Rhinoplasty is a surgical procedure in which the nose is reshaped for cosmetic and functional reasons. Among the most popular of cosmetic surgeries, rhinoplasty is also the most complex. A rhinoplasty surgeon must have the aesthetic eye and skill to be able to sculpt the nose to be in balance with the rest of the face, as well as an in-depth knowledge of the inner workings of this important piece of human anatomy. Many individuals elect to undergo rhinoplasty surgery to improve self-confidence which has been diminished by an unattractive nose given to them by heredity, aging, or injury. Others seek improved function for better breathing.
An important part of the rhinoplasty process is the consultation. The cosmetic consultation should be thorough, with the surgeon making the patient comfortable and informed about his or her options. During consultations with Dr. Nassif, patients are made well aware of all aspects of the experience they will have, from pre-op instructions to recovery.
Private in-person consultations are offered at Spalding Drive. Consultations are also available via video through Skype. Lasting about 1.5 to 2 hours, the consultation begins when a rhinoplasty candidate is greeted by the front office staff and fills out the necessary medical history and other information that will enable the doctors to provideoptimum care. The experienced patient care coordinator will then guide him or her through the consultation process and answer any and all questions regarding goals for the new image, as well as present before and after photos of past patients. The doctor and candidate then meet for a discussion, during which he will share his advice for the best course of action to take to attain a harmonious appearance. A complete examination of the nose will be performed to help plan for the individual’s needsand to limit any unexpected complications from arising during surgery.
As with any important life decision, fees are a determining factor. The patient coordinator will discuss the cost and provide a quote, along with information about financing options. For complete ease of mind, follow up questions can be answered by phone, second consultations can be scheduled, or conversations with patients who have undergone a similar procedure can also be arranged. Cosmetic consultations can be scheduled by phone at 310-904-6999 or by filling out the appropriate contact information on thewebsite.
During the primary rhinoplasty, local anesthesia coupled with intravenous sedation will be administered. General anesthesia is also an option for some patients.
Rhinoplasty is performed under either an open or closed procedure. Incisions for closed rhinoplasty are placed inside the nose to avoid visible scarring. During open rhinoplasty, an incision is made across the tissue separating the two nostrils to gain greater access to the underlying nasal cartilage and bone. Which technique is used is determinant on the aim of the surgery and the patient’s nasal anatomy. In either case, bone and cartilage are reshaped, rearranged and/or removed. Incisions are closed with fine sutures, and a splint and dressings are placed to help the nose retain its new shape.
If surgery of the septum must be performed, such as when a deviated septum is present, a septoplasty is combined with the rhinoplasty and the obstructing bone and/or cartilage is removed. Many patients may also choose to have a chin augmentation or other cosmetic facial procedure along with rhinoplasty. This can help to create a greater impact on the harmony among facial features. In some cases, rhinoplasty alone may not be able to meet a patient’s goals.
Unfortunately, due the complexity of rhinoplasty, not every procedure can go as planned. Complications can arise during surgery, improper healing can occur, or sometimes the patient would like some minor adjustments to get closer to the image they envisioned. Deviated septum or other functional issues are other reasons a patient may need to go back for additional surgery. Even under the best of care, revision rhinoplasty may be necessary. The national average for rhinoplasty procedures that require revision is about 15%, which is higher than other cosmetic surgeries.
Revision rhinoplasty can be performed anytime after the nose has completely healed. It can take a year or longer for the final traces of swelling to subside. Once this has happened, a decision can be made as to if a revision is in order. A person may choose to return to the surgeon that performed the primary rhinoplasty or locate and consult with a new physician. If the patient feels comfortable in the hands of the original surgeon and is looking for a minor revision, than there should be no problem returning to that doctor. Not all surgeons specialize in revision rhinoplasty, though, so finding someone who does may be a better choice under certain circumstances.
Dr. Nasif is an expert in ethnic rhinoplasty, having performed surgery on Hispanic, African American, Middle Eastern, and Asian peoples. Each ethnicity has unique characteristics specific to the nasal structure of its members. For example, some common traits of a Hispanic nose are thick skin, a wide bridge, and bulbous tip, with wide horizontal and flaring nostrils. The goal of ethnic rhinoplasty is to correct functional and cosmetic nasal problems while maintaining the aspects that connect the person with members of his or her family; not altering it so much that the individuals blends in with the rest of society. As with all rhinoplasty, the nose should complement the other characteristics of the person’s face.
A skilled and experienced surgeon is able to maintain a patient’s unique appearance while refining the nose to the appropriate extent. As in the case of the Hispanic nasal characteristics mentioned above, the patient may wish to extend the nasal tip or narrow the nostrils. Specialized techniques are used to achieve these and other adjustments to an ethnic nose while ensuring that function remains favorable and the sense of ethnicity remains intact. Obstruction or problems affecting function may be fixed at the time of the procedure.
People of Asian ethnicity commonly have certain nasal features such as thick and sebaceous skin, a deep and flat radix, and an under-projected bulbous tip. The bridge of the nose may be low, wide and flat, accompanied by a wide nasal base. The columella, the tissue between the nostrils of the nose, is typically short and retracted.
Asian rhinoplasty surgeons must consider these features, among others, while improving form and function. A common request is to create greater projection, but too much alteration can create an overly westernized appearance that does not compliment the other facial features. There are techniques that can help achieve this, however, without looking unnatural.
A consultation and thorough examination of the individual’s nose will aid both patient and surgeon in communicating their goals for rhinoplasty and realistic expectations. Computer imaging allows the patient to see what the new nose will look like, giving them the opportunity to alter the idea they had in their head once they see how it will look in relation to their eyes, cheeks, chin, etc. In addition to primary Asian rhinoplasty, Dr. Nassif also specializes in Asian revision rhinoplasty to correct the results of previous procedures.