Rhinoplasty is one of the most frequently performed procedures in plastic surgery. The size and shape of the nose has a great impact on how a person looks, and the correct improvement can greatly enhance one's appearance.
Dr. Miller and Dr. Heller have spent the last 15 years performing rhinoplasty and refining their techniques to give patients exceptional results. They trained with nationally recognized rhinoplasty surgeons to learn the intricate nature of this procedure. They perform rhinoplasty every week, which results in a large body of experience. This experience allows Dr. Miller and Dr. Heller to concentrate on the fine details of rhinoplasty which ultimately results in a better outcome.
Analysis of the nose is the most important part of rhinoplasty. While the surgery is meticulous, the wrong plan can produce significant problems even if the procedure is done well. Dr. Miller and Dr. Heller will analyze your nose, and, together with your input, they will create an ideal plan. This plan is enhanced with computer imaging to help you understand what can and cannot be done. It is important for the patient to have realistic expectations and the maturity to understand surgery, whether he or she is 17 or 70 years old. Let's look at some examples:
Case 1: Nasal bump with droop tip This patient was dissatisfied with the hump and the fact that the tip pointed down. We removed the bump and sculpted the tip so it pointed in a more natural feminine direction.
Case 2: Crooked nose
This patient desired a straighter nose and to breath easier. He was corrected by altering the nasal bones and cartilage. Internally, his breathing was perfect.
Case 3: Wide tip
This patient disliked the bulbous tip. We sculpted the cartilage to refine it in a natural way.
is complex and is not performed the same way on everyone.
Different rhinoplasty procedures include:
- Primary Rhinoplasty
- Rhinoplasty for Men versus Women
- Revision (re-do) Rhinoplasty
- Open vs. Closed Rhinoplasty
- Rhinoplasty for Asian and African-American Patients
- Rhinoplasty with Sinus Surgery or Septoplasty
- Nonsurgical Rhinoplasty
Primary rhinoplasty means this is the patient's first nose job. Primary rhinoplasty is the best time to get the procedure correct, as subsequent procedures are much more difficult. Dr. Miller and Dr. Heller usually achieve a refined, natural nose that rarely needs improvement. During a primary rhinoplasty, the skin is easily lifted off of the cartilage structures through hidden incisions. Then the cartilage is sculpted, the bump is removed, and the nose can be straightened. Finally, the skin is redraped and the incisions are carefully closed.
Rhinoplasty for Men versus Women
It is extremely important that rhinoplasty surgeons understand the differences between a female nose and a male nose, and that these procedures be performed differently. The female bridge is a little softer and the tip is set slightly higher than a man's. From the side view, the tip extends a little bit past the rest of the nose. A man's nose has several features that are particular to a masculine appearance. The bridge is stronger and the tip is set slightly lower than that of a woman. From the side view, the tip is straight in line with the rest of the nose. Observing these differences is crucial because feminizing a male nose would look completely unnatural, and a woman is also upset when her nose has a masculine appearance.
Revision (re-do) Rhinoplasty
Dr. Miller and Dr. Heller perform many revision rhinoplasty procedures on patients that were initially operated on by other surgeons. During this procedure, the skin is lifted, but it is usually much more difficult than primary rhinoplasty because of scar tissue. Usually, the cartilage has been overresected, and Dr. Miller and Dr. Heller will build the nose back up again using the patient's own internal cartilage as support. This will result in a natural appearing nose without an “operated on” look. Usually, the patient's breathing will be much improved as well.
Open vs. Closed Rhinoplasty
These two procedures are performed in the same manner, except in the open rhinoplasty, a small incision is made between the nostrils to lift up the nasal skin. This technique allows excellent vision of the nasal cartilages and allows precise maneuvers to be carried out. The incision, carried out with meticulous care, disappears in time. Closed rhinoplasty is carried out when mostly bony work has to be done. Dr. Miller and Dr. Heller perform rhinoplasty both ways and will determine which way is best for your nose job.
Rhinoplasty for Asian and African-American Patients
Just as rhinoplasty for men and women requires different approaches, nose jobs for different ethnic groups require alternate methods as well. An Asian or African-American patient often will have a flat nasal bridge. The bridge can be built up to create a more balanced nose, taking the emphasis off the tip. The tip or the nostrils are often wide in the ethnic patient, and Dr. Miller and Dr. Heller can sculpt or thin these areas to improve the shape while keeping the patient's general ethnic appearance intact.
Rhinoplasty with Sinus Surgery or Septoplasty
Many patients may have breathing difficulties or chronic sinus conditions that are no longer responding to medical treatment. A rhinoplasty can easily be done at the same time to improve the outer appearance of the nose. Dr. Miller specializes in surgery of both the inside and outside of the nose, and performs this combination regularly. Also, insurance may cover the surgery done inside the nose. This will allow you to look better and breathe easier all in one procedure.
Some patients ask if a rhinoplasty can be done without surgery. In general, surgery is the best method to effect a permanent change on the nose. However, sometimes a patient may not be ready for surgery, and in these cases, a filler called Radiesse
can be used to make an improvement in the shape of the nose. A bump can appear to be corrected by injecting the Radiesse above and below the bump to give it the appearance of a smooth profile. Also, certain asymmetries may be corrected by injecting the filler in the appropriate area. Radiesse injection is a simple in-office procedure that takes about 5 minutes and the results typically last 9-12 months. After surgery
, one can expect some mild congestion, but minimal pain. Patients often do not need strong painkillers. At six days, the splint and stitches are removed. No uncomfortable packing is needed. Most patients return to work in one week, and avoidance of strenuous activity for two weeks is advised.