Tag Archives: plastic surgery

Rhinoplasty, sometimes called a “nose job” or “nose reshaping” by patients, is a surgical procedure that reshapes or resizes the nose for health or cosmetic reasons. Due to its status as a well researched, regulated, and safe procedure, it is the third most common plastic surgery procedure in the United States. 

According to data collected by the American Society of Plastic Surgeons (ASPS) there were 217,979 rhinoplasty surgeries performed in 2015, accounting for about 13 percent of the year’s plastic surgery procedures. 

Both revision rhinoplasty surgery and the initial rhinoplasty procedure can be used to resolve health problems, such as correcting impaired breathing caused by the structure of the nose. Rhinoplasty is also used to resolve aesthetic problems by enhancing the harmony of the face’s lines and balancing the proportions of the nose.

Rhinoplasty can create dramatic improvements to:

• Nose size and proportion in relation to facial harmony
• Nose width at the bridge, or a profile with visible bumps on the bridge
• The size, shape, and position of the nostrils
• A nasal tip that is bulbous, drooping, upturned, or hooked
• Nasal asymmetry (an imbalance between the left and right hemispheres of the nose)

There are two major rhinoplasty techniques, open rhinoplasty and closed rhinoplasty. Let’s take a closer look at each procedure now… 

About Open Rhinoplasty 

Open rhinoplasty is performed after an incision is made in the columella (the delicate tissue that separates the nostrils). This allows the surgeon greater access to the tissue throughout the nose. Because it allows increased visibility of the nasal tissue during the operation, an open rhinoplasty is easier for the surgeon to perform. Another advantage to having an open rhinoplasty is that it can also allow for more dramatic revision of the shape and proportion of the nose. 

The open technique does sometimes lead to more noticeable scarring than the closed rhinoplasty technique.  Recovery after rhinoplasty using the open technique can also be more unpredictable and prone to complications than closed rhinoplasty recovery. On the other hand, open rhinoplasty can actually be less traumatic to the nose because the technique gives the surgeon more room to work and requires less modification to other internal nasal structures.

About Closed Rhinoplasty

Closed rhinoplasty involves performing the surgery entirely inside the nose without interfering with the columella. An internal procedure prevents visible scars from showing, so it is more favorable to patients seeking a more subtle transformation with less intrusive techniques. The closed rhinoplasty technique does require a facial surgeon with more experience and precision than its counterpart, the open rhinoplasty.

Although the closed rhinoplasty technique does result in minimal scarring, which is inside the nose and therefore not visible, it is also limited in the scope of the revisions it can make to the nose. Closed rhinoplasty recovery time can be easier and more predictable than recovery following rhinoplasty performed with the open technique, but it can also be more traumatic if a surgeon is indelicate or tries to make revisions that are too significant.

A Brief History of Rhinoplasty

Cosmetic surgery procedures of today are so medically advanced that they bear little to no resemblance to the techniques that gave birth to the field of rhinoplasty. Believe it or not, the first nose job was performed over 2,500 years ago on the subcontinent of India. It was achieved by removing a portion of flesh from the patient’s face and using this biomaterial to form a new nose.

About 20 centuries later, Europeans tried their hand at reimagining the human nose. Rampant warfare had left soldiers disfigured by the thousands, so medical experts of the time decided to engineer a prototypical grafting technique. It required the patient to keep his or her face pressed up against the upper region of the arm, allowing the skin around the new facial feature to re-grow. This process took a staggering three weeks of time, demanding an unimaginable level of stasis and contortion on the part of the recipient. After this initial phase of grafting, another two weeks was necessary to heal and reshape the flap of skin that was the patient’s de facto new nose.

These early examples would be considered the ultimate in “open rhinoplasty” since they greatly altered the skin around the nose (and elsewhere on the body) to create drastically new facial protrusions for these rudimentary test cases.

Luckily, technology and health sciences have made quantum leaps in the years since those dark old days. Instead of looking outward for tissue to replace the nose, skilled surgeons can utilize the flesh within it to craft a whole new look via closed rhinoplasty methods.

