Q&A

Q: Non-surgical Nose Job Procedures to Reduce Nose Size?
Are there any non-surgical procedures to make my nose smaller, or is surgery my only option?

A: Non surgical rhinoplasty Injectable rhinoplasty using facial fillers has become very popular over the past few years. They can be a good alternative to surgery it patients need to build up or add to depressions along the bridge of the nose. They are called filler, because they add volume, so these products cannot be used to make the nose "smaller." However, they can be used to give the nose a more balance shape which can potentially achieve the result of a reductions rhinoplasty.

Q: How long is it normal to have swelling after rhinoplasty?
I had a Rhinoplasty 3 weeks ago and my nose is still very swollen. How long is it normal to have rhinoplasty swelling after surgery?

A: Swelling after rhinolplasty I typically tell my patients to expect bruising and swelling after the surgery. The first month after surgery patients can frequently see daily changes. After about 6 weeks 80-90% of the swelling has resolved, however the last 10-20% can take months to resolve.

Q: Composite Graft Repair versus Alar Rim Cartilage Graft Repair for an External Notched Scar at the Upper Nostril Rim?
In addition to the option of composite graft repair, it has been suggested to me that a simple alar rim cartilage graft might help normalize the contour of my externally notched nostril scar. Unlike an intact but retracted nostril rim, my notched nostril rim appears as though the skin of the rim is split apart. Realistically, which of these techniques is the better option to try?

A: Alar notch Alar notching can be a very complex problem to fix during rhinoplasty surgery. The best answer I can give you is it depends on the severity of the notching. There is not one best option that fits for everyone.

Q: I Wanted to Get a Septo-rhinoplasty Done to Improve my Breathing, Sinus and Also Appearance of my Nose?
I am from India and most drs in Houston TX probably have experience working on Caucasian noses. Every ethnicity has diff nose and diff general face structure. I am just worried that they will try to fix my nose just like a Caucasian nose. I have seen 3 drs until now. I have narrowed down to 2, due to their experience in facial plastic surgery and ENT background which will help with the medical part. I am just not sure about the Rhino part and also how to communicate what exactly I need. Any suggestions?

A: Ethnic rhinoplasty concerns
You are correct there are significant cultural factors which influence aesthetics and these aesthetics can very between ethnic groups. Being in NYC many of my patients have your same concerns. It is also important to visit a surgeon who can improve your functional nasal concerns as well. In Houston two great facial plastic surgeons are Drs Yalamanchili and Kridel.

Q: How Important is It to Go to a Doctor That Specializes in Rhinoplasty?
I am getting a rhinoplasty and I am still trying to find the right surgeon. I found one that I think I like and is in my price range but I am a little skeptical because he does all kinds of surgeries (implants, lipo, etc), whereas the other doctors I have seen specialize only in facial surgery. If I go to this doctor, could I be risking a "jack of all trades, master of none" kind of experience? How normal for is for a plastic surgeon not to specialize in one area?

A: Importance of seeking a rhinoplasty surgeon
You are correct in your concerns. It is important to choose a surgeon who is comfortable with rhinoplasty surgery and also someone who understands the importance of the function of the nose. Probably best way to assess this is to see their work and unquire about the volume of rhinoplasties he/she does a year.

Q: My Nose Size is Larger Than Usual Shape What Type of Surgery Should I Do and at What Cost?

A: Reduction rhinoplasty
Thanks for sharing your photos. Looks like you may benefit from reducing the bridge height, reducing the height of your tip, rotating the tip. Would recommend an open rhinoplasty approach for you. Please call us for an more in depth evaluation with computer imaging.

Q: Rhinoplasty to Make Nose Slightly More Upturned?
My nose has gotten larger and more pronounced within the last few years and I really want it to be more upturned but I don't want that pig look! Or is it possible to have the skin below the tip of the nose (I don't know the technical term!) pulled up? Would this be the correct procedure with what I'm trying to achieve? Thank you so much!

