Rhinoplasty Specialist Surgeon

FAQ

admin — Wed, 29 Feb 2012 11:55:41 +0000

+1. How would you improve broad or wide nostrils as commonly seen in African American noses?

The width of the nostrils or “ala” can be reduced in several ways depending on the anatomy. This nostril reduction or alar reduction is a very common procedure amongst African American rhinoplasty patients. You can read more about African American Rhinoplasty here: http://www.rhinoplastyspecialistsurgeon.com/ethnic-rhinoplasty/african-american/

+2. I’m a Philipino man in my late 40s with a nose as large as the size of Iowa! I’d like to get ethnic rhinoplasty and would like to know how exactly you perform this surgery on someone of my race.

Your rhinoplasty will depend on your anatomy which includes bone and cartilage shape as well as skin thickness. I would have to see you to examine you and then take pictures and, using computer imaging, show you what your options are and what your nose may look like after an ethnic rhinoplasty. Skin thickness is a very important part of ethnic rhinoplasty and you can read more about it here: http://www.rhinoplastyspecialistsurgeon.com/ethnic-rhinoplasty/thin-skinned-vs-thick-skinned-rhinoplasty/

+3. What kinds of painkillers will I be given for a revision rhinoplasty procedure?

The majority of my patients do not need ANY pain medicine. If your plastic surgeon does your revision rhinoplasty meticulously without much trauma and without packing your nose, you should not need any major pain medicine other than maybe a few Tylenols. Packing the nose is what really hurts and I do not like to routinely pack the nose after a rhinoplasty. However, I still give my patients Vicodin or Celebrex for those who are going to experience a bit more discomfort since pain it truly subjective.

+4. I know that my first nose job recovery period was extremely painful and prolonged, thus not allowing me to go to work for several weeks. Post revision rhinoplasty surgery, how long until I can resume normal activities?

Almost all of my patients for primary rhinoplasty or revision rhinoplasty take only one week off from work. When the nosejob is done pristinely without too much bruising and swelling and without packing, most patients recover quickly and are back to work in one week after their nasal reshaping plastic surgery.

+5. I’m 25 years old and had a rhinoplasty two years ago. I’m still unhappy with the length of my nose, am I eligible for another procedure? Would I be more at risk for a polly beak deformity?

I have had patients come to me who have had 3,5 or even more previous poorly executed Rhinoplasties and a revision rhinoplasty can improve many of the problems with their nose. I also see patients who have had 1 or more previous Rhinoplasties elsewhere who are still unhappy with their nose but I talk them OUT of another surgery if I think another revision rhinoplasty will not help them. I would have to see you and examine your nose in order to tell you if you should or should not undergo another rhinoplasty.

+6. A bulbous nasal tip seems fairly common in many ethnicities. How is this fixed?

The tip cartilages called the Lower Lateral Cartilages would need to get trimmed and/or reshaped in order to refine the bulbous or ball like tip. See the anatomy below: http://www.rhinoplastyspecialistsurgeon.com/choosing-a-rhinoplasty-specialist-surgeon/nasal-analysis-anatomy-2/

+7. I never had a problem with my nose but now, as I’m about to turn 60, I’ve been noticing that it’s changed in shape over the years. The tip seems to have become more round and my nostrils more noticeable. Is this something that can be fixed with a nose job? Is it normal for changes like this to occur with age?

Our face and nose changes with age. This is normal as long as nothing is actually growing on your nose like a mass. While the typical age for rhinoplasty is in the late teenage years up to about the mid thirties, many older patients undergo primary rhinoplasty to look younger in fact. My oldest primary rhinoplasty patient was in her 70’s and she loved the changes of her nose. The important thing is to create a nose that is age-appropriate. You don’t want a 14 year old’s nose on a 60 year old!

+8. I’ve been told that I have a lot of scar tissue in my nose. I’d like to get a revision rhinoplasty procedure. How will it be affected by the scar tissue?

You cannot do any surgery without ending up with scar tissue. Scar tissue develops with any surgery and a nose job is no exception. But too much scar tissue is bad. If your surgeon lifts your nose skin in the wrong plane and if you have very thick skin then you may get more scar tissue. Steroid injections can melt some of the scar tissue thereby avoiding a revision rhinoplasty. Scar tissue makes elevation of the skin and penetration of your nose more time consuming as opposed to a primary rhinoplasty nose which had no scar tissue.

+9. I keep hearing how Hispanics tend to have thick skin and that this affects the outcome of rhinoplasty surgery. What other factors are there in Hispanic patients that come into play?

Not all Hispanic patients have thick some. Some have thin oily skin and others have thick sebaceous skin. Many Hispanics have weak lower lateral tip cartilages and underprojected nose tips. There are many factors that need to be taken into consideration with a Latina or Latino or Mestizo Rhinoplasty. See below: http://www.rhinoplastyspecialistsurgeon.com/ethnic-rhinoplasty/hispanic/

+10. Can you explain what an alar base reduction is? Does this help with the width of the nose at the base?

Ala are the nostril margins so alar base reduction is the same as nostril narrowing. Alar base reduction is done when the nostrils are wide or flared and often are necessary in African American noses although many other cultures and races need nostril narrowing as well.

+11. I am an African American female looking to have a nose job. I feel that my nose is too wide, but I am also scared that a generic small nose might look out of place on my face. Is there a chance of sort of ‘losing my ethnicity’ by having a rhinoplasty?

If your nose fits your face then you should not “lose your ethnicity.” But more importantly you need to see a plastic surgeon who routinely performs computer imaging so you can somewhat visualize yourself with the new nose and the new changes and do you can decide for yourself if you like your new face or if you think the rhinoplasty changes your ethnicity. I have never had anyone complain of that after their nose job but I have seen Hispanic patients who had aggressive rhinoplasty elsewhere and then complain of looking too Asian with their new noses.

+12. I am Asian and hoping to have a rhinoplasty. Would my surgery be different from other ethnicities seeking a nose job?

Each nose is unique. There are some characteristics that are common to each race and ethnicity but ultimately each nose is unique. For example while most Asian rhinoplasty patients need their nose bridges built up with cartilage, some Asian rhinoplasty patients actually have humps similar to middle eastern patients and need that reduced. See more here: http://www.rhinoplastyspecialistsurgeon.com/ethnic-rhinoplasty/asian-rhinoplasty/

+13. Does a non-surgical rhinoplasty actually work? What are the benefits and the risks?

Not all nose job patients are candidates for nonsurgical rhinoplasty but for those who are, it works great. Benefits are a better nose without surgery and less downtime but risks are bruising and infection and allergic reaction and scar tissue. However you need to treat a nonsurgical rhinoplasty like an actual rhinoplasty and see a plastic surgeon who does nose jobs who understands the nose and not let a Dermatologist or family doctor just randomly inject filler into your nose.

+14. I feel that my nostrils are too large and uneven. Can a rhinoplasty fix this problem? Is it a complicated procedure?

Nostrils may be able to be reduced if it is not simply a very thick nostril skin issue. Thick nostril skin is very difficult to improve. Uneven nostrils can also be improved on most occasions but perfect symmetry is often unrealistic. All rhinoplasty is complex and should be left to plastic or facial plastic surgeons who specialize in nose reshaping.

+15. I’ve had rhinoplasty 3 times. There are still a few minor things about the appearance that I don’t like but I’d be willing to let them go to avoid having another surgery. Unfortunately I’m also having a lot of trouble breathing. I’d like to get the breathing fixed but I’m concerned that having yet another surgery will make my nose look even worse.

