The Best Rhinoplasty in Beverly Hills — Dr. Andrew Frankel!
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.
- What is Rhinoplasty?
- The Rhinoplasty consultation
- Am I an ideal candidate for rhinoplasty surgery?
- The Rhinoplasty Procedure
- Making the incisions in your nose
- Shaping the Nose
- Differentiating Types of Rhinoplasty
- Primary Rhinoplasty Procedure
- What to expect on the day of Rhinoplasty surgery
- What to expect after Rhinoplasty surgery
- Rhinoplasty Recovery
- Possible Risks of Rhinoplasty Surgery
- RHINOPLASTY PROCEDURE FAQs
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. This surgery after a nasal injury will treat broken bones or airway restrictions.
It is also an ideal procedure for an aging nose (drooping tip), an undefined nasal tip, and much more.
The Rhinoplasty consultation
During the rhinoplasty Beverly hills consultation with an expert and board-certified plastic surgeon, 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 also discuss preparing for your procedure. As with any surgery, certain medications, vitamins, and herbs should be avoided beforehand as they can cause you to bleed more than normal. These should generally be stopped two weeks before 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 an ideal candidate for rhinoplasty surgery?
Men and women often 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
Before your nose reshaping surgery, Dr. Frankel will review your custom surgical plan with you. If you are given general anesthesia, you must 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 incisions in your nose
Rhinoplasty surgery starts with an incision made either externally at the bottom of the nose or inside the nose.
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 is the only downside of open rhinoplasty.
The ‘closed approach’ involves incisions inside the nostrils, with no external cuts. This closed rhinoplasty may be appropriate for patients who only need small changes, but most surgeons favor the open approach for the best results.
Dr. Frankel will go over the surgical technique he plans to use for your procedure before the surgery to ensure you are fully informed and 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 nose’s new shape 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 nose surgery and knows how to improve or maintain nasal function when changing the shape of the nasal tissues.
A primary rhinoplasty will take an average of one to two hours. 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.
Differentiating Types of Rhinoplasty
NASAL TIP RHINOPLASTY
This is limited surgery that is focused on the tip of the nose. There are myriad ways of modifying the tip cartilage’s shape; this can be done without involving any other nose parts 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.
In rhinoplasty reduction, the nose’s overall size may be reduced, or specific areas may be made smaller, like the tip or a hump, or a bump. Resizing is often done by removing cartilage and/or bone from the nose to achieve the desired shape and size.
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 rhinoplasty is a term referring to 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. Specifically, anatomic relationships are associated with each ethnic group and relate to common aesthetic features. Dr. Frankel regularly sees a wide variety of patients from various backgrounds from all over the globe. Dr. Frankel has lectured on ethnic rhinoplasty at national medical conferences as an expert in this field.
The right cosmetic procedure performed at the right time can greatly impact a young person’s physical and emotional development and self-confidence. Dr. Frankel requires a consultation before surgery, where he will assess the physical and emotional maturity of a teenager requesting surgery. Dr. Frankel is known for being honest with his youngest patients, discussing risks, recovery, and reasonable expectations.
Due to structural defects, a nose may require reshaping to function properly. Patients may be born with, develop, or acquire nasal defects that interfere with breathing, eating, or sleeping through an accident or physical confrontation. Functional rhinoplasties are imperative to fix a variety of nasal structural abnormalities. If you have difficulty breathing through your nose, the functional advantage of rhinoplasty can be as dramatic as improving your appearance.
Revision rhinoplasty relates to nasal surgery done to improve or correct the outcome of a prior rhinoplasty. Because rhinoplasty is such a challenging procedure and healing is not 100% predictable, revisions are quite common, and often patients present to Dr. Frankel after having had several previous surgeries. Obtaining consistent results in revision cases requires a great deal of extensive experience and skill. Dr. Frankel appreciates the trust his patients impart to him by choosing him to be their surgeon. Dr. Frankel is renowned among the medical community for his revision rhinoplasty expertise.
Nasal surgery on a patient that has never undergone this type of surgery is called primary rhinoplasty. Primary rhinoplasty is the best opportunity to deliver optimal results because the anatomy is undisturbed, and there is no scar tissue or missing cartilage.
Primary Rhinoplasty Procedure
What to expect on the day of Rhinoplasty surgery
The majority of all operations that Dr. Frankel performs will be under the direction of a board-certified anesthesiologist and involve twilight anesthesia without the need for a breathing tube, ventilator, or paralysis. Even in surgeries taking several hours, the anesthetic is well tolerated, and patients wake up quickly feeling very good. The entire experience is enhanced.
Day of Surgery
The first one to two hours after rhinoplasty is spent in the recovery room on monitors and under the care of a registered nurse. Patients are transferred to private rooms once more awake, where their families or friends can join them. Once fully alert, patients can return home with post-operative instructions.
Rhinoplasty is not typically very painful, and most patients experience more discomfort than pain, particularly immediately after surgery, while the local anesthesia is still working. While recovering at the clinic, patients may receive intravenous medications to stem any acute pain. Patients are discharged from the clinic with their prescribed medications.
You will likely feel various emotions before surgery: excitement, anxiety, fear, etc. It is normal to have some apprehension before any operation and, in particular, one that will change your appearance. If you are questioning things, Dr. Frankel suggests that you trust yourself and the time and effort you spent deciding to have surgery and choosing the best doctor.
What to expect after Rhinoplasty surgery
Swelling Post Operation
Following surgery, a splint will be placed on the nose, both for protection and to help it maintain its new shape. The nose will be moderately swollen and stuffy for several weeks, and the remainder of the swelling will gradually resolve for the next six to eighteen months.
Hydration of your nose
Sleeping with a humidifier can be helpful for the first two weeks after surgery. Once Dr. Frankel gives the go-ahead, use a nasal saline spray to help keep the inside of your nose moist. Using a saline spray will minimize your nose’s crust and make breathing easier.
Rest and exercise post-surgery
Rest for the week after surgery and avoid excessive smiling or bending over. Most patients can drive a car and return to work and social activities after eight days. Avoid strenuous/extreme physical exercise for three weeks, and contact sports should be avoided for eight weeks.
Average recovery time
Every patient heals differently. If you notice that a particular behavior or activity is causing swelling, do your best to avoid that activity until you have healed. Physical recovery from the surgery is fairly quick, but the nose will not achieve its final form for well over a year.
After rhinoplasty, you’ll have bruising and swelling that may subside quickly or last for months. Most patients can expect most 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 work to ensure that you have the relaxation you need to heal.
Following all of Dr. Frankel’s instructions and tips for recovery from rhinoplasty is important. These may include how to ice and clean the area properly, instructions on using your pain medications, alternatives for blowing your nose, what to avoid after rhinoplasty, and how to prop yourself up when you sleep to help reduce swelling.
You should not engage in 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. If you are feeling depressed after rhinoplasty, don’t be afraid to consult with Dr. Frankel to clarify your doubts post-surgery.
Possible Risks of Rhinoplasty Surgery
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
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 other nose job methods.
Many surgeons do not want to perform rhinoplasty except for simple cases such as reducing a dorsal hump. In contrast, Dr. Frankel welcomes the challenge of complex nasal surgery 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 his approach to cosmetic surgery. This helps to ensure that patients receive the best results possible.
NOSE JOB BEFORE AND AFTER
*Each patient is unique and individual results may vary.
RHINOPLASTY PROCEDURE FAQs
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.
Want to understand more about what to expect on the day of surgery?