Nose Surgery In New York City
Serving New York City In Manhattan And Surrounding Areas
Every year over two-hundred thousand Americans decide to change the shape of their noses with nose surgery or rhinoplasty. In the near future this number could double. Rhinoplasty or a "nose job" is one of the most frequently performed cosmetic procedures. While there is little risk to you, it demands a high degree of surgical skill on the part of your surgeon for two extremely significant reasons.
First, your nose is your most prominent facial feature. Regardless from which direction you view your face — above, below, head-on, or profile — your nose is always the center of attention. Therefore, any change to the size or shape of your nose will affect the appearance of your whole face.
Second, the surgical technique is extremely demanding, and it is difficult to perform well. Inside, your nose is supported by a delicate framework of tiny bones and moveable cartilage. Even a minute miscalculation on your surgeon’s part may lead to disappointing results or even unacceptable outcomes.
In fact, some surgeons never learn to perform the surgery properly, as evidenced by unhappy patients whose noses have obviously been "done." People may think that they can recognize every nose job, but in reality, they can only recognize the bad ones. With properly performed surgery it is definitely possible to create a normal-looking, beautiful nose.
Your highly trained plastic surgeon should be able to perform more than one kind of nose surgery. Your surgeon should be proficient at changing your nose to fit your individual face. If you can look at someone and know which doctor fixed his or her nose, be cautious of letting this doctor perform a rhinoplasty on you. A particular nose type might be good-looking on someone else’s face, but not necessarily on your face.
It takes lots of experience to affect good nose surgery outcomes. Even if your surgeon has extraordinary skill, he or she has to know what you want before your surgeon can fulfill your wishes, so be sure to discuss your expectations thoroughly during your consultation.
Most plastic surgeons begin by handing you a mirror and requesting your view on what needs to be changed. Many people don’t know exactly what bothers them. Sometimes they ask for impossible alterations that just cannot physically be done. For the most part, however, any irregularities you have can be at least partially improved.
Of course, you are usually much more concerned with the "after" as opposed to the "before." You want to see how your operation will change your appearance, and your surgeon has an excellent way to show you. (See Dr. Bellin’s before and after photo gallery.)
Prior to the performance of any cosmetic procedure, medical photographs are taken of you to provide a record of your preoperative appearance. Your picture is then printed on a special kind of paper on which notes can be written. Before your surgery, your doctor can draw over the photo, illustrating what your procedure will change by showing your new nose on the picture of your own face.
If it doesn't look just right, your nose can be erased and redrawn until it looks exactly the way you want it. While this technique cannot guarantee good results, it is the best way to ensure that both you and your surgeon are on the same page regarding your nose surgery.
If you are not one-hundred percent sure that your surgeon knows what you expect, schedule an additional consultation before going ahead with your nasal surgery. If there is a lack of communication and you end up with an unattractive result you will be unhappy. Please communicate your wishes to your nose surgeon as precisely as possible.
While there are many ways to change the shape your nose, all of them can be performed in your doctor's office with a local anesthesia. Moreover, the basic surgical technique is always the same.
Almost all of your incisions are made inside your nose to prevent visible scars. Then through your incisions, your surgeon reshapes your underlying bone and cartilage structure and allows your skin to redraw over your new structure.
To increase his or her accuracy, your doctor wears a headlight and utilizes special retractors to keep your nose area highly visible. Then, once your surgery is finished, your nose may be packed and held in position with tape and a metal splint. The average rhinoplasty takes 45 minutes to an hour to perform. And it probably costs significantly less than you might expect.
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Deviated Septum
An astonishing number of people unknowingly suffer from a deviated septum. A deviated septum is an abnormal displacement of the wall that separates the two chambers your nasal cavity. This condition often obstructs your air passages and hinders your breathing. Other people have forgotten injuries from childhood, such as old nasal fractures. In either case, these deficiencies can be corrected simultaneously with your nose reshaping, and then part or all of your costs will be covered by insurance.