I would have to examine you and see if there is anything that can be done to help you breathe better. It may be something simple and minor like a turbinate reduction or it may be much more involved and require major revision rhinoplasty.

+16. Since my rhinoplasty a month and a half ago, I have a vein on the top of my nose that seems swollen and occasionally burns. What could this be and will it go away?

Telangiectasias or neovascularization after any cosmetic surgery such as a facelift or rhinoplasty are common. IPL or Pulsed Dye Lasers (PDL) or KTP lasers or YAG lasers can all be used to shrink down the vessel. I would suggest you see your doctor to make sure everything is OK then wait a few months after that to see if the vessel will improve on its own but if not you may be able to use one of the lasers above for this red blood vessel.

+17. Are there any differences in the recovery between open and closed rhinoplasty procedures?

While many rhinoplasty patients are told that there is a difference in recovery between open and closed approaches, the main difference is in duration and extent of post rhinoplasty swelling and scar tissue at the tip of the nose as well as numbness of the nasal tip. Recovery is slightly different between the two nose job approaches but recovery after a rhinoplasty is more a function of extent of work being done by the plastic surgeon as well as the individual patient’s unique anatomy such as skin thickness, etc. With all things being equal, close rhinoplasty does have a somewhat quicker resolution of post op swelling and shorter “recovery time” although in either approach, “final results” take many years to develop while the down time is about 7 to 10 days. This highlights the many phases of healing and recovery after rhinoplasty.

+18. I have a hump on my nose that I would like to have removed. Is this done by filing down the hump or by breaking the bones? Can it be performed through closed rhinoplasty?

If your tip position is perfect then the hump can be removed easily through a closed rhinoplasty. If your tip is over projected or under projected or its rotation angle needs adjustment then this affects the amount of hump requiring removal and the tip should be fixed as well. This too can be done closed but sometimes open rhinoplasty allows more stable long term results.

The composition of the hump may be mostly cartilage or mostly bone or partly each. If the hump is large enough then the bones need to be broken with osteotomy in order to close the gap or “open roof” that results on the top of the nose after hump removal.

+19. I had a nose job that didn’t turn out the way I expected. I am quite anxious about getting it repaired. Are you able to add tissue to the nose? My nose was made too short for my face.

Absolutely. Do not panic! I see patients like you all the time. In a Revision Rhinoplasty I can correct the errors of omission or Errors of Comission of another plastic surgeon who either took too much tissue out of your nose or did not do the proper rhinoplasty in the first place but you have to wait about 12 months from your last rhinoplasty before I can do a revision nose job for you. It would be good if you can get your operative report from your original plastic surgeon and bring it with you as well as pictures of your nose before your surgery.

+20. I had a bad nose job and have not been able to pass a mirror without grimacing ever since. I am so worried that surgery to repair it can go wrong too. Can revision rhinoplasty fix all problems?

Revision is more complex than primary and there are limitations and ALL problems may not be fixable but significant improvements can be made. Do not panic! I see patients like you all the time. In a Revision Rhinoplasty I can correct the errors of omission or Errors of Comission of another plastic surgeon who either took too much tissue out of your nose or did not do the proper rhinoplasty in the first place but you have to wait about 12 months from your last rhinoplasty before I can do a revision nose job for you. It would be good if you can get your operative report from your original plastic surgeon and bring it with you as well as pictures of your nose before your surgery.

+21. I have what I think of as fat nostrils. Maybe this is because I’m Middle Eastern. How do you fix this with nose surgery?

If the nostrils are wide the width can be reduced but if the skin is thick there are no great options for reducing the skin thickness without giving you noticeable unsightly scars. I do Middle Eastern Rhinoplasties all the time and I can tell you what is and what is not possible after I see you in person in my Virginia or Maryland offices and examine you.

+22. I keep seeing online that it’s common to have septoplasty and rhinoplasty performed together. Why is this and what exactly is septoplasty? What’s the difference between that and rhinoplasty?

Septum is the structure on the inside of the nose that separates the left side from the right side. If you have a deviated septum then a septoplasty can be done to improve the deviation and improve your breathing. That can be done without rhinoplasty but if you want to change the shape of the nose as well then combining the two surgeries makes the most sense and doing one without the other may complicate things.

+23. I’ve had a hard bump on the tip of my nose since my nose job which was 1.5 years ago. What can fix this?

I would have to see your nose and examine it. Many times you wont know for certain unless the surgeon who did the surgery is the one evaluating it. Often times you have to open the nose to be able to tell with certainty. But most of the time the hard bump will be a cartilage edge or a cartilage graft that can be shaved down and improved by your Plastic Surgeon.

+24. My rhinoplasty was 8 weeks ago. The swelling has gone down from my bridge and that looks great but my nasal tip is still very, very swollen. Is it likely at this point that I’ll need revision rhinoplasty to refine the tip? Does swelling generally remain in the tip longer?

Swelling and scar tissue can obliterate some of the results that you will eventually see over time as swelling resolves and scar tissue matures and dissolves. The tip of the nose should continue to get smaller and shrink wrap for many years. Even after 1, 2 or 5 years you should continue to see the nose, especially at the tip and even the bridge, get slimmer.

+25. I have inherited my father’s Egyptian nose and I’d like to improve it. I feel like it’s too large overall and I also have a very large hump. Can these things be fixed?

Absolutely. But I would have to see and examine your nose and take pictures to be able to discuss your options with you with the aid of computer imaging as a discussion and dialogue tool so that you can get a good idea of what may be possible and what are the limitations of any rhinoplasty. Egyptian and middle eastern nose jobs are very common and nice results are very achievable.

+26. Are there limitations to the changes that can be made with rhinoplasty?

Definitely! The nose is not a solid structure. A block of granite can be carved into any sculpture but your nose is made up of thin sheets of cartilage and bone with unique skin thickness and then add healing and scar tissue to the mix! Beautiful improvements can be achieved but there are limitations and computer imaging and a top rhinoplasty expert can discuss these with you.

+27. I am a 16 year old girl interested in a rhynoplasty. How soon can I get the nose job or do I have to wait till I’m older?

Sixteen is typically a good starting point for patients seeking Rhinoplasty. Occasionally I will offer a rhinoplasty to a 15 or even a 14 year old if they are mentally and physically mature. Then again, I have seen plenty of 40 year olds who are unrealistic about the surgery and hence are not mature candidates for the surgery. I would be happy to see you along with your parents in my chevy chase Maryland or my Herndon, virginia office to examine you, perform computer imaging and discuss your options, etc. Having support of your parents is important and often parents have their own set of fears and hesitations and questions that may be different from yours.

+28. I’m a 64-year-old male and I’ve noticed as I’ve gotten older that my nose has gotten more and more droopy at the tip. Is this something that can be fixed with a nose job and what would be any concerns for surgery given my age? Would my nose continue to droop afterward?

Tip ptosis or drooping of the tip is very common as we get older. A rhinoplasty to elevate your nasal tip and correct the droopiness can help improve your face and make you look even younger. It is important for the new nose to be age-appropriate as well as sex-appropriate and natural looking. Once the tip has been elevated and supported it should withstand gravity better over the coming years.

+29. I’m trying to prepare for my nose job which is scheduled in a few weeks. What can I do beforehand to help prepare or set up for my recovery at home?

