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.


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Rhinoplasty: Questions & Answers

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.

What is this funny smell in my nose post-rhinoplasty?

It may be best for patients to evaluate with their surgeon if they detect unusual smells. This may be the sign of a residual suture which needs to be removed, but could also be indicative of an infection.

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 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 long does it take for dissolvable stitches to dissolve?

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

How much does the nose grow during the teenage years?

As you probably learned in your middle school health classes, puberty is a time of great changes for the body and, as such, it is also a time of great changes for your nose. Before nasal growth stops permanently in one’s 20s, it progresses extensively in the teenage years and features which stood out before on the nasal area will stand out further (bumps will grow, etc.).

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.

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.

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 possible for rhinoplasties to cost less than $1000?

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

Do alarplasty scars take a long time to heal?

Generally, alarplasty scars though pretty much permanent are extremely well hidden along the alar/nasal intersection and will generally fade over time.

When can I smoke marijuana post-rhinoplasty?

Smoking any substance like marijuana will cause pulmonary irritation that will cause a longer healing process. I would recommend waiting at least 3-4 weeks before doing anything of the sort.

Can a typical African-American nose be modified to a Middle Eastern nose (pointy but with a drooping tip)?

Unfortunately, due to the thick nasal skin associated with an average African-American nose, it is very unlikely that even the most skilled surgeons can complete this transformation without risking the nose being unnatural looking. The nostrils and the tip can be narrowed and the nasal bridge can be augmented, but not to the extent that many will desire.

Can I get a rhinoplasty surgery in Pakistan?

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

Why do steroid injections only work temporarily?

Steroid injections, though present for a little while after they are introduced to the body, only provide a temporary preview of the final result of the procedure before being absorbed by the body.

Can I re-break my own nose in order to straighten it?

This is highly inadvisable as patients often do not know the precise motions which are required to set the nose in a perfectly straight manner. It is recommended that patients with a deviated nose go to a professional to have it fixed.

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.

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.

My upper lip and tip of my nose are not moving after my rhinoplasty. Why?

Numbness following a rhinoplasty is not uncommon, but a consultation with the surgeon is probably necessary just in case. Speculation would seem to indicate that the numbness in the tip of the nose is caused by the resection of the depressor septi muscle, the symptoms of which will probably dissipate after three months. The numbness in the upper lip is most likely the symptoms of nerve aggravation which will also resolve itself as time goes on.

Can nasal valve collapse cause sinus infections?

The collapse of the nasal valves will not directly lead to sinus infections, but their effect on airflow to the sinuses can indirectly lead to sinusitis.

What is a septoplasty?

A septoplasty is a procedure which modifies the nasal septum (the wall in the center of the nose) and usually helps with deviation of the septum in order to correct breathing.

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.

Can I reduce the size of my nose non-surgically?

Unfortunately, this is highly unlikely. Non-surgical nasal modifications, by their nature, use fillers to make certain areas bigger in relation to others, so surgery is the only option to reduce nose size.

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”.

Should I have the dorsal hump on my nose corrected with open or closed rhinoplasty?

Either approach would work, with the open approach having more bruising and a more noticeable scar. However, it is important for patients to consider whether they also need changes in addition to the dorsal hump (e.g. Droopy tip, etc.) which could better be fixed by the open approach.

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

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

I have septum pain and deviation as well as enlarged turbinates. What should I do?

Generally, deviation of the septum and enlarged turbinates are not associated with pain unless combined with a sinus infection. Consulting with your surgeon is probably the best course of action, but the solution may simply be dryness of the nasal canal.

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.

There is a red spot on my nose post-rhinoplasty. Should I be worried?

I would demonstrate some concern and consult with my surgeon. This could be inflammation due to a suture or graft material.

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.

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.

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.

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 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 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

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.

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.

Should I consider a chin implant in addition to a nose job?

While it is difficult to really answer this question on a case-by-case basis, it can be answered generally. The nose and the chin, being along the same midline of the body, are very intimately related and a change in one can impact how the other looks. For instance, patients with a larger nose may look bird-like if their chin is weaker, while patients with a smaller nose may look bottom-heavy if their chin is particularly strong. The overall goal of any facial plastic surgery procedure is to increase overall facial harmony, so ask your surgeon whether a chin implant/reduction would be advisable.

