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

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.

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 Jennifer Aniston’s nose?

This depends on how her nose works with your existing facial features and how similar your noses are. It is always good to bring in pictures to your surgeon’s office to get him/her a sense of what you want your final result to be. However, patients must realize that celebrity noses do not necessarily look good on every face and that the surgeon can only modify existing noses, not create new ones.

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.

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.

How much will it cost to correct a bulbous tip and a profile?

This can be done via a rhinoplasty which will generally hover in the cost neighborhood of about $8,000-$10,000.

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.

Do I have scar tissue or swelling after removing my nasal implant?

This may be fibrous tissue that can take up to a year to fully heal. Consult your plastic surgeon to ask his opinion.

How long is a rhinoplasty procedure?

A typical rhinoplasty will take around 2 hours to perform.

I have disproportionate swelling on my columella. Is this normal?

It could be. Many surgeons who make a columellar incision will find that whatever side the incision is made on will tend to swell more than the other side. However, if the columella appears to have shifted, it may require the resectioning of septal cartilage.

Is there nerve damage during a rhinoplasty?

Generally, a typical rhinoplasty will involve cutting of sensory nerves within the skin, thus causing a decreased response to touch within the area for a period of several months. This is particularly apparent at the tip of the nose which undergoes the highest proportion of trauma during this procedure. Motor nerves, however, in particular the facial nerves which control the mouth and nose, should not be impacted during the surgery.

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.

Can rhinoplasty correct flaring nostrils?

Nostril flares can be corrected with procedures like the alarplasty/alar base reduction in which the nostrils are narrowed and an alar base resection is performed with the help of a crescent-shaped wedge removal in the nostril wall. However, this procedure is rather difficult as it entails extreme precision in order to reduce the likelihood of asymmetrical nostril development.

Can a deviated tip be corrected without rhinoplasty (ex. Grafts, etc.)?

Yes, this can be done. It is rare, but grafts can be applied to the tip area to help with deviation, especially one that is caused by nasal trauma (punch to the face, etc.). Fillers may also help if you are for non-surgical solutions.

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

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

How long does bruising persist after a rhinoplasty?

Bruising from rhinoplasty as a general rule will mostly fade away within 2-3 weeks post-rhinoplasty. In the majority of cases, however, it will disappear even sooner (within 1-2 weeks).

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.

Do bones swell post-rhinoplasty?

No, the bones do not swell. The tissues around them, like the skin and other softer tissues, do though.

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.

When can I start smoking following surgery?

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

How long should I wait post-rhinoplasty to get steroid injections?

Kenalog injections can be safely administered 4-6 weeks apart as early as one month following the rhinoplasty procedure.

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.

Can I gargle with salt and water post-rhinoplasty?

This symptom probably resulted from the breathing tube used during the application of general anesthesia and salt water can help, as can throat lozenges.

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.

When can I start lifting weights?

Patients can resume light exercise after 3 weeks post-rhinoplasty and then build up to strenuous exercise over the next couple of weeks after. However, I often recommend that they stop if they detect additional pressure in the nasal area. Increased blood flow to the area could increase the amount of potential scar tissue that forms post-rhinoplasty.

Can I die from a rhinoplasty?

It is rare for patients to die of complications directly associated with rhinoplasty, simply because the nose is not exactly crucial for survival. If deaths do occur, and this is EXTREMELY rare, it will occur due to complications with anesthesia or because of prior health concerns which are not disclosed to the surgeon. Make sure, during your consultation, to tell your surgeon everything and also look into general anesthesia in which a breathing tube is inserted to ensure proper ventilation.

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.

When can I wear glasses post-op?

It is recommended that, if patients have contact lenses, that they utilize those rather than glasses for at least 4 weeks post-op. However, if glasses are the only vision correcting tool available, they can be worn over the splint. When the splint is removed, however, patients are recommended to tape their glasses to their forehead or acquire a common pharmacy device which allows the glasses to rest on the cheeks.

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.

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

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

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 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.

Can I simply make my nose smaller by shortening the tip?

Sometimes, surgeons will simply rotate the tip upwards in order to give the illusion of a smaller nose. However, this does not always work with most patients and instead gives the appearance of a pig-like nose. Unfortunately, long pointy noses can also be corrected with a rhinoplasty procedure in which the septum and the surrounding structures are reduced.

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).

What are the pros and cons of steroid injections post-rhinoplasty?

Steroid injections are introduced in patients to prevent the buildup of scar tissue that can actually deform the tip. However, while helpful, it can also cause atrophy of surrounding tissues and overthinning of the skin if not used judiciously.

If I already have a broken nose, do I need to wait longer before getting a rhinoplasty?

Absolutely not. Because rhinoplasties often require osteotomies anyway, I would recommend that patients, if they do have a broken nose that they wish to have repaired, come after 5-7 days but no later than 2 weeks post-injury. At the 2 week mark, the bones will have already begun to heal and it may be more difficult for surgeons to correct the original defect.

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

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

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.

When can I lay on my side post-rhinoplasty?

