Doctor’s Thoughts on Rhinoplasty

At Pacific Center Plastic Surgery, we strive to understand your unique concerns and goals to find the right treatment plan for you. When it comes to surgical rhinoplasty, we will be honest about the pros and cons of this treatment option. We’ve helped hundreds of patients achieve long-lasting results from their rhinoplasty procedure to enhance the size, shape, projection, and even function of the nose. The procedure is highly customizable, addressing the unique concerns of the patient.  As board-certified surgeons, we aim to deliver the best care, from consultation to post-op. To get started on your procedure or to learn more about your options, contact our office and schedule your consultation. 

What is a Rhinoplasty?

Dr. Horowitz and Dr. Nichter have been performing rhinoplasty surgery and functional nose surgery for over two decades. Their attention to detail, eye for aesthetic balance, and surgical expertise have gained them the reputation of being two of the best rhinoplasty surgeons in Newport Beach, CA. They perform rhinoplasty surgery on all ethnicities and address each patient individually based on their surgical goals. Some patients wish to maintain their ethnic appearance, while others prefer a more westernized nose. Some patients have rhinoplasty to address both cosmetic concerns and functional issues. It is important for any rhinoplasty surgeon to listen to the needs of their patients to ensure the optimal result is achieved.

Types of Rhinoplasty

Our doctors categorize nose surgery by the following:

Primary Rhinoplasty: 

This is the first surgery performed on the nose for cosmetic reasons. The procedure reshapes the nose to create a better balance of facial features. It is oftentimes combined with chin augmentation or functional nose surgery.

Ethnic Rhinoplasty

Still considered a first nose surgery, but for ethnic patients who wish to fix aesthetic issues with or without maintaining their natural cultural look. Ethnic rhinoplasty includes Hispanic, African-American, Asian, Middle-Eastern, Eastern European. There are common traits seen in the nose for each ethnicity mentioned. Skin thickness plays a major role with certain ethnic noses and can impact the amount of visible improvement that can be achieved.

Revision Rhinoplasty 

One of the most technically challenging procedures in all of the cosmetic surgery. Not to be left in the hands of a plastic surgeon with little experience in revision nose surgery. Revision rhinoplasty can address issues not corrected to the patient’s liking or complications from the first surgery.

Functional Nose Surgery

Correction of internal issues not cosmetic in nature. Used to improve breathing, headaches, facial pain, snoring, postnasal drip, and more.

Who can Benefit from a Rhinoplasty?

Any patient who is in good health who wants to improve the appearance of their nose and/or internal functional issues. This includes patients who have experienced a traumatic injury to their nose (broken nose) or require revision surgery due to a botched rhinoplasty. The intended result of functional rhinoplasty is to improve breathing and to provide relief from other symptoms.

Cosmetic Rhinoplasty Can Correct:

Dorsal Hump

This by far the most common reason for having nose surgery. A dorsal hump refers to the bump or prominence of the bridge of the nose. While the front view may be acceptable, patients are usually very unhappy with their appearance from the profile view. Correcting a dorsal hump may seem quite easy, but it actually requires a great deal of technical skill.

Long Nose

In many cases, the nose may appear longer due to the presence of a dorsal hump or a droopy tip. In either situation, Dr. Horowitz or Dr. Nichter will perform an examination to determine what exactly is causing the longer nose and what should be done to fix it. The objective is usually to reduce or flatten the bridge and may require elevation of the tip. The importance of long nose correction is to not overcorrect.

Wide Nose

A wide nose can be a result of the dorsal bridge, dorsal base, nostril flare or tip. Each one requires a different approach. The structure of an individual’s nose can limit the amount of narrowing that can be done.

Droopy Tip

A droopy tip is oftentimes caused by a long septum or long cartilage. Either one essentially pushes on the tip causing it to hang downward. Patients often complain that smiling makes it look worse, so they avoid taking pictures. The first step is to determine what is causing the tip to droop and then treating the underlying cause/s.

Other

Noses which are crooked, pointy or flat can also be corrected with rhinoplasty surgery.

Functional Rhinoplasty Can Correct:

Deviated Septum

Frequently, the nasal septum (the cartilage separating the right and left nasal passages) is deviated and needs to be corrected. A crooked nose can also contribute to septum issues. The procedure performed is called a septoplasty.

Enlarged Turbinates

Turbinates help to add moisture and filter air. When enlarged, they can contribute to airway blockage, and will need to be removed as part of the nasal surgery.

Airway/Valve Collapse

Additionally, narrowed passages and airway “collapse” can require placement of cartilage grafts (also called spreader grafts) for structural support. On rare occasions, scar tissue within the nose from previous injury or surgery may block airflow and require correction.

How is the Rhinoplasty Performed?

Cosmetic rhinoplasty can sometimes be performed using a local anesthetic along with I.V. sedation. More often though, general anesthesia is used. Options will be discussed during the consultation. Functional rhinoplasty requires general anesthesia. Both are considered outpatient procedures and are performed in our Newport Beach accredited surgery center.

 

Cosmetic rhinoplasty has incisions hidden within the nostrils. In some cases, a small “nick” in the skin is placed at the upper nose near the corner of the eye. More complex nose surgeries often require an incision placed at the base of the nose called the columella. This is called “open rhinoplasty,” because it allows the surgeon to elevate the nasal skin to directly view the interior of the nose and make necessary corrections. This technique is preferred because it greatly increases the surgeon’s ability to achieve the best possible result and avoid the need for revision surgery. The scar heals very well, and overtime is nearly invisible to the eye.

 

Wide noses may require a narrowing of the base, which requires small incisions (Weir incisions) placed in the groove where the nostril meets the cheek. This allows the base to be positioned closer together.

More complex nose corrections may require grafts. Cartilage and bone grafts are often taken from within the nose (septum). Ear cartilage, rib, hip, or outer portion of the skull are other possible grafts. Synthetic nasal implants may be used to build-up portions of the nose.

Recovery After Rhinoplasty

Your rhinoplasty recovery will vary depending on the techniques used and your individual healing process. Typically, it takes about two weeks before you can get back to your regular routine and work. During this time, swelling, bruising, and some general discomfort can be expected and managed with pain medication and an ice pack. The nose will be packed and bandaged to support its new structure. Strenuous activity and exercise should be avoided for about six weeks while healing.

Rhinoplasty Results

The results of your rhinoplasty will become apparent as swelling and bruising continue to diminish. Semifinal results are seen around 3 months. Final results are seen around 12-14 months post-surgery, which is the time necessary for complete healing of the exterior and internal portions of the nose.

Your Consultation at Pacific Center Plastic Surgery

To learn more about your rhinoplasty at the Pacific Center Plastic Surgery, contact our office and schedule your consultation. Dr. Nichter and Dr. Horowitz are experts in all types of rhinoplasty procedures and can go over which techniques are best for you.