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

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

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

Is my nose broken during a rhinoplasty?

It often scares patients to think that their nasal bones will be broken during rhinoplasty procedures. However, they should be aware that the breaking is not at all similar to a typical nose break caused by a punch to the nose, but is rather more precise and done with instruments. Also, rhinoplasty procedures take place under anesthesia, so the only pain which will be felt is afterwards (and it is a mild pain, similar to a headache following a broken nose).

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.

What is the best scar cream after an open rhinoplasty?

This should probably be best addressed by your surgeon, but personally, I believe time is probably the best healer for scars especially if it is soon post-op.

How long is my tip numb following rhinoplasty?

Generally, numbness in the tip should begin to improve within 6-12 weeks following the procedure, but may take up to a year to fully resolve itself.

How can I remove a post-rhinoplasty scar?

Unfortunately, scars cannot be permanently removed in the way that patients would like to see. However, they can be mitigated via cortisone injections and, long-term (after the healing process is complete), via laser resurfacing and dermabrasion treatments.

I have a cartilage-like growth on my lower nose years after rhinoplasty. What is it?

This sounds like a shifted cartilage graft. It might be best for you to evaluate this with your surgeon.

Is the bulbous nose which I have post-rhinoplasty a sign that I need to do a revision rhinoplasty?

Even months post-rhinoplasty, the nose can still have a good deal of swelling which skews the appearance of the final results of the surgery. My best advice to patients post-rhinoplasty is not to worry too much about the appearance of the nose until at least 8 months post-rhinoplasty.

Can I modify the tip of the nose without breaking the nasal bones?

This can absolutely be done and it is known as a tip rhinoplasty. However, patients must keep in mind that it is rare for a patient to have a wide tip but normal-width nasal bones. Often, both are wide which requires osteotomies to fix.

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.

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.

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 lump on my nostril following rhinoplasty. What is it?

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

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.

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.

Will rhinoplasty affect my voice?

Generally no, other than during the initial period when there will probably be some nasal congestion that occurs (but this should clear up). The biggest concern in terms of vocal sound will be from the intubation needed to keep breathing up during general anesthesia application.

Can I sleep on my side post-rhinoplasty?

Patients can sleep on their sides post-rhinoplasty. However, it is suggested that they maintain extra caution to not bump their nose on the bed frame or a pillow. It might be advisable to sleep with extra pillows under your head to help with this and to counter swelling which will occur in the few days post-rhinoplasty.

Is there a risk in flying post-rhinoplasty?

Generally, a week is enough time to fly again post-rhinoplasty (2 weeks for turbinate or septal surgery). Spraying the nose with Afrin ½ hour before take-off and landing will likely help.

Why do I have pain in my palate post-rhinoplasty?

This pain is likely a result of the endotracheal tube which was placed in your windpipe during the rhinoplasty, a measure of precaution against breathing difficulties under general anesthesia.

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.

When will internal swelling subside post-rhinoplasty? I want to breathe!

In some cases, rhinoplasty patients will experience a permanent decrease in breathing due to factors like smaller nostrils, formation of scar tissue on the inside wall of the nostril, etc. Generally, though, breathing difficulties should subside within 2-3 months post-rhinoplasty, but may dissipate as soon as 2-3 weeks.

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.

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.

How can I correct my male upturned nose?

Depending on the patient, this may be best addressed by trimming a portion of the columella to decrease the columellar show and adding cartilage in order to weight down the tip and rotate the tip downwards.

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 breathing problems and a cracking noise in my nose. What’s wrong?

This problem is probably best addressed by an examination in a qualified surgeon’s office. However, pure speculation indicates that this may be an issue of the nasal conchae or caused by septal deviation, both of which require surgical solutions.

Can I have fractured cartilage in spite of a negative X-ray?

Definitely. X-rays only show fractures in hard tissues such as bones and not soft connective tissue, like cartilage. Evaluation by a surgeon is probably the best avenue to determine whether cartilage is indeed fractured.