A: Tip Rotation
Thanks for your post. Rotating the tip of the nose involves modifying the shape of the underlying tip cartilages. This typically is performed either through an open or closed rhinoplasty approach.

Q: Nose Job For More Pointy Nose Tip That Has Very Little Cartilage?
I consider my nose to be rather large, although some may disagree. My problem isn't really the bridge, although personally I wouldn't mind it a bit straighter, but my real issue is my tip. It has very little cartilage and is fat. If I push it, I can squish it all the way to my face. I know it sounds funny, but I really feel if there could be some fat trimmed from it and more of a point, I would have a really nice nose. What is the minimum amount of surgery possible for something like this?

A: Tip support - rhinoplasty
Sounds like you may have thick nasal tip skin along with weak tip cartilages. To address this you would likely need an open rhinoplasty approach. This would allow the surgeon to address both issues. You would likely need to strengthen that to support using several options such as a columellar strut and/or tip graft.

Q: I Am a 31 Year Old Who Would Like to Do Facial Surgery on my Eyes and Nose?
I would for my eyes to be more elongated and raised in the corners and for my nose to have more definition and a point to it, maybe narrower?

A: Rhinoplasty in New York City
Thank you for sharing your photos. Your concerns are quite frequently seen in our practice. Based on your photos, you may benefit a rhinoplasty to improve tip definition. To do this you would likely need an open rhinoplasty using tip defining techniques and possible tip cartilage grafts. I would like to extend an invitation for a consult to discuss firsthand the changes will begin to achieve with your nose and eyes.

Q: Worth It to Get a Rhinoplasty?
I have a big face and a long, narrow nose with a tip that is slightly too wide for the bridge. I want my nose to be shorter and the bridge less narrow. I consulted a PS and he suggested spreader grafts and columellar strut. My only concern is that I have a wide face and in the computer images my shorter nose sort of drew attention to that and made me look piggy. I'm concerned that changing my nose could end up just drawing more attention to other parts of my face that are unattractive.

A: Natural results should be your goal
Thank you for sharing your photos. Based on your photos and from your description, you may benefit from tip rotation and refinement. There are several reliable tip techniques which can achieve this. The goal for any rhinoplasty is to achieve harmony with your other facial features. Regarding use of spreader grafts I would need to evaluate you firsthand. We welcome to you come in for a consultation.

Q: How Can I Correct my Asymmetrical Nostrils?
My nostrils are asmmetrical and my nose curves off to my left. i dont really notice it if i look in the mirror too much but if i go on cam or have a photo is really noticable! It even makes each side of my face look different. I would really like to know what i could have done to correct it and if it would leave any scars. I am really happy with my left side profile but my front and right side is awful as i had an accident when i was 2 and the scar has caused my nose to deviate to the right. There is also a dip in my face where the right nostril lies can this be built up? I really just want my profiles to be the same and have a straight looking nose from the front.

A: Rhinoplasty – asymmetric nostrils
Thank you for sharing your photos. Based on your photos you may have a deviated septum which may be contributing to your nostril asymmetry. In addition, the columella seems slightly wide. A rhinoplasty can be performed to improve your nostril asymmetry.

Q: Pulled Dissolvable Stitch out After Rhinoplasty
I had a tip Rhinoplasty on 2/27/09, and while I was cleaning my nose on the right side today (around a week after surgery), I pulled out my dissolvable stitch, thinking it was hair. Will this affect my long term result? How long does it take for dissolvable stiches to dissolve? Will my right nostril be uneven because of this? Thank you!