You haven’t mentioned if I am your surgeon or if you are simply asking me this because your own surgeon has not gone over this information with you. If I am your surgeon then I would have already gone over these things with you at least twice and you should have gotten the info in detailed writing so you can prepare. My staff also go over pre and post rhinoplasty instructions with all my patients in great detail. If your surgeon is someone else then you should contact him/her to see what he/she wants you to do. Each plastic surgeon has his or her own set of instructions. You can get an idea of what I tell my rhinoplasty patients by reading this: http://www.virginiafacialplasticsurgery.com/vfps-instructions.html

+30. If the nasal bones are fractured during a nose job, does the recovery and healing take longer?

The more that is done to a nose during a nose job the longer it takes for the nose to heal and the more the variability in healing. With that said, often times, if you require osteotomies (breaking of the bones) then you need it and if you avoid it simply out of fear or out of a desire to heal quicker, you may end up with a nose that just does not look balanced.

+31. When you perform a combined deviated septum surgery with a nose job, how does insurance coverage work? Do they pay the whole thing or a portion of it? If just a portion, how do you separate out what gets paid and what doesn’t?

We get this question about insurance and septoplasty and rhinoplasty a lot and we have many patients that require both functional septoplasty as well as cosmetic Rhinoplasty.

For all practical purposes these two procedures are kept separate and billed separately although they can both be done at the same time/session. For example if you had a skin cancer removed as well as got breast augmentation then in the same surgical session both could be done by your plastic surgeon (not me since I do not do Breast Augmentation) but both can be done while you are under anesthesia and the breast implants would be cosmetic and the skin cancer removal would be through insurance. For the nose, insurance would hopefully cover the septoplasty although some insurance do refuse even that. If insurance paid for the septoplasty then it would cover the surgeon’s fee as well as part of the hospital fees and part of the anesthesia fee. However, for most facial plastic surgeons, the cosmetic fee for the rhinoplasty is much higher than the fee for the septoplasty so in effect you end up saving a little bit of money when it’s all said and done compared to paying for the entire thing yourself out of pocket. If your insurance deductable is very high then you may actually be better off paying for everything out of pocket much like a situation where a driver may choose to pay for a minor car collision themselves if their auto insurance deductable is too high.

There are some general ENT surgeons who will primarily charge your insurance and charge you just a tad more for the rhinoplasty but that is because their cosmetic rates are much lower than a facial plastic surgeon who is known for their cosmetic work and skill and training.

+32. Since my rhinoplasty a week ago, the tip of my nose looks like its lifted unnaturally high, too upturned I suppose. Will this change in time or should I be considering revision?

Most patient’s nasal tips will drop down and back in the first 3-4 months after rhinoplasty. Your 1 week results are hardly the final results of your rhinoplasty so do not judge a half cooked meal just yet.

+33. I’m interested in narrowing my nostrils and having my bridge made smaller and I’ve been told that performing both can sometimes be tricky. Is this true and, if so, why?

All rhinoplasty can be considered “tricky” because a nose job is the most complex of all facial cosmetic surgery procedures. In expert hands of a rhinoplasty specialist surgeon these are not tricky but in the hands of an average plastic surgeon or a novice, these may be “tricky.” Regardless, perfection after a rhinoplasty is “tricky” due to the unpredictable healing forces acting on a nose for many years to come after a nasal reshaping operation.

+34. How common are problems with implants used in rhinoplasty? How often does extrusion or implant shifting occur?

Implants in rhinoplasty are often used in Asia by Asian surgeons. Infection, shifting and extrusion are very real possibilities with nasal implants and that is why most rhinoplasty specialist surgeons prefer using natural cartilage or tissue.

+35. I have type 1 diabetes. Are there any concerns about undergoing rhinoplasty?

We have all of our patients undergo a thorough history and physical examination by their primary care doctors prior to rhinoplasty. I require lab work such as CBC with Platelets as well as PT/PTT/INR and even an EKG if indicated by age. I want to make sure my patients are healthy enough for surgery and if not I want their primary care doctor to optimize their health and get them ready for rhinoplasty. If a patient is just too medically unstable then I try to talk them out of rhinoplasty and will not perform surgery on them. Type I diabetes does not rule you out for a rhinoplasty but it does require proper pre and post op care that your family doctor needs to be involved with. If your diabetes is so labile that you are on an insulin drip then you should avoid elective cosmetic surgery

+36. It’s nearly two month since my rhinoplasty and my nose is very stuffy and whistles every time I take a deep breath. What could this be and how can it be fixed?

You need to see your own plastic surgeon and have him take a look inside. There may be some significant issues such as septal perforation or synechia formation or septal deviation or turbinate hypertrophy or cicatricial scar formation, etc. Alternatively it may just be post op edema or crusting. Some will resolve on their own and others have an easy solution and yet others are much more complicated and problematic.

+37. I have my rhinoplasty scheduled but have just developed a tooth infection. Will my surgery need to be postponed and why?

Your rhinoplasty needs to be postponed till your dental infection is resolved. It is not safe to undergo elective cosmetic surgery when you are infected or have fevers. You have to be at your optimum medically. Anesthesia weakens your immune system briefly so your tooth infection can get worse. The infection may spread to your nose. Its just best to wait and treat the infection first.

+38. Is it possible to drive myself home after my rhinoplasty surgery or will I need to have someone else drive me?

You definitely cannot drive yourself after rhinoplasty. You have to have someone drive you home and stay with you the first 24 hours after your rhinoplasty mostly due to anesthesia but also due to the rhinoplasty itself. Alternatively you can choose to stay overnight at the hospital if possible and have the nurses take care of you. There are limousine or taxi services available as well as home nursing that could be utilized.

+39. What kind of stitches are used during rhinoplasty surgery? Will they disintegrate on their own, or do I need to return to the doctor to have them taken out?

I like to use absorbable sutures. Some plastic surgeons use permanent sutures inside the nose to hold the tip but these sutures can become infected on occasion and trying to go back into the nose and trying to find these small sutures engulfed in scar tissue to remove them is a very hard task. Absorbable sutures (stitches) hold your cartilage in place long enough until your own scar tissue acts as a glue and holds things in place.

+40. How long after rhinoplasty will it be before the swelling subsides enough to feel comfortable in public?

Swelling after a nose job depends on your surgeon’s technique and your own propensity for healing. Most of my patients only take 7 to 10 days off work at the maximum. A minority like to take 2 to 4 weeks but truly after about 10 days your nose should be good enough to go in public while it will take 2 to 3 years for most of the swelling to resolve.

+41. Is it possible to have your nose sufficiently analyzed by a doctor over the Internet, by emailing pictures back and forth?

A large number of my patients come from other states, countries and continents! We start the process by email, phone and internet and we can do most of the rhinoplasty consultation and planning this way but I do need to see them the day before the surgery and examine them in order to finalize my surgical plan. Feeling and touching the nose is crucial in rhinoplasty as is looking inside the nose.

+42. When is it necessary to break the nose during a rhinoplasty surgery?

Breaking of the nasal bones or osteotomies are done to narrow a wide nose, straighten a crooked nose, or close an “open roof” after removal of a large nose hump.

+43. I’ve had a runny nose since my rhinoplasty surgery which was five months ago. Is this normal? Why is it happening and will it stop?

