Rhinoplasty, is a surgical procedure meant to improve the appearance and function of the nose. It is considered by many to be the most challenging procedure in cosmetic surgery.
There are an unlimited number of ways the nose can be modified with a rhinoplasty. The overall size of the nose can be reduced or increased, a hump can be removed or the bridge built up, the angle between the nose and the upper lip can be changed, a multitude of changes can be done to the tip, the nostrils can be narrowed, and so on. Rhinoplasty can also correct many types of breathing problems related to the nasal structure.
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THE PROCEDURE
A Rhinoplasty operation is tailored toward each patient’s anatomy and individual aesthetic desires. The surgery is performed at the Lasky Clinic Surgical Center under twilight anesthesia. Both open and closed approaches are utilized, depending on the situation and the patient’s anatomy, and will be discussed with Dr. Frankel before surgery.
PRIMARY RHINOPLASTY
The term ‘Primary rhinoplasty’ is used when a patient that has never undergone this type of surgery before. Primary rhinoplasty is the best opportunity to deliver optimal results because the anatomy is undisturbed and there is no scar tissue or missing cartilage. Careful planning and excellent execution can deliver gorgeous outcomes with fewer limitations than those which occasionally accompany secondary cases. While many surgeons like to perform primary nose jobs, few take the time to analyse and attend to every detail, so that the outcome will be nuanced, balanced, and provide a pretty nose that no one ever suspects of being “done.”
TYPES OF RHINOPLASTY
NASAL SURGERY
Rhinoplasty is a surgical procedure to improve the appearance and function of the nose by reshaping it. Rhinoplasty is considered the most difficult procedure in cosmetic surgery because of the delicate nature of the cartilages, the effects of powerful scar contraction and the subjectiveness of the results. The nose can be reshaped in numerous different ways, and just about any element of the nasal anatomy can be modified.
REDUCTION RHINOPLASTY
In reduction rhinoplasty, the overall size of the nose may be reduced, or specific areas may be made smaller, like the tip or a hump or bump.
Resizing is often done by removing cartilage and/or bone from the nose to achieve the desired shape and size. Reduction rhinoplasty reduces the framework size of the nose, but the skin that drapes over the nose is not touched. The elasticity of skin allows it to shrink to the size of the smaller frame.
AUGMENTATION
Occasionally, a nose needs to be built up because it has been over reduced with prior surgery or because of prior trauma or congenital issues. Augmentation of the nose involves using cartilage from the nasal septum, chest wall or ear to add support, height and projection. An augmented nose can be beautiful and natural-looking.
ETHNIC
The term Ethnic Rhinoplasty is used when the goal of surgery is to improve the overall appearance of the nose, while retaining the features unique to that person’s ethnic background. There are specific anatomic relationships associated with each ethnic group and these relate to common aesthetic features. Dr. Frankel regularly sees a wide variety of patients, representing numerous backgrounds, who come from all over the globe. As an expert in this field, Dr. Frankel has lectured on ethnic rhinoplasty at national medical conferences.
REFINEMENT
The term refinement in rhinoplasty generally refers to being able to elicit more detail at the tip. A nose that is more refined has more highlights emphasizing the underlying structure.
Refinement can be accomplished by making the cartilage more prominent or by thinning the overlying soft tissue. Sometimes both are done in order to allow for the beautiful underlying tip cartilages to be more fully appreciated.
NASAL TIP
This is limited surgery that is focused on the tip of the nose. There are a myriad of ways of modifying the shape of the tip cartilages and this can be done without involving any other parts of the nose if indicated. While the recovery from this more limited operation might be easier for the patient, refining a tip can be very challenging for the surgeon.
FUNCTIONAL
Due to structural defects, a nose may require reshaping to function properly. Patients may be born with, develop, or acquire through an accident or physical confrontation, nasal defects that interfere with breathing, eating or sleeping.
Functional rhinoplasties are imperative to fix a variety of nasal abnormalities. It is as important to preserve or restore normal function as achieving an attractive cosmetic result. If you have difficulty breathing through your nose, the functional advantage of rhinoplasty can be as dramatic as the improvement in your appearance.
ADOLESCENT
The right cosmetic procedure performed at the right time can greatly impact a young person’s physical and emotional development, as well as self-confidence. Dr. Frankel requires a consultation prior to surgery where he will assess the physical and emotional maturity of teenagers requesting surgery.
Dr. Frankel is known for being honest and frank with his youngest patients, discussing risks, recovery and reasonable expectations.
DR. FRANKEL’S NOTES
“I love performing rhinoplasty! The surgery is intricate and allows for multiple approaches to create the desired shape. A beautiful nose can change a person’s self confidence and thus the trajectory of their life. However, a poorly performed rhinoplasty can have devastating consequences and create breathing problems. Because the surgeon cannot completely control the healing process, decisions made in the operating room will have a significant impact on how that nose changes over the years and I enjoy the challenges that this poses.
Having a rhinoplasty is a big deal and patients must choose their surgeon carefully; this is not a place to cut corners. My compulsive nature is to be as exacting as possible and to hold myself to very high standards; with the patient’s satisfaction being the ultimate goal.”
– Andrew Frankel, M.D.
Before and after
*Each patient is unique and individual results may vary.
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Preparation & Expectations
Preparation
Our office will provide a comprehensive plan for how to prepare for surgery and a list of and vitamins, herbs or medications to avoid in the days and weeks before the procedure.
You will also need to stop smoking before and after surgery as it inhibits healing.
Length of surgery
Surgery length varies greatly. Dr. Frankel will provide more information during your consultation.
Recovery time
While everyone heals differently, patients are typically able to return to work within about a week after their 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.
After care
Following surgery, a splint will be placed on the nose, both for protection and to help it maintain its new shape.
The stitches are usually removed within about six to seven days after surgery.
The nose will be moderately swollen and stuffy for several weeks, and the remainder of the swelling will gradually resolve over the course of the next six to eighteen months.