A: Dissolvable stitches in rhinoplasty
Many types of sutures are used to perform rhinoplasty surgery. Some sutures are dissolvable and some are permanent. Depending on need, a surgeon will choose various sutures for different reasons. When using dissolvable sutures the surgeon only relies on the suture for a temporary time after that your own tissue should maintain its intended position. Occasionally deeper sutures can work their way to the surface of the skin. I would not suspect removing the suture would have any effect on your final outcomes

Q: Hard Bumps on Nose After Rhinoplasty
I am five weeks post open rhinoplasty. I had a tension nose with a pronounced hump and droopy tip. Everything has gone very well, and I was extremely pleased upon removal of the cast, splints, etc... At that time, my hump was gone, the front and sides of my nose were very smooth, and my tip no longer drooped. However, over the last couple of weeks I have developed bumps on both sides of my nose - on the right side just next to my eye, and on the left side a little lower than my eye. The bump on the left is fairly significant and hard. It makes my nose look crooked - similar to Owen Wilson's nose. I realize that it can take up to a year to achieve final results. My surgeon has been great, but his response to my bumps is 'we will just wait and see'. However, I need to know if this is common and how likely these bumps are to go away. People are even starting to comment that my nose looks crooked. Please share your experiences with me, so that I have some idea of what I am dealing with. Is this likely part of the healing process, or should I be concerned?
Thank you,
Nancy

A: Bumps after rhinoplasty
Thank you for your question Nancy. From what you are describing the irregularities may be in the region of the osteotomies which were probably performed during your rhinoplasty. Overall I agree with your surgeon in that things are very early and you can expect further changes. Some patients may feel ridges along the osteotomy sites.

Q: Celebrity Nose Jobs: Better Than What Anyone Can Get?
Is a celebrity nose job going to be better because they're famous and can afford perfection?

A: Celebrity nose job myths
Celebrities nowadays are scrutinized more than ever. With numerous social media outlets celebrity gossip, especially celebrity plastic surgery, tends to generate great public interest. Celebrities who appear and magazines or advertising prints often have make up artist and Photoshop to achieve that "perfect" look. Patients interested in rhinoplasty should understand these differences. But to answer your question, most surgeons who performed rhinoplasty frequently should be well versed in the most current techniques which are applied universally, to all patients.

Q: Wide Nose. Can I Ever Get an Skinny One?
My nose is huge from the front its flat and has no tip at all. It looks good from the side but not from the front. I'm 18 and its done growing. can I ever get an desired nose? Such as Megan Fox or such? I know thats a little too drastic but I think I would look soo much better and so would my features if I had an skinny nose such as Megan.

A: Tip refinement with thick skin
Refining the nasal tip is dependent on several factors. Some of the major concerns when narrowing a nasal tip is the skin of the tip and the strength underlying tip cartilages. Based on your photos, you seem to have thicker nasal tip skin and possibly weaker tip cartilages. To narrow your tip you may likely need to thin the tip skin and require a tip graft. I recommend visiting a rhinoplasty surgeon to better evaluate your notes firsthand.

Q: Causes of a crooked nose
Your nose looks very similar to many patients I see interested in straightening a crooked nose. Some of the most common causes of a crooked nose include a deviated septum, a depressed upper lateral cartilage, and malpositioned nasal bones. Based on your photos, I would assume you likely would have nasal breathing issues. If so, you would benefit from a functional rhinoplasty.

A: Filing Down the Dorsal Hump?
I have a small dorsal hump that I would like to get fixed on my nose, and was considering closed rhinoplasty. The plastic surgeon informed me that he could just go in and file it down without breaking or fracturing any bones. Does this sound like a good idea? The absolute only thing I want done is the hump shaved down, and it is very small. Will any other part of my nose need fixing if the surgeon simply files the hump down?

Q: Why is my Nose So Crooked?
hey all i didnt notice how crooked my nose was until a couple weeks ago people started to ask me if i had ever had it broken but i never have, my nose was always prone to being hit with a ball so i think it is probably sports related.

A: Causes of a crooked nose
Your nose looks very similar to many patients I see interested in straightening a crooked nose. Some of the most common causes of a crooked nose include a deviated septum, a depressed upper lateral cartilage, and malpositioned nasal bones. Based on your photos, I would assume you likely would have nasal breathing issues. If so, you would benefit from a functional rhinoplasty.