Hence, you now have the benefit of extensive research, experience, and options as you approach the myriad possibilities for your impending rhinoplasty procedure.

Is Open or Closed Rhinoplasty Best for Me?

Each rhinoplasty candidate is unique, so it is impossible to generalize and make a categorical statement about which rhinoplasty technique is better for all or even most patients. Health is never a “one size fits all” endeavor, so you should consult with a trusted physician before taking any definitive action.

Generally speaking, closed rhinoplasty is typically preferred because of the easier recovery process and the minimal, hidden scars, but there are numerous situations in which an open technique may be better for the patient.

Because it allows for more significant nasal revisions, open rhinoplasty may be preferable for candidates who are seeking a dramatic change, or who need dramatic reconstruction. A skilled plastic surgeon will still be able to minimize scar tissue and the appearance of scars following an open rhinoplasty. 

A patient who is only seeking a slight revision, or revisions that are concentrated on the bridge of the nose, and little to revisions desired for the tip of the nose, may be recommended to undergo the more subtle changes of a closed rhinoplasty operation.

Recovery and Results: A Case Study

As mentioned above, open rhinoplasty techniques allow for greater flexibility when it comes to more dramatic alterations of the patient’s chief facial feature. This includes the passage to the tip of the nose from within since the surgeon has full access via the osseocartilaginous vault. But if you’re hesitant to consider this procedure due to its invasive nature, please consider this recent case study:

98 patients underwent open rhinoplasty procedures in a given time period. Of those 98 subjects, only two required revision rhinoplasties, indicating that the open method allowed the surgeon to successfully operate without the hindrance of a closed approach. And in terms of scarring, the incision mark along the columella was virtually invisible on all of the patients involved in the study within weeks of the date of their respective procedures.

Is Rhinoplasty Right For You?

Regardless of which method of rhinoplasty (open vs. closed) you desire, you should be confident in your candidacy for the procedure before moving forward. As always, having a frank conversation with your doctor is the ideal first step in making this determination, but here’s a quick checklist to jump-start that talk…

You are a potentially good candidate for rhinoplasty:

• If you are of a mature enough age so that your facial growth is complete
• If you are in good overall health – while cosmetic surgery is safe on the whole, it does require a certain level of stamina to assure a speedy recovery
• If you are a non-smoker (tobacco use is detrimental to your health in a plethora of ways, damaging your skin, lungs, and thus increasing your recovery time)
• And if you have a positive, realistic outlook and goals for what you expect in the improvement of your appearance

Choosing the Right Plastic Surgeon for Your Rhinoplasty

Now that you have considered whether or not rhinoplasty is right for you, let’s ask an even more important question: who is the right doctor for your specific needs? Your facial surgeon must exude a trustworthiness so that you can ask him or her anything that’s on your mind before you set foot in the exam room.

This individual can help you determine which technique is best for your rhinoplasty procedure during your initial consultation. It’s important to clearly communicate your expectations for the results of your rhinoplasty surgery and share your complete health history, including dental history, with your plastic surgeon, so that they can choose the best technique for your health and goals.

It is therefore essential that you choose the right plastic surgeon for your rhinoplasty procedure in particular so that you can be confident in your results. A plastic surgeon who is skilled and experienced, especially in rhinoplasty, is the difference between glamorous plastic surgery results and a tragic plastic surgery horror story.

If possible, patients should seek out a plastic surgeon who specializes in facial plastic surgeries like rhinoplasty.

Dr. William J. Binder

Dr. William J. Binder is a facial plastic surgery specialist with over three decades of experience with facial plastic surgery.

He is double board certified and has 10 U.S. and global patents on medical and surgical devices and pharmaceuticals and is extensively published across various medical journals.

If you want your rhinoplasty, whether open or closed, performed by one of the world’s leading facial plastic surgeons, contact Dr. Binder’s office today to schedule your consultation.

