Do you feel unhappy with the appearance of your nose, or feel like it’s the only thing holding you back from the look you’ve always wanted? Many people feel the same way. At the Lasky Clinic, double board-certified facial plastic surgeon Dr. Andrew Frankel gives rhinoplasty patients from Beverly Hills, Los Angeles & surrounding areas incredible results that last a lifetime.
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Table of Contents
What is Rhinoplasty?
Rhinoplasty is a surgical procedure that reshapes the nose for aesthetic or functional reasons.
A rhinoplasty, more commonly known as a nose job (or nose surgery), can help even out your facial features while addressing any functional issues like breathing problems or a deviated septum. It is also an ideal procedure for an aging nose (drooping tip), undefined nasal tip and so much more.
Of all the operations in the field of plastic surgery, rhinoplasty is considered the most difficult. The appearance of the nose affects the overall aesthetics of the face, including facial balance, making the process of rhinoplasty surgery exacting and unforgiving. Because the nose contains cartilage, bone, and skin, predicting how the area will heal can be extremely challenging. It takes a high level of skill, attention to detail, and artistry to execute each custom procedure well.
During the consultation with rhinoplasty expert Dr. Andrew Frankel, there will be an in-depth discussion with the patient about their goals, expectations, and any previous procedure(s). There will also be a pre-operative evaluation of the nose and the overall facial balance. Computer imaging may also be used. Expectations, results, methods, and risks will all be discussed.
As part of our consultation, we will discuss preparing for your procedure as well. As with any surgery, there are certain medications, vitamins, and herbs that should be avoided beforehand as they can cause you to bleed more than normal. These should generally be stopped two weeks prior to surgery. Dr. Frankel will provide you with a list of these medications.
Schedule a consultation today with Dr. Frankel, a facial plastic surgeon & rhinoplasty specialist in Beverly Hills.
Am I a Candidate?
Men and women alike often choose to change their noses with rhinoplasty for cosmetic or functional reasons. Plastic surgeons look for patients who are in good physical and emotional health. Patients must understand that a nose job is meant to improve the nose’s shape and will not always be able to create a perfect nose. Realistic expectations are key before moving forward with plastic surgery.
The Rhinoplasty Procedure
Prior to your nose reshaping surgery, Dr. Frankel will go over your custom surgical plan with you. If you will be given general anesthesia, you will need to refrain from eating or drinking after midnight the night before your surgery. Other patients may only need local anesthesia with sedation and may be given other instructions.
Making the Incision(s)
Rhinoplasty surgery starts with an incision made either externally at the bottom of the nose or inside the nostrils.
Making the incision externally is known as the “open approach” and allows the doctor to gain better access and visibility when manipulating the structures within the nose. The small scar that is considered to be the only downside of this approach is very small and tends to fade well.
The “closed approach” involves making incisions inside the nostrils, with no external cuts. This may be appropriate for patients who only need small changes made, but most surgeons favor the open approach for best results. Dr. Frankel will go over the surgical technique he plans to use for your procedure prior to the surgery to ensure you are fully informed and feel comfortable with the process.
Shaping the Nose
Once the incisions have been made, the skin on the nose is separated from the bone and underlying cartilage. Bone and cartilage are trimmed to create the desired shape. Additionally, cartilage grafts may be created and placed to enhance the shape of the nose. The incisions are then closed and a splint is put in place to support the new shape of the nose while it heals.
Many people seeking rhinoplasty or revision rhinoplasty in Beverly Hills have significant problems breathing through the nose. Dr. Frankel is well-versed in functional surgery of the nose and knows how to improve or maintain nasal function when making changes in the shape of the nasal tissues.
A primary rhinoplasty will take an average of one to two hours to complete. Rhinoplasty is an outpatient procedure, so patients can go home with a friend or family member after being cleared by the staff at the Lasky Clinic.
