Nose

Aesthetic and Reconstructive Nose Surgery (Rhinoplasty)

Significant advancements in nasal surgery in the last 15 years have allowed surgeons to refine the nasal shape with a more natural appearance and improve function with better breathing.

Rhinoplasty, the surgical term for nasal refinement, has undergone a recent renaissance in plastic surgery. The resurgence has resulted in the creation of natural nasal shapes that can greatly enhance one's appearance. A successful result from any nasal surgery involves good planning on the part of the surgeon to thoroughly evaluate your facial proportions and examine internal nasal anatomy in order to develop the most effective treatment plan for your nose. In some cases, the plan can be as simple as raising the tip of the nose 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 existing facial features. In many cases, surgeons use a series of more precise techniques through the use of "open approach" rhinoplasty, which enables direct contouring of nasal cartilages to sculpt the final shape. This approach allows for the easier placement of invisible support grafts to improve aesthetics and function. These advances lead to more predictable results from nose surgeries. In cases of a second or third nose surgery, the open approach rhinoplasty has enabled surgeons to define anatomy clearly and 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 become more effective, and in some cases exercise tolerance is increased because of better breathing. Insurance could cover nose surgeries that have a component of airway obstruction.

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

Frequently Asked Questions

What type of recovery can one expect from nasal surgery?
Most patients require about one week to recover from nasal 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 reduces every few weeks until the last refinement swelling, which is minor and takes as long as 6 to 8 months to resolve. The level of discomfort after the surgery is usually very tolerable, with most patients requiring only minimal pain medication.

Does every nasal surgery involve breaking the nasal bones?
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.

What role does skin thickness play in the final result?
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.

How much improvement in breathing can one expect from nasal surgery?
The level of breathing improvement from surgical correction will be discussed during the initial consultation with Dr. Applebaum. 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.

Is it possible to retain certain characteristics of my nose and improve others?
Current techniques used in nasal refinement enable selective changes to specific areas of the nose, leaving some characteristics 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.

Is it necessary to pack the nose after nasal surgery?
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. 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 while creating 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 his nasal surgery.

"After having my nasal surgery with Dr. Applebaum most of my friends were not quite sure whatI had done, but loved my new look because it fit my face and matched what I was looking for."

— R.T. a 35-year-old personal trainer who had been thinking about having her nose done for many years to remove the bump and make it look more elegant.