The Best Rhinoplasty in Beverly Hills — Dr. Andrew Frankel!

It is generally advised that rhinoplasty not be performed on younger patients until the nose and face have nearly completed their growth. Additionally, the individual’s emotional maturity is a very important factor, and Dr. Frankel must assess this.

The consultation will include an in-depth discussion about your desires regarding your nose. A detailed medical history emphasizing nasal function and an examination will follow. Computer imaging will be used to aid in communication and offer them the opportunity to have input into their aesthetic goals.

Your rhinoplasty will most likely be performed at the Lasky Clinic Surgical Center, in the same building as Dr. Frankel’s office. On rare occasions, surgery might be done at a hospital or another facility if specific situations require so.

Incisions are made either within the inside of the nose or both inside of the nose and one small one under the tip of the nose. The skin is then separated from the underlying bone and cartilage, which is then sculpted to the desired shape. The skin is redraped over the new framework, and the incisions are closed.

Avoid extreme physical activity, including athletic activities and intercourse, to prevent bleeding and increased swelling. After 24 hours, you are encouraged to go for light walks and strolls. Light cardio, such as an elliptical machine or spin bike on a low resistance, can begin on postoperative day seven (7). Do not engage in any heavy cardiovascular activity (running), any activity that involves straining (weight lifting), or anything that involves bending over (yoga, pilates) for at least three (3) weeks unless otherwise instructed.

Insurance typically does not cover rhinoplasty procedures performed solely for cosmetic purposes. Some degree of coverage may be provided in cases where breathing problems are being treated.

Nasal packing is simply used to minimize bleeding or dripping from the nose after surgery. It is also helpful in compressing the internal tissues to prevent collections and swelling. Packing is generally comprised of a soft, absorbent material or strips of gauze.

Swelling is a normal and expected part of the healing process and may take 18 months. Usually, the acute swelling subsides, and the nose begins to look normal within three weeks. With time, the nose becomes thinner, smaller, and more refined at the tip as the edema resolves.

I cannot speak to how other doctors operate on noses. I am a very experienced and versatile rhinoplasty surgeon with many techniques to draw on to accomplish my goals. Sound surgical techniques are published and available to all surgeons, yet very few study all of them and utilize them. I pride myself on being able to adapt and utilize whatever maneuvers are necessary to reach the desired final outcome.

When a long nose is shortened the rhinoplasty usually changes the way it looks from both the facial profile and the front.

While computer imaging can be employed for photos sent via the internet and communication can be productive, examining the patient to determine the specific characteristics of the skin, cartilage, bone, and other related features is always relevant.

If a patient has a very narrow nose but also has a very thin face, then it may be advisable to forego nasal surgery. This is a very important point, as the nose must balance with the other facial features and it must fit into the context of the rest of the person.

If someone has already had several rhinoplasties, and he/she is still unhappy, the nose may still be able to be fully corrected. This necessitates finding the right surgeon and allowing him/her to carefully examine you and create a surgical plan. There are cases that should be left alone, but these are the rare ones. In my experience, I can improve the nose, and the post-operative course is usually easier for these patients than their prior surgeries.

Surgery that involves the nasal tip must be done with precision and foresight as to what the effects of healing will be. Wound healing and scar contraction often impact the way the tip heals and, as such, these need to be considered when operating on the tip.

Swelling postoperatively often stays longer at the tip because it is the most dependent (lowest) part of the nose, and also because the skin there is thicker. Additionally, I rely on the healing process to help create the desired tip shape, and this process takes time.

If a patient is traveling to me for surgery and will be flying, then I advise he/she stays for at least 9 nine days. The reason for this is that the cabin pressure on planes will cause swelling to occur, and the nose will then take longer to acquire its desired shape. Rarely, this may impact the final result. There is no medical risk to flying earlier, and often patients do it and I have seen no ill effects thus far, but ideally, I would have them wait.