Can I achieve adequate tip definition even with thick skin?

Because thick skin is generally more elastic and less pliable, it tends not to drape as gracefully over the newly aligned cartilage and bone in a rhinoplasty. That being said, however, notable results still can be achieved with ethnic rhinoplasty via the use of cartilage grafts to give the underlying framework of the nose under the skin more definition that will be apparent even under thick skin.

What is an alar base reduction?

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

Why did I lose my sense of smell post-rhinoplasty?

Loss of smell immediately post-rhinoplasty is usually temporary due to the blockage of nasal passageways from swelling. However, it may be advisable to wait and, if things do not improve, to visit an otolaryngologist for a smell test to check for damage to the olfactory nerve.

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.

I do not have a good credit score and so, cannot use CareCredit to fund my rhinoplasty. Anything I can do?

Unfortunately, while surgeons would be open to helping you, it is important that you find a way to pay them for their service. I would recommend that patients achieve a degree of financial stability prior to scheduling surgery, especially since revision procedures may be needed.

Is columellar stiffness a problem post-rhinoplasty?

Due to the incisions made in the columella area during the surgery, it is normal to experience swelling and tightness in that particular region for up to a year post-rhinoplasty. I wouldn’t personally worry about it.

Is a growing dorsal hump normal in the 20s?

Probably not, as nasal growth tends to stop soon after puberty (15-17 for girls, 16-18 for boys). This may be the sign of a callus formation, or the buildup of cartilage and bone.

Can I simply just have a nasal hump removed rather than having a full-on rhinoplasty done?

Unless the nasal hump is small, it is probably best to having a full-on rhinoplasty simply because of the risk of open roof deformity (shaving off a larger bump leaves a hole that can only be filled with osteotomies that force the nasal bones inward). In addition, removing the nasal bump without having tip work done also makes the nose look unintentionally longer as well.

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 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.

Can I reduce my nasal bridge height while still looking natural?

Decreasing bridge prominence can be accomplished via rasping and potential osteotomies (if the dorsal hump happens to be large). Tip rotation may also help in this case, which can be done via the manipulation of the lower cartilages.

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.

I’m coughing up bloody phlegm after my rhinoplasty. Am I dying?

Especially in the case of a combined rhinoplasty and septoplasty/turbinate reduction, patients can expect to cough up bloody phlegm in the weeks post-rhinoplasty. However, this should not be an ongoing problem and should correct itself soon afterward.

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.

What is your opinion on gortex nasal implants?

It is a general consensus among surgeons that they prefer cartilage over man-made implants simply because there is less risk of infections and other complications.

Should I bring pictures of my ideal nose to my surgery consultation?

I don’t see how this could hurt you. However, it is important for patients to recognize that the goal of surgeons is to match the nose we create to the face and create overall harmony, meaning that a certain celebrity’s nose may not match up with a patient’s face and may not be advisable. However, it does give the surgeons a good idea of what the patient wants and expects.

Can I get my nose closer to my face?

There are several methods by which this can be done. One way is to decrease the height of the nasal bridge. The other is shortening the tip cartilages in order to rotate the tip of the nose upward and create the illusion of a shorter, less projected nose.

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.

Did my rhinoplasty age me unnaturally?

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

How visible are the scars from a nose job?

In closed rhinoplasties, all incisions are made within the nostrils and thus the scars that form are generally imperceptible unless Weir reductions are also done to reduce nostril size. Open rhinoplasties, however, will also make use of an incision at the columella (the thin strip of skin between the nostrils) which risks more apparent scarring. However, in the hands of an experienced surgeon, even this scar will heal nicely.

Can I do a nostril reduction post-rhinoplasty?

Yes, this simple procedure can be done after a rhinoplasty under local anesthesia. However, it is probably best for patients to wait at least 9-12 months before deciding to undergo any revision/additional procedures.

