Aesthetic and Reconstructive Nasal Surgery

Nasal surgery has undergone tremendous advancements in the last 15 years, which has allowed surgeons to refine the nasal shape with a more natural appearance and improve function with better breathing.

Rhinoplasty, surgical term for nasal refinement, has undergone a recent renaissance in plastic surgery, which has resulted in the creation of natural nasal shapes that can greatly enhance one's appearance. A successful result for any nasal surgery involves good planning on the part of the surgeon to thoroughly evaluate your facial proportions and examine the internal nasal anatomy, in order to develop the right treatment plan for your nose. In some cases the plan can be as simple as raising the tip slightly to shorten the nose and open up the midfacial area, which can also have an enhancing effect on your smile. Improving the appearance of your nose through nasal surgery can reduce its size, change the shape of the tip or bridge, or narrow the span of your nostrils. It may also correct a deformity from birth or injury.

Aesthetic nasal surgery combines the art and science of plastic surgery to create a final shape that blends with the existing facial features. In many cases, surgeons now use a series of more precise techniques through the use of "open approach" rhinoplasty, allowing direct contouring of the nasal cartilages to sculpt the final shape. Invisible support grafts to improve aesthetics and function can be placed more easily through this open approach rhinoplasty. What these advances lead to is a more predictable result in the hands of the plastic surgeon. In cases of a second or third surgery of the nose, the open approach has enabled surgeons to define the anatomy clearly and to reconstruct the necessary support under direct visualization.

Improvement in nasal airway breathing can change your life by alleviating blockages from a curved septum or over-reactive mucous membranes. Plastic surgeons have refined several techniques that lead to better airflow and provide long lasting support of the nasal framework. After airflow has been improved one’s sense of smell can also improve, and in some cases exercise tolerance is increased because of better breathing. Insurance may cover those surgeries that have a component of airway obstruction.

Dr. Applebaum will evaluate how your nose can be refined to enhance your appearance. In some cases Dr. Applebaum may recommend changes to your chin at the same time, so that your profile will be balanced. Changing the shape of your nose can help to create a well-proportioned image that will place all parts of your face in a natural harmonic balance.

Commonly Asked Questions about Nasal Refinement

Q: What type of recovery can one expect for nasal surgery?

A: Most patients require about one week to recover from the surgery and can return to work in seven days. Each nose heals a little differently, but the general rule is that at 7- 10 days you are presentable to return to work. The recovery swelling has a series of steps with reduction every few weeks and eventually the minor last refinement swelling, which will take up to 6 to 8 months to resolve. The level of discomfort after the surgery is usually very well tolerated, and most patients require only minimal pain medication.

Q: Does every nasal surgery involve breaking the nasal bones?

A: Each nose is different, and it is up the surgeon to decide if the width of the upper portion of your nose needs to be narrowed. In cases where an aesthetic improvement could be made by narrowing the upper portion of the nose then "in fracturing," or breaking this specific area, would be beneficial.

Q: What role does skin thickness play in the final result?

A: The thickness of the skin that drapes over the cartilage and bone framework plays a major role in defining the features of the nose. The thickness of the nasal tip skin can be a limiting factor in trying to sculpt a nose that has a round or large tip.

Q: How much improvement in breathing can one expect from nasal surgery?

A: During the initial evaluation with your doctor the level of improvement from surgical correction will be discussed. In some cases, the improvement range can be as high as 70 to 80 percent. On average, improvement from correcting a deviated septum and reducing the mucous membrane prominence should lead to a correction of 30 to 60 percent in overall breathing. In many cases the sense of smell can also be improved.

Q: Is it possible to retain certain characteristics of my nose and improve others?

A: The current techniques used in nasal refinement can allow for selective changes in specific areas of the nose, leaving some characteristics that are desirable to the patient. In many cases, for example, patients desire refining the nasal tip while leaving the bridge of the nose alone due to family characteristics. There are also cases in which a patient simply wants a small bump removed without changing the shape of the nose in any other way.

Q: Is it necessary to pack the nose after nasal surgery?

A: Nasal packing after surgery is not used on a routine basis and is usually reserved for specific cases involving more complex airway work or in cases in which oozing occurs after surgery. In general, only 15 percent of Dr. Applebaum's nasal cases involve packing after surgery. And in that small number of cases, the packing remains for a short period of time.

What our patients say

"Dr. Applebaum did a great job in giving me a result that fit my face perfectly and has a completely natural appearance."

T.W., a 28-year-old graphic designer who wanted to maintain certain features of her nose and yet create a noticeable improvement in her look.

"I had terrible breathing problems that affected my daily life. Now after my corrective nasal surgery, I feel as if there's a parade of fresh air every day.

J.S., a 45-year-old engineer who was using nasal sprays and decongestants every day to help him breathe. He experienced a complete turnaround after airway surgery opened his nasal passages.