If your nose surgery is performed well, your nose should end up looking entirely natural (as if you were born with it). In fact, the greatest compliment your nasal surgeon can ever receive is when his or her rhinoplasty goes unnoticed.
Nose Deformities
There are several nose deformities that can be greatly improved. Your surgeon may even make many separate repairs during your nasal surgery. In some cases, your chin or other facial features may also need rebuilding to balance out your appearance. If so, there will obviously be some additional costs involved.
Here are some common deformities of the nose and how they are treated.
Big Nose
This is by far the most frequent malformation. Your surgeon starts by removing some of your excess bone and cartilage along the top of your entire nose. Then your surgeon reshapes your framework, either by making it straight or by giving it a slight curvature. Noses that are straight along the top usually look more natural. However, this is up to you and your surgeon to decide together. Of course, there are physical limits as to how small your reshaped nose can be made. If too much cartilage is removed above your nose tip, scar tissue may heap up, more often than not resulting in a "parrot beak" deformity, so make sure your plastic surgeon is extremely qualified to perform nose surgery.
Bump on Your Nose
In many cases, only part of your nose may be too prominent. If an unattractive bump is bothering your otherwise normal-looking nose, it can be filed down (or shaved) to create a smoother and straighter nose line.
Your Nose is Too Wide in Your Bony Section
The upper part of your nose (between your eyes) is made out of bone and offers no flexibility. If this area on your face is too broad, it can be slimmed down by cutting your bones down to your cheek level. Then we can move them closer together to give you a more narrow-looking appearance.
However, your bones must be moved equally or your nose will end up looking crooked. Also, if your bone is not cut close to your cheek, an unattractive "step" will arise on the side of your nose.
Crooked Nose
If your bones are simply out of place from a previous circumstance (such as a fracture), the surgery mentioned above (Nose Too Wide in Your Bony Portion) will reposition them quite effectively. However, if the lower cartilaginous portion of your nose is crooked, straightening it can be difficult or impossible. The best chance for you to straighten your nose in this situation, is to take a strip of cartilage from the inside of your nose and then to graft it along the indented portion of your nose. If your nose procedure is successful, your nose should appear completely centered.
Your Tip is Too Large or Bulbous
This is a common deformity which can be improved by removing or reshaping your cartilage in the tip of your nose or nasal tip. By doing so, a lot of your fullness is usually reduced. However, your cartilage should be left essentially intact along the rim of your nostrils to prevent them from looking pinched. Dr. Bellin can create a more subtle nose tip.
Click for more information on sculpting the nose tip.
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Your Tip is Poorly Defined
The tip of your nose should be slightly separated from the upper part of your nose, and it should also project slightly beyond the main body of your nose. Your surgeon can achieve this desired result by operating on your nose tip cartilage. If correctly performed, your nose will not "fall" after your surgery has been finished.
Your Nose is Too Wide in Your Nostril Area
The "wings" of your nose can be narrowed by cutting out a wedge-shaped piece from the outer base of each of your nostrils. This is referred to as alarplasty, and it is one of the few times that an external cut is made on your nose. If your surgeon is careful, your resulting scars should be thin and hidden from view in the natural crease of your nostrils. An equal amount must be taken from each of your nostrils or your nose will look uneven.
Learn more about narrowing your nostrils.
Learn more about narrowing your nose.
Your Nose is Too Narrow in Your Nostril Area
This condition is sometimes caused by an excessive alarplasty (see Your Nose is Too Wide in Your Nostril Area). The correction involves taking a full wedge of skin and cartilage from the rim of each of your ears, and then grafting one of the wedges to the base of each of your nostrils to elevate and widen them.
Click here for more information on widening your nostrils.
Your Nostril Rim is Too Thick
Your nostril rims can be slimmed down by making incisions in the margins of your nostrils and removing thin pieces of your skin. Then your remaining skin is drawn together and sutured, leaving a slightly visible scar.
The Tip of Your Nose Hangs Down
This is usually more of an illusion than a real deformity. When you have a curved bump on your nose, your eye tends to follow it down to the tip, which seemingly droops. When your bump is treated, your tip should take on a more normal appearance.