A runny nose or a dry nose can be common after a rhinoplasty. You need to see your own plastic surgeon to make sure the runny nose is not a CSF leak which albeit rare, is a much more serious condition!

+44. How soon after my rhinoplasty surgery will I look healed enough to go out in public?

Healing takes months to years. I tell my cosmetic surgery patients that their noses will change drastically for the first 2 to 3 years after their rhinoplasty but the down time until they are ready to go out or back to work or school is about 7 to 10 days. Each rhinoplasty patient will have a different experience.

+45. I’ve had nose bleeds ever since my rhinoplasty surgery, which was two years ago. Is it possible I suffered a septal perforation that’s to blame?

You should see your own plastic surgeon and an ENT surgeon to be examined. You may have a septal perforation or may have a prominent blood vessel that keeps bleeding or you may even have a tumor that is unrelated to the rhinoplasty. Please get evaluated soon

+46. I’ve had two rhinoplasties now and both have healed and left my nose crooked. Is this just my nose? Is it possible to fix this with another surgery?

I have seen patients who have had multiple poorly performed Rhinoplasties. I corrected the nose of a beautiful African American female who had 4 or 5 previous Rhinoplasties in Loudoun County by the most well known plastic surgeon there and each time her nose ended up crooked. If the septum is crooked that may need to be fixed along with the external nose. While perfect symmetry is often impossible significant improvements can be made. The way your body heals and your own facial asymmetries are an important variable as well.

+47. How is alloderm used in rhinoplasty and is it a good option if you need portions of the nose built up?

I like Alloderm as much as I like Temporalis Fascia in Rhinoplasty and Revision Nasal reshaping surgery. These are great for thin skinned patients to camouflage and soften the underlying cartilage and bone. Alloderm or Fascia are not so great for building up and structure. Cartilage is used for structure but cartilage can be covered or wrapped in Alloderm or Fascia in Rhinoplasty.

+48. My nose job was several months ago. The cartilage in my nose now seems very lumpy. Is this normal and will eventually clear up as I heal? Is it scar tissue? Should I be concerned by this?

You should see your own plastic surgeon to be examined. You could be noticing normal cartilage contour or scar tissue or swelling or grafts in your nose. There are many possibilities. Most noses may not feel totally smooth and symmetric to the touch after a rhinoplasty due to healing edges of bone and cartilage but if the lumpiness is clearly visible then your cosmetic surgeon should figure out the cause. He may show you some massages you can do to help mold the nose.

+49. Are there any cases in which breathing problems occur from a nose job?

Absolutely! If your plastic surgeon does not understand the nose inside and out then he may compromise the internal function of the nose. Facial Plastic Surgeons are plastic surgeons of the head and neck following an ENT – Head & Neck Surgery training so they understand the inside and outside of the nose. But even in great surgical hands and with great technique, healing can create warping and changes that can affect breathing. So can reduction of the nose and nostrils.

+50. I feel like my nose has changed as I’ve gotten older. I’ve heard of noses drooping with age, but I seem to have grown a hump that I never had before. Can rhinoplasty fix this?

Rhinoplasty in older patients can be very rewarding and can bring youth and rejuvenation and balance back to the face. If the tip droops and the skin thins out, humps may appear especially if you lose volume from your face and cheeks which will make the nose appear proportionately larger. A good rhinoplasty in an older patient can give the illusion of a facelift!

+51. I am a 26-year-old male looking to have a nose job. I am a long time smoker, and I have stopped smoking for the past few weeks so I can have the surgery. I was told I would have to give up smoking after the surgery as well, but I am not sure I can resist. What will happen if I smoke too soon after my rhinoplasty? What is the least amount of time I can wait before smoking again?

Smoking is an absolute contraindication for facelift or any facial flap reconstruction. For Rhinoplasty if the surgery is an open rhinoplasty, then smoking will increase risk of skin necrosis and loss at the tip and it should be stopped for 2 weeks before and 2 weeks after the surgery. That includes all Nicotine containing products so you cannot use Nicotine patches or gums either. However, as far as Anesthesia purposes, smoking should be stopped several months prior because stopping just a few weeks can increase your airway secretions and complicate the anesthesia.

+52. I had a rhinoplasty procedure about 4 days ago and I still have bruises around my eyes. Is this normal? How long should it take for the bruises to go away?

Every rhinoplasty patient has a somewhat different experience after their nasal reshaping surgery. Some patients barely bruise while others look like they got hit by a train or Mike Tyson! Bruises can last 1-4 weeks or even longer in much older patients with thinner skin. At 4 days after a rhinoplasty though bruising is normal but make sure you talk to your own plastic surgeon to make sure all else is OK. Most of my patients are quite surprised by the lack of pain and minimal bruising after their rhinoplasty.

+53. Why do you often see patients getting both rhinoplasty and a chin implant? Is it safe to have both surgeries at once and what are the benefits?

If the chin is weak, it can make the nose look over projected so to be able to balance the face and nose properly it is wise to correct the chin weakness as well. But it is not absolutely necessary. Some plastic surgeons get stubborn and refuse to do a nose job without a chin implant because they don’t want you to come back and say my nose is still too big while in fact the nose may look still too big because the chin is still too small. Chin implants have to be subtle and feminine in women and I have seen chin implants that are too large, too wide and too masculine for female rhinoplasty patients.

+54. I am self-conscious about my appearance, which is one reason I am having a rhinoplasty. How large and conspicuous are the bandages for rhinoplasty recovery?

Each plastic surgeon will have a different nasal splint or dressing or cast. I have seen ones that cover the forehead and cheeks. I use a very small cute splint that is not bad at all and I do not routinely pack the nose either. But most patients still choose to lay low for the week after their rhinoplasty when they have their nose dressing bandages on.

+55. I have heard that good plastic surgeons can do wonders. I have a thick nose. The nostrils are very wide, the skin on the nostrils is thick and I have a wide bridge. Can rhinoplasty correct these defects without scar tissue forming?

Good plastic surgery can do wonders but bad plastic surgery can destroy lives as well so be careful and do your research well before proceeding. All of the issues you described can be corrected with Rhinoplasty and I have many patients with your described nose features who underwent successful rhinoplasty with fantastic results. However, scar tissue will always form as scar tissue is the glue your body forms to heal things. I see my patients back frequently in order to assess if steroid injections or kenalog injections to their nose tip is needed to counteract the possibility of too much scar tissue forming.

+56. I am having a nose job next week. My doctor told me that I could have the procedure under local anesthesia. What type of drugs do you use for locals? Would I be getting an injection or is this IV?

I do not like local or IV sedation (twilight anesthesia) for rhinoplasty. Nearly all of my patients choose general anesthesia because it is much more comfortable that rhinoplasty awake under local anesthesia and also a better way of protecting the airway that with IV sedation. All surgery and all anesthesia have risks and performing your rhinoplasty in the proper hospital setting or major surgery center setting minimizes risk. I see too many plastic surgeons doing risky rhinoplasty in their office in a back room!

+57. I have terrible seasonal allergies right now. Can I get rhinoplasty or should I wait until next season?

You should make sure your allergies are under control before going through any elective cosmetic surgery. Turbinate reductions in conjunction with cosmetic rhinoplasty may improve your allergy symptoms of nasal obstruction but allergies are medical issues that need treatment. If you are under the care of an allergist and under decent control then there is no reason you cannot undergo a cosmetic rhinoplasty as long as it is OK’ed by your primary care doctor.

