Rhinoplasty is one of the most frequently performed cosmetic facial 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. According to the AAFPRS, the top trend in facial plastic surgery in 2015 was people requesting natural-looking rhinoplasty results. Our doctors have 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.
Find out more about rhinoplasty (nose job):
- Analysis of the Face
- Rhinoplasty Infographic
- Primary Rhinoplasty
- Rhinoplasty for Men Versus Women
- Revision (re-do) Rhinoplasty
- Revision Rhinoplasty Before-and-After Images
- Open vs. Closed Rhinoplasty
- Rhinoplasty for Asian and African-American Patients
- Rhinoplasty with Sinus Surgery (Septoplasty)
- Nonsurgical Rhinoplasty
- Before-and-After Nose Surgery Images
- Recovery After Rhinoplasty
- Contact Our Rhinoplasty Surgeons Today
Analysis of the Face
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.
Our rhinoplasty surgeons 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.
Another important factor in rhinoplasty surgery is to ensure that your sinus passages are properly open and even. Our surgeons will of course take all of these factors into account and ensure that your breathing will not be affected, if anything it will be improved.
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 vs. 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.
Our rhinoplasty surgeons have the expertise and experience necessary to craft these differences.
Revision (Re-Do) Rhinoplasty
Revision rhinoplasty is one of the most complicated procedures in all of plastic surgery. Any nasal surgery is difficult because of all the different interactions between the delicate cartilages, bone, and skin. After an initial rhinoplasty has been performed, scar tissue forms. This scar tissue can be very strong and can cause the cartilage, skin, and even bone to sometimes shift, resulting in irregularities of the nose. The goal of revision rhinoplasty is to reverse those problems and create a natural, aesthetically pleasing nose.
The process begins with extensive evaluation and planning. During consultation the nose is carefully examined for irregularities and other aspects that seem unnatural. We will also examine the areas that you feel did not come out correctly. Finally we will evaluate the inside of the nose for proper structure and breathing. Next, computer imaging will be used as a tool to both convey to the patient what can be done and to confirm that we are giving the patient the result that he/she wants. Remember the computer imaging is only a simulation and cannot guarantee a particular result. Once the exam and computer imaging is finished, a detailed plan for the revision rhinoplasty can be constructed.
Revision Rhinoplasty Examples
This is a 32 year old patient that had rhinoplasty 10 years previously at another location. She felt like her nasal tip was distorted and she couldn’t breathe well through the nose. If the frontal view is examined, it appears as though her nasal bridge is washed out and the tip is pinched and shifted to the left. The side views shows a nasal bridge that has been over resected and a tip that is too long. The base view shows the crookedness in the middle part of the nose and obstruction to breathing. During the revision rhinoplasty we built up the bridge to make it smoother. We also reconstructed the tip cartilages to give them support and remove the pinched effect. Then we straightened the middle part of the nose to improve her breathing and fix the crooked appearance. She is very happy with the result because the nose simply looks normal now. The pinch is gone, her nose looks balanced with a nice bridge, and her breathing is great.
Recovery after revision rhinoplasty can take a bit longer than primary rhinoplasty because of the additional scar tissue present. The swelling may last longer, but if a strong cartilage support is constructed, the skin will tighten down and the result will be worth the wait.
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 New Jersey and Staten Island area 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.
Before-and-After Nose Surgery Pictures
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 wanted to breathe 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.
Recovery After Rhinoplasty
After surgery, you 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.
Contact Our Rhinoplasty Surgeons Today
To learn more about, discuss your options or talk about the cost of rhinoplasty, please call Associates in Plastic Surgery at (800) 860-1435 or complete the online contact form to arrange a consultation. Experienced nose surgeons Dr. Miller and Dr. Heller serve patients in communities throughout New Jersey, as well as visitors from the Staten Island area.