After rhinoplasty, you’ll have bruising and swelling that may subside quickly or last for months. Most patients can expect the majority of the swelling to resolve within 2-4 months and residual swelling to last up to a year. You should take at least two weeks off from work to ensure that you have the rest and relaxation you need to heal.
It is important to follow all of Dr. Frankel’s instructions during the recovery period. These may include how to ice and clean the area properly, instructions on using your pain medications, alternatives for blowing your nose, and how to prop yourself up when you sleep to help reduce swelling. You should not engage in any strenuous activities for two or three weeks, but you can return to work in a week or two. Patients should also avoid sun exposure and bumping or jarring the nose for eight weeks.
Because rhinoplasty is a surgical procedure, there are some risks involved. For most people, the risk is minimal, especially when the procedure is performed by a board-certified facial plastic surgeon specializing in rhinoplasty. Risks and complications may include:
- Breathing problems
- Unfavorable scarring
- Changes in sensation
- Poor aesthetic results
- Anesthesia complications
- Skin necrosis
Because rhinoplasty is such a complex and difficult procedure, patients occasionally end up with a less-than-ideal result that requires expert correction. Revision rhinoplasty refers to nasal reshaping surgery that is performed on an individual who has undergone one or more prior rhinoplasty procedures. Revision rhinoplasty can range from a simple procedure to remove some residual excess bone or cartilage in the nasal bridge to a very complicated complete overhaul of the nose.
Primary rhinoplasty may be extremely challenging, but a revision rhinoplasty is typically even more difficult. Scarring, lack of cartilage for grafting, and structural issues from the previous surgery or surgeries can create limitations in the type of correction a surgeon can make. In major revision rhinoplasty cases, patients need to be realistic about the result that can ultimately be achieved.
With that said, a skilled rhinoplasty specialist like Dr. Frankel can typically make a significant improvement in a patient’s nose following an unsatisfactory rhinoplasty.
Other Types of Rhinoplasty
Today, the emphasis in rhinoplasty is placed on achieving a well-balanced nose that fits harmoniously with the other features of the face, ethnicity, and size of the individual. It is rare that any individual’s nose can be categorized into a neat “cookie cutter” type of operation that is done similarly on all patients.
There are many factors that dictate which surgical methods will produce an optimal ‘nose’ for each patient. A skilled surgeon can mix and match the following techniques to produce great results for almost any patient, customizing the procedure to suit the patient’s unique needs.
Following an extraction or, occasionally, facial trauma, the nose may be left severely disfigured. Reconstructive rhinoplasty refers to surgery required to restore tissue that is absent or has been damaged beyond repair. Surgical repair requires the use of grafts and flaps from various parts of the body to restore the missing component tissues.
The overall reconstructive process typically requires multiple staged surgical procedures. Again, both surgeon and patient need to understand the limitations in the final outcome that such deformities are associated with.
The most common complaint among rhinoplasty patients is that their nose is too ‘big’. More accurately, the size of their nose is disproportionately too large for their face. In addition, many people with big noses tend to have a ‘hump deformity’ of the nasal bridge.
State of the art reduction rhinoplasty aims to reshape the nose rather than simply remove underlying structure so that it does not change drastically over time and become pinched or non-functional.
The ideal nose has subtle features which make it attractive. Even if the length, width, and projection are acceptable, other elements will influence nasal aesthetics. Important considerations include tip definition, contour irregularities, asymmetry, and the brow-tip nasal aesthetic line. These can all be addressed with refinement rhinoplasty.
Each ethnic background has characteristic nasal features. People from the Middle East typically have longer noses with less distance between the base of the nose and the upper lip. People of Asian or African descent tend to show a wider nose with less projection than Caucasian noses. Hispanic individuals fall somewhere in between.
Ethnic rhinoplasty involves modifying the non-Caucasian nose to improve the overall appearance while retaining the features unique to each ethnic background. Years ago people often desired a nose that looked more Caucasian so that they could assimilate. That has changed and in more recent times people tend to want to retain their ethnic look.