Can the nose be lengthened to reduce the distance between the upper lip and the columella?

Yes, this can certainly be done via the application of cartilage dorsal grafts to weigh the tip down and create the illusion of a longer nose and minor trimming of the columella.

I have a crooked columella months post-op. What is wrong?

Unfortunately, this may require a revision rhinoplasty. It seems that there may have been deformities in the columellar cartilages (medial crura) that were not addressed in the rhinoplasty you underwent or a septal deviation. It is best to consult with your surgeon regarding your options at this point.

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.

Why is my nose tip still swollen after surgery?

As stated in other queries, the true results of a rhinoplasty do not materialize fully until after a year post-op. Residual swelling particularly in the tip is extremely common among rhinoplasty patients, so no concern is necessary if this condition persists.

How long post-rhinoplasty should I wait to have sex?

It is best for patients to avoid any form of strenuous activity, including sex, for at least 3 weeks post-rhinoplasty in order to reduce the risks of cut down on swelling and mitigate the risks of hematoma and post-operative bleeding.

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.

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.

Who are the best rhinoplasty surgeons in Chicago?

It is difficult for me to call this for myself. It is more of a decision for the patients, that is, “Who is the best surgeon for you?” When evaluating surgeons, patients need to make certain that their surgeon of choice is board-certified, specialized in their desired type of procedure and has experience doing these surgeries, has satisfactory before-and-after photos, etc.

There is some nostril asymmetry following my rhinoplasty. Should I be concerned?

Not at all. Again, swelling is a perfectly normal part of the post-rhinoplasty healing process and will take up to a year to fully dissipate (especially in the tip and nostril area). Therefore, most imperfections seen post-rhinoplasty are merely the result of swelling and will also disappear.

What should I do if I get an infection post-rhinoplasty?

Serious infections following a rhinoplasty are exceedingly rare. However, when they occur, they are very easily treated like any other infection, with antibiotics and careful monitoring by the surgeon.

How can I tighten my nasal skin post-rhinoplasty?

Generally, skin will not need any help contracting and tightening appropriately following a rhinoplasty, so patients with abnormally looser skin are encouraged to wait it out and check for new development. However, steroid injections may help alleviate some of these problems.

How can I massage my nose after nasal fracture reduction surgery?

I would advise against massaging the nose after this procedure simply because of the effect it could have on the movement of bones and cartilage in the surgical site.

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.

What is the proper icing technique following a rhinoplasty?

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

The columella is hanging post-rhinoplasty. Is this bad?

As stated in other questions, the columella area is a primary incision site during the surgery and undergoes more trauma than other portions of the nose in the procedure. Lymph flow may be disrupted in this area causing fluid buildup (edema), but this will resolve itself over time.

Can rhinoplasty be done without anesthesia?

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

How much will rasping cost?

Rasping is considered a rhinoplasty procedure and thus may cost anywhere in the neighborhood of around $3,000-$6,000, depending on the anesthesia used.

Is it bad if the surgeon left in a stitch?

Not necessarily. I would not recommend trying to remove it yourself, but would rather opt to go to the surgeon for professional removal in order to prevent infection.

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

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

I have purple spots on my nose post-rhinoplasty. What should I do?

Patients with this condition should contact their surgeon immediately. While it may just be localized bruising, this may also be a sign of unhealthy pressure from a cartilage graft in the skin or decreased blood flow to the area that could result in necrosis of the tissue.

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.

How long does congestion last post-rhinoplasty?

Congestion usually clears up within 6-8 weeks of a rhinoplasty and tends to get better gradually.

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

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

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.

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.

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.

Can I remove excessive cartilage without an osteotomy?

This can only be answered on a case-by-case basis. If the excess cartilage in question is around the tip, a tip-plasty can be performed without osteotomies. However, extra wideness on the bridge of the nose or any areas other than the tip will most likely require a careful breaking of the nose which only an osteotomy can provide.

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