Q: Filing Down the Dorsal Hump?
I have a small dorsal hump that I would like to get fixed on my nose, and was considering closed rhinoplasty. The plastic surgeon informed me that he could just go in and file it down without breaking or fracturing any bones. Does this sound like a good idea? The absolute only thing I want done is the hump shaved down, and it is very small. Will any other part of my nose need fixing if the surgeon simply files the hump down?

A: Dorsal hump
A small dorsal hump can be approached through a closed rhinoplasty technique. The dorsal hump can be addressed other by filing down the nasal bones for trimming the dorsal cartilage. It the hump is very small and is largely due to excess dorsal cartilage then nasal bone osteotomies may not be required.

Q: I Would Like to Have a Primary Rhinoplasty Soon. I Have Met with So Many Doctors but I Don't Know Who to Choose?
The 1st doctor seems patient but he said I shouldn't be upset if it doesn't come out ideal which scared me off. The 2nd doctor seems to have a lot experience but he knows this other doctor that is covertly mean, and ignored my email. The 3rd doctor is busy and his staff didn't return my call, which isn't acceptable and he only has about 3 B/A photos. The 4th was referred & he's popular in marketing but I feel I may not trust him based on who referred me. All of these are cert. by AB FPS.

A: Choosing a surgeon
Choosing a surgeon and can be daunting, especially in a major metropolitan area. One obvious screen which you have already done is to verify the surgeon's credentials. Make sure the surgeon is board –certified by either the American Board of Facial Plastic and Reconstructive Surgery or the American Board of Plastic Surgery. Also, ensure that the surgeon has hospital credentials at a respectable institution. Go on multiple consultations, to compare each surgeons aesthetics, demeanor, and office staff. Finally, go with your gut instincts. Good luck!

Q: I Have No Cartilage in my Nose Whatsoever. So I Wonder Can Rhinoplasty Add Cartilage to my Nose?
My nose really has no shape. When I lay down my nose falls with me. I really would like to know can rhinoplasty fix this. Can they add cartilage or a bone in my nose to give it a shape? And if yes how much would that cost? Thank you.

A: Alternative nasal cartilage options
I have dealt with many rhinoplasty surgeries which require alternative sources for cartilage. Typically septal cartilage is the primary source for grafts required in rhinoplasty surgery. However it the patient has had prior surgery, in which the majority septal cartilage was removed, or if the changes required may need more grafts than can be provided by the patient's native septum, alternative sources for cartilage may be necessary. Several options exist depending on the specific needs. I would be happy to review your specific requirements with you.

Q: What To Expect From A Rhinoplasty Consultation and Can I Still Look Lik e ME After Surgery?
As a teen, I detested my nose. However with time (and age) I've learned to be far more accepting... but, I still strongly DISLIKE my nose and am considering surgery to refine it. I want it to be straighter on my face (slight deviation to right), have less of a bump, and raise the tip. I want it to still look like ME though, and I want it to suit my face. I would love advice on what type of surgery would be suitable and what to expect at a consultation. Thanks!

A: Natural looking results
Your concerns are common, a lot of my patients who have undergone rhinoplasty surgery comment "I wish I had done this earlier" or "this is the nose I should have had". Hearing those words from my patients gives great satisfaction to me as their plastic surgeon. My goals for my rhinoplasty patients is to achieve natural results which complement his or her facial features. To help with this, I feel is essential to incorporate computer imaging during a rhinoplasty consultation. This technology allows both the patient and myself to express each other's aesthetic goals. I recommend to any patient inquiring about rhinoplasty to seek surgeons who offer computer imaging.

Q: My nostrils are looking very different since the cast was removed.
I have open rhinoplasty 13 days ago, and whilst the cast was on my nose looked fantastic, now that the cast has been removed 6 days ago one nostril appears to look thinner and the septum is clearly visible. I do still have a lot of facial swelling, but am concerned about my nostrils.

A: Nostril asymmetry after surgery
During your first few months (especially your first month) after surgery patients undergoing rhinoplasty will undoubtedly have asymmetries as they are healing. These asymmetries can be anywhere on the nose from the top of the bridge to the base of the nose (nostrils included). This is can be very nerve racking as the patient, but some trust and patience are required during this phase of the recovery. Of course close post operative evaluations and discussions with your surgeon will help relieve some concerns.