+58. I have chosen to undergo rhinoplasty for the second time in ten years. Does the scar tissue from the first nose job affect this second procedure?

Yes. Scar tissue, lack of tissue, possible sutures, possible mal positioned grafts, changes in your skin and blood flow are just some of the many issues we encounter in Revision Rhinoplasty.

+59. Help! I hate my nose job and I only had it done a year ago. What can I do to get it fixed?!

I see this all the time. Many plastic surgeons do not communicate properly with their patients so the nose cast removal often ends up being a sad and troubling occasion rather than a happy and momentous one the way it should be. Many plastic surgeons who are jacks of all trades and do not specialize in rhinoplasty end up creating results that may be too drastic and unnatural or even worse than the original nose requiring revision rhinoplasty. You need to see a respectable rhinoplasty specialist surgeon to be examined and then told of your options for revision rhinoplasty. If you are in the Washington DC area or Chevy Chase Maryland or Northern Virginia I would be happy to see you.

+60. I would like a nose job to remove or reshape a rather large, bulbous tip. Does this require general anesthesia? Will my nose be packed afterwards? How long does the bruising usually last?

Each plastic surgeon is different but I do not routinely pack the nose. Making your nose tip smaller usually requires local or general anesthesia. IV sedation or twilight anesthesia is not usually recommended for rhinoplasty due to the bleeding but if it is only your tip then it may be an option. Pain and bruising are minimal to none at all with simple tip work but I would have to examine your nose to make sure the bridge does not need refining to make it match the tip because sometimes if the tip gets cuter and smaller then the bridge may appear too wide or high and the whole nose needs to fit and look good.

+61. I had rhynoplasty about ten years ago. My nose does not seem to have aged well and I don’t know if it is the previous nose job or just aging. The tip of my nose overhangs more than it used to. I would like the nose shortened just a bit and the tip brought up. Can the nose be shortened without leaving a scar?

The nose continues to change for the rest of your life with or without rhinoplasty and rhinoplasty results continue to modify for many years and the saying that the “final results of a nose job are seen in a year” is a total myth. I would have to examine your nose to see what is the issue and what needs to be done. It may be a simple 10 minute operation or it may be a 2-3 hour complete revision rhinoplasty of the tip.

+62. I am a very athletic person, and in particular I am on the swim team at my college. I want to have a rhinoplasty over the summer; will I be able to do any summer training in the pool after my surgery? Can the pressure of the water affect my surgery?

You need to take your activities into account. I have many athletes and I tell them that for 2-4 weeks after rhinoplasty I do not want them to do any strenuous activity or anything raising their blood pressure or heart rate and for 3 months I do not want any contact sports. Gentle swimming in the pool is OK after a month but no diving for 3 months.

+63. I am a 19-year-old female and I am supposed to have a rhinoplasty surgery in a few days. However, this week I was in Mexico for spring break and I am very badly sunburned. Can I still have the procedure? What are the risks of having a nose job with badly burned and peeling skin?

You should talk to your own plastic surgeon and let him know of your sun burn but I would tell you to postpone your nasal reshaping surgery until your skin has healed. Sun damaged or sunburned skin can complicate the surgery and healing whether you get the sunburn before or even after your nosejob.

+64. It has been two weeks since I had my nose job and I am still congested all the time. What is causing this? When will it go away?

Please talk to your own plastic surgeon so he can examine you and make sure you do not have a septal hematoma or other cause such as residual packing! Otherwise, internal swelling and scabs and clots and crusts will make breathing congested for a few weeks to a few months but if all is well then your breathing problems should resolve soon.

+65. My nose has always had a hook on the end that makes my profile imperfect. Will I have to have work done to my entire nose or can rhinoplasty be focused on one area of the nose?

Whether you need a tip rhinoplasty or a dorsal height takedown or both needs to be determined. The “hook” that you describe could be from the shape and position of the tip cartilages which may need tip rhinoplasty. Or the hook nose may be from extra cartilage height just above your tip creating the appearance of a hook or it may be from both issues needing a complete top to bottom rhinoplasty.

+66. I’m 27 and I’d like to get a nose job. I heard that the nose grows and changes as you get older. Is this true? What does these mean for the results of the nose job then?

The nose does not usually grow although in some people, especially men, it can. Usually though the issue is the tip droops and make the nose look longer and you lose volume from your cheeks and face thereby making the nose appear relatively larger. A good rhinoplasty can bring balance to the face and in my older patients who undergo rhinoplasty, it can make them look much younger. And in my younger patients, it supports the nose and tip and maintains the nose shape as they get older.

+67. I have a nose that is too wide at the tip. I would like this reduced in size and I would also like the nose shortened. Do you use the open-tip technique with an incision across the columella? Is general anesthesia suggested or required?

I perform about half of my Rhinoplasties closed and the other half open. Each nose has to be evaluated individually and the best approach to the nosejob be planned whether it be an open rhinoplasty or a closed rhinoplasty. The incision across the columella heals very nicely and its not a major issue but many patients do not require an open nose job.

+68. I have a “piggish” nose. It is upturned so much you can see inside my nostrils. I want a nose job. How long is the recovery time for rhinoplasty? Will I need to remain in bed the following day?

To lengthen a short upturned nose requires a major reconstructive or augmentative rhinoplasty with grafts. Recovery is in stages. Typically the downtime following a nose job is about a week but the nose continues to heal for many years. I do not want my rhinoplasty patients lying in bed. I rather you sit up and watch TV or read a book to decrease swelling to your face.

+69. I had a disastrous nose job last year. I am so embarrassed by my nose now that I have practically become a hermit because of it. I suffer from bouts of depression but I am ready to try to fix it. The tip of the nose projects too far forward and downward and the nose looks crooked. Do you think that this can be fixed given that there is probably scar tissue in my nose? Is the revision surgery more difficult than the original rhinoplasty?

Most bad nose jobs can be improved. Perfection is not realistic but as long as you have nice realistic goals then a successful revision rhinoplasty may be possible. Revision Rhinoplasty is more complex than a primary rhinoplasty but I have corrected the bad noses of many patients who had previously undergone 3 or 4 poorly performed previous Rhinoplasties.

+70. How long does the swelling after a revision rhinoplasty surgery last for?

Swelling after any rhinoplasty lasts for months to years but not to the naked eye. Your down time is about one to two weeks but it takes several years for the healing to push out most of the swelling. However you can start enjoying the results immediately.

+71. I keep hearing about something called finesse rhinoplasty. What is this?

I along with a few other Rhinoplasty Specialists coined the term “finesse rhinoplasty” to indicate rhinoplasty cases where very little changes would be required to make a significant difference. For example I have had patients who underwent a 12 to 15 minute closed rhinoplasty with me and that is all they needed but some of these same patients had been to other Plastic Surgeons for consult and had been told they needed 4 hours of open rhinoplasty!? Certainly a nose that needed a very minimal improvement would have ended up looking horrible after 4 hours worth of manipulation and swelling and scar tissue and nose job work! Therefore a nose like that would be best improved through a “finesse rhinoplasty.” Unfortunately many plastic surgeons are now using the term finesse rhinoplasty for marketing purposes and I have had patients who require a full major 2 hour rhinoplasty tell me that they saw on some other plastic surgeon’s website that he offers “finesse rhinoplasty.”

+72. My nose bothers me all of the time. From a profile view, it looks like it has been pulled down. I am not sure if this is what is called underprojected or not. I know that rhinoplasty can decrease the size of a big nose, but can it lengthen it as well?

