Rhinoplasty, also known as nose surgery, nose reshaping, or a nose job, is a surgical procedure that reshapes the nose in order to create a more aesthetic facial appearance. Rhinoplasty may also help to improve nasal function.
Most rhinoplasties today emphasize a more natural and lasting result using more conservative techniques. In this way, the nose can be reduced or increased in size, a hump can be removed, the nostrils can be narrowed, the tip or bridge of the nose can be reshaped, and the angle between the nose and upper lip can be changed. Altering the appearance of the nose can often help to achieve facial balance and enhance the other facial features.
- Rhinoplasty Before and After Photos
- Meet Dr. Schwartz
- The Rhinoplasty Surgical Procedure
- What is rhinoplasty?
- The rhinoplasty consultation
- After (Post-Op) Rhinoplasty Surgery
- Rhinoplasty Risks
- Rhinoplasty and Aging
- Who is a good candidate for rhinoplasty?
- The Deviated or Crooked Nose
- Open vs. Closed Rhinoplasty
- Preoperative Computer Imaging in Rhinoplasty
- Rhinoplasty FAQ
Rhinoplasty Before and After Photos
* All patients are unique and individual results may vary.
Meet Dr. Schwartz
With over 25 years of plastic surgery experience, Dr. Schwartz is an expert in facial plastic surgery. But what sets him apart from other plastic surgeons is his ability to create aesthetically beautiful results while ensuring full proper functionality of the nose. As a double board certified doctor, Dr. Schwartz is not just a talented facial plastic surgeon but also a skilled ENT. With Dr. Schwartz you can achieve the look you want with the comfort of knowing that the air passages within the nose will not be affected. Often times, Dr. Schwartz performs revision rhinoplasties to amend surgeries performed by other doctors that either aesthetically missed the client’s desires or caused breathing issues post-surgery. As an ENT, Dr. Schwartz knows how to achieve the right design without any interference with breathing. You can trust Dr. Schwartz with your surgery. Call the practice today to schedule your consultation, 561-655-5562.
The Rhinoplasty Surgical Procedure
Dr. Schwartz performs the rhinoplasty procedure at an outpatient surgery center with IV sedation or general anesthesia. The surgery typically takes two to three hours to complete. In some cases, a small external incision is made on the columella, which is the column of skin between the nostrils. This is known as the “open rhinoplasty approach”. In other cases, a “closed” approach is used which involves internal incisions made solely on the inside of the nose. Dr. Schwartz uses both closed and open approaches, emphasizing that it is not the incision that should concern patients but rather the best approach to achieve the patient’s desired result. Because all noses are different to start, Dr. Schwartz does not apply a “one incision fits all” approach and instead recognizes that a variety of techniques are necessary for achieving different changes.
Working through the incisions, Dr. Schwartz will reshape the nose to the desired appearance. Contemporary rhinoplasty emphasizes creativity in fashioning a new nasal architecture by reshaping, sculpting and restoring skeletal deficiencies as opposed to large volume removal and resection of bone and cartilage. This is a more natural and creative approach which has the added benefit of decreased bruising, a quicker recovery, and more natural, lasting results.
What is rhinoplasty?
Rhinoplasty is a plastic surgery procedure that can reshape the nose and help to improve nasal function. Many changes can be made to the nose including a reduction or increase in overall size, removal of a hump, reshaping of the tip or bridge, narrowing of the nostrils, or a change in the angle between the nose and upper lip. Reshaping the nose can help to achieve a more aesthetic facial appearance by creating harmony among the facial features. Today’s techniques for rhinoplasty are more natural and creative, focusing on reshaping, sculpting and restoring skeletal deficiencies rather than performing large volume removal and resection of bone and cartilage.
The rhinoplasty consultation
During the consultation with Dr. Schwartz you will discuss what it is that you dislike about your nose and what you hope to achieve through surgery. Your nose will be examined, a thorough medical history taken, and your options discussed, including whether a closed or open approach will best be able to achieve your desired result. All details of the procedure will be explained, any questions or concerns that you may have will be addressed and “Computer imaging” may be used to show you the results you want to achieve. You will find some case studies using “Computer imaging” later in this article.
