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Most rhinoplasty patients have been bothered by the shape of their nose since they were 11 or 12 years of age. By the time they are finally ready to move forward with surgery, they have a good idea of what changes they would like to make. Most tell me they like there face as a whole but find this shape and/or size of their nose to be distracting away from their other features. Often, they have one profile they like better than the other and have mastered makeup contouring that best compliments the rest of their face.
One of the most important things I want my patients to understand is the concept that rhinoplasty should not fundamentally change the way you look. Instead, it should bring the nose into harmony with the rest of your facial features in accordance with your aesthetics. The nose is a very defining feature of the face, and its aesthetics and anatomy is variable based on many factors including ethnicity and gender. Since there are as many noses as there are faces, it is paramount that we have a detailed discussion about your desired look and aesthetics.
During the consultation, I often ask to see your nose "inspo". Although rhinoplasty is bound by anatomic limitations and we can never exactly duplicate another nose, seeing what you consider beautiful is very valuable in my understanding of your aesthetics and will serve as a roadmap for a goal we can work toward.
A large portion of my practice is comprised of complex revision rhinoplasty. In my practice, I employed both endonasal or "closed" rhinoplasty as well as external or "open" approaches. Over the years, I have developed a hybrid approach which allowed me to draw on techniques from both approaches to minimize trauma to the nose and maximize results. The surgery itself can take anywhere from 2-4 hours depending on complexity and is scheduled as outpatient, ie you go home the same day. Over the years I have made many modifications that make the recovery comfortable and the downtime minimal.
If you are interested in more in-depth videos and photos, including intraoperative views, related to rhinoplasty, make sure to follow @SamanPlasticSurgery and look at the Rhinoplasty highlights. And don't miss the daily story posts!
I strive to master the techniques as a surgeon, then transcend them as an artist.
Rhinoplasty is an art and mastering it a lifelong endeavor. There are many nuances, details, dynamic and temporal aspects and variations. No two operations are ever the same. This is an art I am passionate about. It is an art I obsess over. There is daily dedicated time for thinking about rhinoplasty in my life. Not a day goes by without me thinking about one aspect of another of rhinoplasty: How can I optimize my results yet preserve more and dissect less? Where can I graft less and maximize outcome predictability?
There are so many dogmas in rhinoplasty: External versus internal approaches, osteotomy techniques, structural versus preservation concepts, autoflap or grafts, rib cartilage or ear, diced or not, push down, let down, roof sparing, component reduction, and the list goes on and on. With humility, and with abundant respect to my rhinoplasty colleagues, a turning point for my rhinoplasty career has been the realization that there is no single “correct” way of doing rhinoplasty and a bespoke approach must be formulated for achieving beautiful and functional results. My approach draws on the best of these various techniques for a customized treatment that results in the desired look.
There are fundamental truths and principles one must adhere to, of course, but at some point, following old teachings in a step-by-step fashion makes rhinoplasty limited and rigid. I don’t know about you, but I much prefer to watch art happen in the passion of flawlessly improvised masterful street tango than to watch well-performed but rigid execution of step-by-step instructions in a rehearsed first dance. #youareart
An overview of what to expect after rhinoplasty
One week postoperative reveal.
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Rhinoplasty, more commonly known as a nose job, is a plastic surgery procedure which helps correct and reconstruct the form of your nose. Rhinoplasties can also help with restoring functions by fixing issues like nasal trauma, congenital defects and respiratory impediments such as deviated nasal septum or a sinus condition while also aesthetically enhancing the nose.
Patients typically go into the rhinoplasty surgery process with a specific end result in mind. Factors for a rhinoplasty include: narrowing the width of the nostrils, removing or lessening a dorsal hump, creating a better angle between the nose and mouth and fixing any respiratory issues or nasal injuries The rhinoplasty is a safe and effective procedure when performed by experienced rhinoplasty surgeon in Dallas.
Preservation rhinoplasty surgery is a new modern technique for nasal reconstruction surgery. The procedure consists of two steps: First, the surgeon removes the excess skin and cartilage from the tip of the nose, then he uses an implant made out of synthetic material to reconstruct the septum and create the bridge between the upper lip and the nose.
The aim of revision rhinoplasty is to revise a previous nose job that may not have been up to the patients standards. When choosing a surgeon to perform a revision rhinoplasty it is important to make sure that they specialize in this area, as it is a surgery that is challenging and requires meticulous surgical techniques. Dr Saman specializes in revision rhinoplasty.
Scarless rhinoplasty, also known as endonasal or a closed rhinoplasty. Is a technique used in order to avoid any visible scarring or incisions on the face. 60% of patients are eligible for this service depending on the extent of work needing to be done on the nose and the patient's anatomy.
Teorhinoplasty is the innovative adaptation of dorsal preservation rhinoplasty with special measures for tip and bony pyramid stability. This technique allows for a minimally invasive approach for outstanding results.
The main benefits of getting rhinoplasty surgery is to enhance the appearance and functionality of the patient's nose. This in turn helps with confidence and can eliminate any ill-feelings or self-consciousness associated from your nose. Rhinoplasty can:
The best candidates for a rhinoplasty are people looking to change the appearance of their nose or to fix any health issues they have involving the nose. Aesthetically, clients looking to get rhinoplasty surgery have noses that are larger, droop, or have prominent bumps. Healthwise, patients are usually looking to correct their nose after an injury or with issues regarding breathing.