Rhinoplasty is about balancing a nose. Some parts of a nose may need to be reduced during rhinoplasty and other parts may need to be augmented or enhanced during rhinoplasty. Ultimately a nose job is called “nasal reshaping” for this reason.

+73. My husband has a nose that seems to push over to one side. It doesn’t bother me but seems to bother him. I constantly see him pushing it over to the other side. I would like to give him a nose job for an anniversary present. Can rhinoplasty straighten out his nose?

Sounds like the lower 1/3rd or lower 2/3rd of his nose which are the cartilaginous portion are deviated. This may also be partially due to a deviated septum on the inside. Perfect symmetry is often unrealistic but significant improvements can be made with a rhinoplasty to straighten a deviated or crooked nose.

+74. Can a nose that is too narrow cause difficulty in breathing? My 6-year-old daughter has trouble breathing through her nose when she is breathing heavily.

You need to take her to a pediatric ENT surgeon to get nasopharyngoscopy and be examined. She may have obstruction of her nose in any of various locations or even a mass inside her nose. Large adenoids can also obstruct air flow. Please have her nose and face examined as soon as possible.

+75. I had a nose job a couple years ago and I am satisfied with the shape. However the nostrils do not seem symmetrical. Should I have this corrected or just forget about it?

Totally symmetric nostrils may or may not be possible. The two halves of the face are quite different in 85% of people with the eyes, cheeks, nose and lips as well as the jaw showing significant asymmetry so nostril asymmetry is often just a part of normal human facial asymmetry. However, sometimes if one nostril is too retracted or too wide or too pinched after a rhinoplasty then a revision rhinoplasty can correct these issues of nostril asymmetry and give your nose a better overall balance. I would have to see you and examine your nose before I can tell you if correcting your nostril asymmetry is possible or not.

+76. My nose seems to hang down over my mouth. I am 73 years old and don’t think it looked that way when I was younger?

Tip ptosis or a droopy nasal tip can occur in many older men and women. A rhinoplasty to balance the nose can make the face look younger but it is important to make sure your nose is “age appropriate” because a nose that is too upturned will not look right on a 73 year old. I do Rhinoplasties on older patients very frequently and practically always they end up looking younger as if they had a facelift!

+77. Can you perform rhinoplasty on an African American without scars showing? I form large scars and really don’t want any scars on my face.

I do African American Rhinoplasties very frequently and bad visible scars has never been an issue. Due to the requirement for tip grafts and caudal septal extension grafts and nostril narrowing, there will be scars and they are visible if you look at them very closely but I have never had any of my African American Rhinoplasty patients complain about a single scar.

+78. I have a pinched tip since my nose job. Can this be fixed?

Pinched tip after rhinoplasty is due to excessive resection of lower lateral cartilages and a pinched tip can be corrected during a revision rhinoplasty with proper cartilage graft placements.

Reshaping Animation

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Rhinoplasty Potomac

admin — Thu, 27 Oct 2011 07:18:48 +0000

Rhinoplasty Potomac Revision Rhinoplasty

Dr. Naderi is a facial plastic surgeon that specializes in revision rhinoplasty, where he repairs the poor work of a previous rhinoplasty. He has extensive work in reconstruction of the nose and is recognized for his work in collapsed nose jobs, deviated septum surgery, and corrective nose surgery. Whether the patient’s nasal problems come from a previous surgery, a traumatic accident, or birth defect, Dr. Naderi can help correct the form and restore the functions of the nose while also enhancing its appearance. Whether it’s a small tweak or a major revision, Dr. Naderi gives all of his patients the same degree of care and attention. Dr. Naderi has already helped transform the lives of many patients in Potomac, Maryland and surrounding areas.

Rhinoplasty surgery can create facial harmony by altering:

Nose size
Nose width, at the bridge
Nose profile
Nasal tip, that is large drooping, or upturned
Large, wide, or upturned nostrils
Nasal asymmetry

A rhinoplasty procedure is a good option if:

Your facial growth is complete
You are physically healthy
You do not smoke
You have realistic goals for enhancing your appearance

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Chevy Chase Rhinoplasty

admin — Thu, 27 Oct 2011 07:06:40 +0000

Rhinoplasty Chevy Chase Revision Rhinoplasty

Dr. Naderi is a renowned facial plastic surgeon that specializes in revision rhinoplasty. He is recognized for his remarkable work in collapsed nose jobs, deviated septum surgery, and corrective nose surgery. As a specialized nasal surgeon, Dr. Naderi is dedicated to delivering natural looking results in both primary and revision rhinoplasty. Whether it’s a small change or a major revision, rhinoplasty can help patients reach total facial harmony. Dr. Naderi has already changed many lives through his work as a top nose surgery specialist and he will continue to provide patients with natural looking results and an improved self image. Dr. Naderi serves patients of all ethnic groups in Chevy Chase, Maryland and surrounding areas with the same degree of care and attention.

People with the following concerns can benefit from rhinoplasty:

A large disproportioned nose
A wide nose
A bump or indentation in the profile of the nose
A bulbous nasal tip
Nasal asymmetry
Flared nostrils
Impaired breathing caused from obstruction in the nose

Candidates for rhinoplasty must be:

Be physically healthy
Stop smoking a week prior to surgery
Have realistic goals in mind

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Bethesda Rhinoplasty

admin — Thu, 27 Oct 2011 07:04:54 +0000

Rhinoplasty Bethesda Revision Rhinoplasty

Dr. Naderi is a facial plastic surgeon that specializes in revision rhinoplasty, where he repairs the poor work of a previous rhinoplasty. Dr. Naderi is recognized for his work in collapsed nose jobs, deviated septum surgery, and corrective nose surgery. As a nasal surgeon, he is dedicated to delivering natural looking results in both primary and revision rhinoplasty. Whether it’s a small tweak or a major revision, Dr. Naderi gives all of his patients the same degree of care and attention. He has already changed many lives through his work as a top nose surgery specialist and he will continue to provide patients with natural looking results and an improved self image. Dr. Naderi serves patients of all ethnic groups in Bethesda, Maryland and surrounding areas.

Rhinoplasty surgery can alter:

Nose size
Nose width
Nose profile
Nasal tip
Nostrils that are large, wide or upturned
Nasal asymmetry and deviation

Candidates for rhinoplasty must:

Be physically healthy
Stop smoking a week prior to surgery
Have realistic goals in mind

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Head & Neck Surgery Article

admin — Wed, 16 Mar 2011 11:24:12 +0000

Revision Rhinoplasty Article

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Specific Types of Rhinoplasty

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Many times during Rhinoplasty or Revision Rhinoplasty, multiple issues may need to be corrected. Occasionally, new issues can arise as a result of correction of a completely separate issue and these must be recognized and corrected before Rhinoplasty and during Rhinoplasty, as the Plastic Surgeon assesses and reassesses the nose. For example, the de-projection of a very long and over projected nose creates a dorsal hump and widens the nostrils during the rhinoplasty that must be recognized and corrected otherwise a patient who had an over projected nose and a straight bridge may end up with a new dorsal hump and flared nostrils that are not pleasing to the eyes. Another situation is narrowing of the nasal tip on a patient with weak alar rims (nostrils). The tip Rhinoplasty maneuvers in such a patient may create alar retraction or notching, which must be recognized and corrected with alar rim grafts or composite ear cartilage grafts. Failure to recognize such issues may result in an unsuccessful Rhinoplasty.