After (Post-Op) Rhinoplasty Surgery
Most patients begin to resume normal activities within seven to ten days after rhinoplasty. Swelling and bruising may occur, particularly around the eyes. While the majority of swelling will subside within two weeks, it can take as much as a year for some subtle, unnoticeable swelling to fade. Any discomfort that patients experience can be controlled with medication. Stitches are removed after one week, and work can usually be resumed after seven to ten days. Aerobic activity can often be resumed after two weeks, while heavy lifting and contact sports should be postponed for four weeks or longer.
Rhinoplasty Risks
As with all types of surgery, there are potential risks associated with rhinoplasty which may include:
- Adverse anesthesia reactions
- Bleeding
- Scar Infection
- Slight nose asymmetries, irregularities
- Nose Deviations
- Unpredictable scarring
Rhinoplasty and Aging
A common myth is that the nose “grows as we age”. This is not so. The nose does not “grow”, but the ligaments that support the cartilages lose their strength and ability to support the nose and that combined with the loss of facial volume (especially if the upper gums have receded) results in the appearance of drooping, larger nose. This is often disturbing to patients who feel that “they never looked the way before.” It can also result in functional problems because as the nose droops it may impinge on the breathing passages as well. It is also a myth that patients experiencing these changes are “too old for rhinoplasty”.
The following patient exhibits what great results can be achieved by performing conservative rhinoplasty in older patients.
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This active 80 year old male still runs distance races. He complained of increasing airway problems from his drooping nose along with difficulty in shaving his upper lip. Preoperative photos show the deviated, elongated nose with drooping tip cutting off his breathing along with creating the illusion of dorsal hump due to poor tip support. While generally healthy there were definitely concerns about doing elective surgery at this age. A conservative rhinoplasty and septoplasty done under local anesthesia provided him great relief with low risk and quick recovery.
Post-operative photos demonstrate straightening of his nose with increased tip support and elevation thus improving his airway and allowing him to more easily shave his upper lip. Conservative lowering of the profile and tip shaping add a more youthful look as well. He now reports his running to be the best he has done in years.
At what age can rhinoplasty be performed?
Rhinoplasty can be performed on patients over the age of sixteen, or once the nose has completed its growth.
Who is a good candidate for rhinoplasty?
Healthy men and women over the age of sixteen who would like to improve the appearance of the nose may be good candidates for rhinoplasty.
The Deviated or Crooked Nose
The patient with a crooked or deviated nose presents a special challenge in rhinoplasty. The deviation may be a result of previous trauma or just aberrant growth pattern.
These types of noses often have asymmetrical features, uneven amounts of bone or cartilage on either side, areas of collapse opposite areas of excess prominence. Often underappreciated is the amount of internal deviation which may also be present and if not also corrected will doom the aesthetic result to failure. The surgeon also must take into account the natural tendency of “cartilage memory” to return to it’s original deviated position even after correction and take steps to counteract this.
Deviated or Crooked Nose (Before & After)
Open vs. Closed Rhinoplasty
Patients often ask about or are concerned about whether their rhinoplasty will be done by an open or closed technique approach. They express concerns about the external columella incision in the open approach, which they fear will leave a visible scar as well as longer periods of swelling and healing. Some will only seek out surgeons who exclusively do the procedure the way they want it done.
Dr. Schwartz uses both the open and closed approach but counsels not to worry about the approach as much as the desired result. “After evaluating what a patient needs to have done to get the result they want, I’ll tell them what approach I’m going to use” says Dr. Schwartz. “I don’t think the external incision creates a problem scar and I think getting the result you want is worth a little more healing time”. “If a patient is set on a certain approach and I don’t think I can get the result that way then I’ll recommend they see another surgeon who can.”
Dr. Schwartz feels that it comes down to training and experience. There is no “right or better way” to do a rhinoplasty. Some surgeons are very comfortable with open rhinoplasties only, some with closed and some with both.