The cost of rhinoplasty varies depending on any factors however usually ranges between $10,000 to $20,000. Factors depend on the unique degree of nasal refinement and length of the surgery. Since some will need a more complex approach involving more delicate techniques such as cartilage grafting this could increase the cost of the procedure.
Following your initial consultation, Dr. Saman will provide you with a complete list of instructions to help you prepare for nose surgery. Here are some things you can do to prepare ahead of time:
It is important to note that though Dr. Saman will take the time to look and assess your unique anatomy before the procedure, side effects are still a possibility with any surgery. Before each rhinoplasty the surgeon should take the time to talk through any potential side effects and risks associated. Here is a list of some side effects you may encounter after the surgery and during the recovery period:
The duration of a typical rhinoplasty will depend on the extent of the changes being made to the patient's nose. Minimal changes will generally require 1 to 1.5 hours. If there are more extensive changes necessary, then the operation could last between 2 to 4 hours.
The average time for most patients is anywhere from two weeks to several months however rhinoplasty recovery time varies from patient to patient. The main factors that affect this are the type of rhinoplasty performed and the extent of the operation.
The recommended age for a rhinoplasty is between 20-40 years old due to facial elasticity which accommodates surgical procedures and allows for less complications. Though this is the recommended age range you can receive a rhinoplasty as young as 13 years old for girls and 15 years old for boys. This is the age at which each gender is physically able to receive a nose job because the nose has grown to an adult size. Rhinoplasty is possible for children under the age of 13 and 15 however it is not recommended.
For the elderly there is no cut off age for when a senior would be eligible for a rhinoplasty surgery. As long as the elderly adult is in good health, they may be perfectly fit to receive the procedure. There have been many cases of patients 70 - 80 years old having a Rhinoplasty performed with minimal to no complications at all.
Due to general or local anesthetic that is given during the operation, and the fact that you’ll be unconscious, you won't feel any pain during the procedure. Soreness, bruising, bleeding and drainage of mucus and old blood are expected for a few days after the surgery which could cause discomfort and/or pain at times.
Patience is key during the recovery process of a rhinoplasty. It is normal and expected to still be experiencing swelling, slight pain, bruising, as well as even headaches for up to four weeks after your procedure. It is important to stay in communication with your surgeon during your recovery time in order to ensure you’re healing properly during this time and to communicate if you are feeling any abnormal pain.
During a closed rhinoplasty (when the procedure happens without opening up the nose), there is no visible scarring at all. Though there are scars when the surgeon uses the open technique or when the operation calls for the narrowing of flared nostrils (a procedure called alarplasty), the small scars on the base of the nose are usually not visible.
Swelling occurs on the inner side of the nose immediately following rhinoplasty. It may take several days to resolve completely. Most swelling usually disappears within six to eight weeks (or a few months). However, it could last up to one year.
You can use ice or ice packs to ease pain and inflammation during your recovery period. Ice helps to reduce swelling and inflammation inside the nose, which makes it easier for you to breathe. As internal swelling resolves, the internal space will be more open and breathing will become much easier and much better.
After the six week period your nose should be able to sustain an injury in the same way as it did before your procedure however initially your nasal bones will be weakened by the rhinoplasty procedure. They will slowly regain their strength and rigidity approximately 6 weeks post-rhinoplasty. It is, however, important to keep in mind that in some rhinoplasty cases where significant amounts of cartilage have been removed from the lower part of the septum which may result in the lower part of the nose being slightly weaker post-operation.
This is an ideal time to undergo just about any type of cosmetic surgery or cosmetic procedures during the months of December through March. Cooler weather allows bulkier clothing to hide swelling as well as bruising and helps keep the body in a desired state of healing. Conveniently there are usually more holidays during these months so you don’t need to take as much time off work during your recovery.
Rhinoplasty is usually performed on an outpatient basis in either a hospital or a clinic however this may change depending on the type of rhinoplasty you are receiving. You may be required to stay for a few extra hours post-op for observation, but in most cases patients are not required to stay overnight and are able to go home.
A closed rhinoplasty procedure, also referred to as an endonasal rhinoplasty, is when all of the incisions are made from inside the nasal passage without the need to surgically open up the nose. People tend to lean towards this option more often because of the lack of scarring that occurs on the face and because of the shorter recovery time.
An open rhinoplasty procedure occurs when the facial plastic surgeon makes an incision on the inside of the nostrils as well as on the outside of the columella, which is the external strip of cartilage that unites both nostrils. This procedure is much easier to perform than a closed or endonasal rhinoplasty because it makes it easier for the surgeon to see what they’re doing during the procedure but does result in very minimal scarring and is sometime the only rhinoplasty option for certain patients due to anatomy or the type rhinoplasty they are receiving.
Septoplasty (a procedure used to correct a deviated septum) can actually reduce or stop snoring entirely and even treat patients with breathing disorders like sleep apnea.
Rhinoplasty is a permanent procedure since your facial characteristics are fully developed as an adult and your nose won’t change unless heavily impacted by external factors. Though it is permanent, a rhinoplasty surgery is also however reversible and unpleasant results can be corrected through revision rhinoplasty surgeries if necessary.
Rhinoplasty Preop Instructions (pdf)
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