The surgeon and prospective patient need to carefully consider the impacts that specific changes in the nose will have on the overall facial appearance and how they will affect the ‘ethnicity’ of the final look.
Why Choose Dr. Frankel?
Dr. Andrew Frankel is board-certified in both ENT (Otolaryngology-Head and Neck Surgery) and Facial Plastic and Reconstructive Surgery. He is a rhinoplasty specialist and has over 20 years of experience fixing nasal airways with septoplasties, turbinate reductions, perforation repairs, nasal valve adjustments, and various other nose job methods.
Many surgeons do not want to perform rhinoplasty except for the most simple of cases such as reducing a dorsal hump. In contrast, Dr. Frankel welcomes the challenge that complex nasal surgery poses and has developed a passion for it.
Over the years, he has performed thousands of rhinoplasties in Beverly Hills and still finds each case unique and educational. By critically analyzing his results, he is constantly improving on the way he approaches cosmetic surgery. This helps to ensure that patients receive the best results possible.
Am I too young for rhinoplasty?
For many young teens, an unattractive nose can be the source of significant anxiety and self-consciousness. This is a time when their social lives are of paramount importance and they wish to look their best. Rhinoplasty is only acceptable for teens once they’ve completely gone through their growth spurt. In general, this tends to occur around the age of 15 or 16 for girls and a bit later for boys.
If nasal surgery is done during a time when substantial growth has yet to occur, then the remaining growth may adversely affect the outcome or, worse yet, the surgery may stunt remaining growth.
Perhaps a more important factor to consider is that adolescents may not truly know what they want for an outcome. At such a young and impressionable age, they might ask for a result that they later find to be unsuitable. For this reason, adolescents should wait, take some time to sit with their desire for rhinoplasty, and think carefully about what they want before embarking on surgery.
What type of anesthesia is used for rhinoplasty?
Revision rhinoplasty is usually performed using either general anesthesia or a combination of local anesthesia and sedation. The type of anesthesia used will depend on the surgeon’s recommendation, the complexity of the surgery, and the patient’s preferences.
Is rhinoplasty a painful procedure?
During the surgery, of course, anesthesia will be used to ensure that patients feel no pain. After the surgery, however, there is likely to be at least some minor discomfort. Many patients are surprised to find that postoperative pain is not as intense as they had feared. Patients can be prescribed pain medication to help alleviate any discomfort that they may feel.
Will I be able to drive myself home after my rhinoplasty procedure?
You will need to have a family member or friend drive you home for safety reasons.
Will I need someone to stay with me after my rhinoplasty procedure and help me out?
It’s often a good idea to have a family member or friend accompany you to surgery and to your home or your place of recovery for the evening. They can help you understand and follow Dr. Frankel’s instructions and give you the chance to rest and recuperate while they take care of any small tasks like food preparation.
When will I be able to go back to work after my rhinoplasty procedure?
Patients are typically able to return to work within about a week after their revision rhinoplasty procedure.
When can I exercise after my rhinoplasty procedure?
Exercise and more strenuous activities can usually be resumed within about two to three weeks, though any activities which may bump or jar the nose or risk sunburn to the nose should be avoided for eight weeks.
When are the stitches removed after rhinoplasty?
The stitches are usually removed within about six to seven days after rhinoplasty.
Are the costs of rhinoplasty covered by insurance?
Procedures which are performed to repair functions of the nose, such as breathing, may be covered to some degree. However, procedures which are solely cosmetic are typically not covered by insurance.
Is financing available for rhinoplasty?
Many plastic surgery procedures are eligible for financing. You will need to discuss individual options with the practice prior to scheduling your surgery.
How long will my rhinoplasty results last?
Once the procedure is performed, expect your rhinoplasty results to last a lifetime. The only changes you’ll experience are due to the natural process of aging.
STILL HAVE QUESTIONS?
Want to understand more about the nose job procedure, terminology or just what to expect?