Q: Would a Nose Job Be Complicated Following Several Years of Insufflation?
This is embarrassing but I'm just going to be blunt and get it over with. I insufflated oxycontin for several years and developed a pretty bad habit. I quit 2 years ago and have been researching rhinoplasty as I have hated my large nose since high school. I saw an ENT who told me I have no apparent damage, just a big bulbous nose (thanks, dad). Should I be concerned about getting rhino, specifically tip reduction and alarplasty?

A: Risk avoided
I'm glad to hear you are sober. Inhaling nouxcious substances can result in significant structural issues with ones nose the most common being a septal perforation. An ENT or rhinoplasty surgeon can evaluate someone's nose to rule this out. Sounds like you would be a good candidate to address your cosmetic concerns with a rhinoplasty.

Q: Does Getting a Nose Job, Drastically Change Your Face?
If you get a nose job can it drastically change your face? Would it just enhance features? Would your lips look fuller or eyes look bigger? I know this may be a shallow question, but can someone go from a 7 to a 9 or 10 (on level attractivnes) after a nose job?

A: Drastic changes after a nose job?
The answer to your question, it depends. Someone who is looking to either dramatically augment their nose or reduce their nose can potentially have a dramatic change. Meaning an individual who has either a extremely large dorsum or an individual who has a extremely saddled bridge a rhinoplasty. Although these changes can be significant the goal for any rhinoplasty surgery is to achieve harmony with the other facial structures and a natural result.

Q: Nose Looks More Bulbous and Round After Rhinoplasty
I had an open rhinoplasty three weeks ago, and I'm concerned about the current results. My goal for the surgery was to remove the side and front humps around my eyes and raise the tip. While I'm very satisfied with my new profile, and the bone is much slimmer around my eyes, the bottom 2/3 of my nose seems much more bulbous, and my tip appears way rounder (maybe kind of droopy too) than even before the surgery. Can I expect this to adjust with time? Is this still swelling? I don't regret having had it done, but I just hate that after all this, I still feel self conscious about my nose. Thanks!

A: Healing after rhinoplasty
Three weeks after rhinoplasty surgery one can expect significant swelling still present at the tip. In some patients assigned can be so significant that it appears more bulbous and round after surgery. During this time, is important to keep your follow-up appointments with your surgeon as a surgeon may recommend steroid injections to help control some of the swelling.

Q: Can a Hit Cause a Permanent Dorsal Hump?
I was hit in the nose two days ago. Not extremely hard, but hard enough for it to be a little sore. It now looks like I have a subtle dorsal hump. Is this just swelling or is it going to permanently be like this? Also, it feels like there is a slight pressure where the hump is. I'm hoping the hump is just swelling, but it feels like bone.

A: Nasal trauma and dorsal hump
Trauma to the nose and results in developing a dorsal up even though the nose still appears straight. Impact to one of the nasal bones can create a buckling effect along the midline of the nose as it meets resistance from the other nasal bone. If this occurs a dorsal hump will develop.

Q: How Can I Reduce Nostril Flare or Size?
I like the size and shape of my nose, but I do not like how my nostrils flare up even when they are relaxed. I am part Latino, and I understand that nostril flare is common among non-white people. Is it possible to reduce only nostril flare (and leave the rest of the nose alone) during Rhinoplasty? What are special risks associated with this surgery? Is this a major surgery with a lot of downtime? Is it a common surgery? Relatively hard to perform? I've never had any reconstructive facial surgery before. Thank you very much in advance for any information!

A: How to correct nostrils flare
The base of our nose or the with of our nostrils contribute significantly to the overall shape of the nose. Excess nostrils flare can be addressed using alar base reduction techniques. These techniques require incisions on the external skin of the nose, to remove the excess skin contributing to the nostril flare. These incisions tend to hide well within the natural creases of the nostril.