A Rhinoplasty Specialist Surgeon should have the skills to diagnose and deal with these specific nuances during the nose job surgery so that the final result of the nose reshaping can be an overall pleasant and beautiful nose.

There is no “bread and butter Rhinoplasty.” No two people should undergo the same nose job. Not even two sisters may undergo the same Rhinoplasty techniques. Sometimes, only a specific area of the nose needs correction while other times the entire nose must be corrected. Below are common specific aesthetic nasal issues encountered by a rhinoplasty specialist plastic surgeon.

Ethnic Rhinoplasty

admin — Mon, 27 Dec 2010 10:47:51 +0000

The term “ethnic rhinoplasty” has been used by plastic surgeons and patients for many years, to describe rhinoplasty on non-Caucasian patients. The term is no longer that accurate or specific as there are many races and ethnicities with different nasal anatomy and facial proportions requiring different analysis and various rhinoplasty techniques. At the end of the day, a rhinoplasty specialist surgeon will be able to properly diagnose each individual’s face and nose and suggest options using computer imaging and then be able to carry out a well thought-out and safe rhinoplasty to improve the nose of the individual patient. The most crucial aspect is proper diagnosis and judgment in order to give each “ethnic” patient a nose that fits his or her face without distracting from the other features. It’s important to discuss the goals with each “ethnic” patient thoroughly. While some patients want a nose that is more “Caucasian” or westernized, others prefer to have a more aesthetic nose that simply still fits their face and does not distract or erase their cultural heritage. Please read more about each specific ethnicity or race below:

Dr. Naderi’s ethnic Rhinoplasty patient with Asian & Latina heritage underwent reductive closed Rhinoplasty to enhance the beauty of her eyes.

Choosing a Rhinoplasty Specialist Surgeon

admin — Mon, 27 Dec 2010 10:32:00 +0000

CHOOSING A RHINOPLASTY SPECIALIST SURGEON (Washington DC, Virginia & Chevy Chase Maryland)

It is a well-known and accepted fact amongst Plastic Surgeons that Rhinoplasty is the most complex and elegant of all Cosmetic Surgery operations. In fact some Top Board Certified Plastic Surgeons will not perform nose jobs and will refer the Rhinoplasty patient to a specialist. What may seem as a “simple hump removal” or a “simple tip refinement” is often a series of very precise surgical maneuvers that can easily be misjudged and over-corrected or under-corrected by the novice Plastic Surgeon. Rhinoplasty is an operation of millimeters or fractions thereof. It is a three dimensional cosmetic surgery that can also affect the function of the nose – breathing. It is purely and simply an operation that takes the utmost skill, artistry and comprehension of the nasal anatomy. Furthermore, the results of a nose job are on display in the middle of your face and continue to modify and change for years. It is in your best interest to understand your own nose and participate in the consultation dialogue with your Plastic Surgeon. You need to be able to choose the correct specialist to trust your nose to, in order to get the best possible results and minimize chances for Revision Rhinoplasty. Dr. Naderi created this website after many years of witnessing how so many irresponsible Plastic Surgeons have adversely affected the lives of hundreds of patients by undertaking an operation they barely understood and have not mastered. He has seen so many patients who had disastrous Rhinoplasty results who now need major Revision Rhinoplasty. Often times these patients had fairly decent noses to start with and required a finesse Rhinoplasty but ended up with major anatomic distortions, emotional devastation, and financial depletion. While no one can guarantee a “perfect” outcome due to the healing nature of Rhinoplasty, many of the errors committed by the average Plastic Surgeon during Rhinoplasty is avoidable. The more you know, the better your chances for choosing the correct Rhinoplasty Surgeon.

Welcome to one of the most comprehensive, scientific and unbiased Rhinoplasty information sources online. This is our original “Online Textbook of Rhinoplasty & Revision Rhinoplasty.” Here, you will learn about the specific anatomy of your nose, as well as about your various Rhinoplasty surgical options. You will learn about benefits as well as risks of Rhinoplasty without any “sales or marketing pitch.” Most importantly, you will read first-hand, “Dr. Naderi’s straight talk.” This is where you will hear it like it is from the doctor with the global reputation for honesty, compassion and directness. You will be able to use the information on this site during your search for a Rhinoplasty specialist, no matter where you live, to help with your decision making process and increase your chances for a successful outcome. Planning to undergo elective nasal surgery can be overwhelming and our goal is to provide you with plenty of research tools and information.

This Rhinoplasty website is your guide to a complete and better understanding of your own particular nose type and your realistic available options. Using the specific information here, as it relates to your own unique nose, you will be able to have a more productive dialogue with your own Rhinoplasty Plastic Surgeon, wherever you live. Active participation in the decision making process will unveil the mystery of Rhinoplasty and increase your chances for a satisfactory post-Rhinoplasty outcome. This website has helped countless patients in their research and planning towards a successful Rhinoplasty surgery.

Dr. Naderi’s elegant and easy to comprehend teaching style will allow you to learn all about Rhinoplasty, as related to different ages, sexes, ethnicities and nose types. For years, Dr. Naderi has instructed other surgeons as well as informed his many happy patients, and now the information is gathered collectively on this comprehensive Rhinoplasty website. Patients from all over the United States and the world come to see Dr. Naderi each year for Rhinoplasty evaluation. Now you can start the process from the comfort of your own home or office.

Surgical anatomy of the nose is outlined using original and copy write diagrams and artwork. Endonasal or Closed (scar-less) Rhinoplasty and External or Open Rhinoplasty are discussed in length. Different types of cartilage and fascia grafts, as well as sutures, are detailed and illustrated. The surgery of “nose reshaping” and its potential limitations and complications are clarified and classified. The more you know, the higher your chances of being happy after a Rhinoplasty. The more informed you become, you will increase your chances of choosing the correct kind of nasal reshaping surgery and the best Rhinoplasty Plastic Surgeon. Dr. Naderi outlines the key factors for men and women of all ages. Different aspects of white, black, hispanic, middle-eastern and asian Rhinoplasty are addressed. Important issues to consider for thick-skinned and thin-skinned patients are outlined. Primary and Revision Rhinoplasty are distinguished and highlighted. Boxy nasal tips, bulbous nasal tips, “meaty nose tips,” asymmetric tips and their variations are covered. Techniques for increasing as well as decreasing nasal length in Rhinoplasty are discussed. Rhinoplasty for droopy nasal tips as well as tips that are too upturned or over-rotated are covered. Crooked and twisted noses are addressed. Surgery for the septum and turbinates to improve breathing and decrease nasal airway obstruction are covered during Rhinoplasty. Nasal bumps or humps as well as saddle noses are outlined. Importance of computer imaging is stressed. Different types of Anesthesia for Rhinoplasty are outlined with their benefits and risks. Even “Nonsurgical Rhinoplasty” is discussed and the ideal patient for non surgical Rhinoplasty is clarified. And finally a range for Rhinoplasty cost across the country as well as the possible role for insurance is covered. You will gain the know-how and the vocabulary to better understand your options and better discuss your surgery with you own Plastic Surgeon. This website has the information you need to know before you undergo any Rhinoplasty or Revision Rhinoplasty surgery. Please read it carefully and feel free to bookmark it and use it as a reference throughout your pre and post operative course.