Around two weeks in is a good benchmark for when you can begin sleeping on your side post-op. However, some surgeons may even recommend as soon as 7-10 days.

What can I do to prevent columella scarring post-rhinoplasty?

Unfortunately, there is very little patients can do to actually prevent scarring. Still, the scars will tend to heal fine if given enough time.

Can implants be infected years post-rhinoplasty?

While it is rare for these cases to occur, they do occur once in about a thousand times. Generally though, if the patient bolsters their immune system with antibiotics, it will go a lot way to preventing infections.

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.

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.

Is keloid scarring post-rhinoplasty a risk?

Keloid scarring post-rhinoplasty is so exceedingly rare that I usually advise patients to not even worry about it.

Did a nasal fracture cause my headaches?

It is definitely not uncommon for patients who experience nasal fractures to experience headaches. It is best for these patients to go to a well-qualified surgeon to plan their best course of action.

Why do I need to tape my nose even after splint removal?

This step is taken to counter and minimize the inevitable swelling which occurs and to counteract the pressures caused by minimal forces to the nose (ex. Eyeglasses).

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.

When can I tan post-rhinoplasty?

Because of the general numbness and delicateness of the nose post-rhinoplasty, the nasal area is particularly prone to sun damage after the procedure and patients are generally not aware of the problem until it is too late to correct it. It is advised, therefore, that patients stay out of the sun as much as possible in the first 6 weeks post-rhinoplasty.

Can the fatty tissue in my nose be thinned out?

Many ethnic patients, particularly African-Americans, have thickened nasal tips as a result of excess fibro-fatty tissue. During a rhinoplasty, this tissue is removed and cartilage is harvested from the ear, etc. to shape the tip.

How can a patient limit bruising post-op?

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

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.

I have clear fluid drainage post-rhinoplasty. Is this normal?

This is perfectly normal as it is could be the mucous from the nasal mucosa which is simply runny due to the nasal trauma of the rhinoplasty. However, I would check with your surgeon as clear drainage could be a potential leak in cerebrospinal fluid which could lead to bacterial infections. Check to see if you have headaches while ONLY standing up, as this could be a symptom.

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.

Is it normal to have headaches every day following rhinoplasty?

Because rhinoplasties often entail the narrowing of the bridge of the nose, it is normal for a minority of patients to experience sensitivity and discomfort for a period of weeks. No concern is needed.

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.

I had grafting done on my nasal bridge and tip, and it warped. What should I do?

One of the problems with grafting, although it is relatively rare, is warping, or twisting out of shape. Unfortunately, there is little you can do now other than consult with your surgeon about your best possible options.

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.

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.

Can I remove the scabs in my nose post-rhinoplasty?

I would not recommend removing the scabs directly as it could lead to infection. Patients who wish to breathe better can apply saline or a water/hydrogen peroxide mix in order to relieve the crusting, but gentleness is key.

Can a broken nose be fixed under local anesthesia?

This can be done, especially if the broken nose is corrected within a week of the original trauma. However, if the broken nose is on a child, sedation or general anesthesia may be more appropriate given the painfulness of the needles.

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.

When can I get a nose piercing post-rhinoplasty?

Because of the risks of infection and complications associated with getting a nose piercing early in the post-rhinoplasty healing process, I would wait at least 6-8 weeks post-rhinoplasty to have this done.

When does my smile return to normal post-rhinoplasty?

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

Can injury cause the formation of a hump?

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

Why do I have breathing problems years post-rhinoplasty?

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

If my septal cartilage is harvested, how is it replaced?

Generally, in the hands of a good surgeon, cartilage which is harvested from the septum will NOT require replacement as the surgeon will leave a large piece of cartilage there to maintain support of the nasal tip. If more cartilage needs to be harvested for grafting, it will be taken from the ear and the rib.

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

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

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).

Do I need nasal packing following a rhinoplasty?

Although improved methods of post-rhinoplasty care have generally made nasal packing after a rhinoplasty relatively obsolete, many surgeons today still use nasal packing as a way of preventing excess post-rhinoplasty bleeding. However, it is usually not needed except in rare cases where other methods to stop bleeding have not helped.

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.

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.

When can I drink coffee and wine post-rhinoplasty?

The recommendation is that patients wait at least 10-14 days post-rhinoplasty to resume drinking coffee and wine, as the former can raise blood pressure (presents risk of increases in swelling) and the latter may also present problems with swelling.

Can I go to an ENT doctor for revision rhinoplasty advice?

It seems like a logical place to start. ENT doctors are generally familiar with the anatomy/issues of the nose, but facial plastic surgeons are probably the best bet for people looking for a specialist in these fields. Even better would be a surgeon specializing specifically in revision rhinoplasties.

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.

I just got a cold a week or so after my rhinoplasty. Anything I should do?

Other than causing congestion and subsequent increases in swelling and post-nasal drip, this should not have a major impact on the final shape of the nose post-rhinoplasty. Patients should just take care not to rub their nose or put any other pressure on it inadvertently.

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