The following patients illustrate how Dr. Schwartz uses both open and closed rhinoplasty for his patients. All patients are seen at over 3 years after their procedures.
Case Studies
Case 1
Case 2
Case 3
Case 4
Case 5
Preoperative Computer Imaging in Rhinoplasty
Dr. Schwartz says: “I find computer imaging to be a great communication tool for my rhinoplasty patients and me.” Many patients come in with a picture in their mind of a certain nose on their face. Others may be focused on only one area they want changed and don’t appreciate that when this is altered other areas become noticed in a way they were not previously and will need to be addressed as well.
Computer imaging helps them see what the best options for them are and make certain that Dr. Schwartz understands what they want to achieve. “I want to be on the same page with my patients,” says Dr. Schwartz “and this gives me the best opportunity to give them the result they want.” Many patients express concern about how accurate computer imaging is in predicting their result. “I tell my patients that computer imaging is not exact, but I will only show them a result that I think I can achieve for them,” says Dr. Schwartz. “If we use it as a guide to set boundaries of being realistic about expectations of how small or how wide or how much change will occur it helps us both.”
The following photos are examples of how computer imaging can be used to preview and guide surgical results. On all photos the pre operative photo is on the left, the computer image is in the center, and the actual postoperative result is on the right.
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Rhinoplasty FAQ
The incisions made for rhinoplasty do result in scars though they are hidden. They may be located entirely on the inside of the nose or an additional small incision may be located on the underside of the nose between the nostrils.
Dr. Schwartz performs rhinoplasty with IV sedation or general anesthesia.
Rhinoplasty procedures that are performed for cosmetic reasons are generally not covered by insurance. When performed for reconstructive purposes or when treating breathing problems or deformities, some degree of coverage may be available. Patients should consult with their own insurance carrier.
According to the American Society of Plastic Surgeons, The average cost of rhinoplasty is $5,350. The cost of a rhinoplasty surgery in South Florida usually range from $3,000 to $7,000.
Dr. Schwartz performs rhinoplasty at an outpatient surgical center.
Once anesthesia is administered, incisions are made. Incisions are hidden and may be located entirely on the inside of the nose or an additional small incision may be made on the underside of the nose between the nostrils. Working through the incisions, the nasal structure is then reshaped to the desired shape.
Rhinoplasty surgery usually takes two to three to perform.
The incisions for rhinoplasty are hidden and may be located entirely on the inside of the nose or an additional small incision may be made between the nostrils on the underside of the nose.
There can be some discomfort after the rhinoplasty procedure as the head and nose may ache at first. This can be managed with medication.
Patients can expect a recovery time of about one week after rhinoplasty. Swelling and bruising, particularly around the eyes can occur, with most of the noticeable swelling fade within about two weeks. Medication can help to manage any discomfort. Work and other normal activities may be resumed in about one week and more strenuous activities may be resumed in about two weeks.
Patients can usually return to work in about one week after rhinoplasty.
Exercise and other strenuous activities may need to be postponed for at least two weeks after rhinoplasty.
As with all types of surgery, there are potential risks associated with rhinoplasty and these may include adverse anesthesia reactions, incomplete improvement, infection, small burst blood vessels, and the need for additional surgery.
There are financing options available for many plastic surgery and cosmetic surgery procedures.
Why choose Dr. Schwartz?
- Dr. Michael Schwartz is certified by both the American Board of Facial Plastic and Reconstructive Surgery and American Board of Otolaryngology.
- MD from Baylor College of Medicine, where he completed his General Surgery Residency at Beth Israel Medical Center and ENT Residency at Columbia Presbyterian Medical Center.
- He is also a fellow of the American Academy of Facial Plastic and Reconstructive Surgery, the American Academy of Otolaryngology-Head and Neck Surgery, and the American College of Surgeons.
- Dr. Schwartz is an active staff member with Good Samaritan Medical Center, West Palm Beach, Florida.
- He has over 30 years of experience as a surgeon and is extensively trained in the latest advancements in facial plastic surgery.