A crooked nose can cause considerable insecurity. Fortunately, rhinoplasty can renew confidence in your facial appearance. If a crooked nose is something you desire to correct, here are a few things to consider before making your final decision on rhinoplasty surgery:

Potential Difficulties

A rhinoplasty procedure designed to correct a crooked nose is actually very complex for a number of reasons. First, the deviated cartilage and bone which cause the appearance of crookedness tend to drift back to their undesired positions, even after surgery. Second, plastic surgeons often struggle when operating on patients with asymmetrical faces, which make it difficult to locate the midline plane where the nose should be repositioned.

The Procedure

In short, the goal of this procedure is to straighten the nasal structure through repositioning the septum and nasal bones. Septal deviation must be addressed, or else the nose will be continually pushed out of position. If the caudal septum is off center, it will have to be rebuilt it in the midline; then, the surgeon will address deviations in the nasal bones.

Deviated Nasal Bones

If trauma has forced the nasal bones out of position, the bones must be treated immediately. Otherwise, the bones will heal in their crooked position. Resetting the bones will take about six weeks. After this, the bone fractures can be addressed. By making osteotomies—or bone cuts— with a chisel, the crooked bones may be reset to their proper positions.

Other Causes of a Crooked Nose

Internal and external valve collapse are other common causes of a crooked nose. Patients who have noticed a pinch in their nose that creates asymmetric shadowing likely have this condition. These conditions will create the appearance of a crooked nose, even if the rest of the nose is properly aligned. This is treated with a spreader graft, which will expand the internal nasal valves that have collapsed.

For more information about crooked nose rhinoplasty and other cosmetic procedures, schedule a consultation with Dr. Binder today.

A larger nose—a broad nasal tip, specifically—is a common source of insecurity. With your surgeon’s approval, nasal tip rhinoplasty would be an excellent step towards achieving a more refined facial structure. This procedure focuses specifically on the nasal tip, which is the most protrusive part of the face. While it may sound like a minor adjustment, a more refined nasal tip works wonders for transforming your facial appearance.

The Results

A tip refinement procedure will be catered to the needs of the patient and the recommendations of the surgeon. The procedure can either make the nasal tip appear more pronounced, or reduce the tip considerably. It all depends on your facial structure. Consult a trusted plastic surgeon to discuss your personal options.

The Procedure

The procedure typically lasts from one to two hours, or longer if extensive alterations are required. After sedation, the plastic surgeon will examine the internal nasal structure using a 3D, high definition camera. Cartilage under the nose is then exposed so that structural alterations can be made.

The remaining steps are then determined by your personal preferences. Fat tissue may be removed or repositioned, creating more definition. Implants may be placed to fortify cartilage and reorient the nasal tip. Grafts may also be used to improve tip projection. When the surgeon has finished, the incisions will sealed with dissolvable sutures.

Recovery

Fortunately, the mucus lining heals quickly, reducing the risk of scarring. Moreover, since every incision is made internally, any scarring that does occur will not be visible.

Following the postoperative regimen prescribed by your surgeon is crucial to achieving the results you desire. Avoid contact sports or other forms of strenuous exercise, which may stress the nose and cause inflammation. Nasal canals should be kept clean to prevent infection. Purchase a nasal kit that will irrigate your nose and sinuses. If you experience pain or discomfort, your doctor can recommend pain-relievers that are safe to use. Contact your doctor immediately if you experience symptoms such as excessive bleeding or intense pain.

Risks

Rhinoplasties carry the same risks as any surgical procedure. Infection may occur, but antibiotics and regular cleansing of the nasal passages reduce the risk dramatically. In rare cases, patients have experienced adverse reactions to anesthesia. Make certain that you are medically cleared for the procedure before deciding on surgery.

If a broad tip rhinoplasty sounds right for you, schedule a consultation with Dr. Binder today to discuss your personal desires and options.