Can I improve swelling several months post-rhinoplasty?

Unfortunately, the only real proven method to reducing swelling months post-rhinoplasty is simply being patient and allowing the body to heal itself naturally. Patients especially if they have thicker skin (which is known to make the nose seem more swollen) must remain calm and have faith that the surgeon did his/her job correctly.

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.

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.

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

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

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

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

Is an 8mm to 1cm reduction on the bridge possible in a rhinoplasty?

This is doubtful. The typical removal for a rhinoplasty ranges anywhere from 4-6 mm. Some patients may warrant more, but the surgeon should make sure that he/she has a definitive plan of what to do with loose skin and whether the nose still remains proportional to the face.

How can I correct a wide nasal bridge without bringing my eyes closer together?

The close-set eyes should not be an issue and the correction of the nasal bridge can be accomplished via an osteotomy that will angle the nasal bones closer together.

Does a crooked nose necessarily mean a deviated septum?

Not necessarily. While a deviated septum could create a crooked nose, problems in the alignment of the underlying cartilage (upper lateral, specifically) or bone may also play a part in creating a misshapen bridge. It is recommended that patients be professionally evaluated in a surgeon’s office.

I have a red, inflamed throat days post-rhinoplasty. Why?

This could have a range of causes, from the endotracheal tube used during surgery, post-nasal drip, or even strep throat. Check with your surgeon about this.

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.

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

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

Are there cheaper ways to disguise/remove a bump on the nose?

Some cheaper options to dealing with a dorsal hump could be to wear larger-frame glasses which take attention away from the bridge, use non-surgical fillers like Restylane to heighten areas around the bump and make it less noticeable, etc.

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.

How can I prevent swelling post-rhinoplasty?

To prevent swelling post-rhinoplasty, patients are advised not to drink alcohol or smoke or engage in behaviors which will result in altered blood flow to the surgical area. They are also advised to sleep with their head elevated and keep ice on the surgical area for the first 2 days post-rhinoplasty.

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 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.

Why is my tip drooping post-rhinoplasty?

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

Can my nose be made straight in spite of my asymmetrical facial features?

Rhinoplasties can indeed be performed even if the patient can has asymmetrical facial features. However, it is best for these patients to seek out experienced, board-certified surgeons who have a good sense of how to perform these types of procedures.

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).

Can I smile after a rhinoplasty?

While smiling may cause a certain degree of discomfort post-rhinoplasty due to edema and other fluid buildup, patients are safe to smile all they want.

How long does cartilage grafting from the rib take to heal?

Though general work-ready recovery time from a rhinoplasty takes about a week or so, grafting from the rib can cause soreness for at least a couple of weeks and it is best to avoid even light exercise for at least 6 weeks or so.

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.

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).

Will weight lifting affect my rhinoplasty results?

The reason patients are advised to wait at least 4-6 weeks before undertaking strenuous activity like weightlifting is because of the increased risk of nosebleeds resulting from heightened blood pressure. Patients can experiment at this point to a degree: try weightlifting moderately once and see if swelling has increased (if so, stop and try again in a week or so).

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.

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.

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.

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).

How can my post-rhinoplasty callus be reduced?

Generally, it is normal for these types of humps to be present over the first several months post-op. However, if the bump is still present after several months post-op, it may be reduced via a rasping procedure that will only require local anesthesia and a few minutes in your surgeon’s office.

Why do I have cartilage lumps post-rhinoplasty?

In most cases, small lumps and bumps post-rhinoplasty are simply the result of residual swelling from surgeries which tends to dissipate over the course of a year. Sometimes, they could be from residual shavings of cartilage which will also be reabsorbed by the body.

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

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.

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.

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.

I am experiencing dry nostrils and burning post-rhinoplasty. What’s wrong?

This may be the result of a suture which has not been removed yet. I would consult with your surgeon to make sure everything is okay.

What causes polly beak deformity?

Polly beak deformity, the common name given to supra-tip fullness, can be seen due to excision of dorsum just above the tip and also from poor nasal tip projection, both of which give the impression of an unnatural curve at the tip.

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.

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