But if your tip really does hang down, it can usually be set right by removing surplus cartilage. This should raise it to a more attractive position. However, if your doctor is careless and removes too much cartilage, your result may be a "piggy" nose, causing your nostrils to look wide and open. Make sure that you choose an extremely careful surgeon so this doesn’t happen.
The Area Between Your Nostrils Hangs Down
The area between your nostrils is called the columella, and it can be corrected by simply shaving off some of the cartilage that is causing your problem. Thus your columella should be elevated to its proper height.
While this condition is uncommon, it can normally be improved without much difficulty. The only danger is an excessive removal that results in an ugly condition called retracted columella, which is the reverse condition from the area between your nostrils hanging down.
The Area Between Your Nostrils Retracts
This particular problem can either occur due to your natural state or as a bad result from a previous nose surgery if it was done improperly. The most common correction is grafting on cartilage (or inserting a piece of silicone) to bring your columella back to normal.
Click here for more information on Shortening the Area Between the Nostrils
“Ski Jump” Nose or “Saddle” Nose
When you have too little tissue along the top of your nose, the middle of your nose may appear to be caved in or even crushed. This condition is especially prevalent in people of Asian or African-American heritage, and it is almost always treated by taking cartilage from the inside of your nose and using it to build up the affected area of your nose.
Some surgeons prefer using silicone implants (not injections) or bone grafts from your hip or rib to create a similar change. These are acceptable alternatives to using cartilage from inside your nose.
Incidentally, your "saddle nose" can also result from removing too much tissue during other types of rhinoplasty or surgery to your septum.
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Poor Result from Your Previous Rhinoplasty
Unfortunately, not every plastic surgeon possesses the same degree of skill. Even in the most competent hands, unexpected and less-than optimum results may sometimes happen. A lot of these results have already been discussed.
In rare cases, your damage may be permanent. But more often than not, a poor job can be improved through a second rhinoplasty operation. If your original surgeon makes the correction, he or she should do it for free. But if your nose looks awful, you may prefer to find another surgeon and pay him or her (preferably an expert in cosmetic reconstruction).
Postrhinoplasty Expectations
The fee for any of these rhinoplasty procedures should be $4,000 to $6,500. If two or more procedures are performed at the same time, you will not usually be charged additional fees.
While your nose area is usually presentable within two or three weeks, it may take up to six months for your final result to be evident or “plain as the nose on your face!”
You can usually to resume your normal activities as soon as your anesthesia loses its effect. Sometimes, however, you will require a day or two of rest.
Immediately after your surgery you will probably experience a little bleeding, but excessive bleeding is fairly rare. You may still bleed up to ten days after the operation. However, sedation and bed rest are usually enough to discontinue it.
You may also experience varying degrees of discomfort due to the packing in your nose or due to small blood clots that may be clogging your nose. However, your bandages and packing, when used, are usually removed within a week, and your discomfort should rapidly stop.
You will definitely experience some swelling and black and blue discoloration under your eyes. While your swelling normally recedes in several days, the bruises around your eyes occasionally last for two to three weeks, but rarely longer.
The area of discoloration can be hidden with sunglasses, and makeup can be applied shortly after your surgery as long as you don’t disturb your bandages.
Your "new" nose will already look good when your bandages are removed, but your end result will not be obvious until the last little bits of swelling have disappeared, and your skin has completely tightened over your rebuilt framework.
Your entire healing process can take up to six months, and you should avoid prolonged exposure to sunlight for this entire period. As time goes by, you should look increasingly better until the effect of your “new” nose is complete.
Compared to other surgeries, your rhinoplasty surgery is typically free of complications.
If you are considering nose surgery (rhinoplasty) in Manhattan, New York City (NYC), or greater New York, contact CosMedica. Our highly experienced plastic surgeon, Dr. Howard Bellin will give you a free consultation at CosMedica, The Plastic Surgery Center of New York.
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