ask about the protocol for cleaning the nose, as it varies from surgeon to surgeon.

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.

Can an alarplasty serve as a quick fix nose job?

This depends on what exactly the patient’s needs are. If the only concern is wide nostrils, then an alarplasty or a Weir reduction is ideal. However, neither of these procedures addresses questions about the tip of the nose or the bridge which are often problem areas for patients requiring a nose job.

What are the pros and cons of grafting during a rhinoplasty?

The pros of using grafts are mainly that it acts as additional support for maintaining the results of a rhinoplasty, particularly procedures which elevate the tip, and should not be avoided when they are warranted. By the same time, cartilage grafts should be used judiciously as they might NOT be needed and may actually lead to unevenness in the nose (which is why patients requiring cartilage grafts should go to an experienced surgeon).

How can I fix a natural ski-slope nose?

A natural ski-slope nose may be best addressed by inducing less projection of the tip (deprojection) and perhaps placing some septal or ear cartilage along the patient’s supratip area to introduce fullness into the area.

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.

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.

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

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

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.

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.

Will my insurance pay to correct my crooked nose?

Unless the crooked nose interferes with breathing, it is unlikely that insurance will cover for the costs of the procedure. However, this is best answered by your insurance provider directly.

Why was an external splint not put on my nose after it was broken?

Although most surgeons will use an external splint in order to protect the results of their work, some (although rare) may opt to just use internal packing in order to realign the nasal bones. However, this method does not work as well as an external splint.

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 long after my jaw surgery can I undergo cosmetic rhinoplasty?

I would wait at least several months before undergoing another major procedure like rhinoplasty. The rhinoplasty operation itself will operate under general anesthesia and takes about an hour and a half.

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.

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