When you are not happy with how your nose looks, it can greatly affect your self-esteem and the way you look at your life. Even your best features can sometimes be clouded by an unsightly nose. Fortunately, there are options for those who are looking to make a change and who might want to consider rhinoplasty. There is also the option for those who would like to try a rhinoplasty without surgery, if the thought of a procedure sounds unappealing.

Traditional Surgery

Surgery has been an option for many years, and patients tend to choose it when they want intense alterations made to their noses. Most plastic surgeons recommend that you take the time to consider the repercussions of surgery and whether or not they will be changes you want for the long term. While surgery can tend to yield great results and many often tend to be happy with how they look after the procedures, the effects can be difficult to fix if it is not what the patient is thinking.

Surgery can also end up costing the patient more in the long run. You will want to discuss how much the procedure will cost with your plastic surgeon before you decided to agree to it. Sometimes, insurance will also cover the cost if the plastic surgery is needed because of an accident or injury. Recovery time is also much longer when surgery is performed.

Non-Surgical Rhinoplasty

Non-surgical rhinoplasty is often the insertion of dermal fillers. It often takes as little as fifteen minutes and only a little bit of anesthesia in order to make changes. However, any major alterations can be difficult to fix only be doing non-surgical rhinoplasty. It also cannot diminish the size of a large nose, a common operation that has to be fixed with surgery—but it can add to the contouring, making it appear smaller overall.

Results tend to vary and often last only a total of a few months. Most report that their new look usually remains for 6-18 months, so if you are thinking about a more permanent solution, surgery might be a better option. Most patients can go back to work the same day of the operation, and it is often much less expensive than investing in a surgical procedure.

Verdict?

When deciding between the traditional method of plastic surgery or non-surgical rhinoplasty, you should think about what are the exact results you want and to make sure to talk to a professional who can decide which option is right for you.

A Rhinoplasty, or nose job, is the oldest and most common plastic surgery procedure around, it is also one of the most difficult. So before deciding on whether this procedure is right for you, it is important to know what to expect after the surgery. Here’re a few things to consider before getting a rhinoplasty.

Take Time Off Work

You will need to take at least 7-10 days off before returning to work after your rhinoplasty. You can cut down your healing time if you stop taking fish oil, non-steroid anti-inflammatories, or aspirin, two weeks prior to your procedure.

Be Prepared for the After-Effects

While getting a Rhinoplasty is not as painful as other plastic surgery procedures, there is some pain related to the procedure as well as, swelling, bruising and slight bleeding, especially right after the procedure. Make sure you have cold compresses and ice gels to help manage the swelling, and bruising, around your nose and eyes. The swelling and bruising are at their worst in the first 3 to 5 days and should completely be gone, within ten days. However, the residual swelling, particularly at the tip of the nose, can last up to 12 – 15 months. This residual swelling may cause your nose to seem asymmetrical, until you hit the 12-15 month mark. It is normal within the first few days to experience some slight nasal bleeding and tiredness. It is also important to keep you wounds clean and manage your recovery with your doctor.

Avoid Exercise

You should avoid exercising for 2 to 5 weeks after your procedure. Elevating your heart rate can cause more swelling, bruising and even bleeding.

The Healing Process

Because it takes about 12 to 15 months for the residual swelling to dissipate, you will not truly see your final results until that time. You must be be patient and monitor your progress with your surgeon. Your internal splints will not be removed until the first post-op visit, seven days, after your rhinoplasty.

Manage Your Expectations

There is no such thing as a perfect nose and is not possible to just “add” any nose to your face. Noses are very specific, and there is a limitation to how yours can be shaped. The best way to manage your expectations is to be in constant communication with your surgeon, prior to the procedure, providing them with as many pictures or descriptions of your ideal nose, as possible. This way you can get an idea what you can expect to look like after your procedure.

Hopefully the information provided will help you decide whether this procedure is right for you. If you have further questions or if you would like to discuss the procedure, feel free to contact us at your earliest convenience. Our expert staff will be happy to address any concerns you may have. To schedule a consultation visit doctorbinder.com today.