Rhinoplasty

Rhinoplasty, or nose surgery, is one of the most finessed and complicated of all cosmetic surgical procedures.

 A plastic surgeon typically will evolve and improve their rhinoplasty techniques throughout the course of their career. With over 25 years of experience, board-certified plastic surgeon Dr. Rapaport, MD, has the expertise necessary for optimal rhinoplasty results.

Rhinoplasty is one of the most commonly performed aesthetic surgical procedures in the United States. In addition to providing cosmetic benefits, rhinoplasty can also improve nasal airway breathing and, in those cases, is viewed as a functional procedure.

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*Individual results may vary.

Learn More About Rhinoplasty

Patients may seek out rhinoplasty for cosmetic reasons, functional problems, or both. Those who want to improve the appearance or function of their nose may benefit from the procedure, which Dr. Rapaport tailors to each patient’s needs. There are multiple rhinoplasty techniques to suit each unique case. 

Ideal candidates should have a fully developed nose, typically over age 16. They should be non-smokers in good health with realistic expectations. Some patients undergo rhinoplasty alongside another procedure, such as chin augmentation, to address multiple cosmetic concerns simultaneously.

There are various types of rhinoplasty surgeries. The procedure may be categorized as functional or cosmetic, full rhinoplasty, primary or revision rhinoplasty, and open or closed. Dr. Rapaport customizes every procedure to the individual patient rather than offering only one type or technique. Rhinoplasty procedure options include:

  • Full rhinoplasty vs. tipplasty: This is the most common form of rhinoplasty Dr. Rapaport performs. It typically involves working both on the nasal bridge and the tip of the nose. A tipplasty refers to surgery only on the tip of the nose.
  • Cosmetic vs. functional rhinoplasty: Some patients undergo rhinoplasty to improve the appearance of their nose, such as reducing the size of an overly large nose, removing a bump, or minimizing flared nostrils. Others have had an injury to the nose and need surgery to improve function and breathing.
  • Reduction rhinoplasty vs. augmentation rhinoplasty: Reduction rhinoplasty refers to a procedure that reduces the overall size of the nose, whereas an augmentation (enhancement) rhinoplasty increases or enhances the nose size with the patient’s own tissues or other materials, which are added to the bridge or tip of the nose. Dr. Rapaport most often performs reduction rhinoplasty.
  • Primary vs. revision rhinoplasty: Primary rhinoplasty refers to a first-time rhinoplasty, while secondary or revision rhinoplasty means that the patient has had a rhinoplasty performed earlier and is having a revision.

Dr. Rapaport most often performs full reduction rhinoplasties. Typically, patients requiring this type of rhinoplasty have a bump on the bridge of their nose (dorsal hump) and wish to refine the tip of the nose. This procedure involves shaving or rasping the bone and cartilage that make up the bump. After the hump has been reduced, the bridge of the nose appears widened, referred to by plastic surgeons as an open roof deformity. This temporary intra-operative deformity is eliminated by moving or fracturing the nasal bones, thereby closing the open roof deformity.

The tip of the nose is typically treated with conservative cartilage removal or internal suturing to improve its shape. If the base of the nasal tip appears wide, alar base resections may be performed to narrow it. 

Open vs. Closed Rhinoplasty

For the past 15-20 years, there has been a continuous discussion and debate among rhinoplasty surgeons on whether the open or closed rhinoplasty technique is best. While some surgeons perform all of their rhinoplasties with only one of these techniques, Dr. Rapaport individualizes his approach depending on the anatomy, complexity, and goals raised in each case.

Open rhinoplasty involves a small incision on the tip of the nose between the nostrils (the columella), giving the surgeon a full view of the nasal tip cartilage. This open technique can allow for more precise suturing, grafting, and overall manipulation of the tip. However, “opening” the tip results in increased swelling, a prolonged healing period, and a columellar scar, though this is inconspicuous.

Closed rhinoplasty uses incisions within the nostrils. This offers faster healing, less pronounced swelling, and no visible scar. However, closed rhinoplasty limits the surgeon’s access and visibility, so it is not always suitable for complex cases.

Dr. Rapaport usually performs rhinoplasties in his fully accredited, on-site operating suite. A full rhinoplasty is performed under general anesthesia and takes about 1.5 hours to complete. Patients may have rhinoplasty performed during a rejuvenation procedure, such as a facelift or eyelid lift. 

When a patient only desires or needs a refinement of the tip of the nose, a tipplasty may be suitable. Tipplasty may be performed with local anesthesia or IV sedation. As opposed to full rhinoplasty, where the bone is moved (and therefore, a plastic splint is applied for several days), after tipplasty, no splint is needed, and the tip area is taped for several days.

Following a full rhinoplasty, patients generally return home and spend most of the first day resting in bed with their head and back elevated about 30 degrees. There will be absorbent gauze between your nose and lips to absorb drainage, and you should apply cold intermittently to the area. Patients typically wear a splint for approximately four days and can return to work five to seven days following their procedure.

Patients should expect swelling, bruising, and a stuffy nose feeling. Bruising around the eyes is also common after full rhinoplasty. You should avoid strenuous activity for approximately one month and contact sports for at least three months.
Some patients want to improve the appearance of their nose without invasive surgery and recovery time. Patients may benefit from a liquid rhinoplasty using dermal fillers in this case.

While some changes are visible just after the splint and tape are removed, improvements appear over time as swelling subsides. Final rhinoplasty results are visible in approximately one year which are permanent. If a patient has unsatisfactory results, a revision or secondary rhinoplasty can be performed after one year. Most patients are very happy with their improved nose, which can enhance facial harmony and overall appearance.

Take the Next Step

Every patient’s transformation journey at Rapaport Plastic Surgery begins with a detailed consultation with Dr. Rapaport. To learn more about rhinoplasty and determine if it’s the right choice for you, fill out the form below or call us at (212) 249-9955 to schedule an appointment. Our team is dedicated to providing the best plastic surgery NYC has to offer.

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