More importantly, it is well known and published that medical education and surgical training in Rhinoplasty is sorely inadequate in the vast majority of Plastic Surgery residencies across the country. Furthermore, most Plastic Surgeons perform too few Rhinoplasty operations to be able to perform this intricate and complex surgery adequately and consistently. While after performing only a 100 of any surgery nearly guarantees consistent great results, the same is not true even after performing 10,000 Rhinoplasties. Unique variations in patient healing is what makes Rhinoplasty such a complex operation. But good surgical technique can increase the chances for success significantly. Many surgeons have been using the same old improper techniques for many years due to this lack of initial training. This website gives medical students, Plastic Surgery residents, Cosmetic Surgery fellows and practicing Plastic Surgeons the opportunity to re-educate and refresh their knowledge base in the proper and safe techniques of successful Rhinoplasty and Revision Rhinoplasty. While certain post-op results are completely out of the hands of the surgeon and are ultimately due to each patient’s healing forces, other “infamous” post-op results such as the late Michael Jackson’s nose, are not due to patient healing, but rather due to poor surgical judgment and improper technique.

Whether you are curious about a Rhinoplasty, are looking to get a Rhinoplasty or have already faced the disappointment of an unsuccessful Rhinoplasty, you can learn more about your own nose and your nose’s possibilities as well as limitations. Many times patients undergo Rhinoplasty without completely understanding their own unique nasal features as well as surgical options and end up trusting inexperienced plastic surgeons only to end up disappointed when the cast is removed. The goal is for each Rhinoplasty patient to be completely familiar with the anatomy of the nose as well as the different aspects of the nose that make each nose and each Rhinoplasty unique. Surgical maneuvers are thoroughly discussed and illustrated in simple to understand but comprehensive terms. This website will be your guide and your reference source throughout your search, whether you live in Washington DC, Chevy Chase Maryland, Fairfax Virginia, Los Angeles, Beverly Hills, Miami, New York, Canada, Europe, Asia or anywhere else, as long as you have access to the internet.

Dr. Shervin Naderi is a double Board Certified Facial Plastic Surgeon, and more specifically, a Rhinoplasty Specialist Surgeon. Rhinoplasty and Revision Rhinoplasty make up well over 90% of Dr. Naderi’s busy surgical practice. He has authored major textbook chapters on the topic of Revision Rhinoplasty and now he has translated his work into easy to understand terms for the general population, as well as other Plastic Surgeons trying to better understand Rhinoplasty. He has taken the mystery out of Rhinoplasty and broken it down to simple, clear facts, pearls and illustrations.

Dr. Naderi is an effective and passionate educator and teacher. He has instructed surgical residents the proper techniques of Rhinoplasty. More importantly, he enjoys taking time to educate his many patients so that they may be able to make the best decision regarding their nose and their surgery. Dr. Naderi’s patients come to him from all over the United States, Canada, Asia, & Europe as well as locally referred by other Plastic Surgeon in Washington DC, Chevy Chase Maryland and Northern Virginia. Dr. Naderi is also a Board Examiner for the American Board of Facial Plastic & Reconstructive Surgery. His offices are located in the greater Washington DC area in Northern Virginia, Fairfax County, just minutes from the popular Reston Town Center, in addition to an office located in the heart of Chevy Chase, on the border of Maryland and Washington D.C., in Montgomery County adjacent to Bethesda, Maryland.

So why should you do so much research before going through a Rhinoplasty? Because Rhinoplasty is the most complex and intricate operation in all of cosmetic surgery. Many Plastic Surgeons are very competent at doing liposuction or breast augmentation or tummy tucks or even face lifts. Yet it is well known that Rhinoplasty is done poorly by many Plastic Surgeons due to various factors outlined on this website.

Rhinoplasty is by far the most unique surgical procedure in all of plastic and cosmetic surgery. Rhinoplasty is an operation requiring a focused plastic surgeon with precise skill, meticulous attention to details, artistic sense and scientific knowledge of the nose. Rhinoplasty requires a surgeon with extensive specialized training, unique anatomic understanding and a lifelong dedication to this one and only operation.

“A Rhinoplasty Surgeon is not a ‘jack of all trades’ but rather a ‘master of one!’”

***

HERE ARE SOME FACTS ABOUT RHINOPLASTY:
The nose sits in the central portion of the face and plays a crucial role in balancing the entire face. A “nose that fits” enhances the beauty of the eyes and intrigue of the lips, but a disproportionate nose distracts attention away from the eyes and lips. Therefore “a successful Rhinoplasty is seen in the eyes.”

Actual African American Rhinoplasty patient of Dr. Naderi before and after Rhinoplasty showing more definition of the bridge and more proportional nostril size.

Rhinoplasty is unique amongst plastic surgery operations because changing a few millimeters makes a significant impact on the outcome, even years later. The same is not true with facelifts, breast augmentation, tummy tucks or liposuction. It is extremely important to demonstrate to patients, using digital computer imaging, how a bridge that is slightly higher or lower can make the nose and face look significantly different. A few millimeters can be the difference between a refined, beautiful nose or a fake-looking, unattractive nose.

The external nose (skin, cartilages, bones, and soft tissue) and the internal septum are intimately connected. A Rhinoplasty Surgeon must be well versed in the cosmetic and functional surgery of the nose. The internal framework or septum is the support structure for the external nose. Most Rhinoplasty Surgeons are exclusive Facial Plastic Surgeons with a background in ENT surgery as well as further specialization in Plastic Surgery of the face, head and neck. There are some exceptional general Plastic Surgeons as well who have taken it upon themselves to educate and dedicate their careers to this one complex structure and operation. “It is amazing hearing from countless patients how often they visited a plastic surgeon who offered to do a rhinoplasty for them but never took the time to look inside their nose!”

Rhinoplasty is the only 3-dimensional operation of millimeters! Changing one view or aspect of the nose will affect the other views. A Rhinoplasty Specialist Surgeon has the thorough understanding and tools to be able to predict and correct such changes. Rhinoplasty is not a “cookie cutter” operation. Each nose has to fit each face. Each Rhinoplasty surgery is individualized for the best outcome.

The nose continues to mold and change after a Rhinoplasty. This process takes years. Although patients can enjoy their new nose as soon as 7 to 10 days after their nose job and will often look completely healed and beautiful at 1-3 months post Rhinoplasty, the nose continues to mold even years later. The nose after a Rhinoplasty has to be able to withstand the changes in scar tissue maturation and healing forces, in order to maintain beautiful results years after the Rhinoplasty.

There is an unacceptably high rate of Revision, after a Rhinoplasty, around the world, due to a combination of factors. These include inadequate pre-operative patient-doctor communication, neglect of computer imaging, poor surgical technique, unrealistic goals and expectations as well as unpredictable healing post Rhinoplasty. The more you know about your nose, the higher the likelihood for finding the best Rhinoplasty Surgeon and ending up happy and satisfied. Sometimes, this may involve being talked out of a Rhinoplasty. Your surgeon must be able to take the time and interest to discuss all of your options including avoiding surgery if it is not in your best interest. Your surgeon must put your interest and safety above all else. Dr. Naderi is famous for his compassion and for taking the time to educate and talk up to 20% of his patients out of an unnecessary rhinoplasty or revision rhinoplasty. Patients trust Dr. Naderi’s skill and expertise but even more so, they trust his judgment and trust him as a caring physician and genuine doctor.