If a patient has any acute problems after rhinoplasty that need urgent attention, they would occur within the first week. Otherwise, the problems that develop over time are less in need of immediate attention and can be addressed by me at a later date or via the internet with correspondence. If a patient requires a medical visit, I will contact a colleague in the patient’s vicinity and have him/her evaluated.

Nostril asymmetry is extremely difficult to fix, especially if it is due to congenital factors where the nostril attaches to the face. Asymmetries that result from tip cartilage variability are less difficult to repair.

A bump on the nose may be the result of trauma or just because the nose is shaped that way. There are some subtle differences in the treatment of these two entities, but they should both be amenable to correction.

I often perform chin augmentation at the same time as rhinoplasty. Oftentimes, it is necessary to use a chin implant to correctly balance the way a nose looks on the face. Sometimes, I am able to leave a stronger nose by using a chin implant. Chin implants are extremely powerful in achieving facial harmony, and they are relatively easy to perform, low risk, and can always be removed if the patients don’t like them.

Lengthening a short nose is very difficult, but it can be done by using a patient’s own cartilage to elongate it, or by creating the illusion of length with various maneuvers. It is more difficult to lengthen a nose that was shortened as a result of prior surgery than one that is naturally short.

To narrow a nose, I often fracture the nasal bones and bring them in. I also occasionally narrow the middle part of the nose by removing some of the nasal septum or upper lateral cartilage. The tip cartilage can be narrowed by removing cartilage or by using sutures to change its shape, and the base of the nostrils can be narrowed by removing some soft tissue. Occasionally it is necessary to build up the height of the nasal dorsum to make the nose look narrower.

If the end of your nose points upward, it can be re-oriented to point forward by using sutures to change its shape or grafts to elongate it. Sometimes, removing some septum or membrane can also accomplish the same goal as well.

Revision rhinoplasty is a secondary operation that serves to improve upon or correct problems that still remain after prior rhinoplasty. I have performed many revision rhinoplasty operations on patients who have had five or six prior nasal surgeries. I find revisions more technically difficult, but also more rewarding for myself and the patient.

Children who have yet to fully mature may be adversely affected by a rhinoplasty because their faces have yet to become fully developed and may continue to change. In this scenario, the rhinoplasty yields a result that may initially look good, but not as the jaw bone grows or other facial features change. Additionally, the nasal septum serves as a secondary growth center for the mid-face and it may be impacted by surgery, interfering with mid-facial development (although the recent science on this suggests it may not be so important).

The term finesse rhinoplasty refers to a situation in which the patient needs only a very minor or subtle change to refine the nose. Whether or not someone is a good candidate for such a procedure depends on how much the patient thinks such a change would benefit him/her, how confident the surgeon is that he/she could execute such a result, and what the risk/benefit ratio is to doing so.

If I consult with a patient and we have a disagreement about what should be done, how to accomplish our goal, or what is possible, then I prefer to refer that patient to another surgeon who may be more appropriate for that particular patient. I will not operate on this patient because I feel he/she may not be content with the result, even if I do my job well.

Ultimately, the question of balancing the nose with the other facial features is one of judgment, and each surgeon will have a slightly different aesthetic sense. There are never any guarantees the patient will love his/her nose, however with the use of computer imaging, I can discuss this more fully with each patient ahead of time in an attempt to understand what he/she hopes to achieve.

Nasal bones become twisted from a variety of causes, such as trauma or tumors. Oftentimes the nose is injured when someone is very young or even at birth, and the structure of the nose becomes curved as that person ages, and the cartilage bends more and more. Cartilage tends to distort more with age, and the soft tissue support diminishes. Certain people have larger nasal septums and occasionally, they are too large for the soft tissue envelope that encloses them which results in a twisted or curved nose.

If you live near Beverly Hills, CA, DR. Andrew Frankel, offers rhinoplasty among its services and is conveniently located at 201 S Lasky Dr. Beverly Hills, CA 90212.
Please contact our Beverly Hills office in Los Angeles at 310.552.2173 if you have any questions or if you would like to schedule a consultation with Dr. Frankel, fill out the information below.