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. The doctor will conduct a detailed exam emphasizing nasal function and will review the patient’s medical history. The doctor will use computer imaging to aid in communication and offer the patient 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 doctor will then separate the skin from the underlying bone and cartilage, which he will then sculpt to the desired shape. He will redrape the skin over the new framework and close the incisions.

Patients should avoid participating in strenuous physical activities, including athletics and intercourse, to minimize the risk of bleeding and swelling. After 24 hours, patients may take gentle walks and strolls. They can begin light cardio, such as an elliptical machine or spin bike on a low resistance, on postoperative day 7. Patients should avoid intense cardio exercises like running, activities that require exertion like lifting weights, and movements that require bending forward such as yoga and pilates for a minimum of 3 weeks, unless directed otherwise.

Insurance policies generally exclude coverage for rhinoplasty procedures that are done solely for cosmetic reasons. However, some coverage may be available if the procedure is being performed to address breathing issues.

Nasal packing is simply used to minimize bleeding or dripping from the nose after surgery. It also helps compress the internal tissues to prevent collections and swelling. Packing is generally composed 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 adapting and utilizing 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 in person 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 is still unhappy, the nose may still be able to be fully corrected. This necessitates finding the right surgeon to carefully examine you and create a surgical plan. In some cases, the nose should be left alone, but these are the rare ones. In my experience, I can improve the nose, and the postoperative course is usually easier for these patients than their prior surgeries.

Surgery that involves the nasal tip must be done with precision and foresight because of the effects of healing. Wound healing and scar contraction often impact the way the tip heals. 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 them to stay for at least 9 days. The reason for this is that the cabin pressure on planes will cause swelling to occur, and it will take the nose longer to acquire its desired shape. Rarely, this may impact the final result. There is no medical risk to flying earlier. Patients often do this, and I have seen no ill effects thus far. However, 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 would be less in need of immediate attention, and I can address them 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 the patient 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. The treatments of these two entities have subtle differences, 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 can leave a stronger nose by using a chin implant. Chin implants are extremely powerful in achieving facial harmony. They are relatively easy to perform and low risk, and they 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. I can narrow the tip cartilage by removing cartilage or by using sutures to change its shape, and I can narrow the base of the nostrils by removing some soft tissue. Occasionally I need to build up the height of the nasal dorsum to make the nose look narrower.

If the end of your nose points upward, I can reorient it to point forward by using sutures to change its shape or grafts to elongate it. Sometimes, I can accomplish the same goal by removing some septum or membrane.

Revision rhinoplasty is a secondary operation that improves upon or corrects 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 someone is a good candidate for such a procedure depends on how much the patient thinks the change would benefit them, how confident the surgeon is about executing such a result, and what the risk/benefit ratio is of 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 may refer that patient to another surgeon who may be more appropriate for them. I will not operate on this patient because I feel they 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 his 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.