Rhinoplasty Surgery at BHSSCI

Rhinoplasty can improve your self-image, boost your confidence, and help you sleep better at night.

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The Rhinoplasty Procedure

Rhinoplasty can improve your self-image, boost your confidence, and help you sleep better at night.

Sometimes informally called a “nose job,” rhinoplasties make up 10% of all surgical procedures performed annually on women and men. That’s not surprising when you consider that your nose is the central feature of your face. You may want to make significant changes, but even subtle alterations can transform the appearance of your entire face.  

Rhinoplasty is also known as nose shaping because, no matter the desired result, it comes from modifying the shape internally and/or externally. From tip refinement to overall size reduction, these changes can give your facial features a more balanced appearance. Another type of nose surgery called septoplasty modifies the internal structure to correct breathing problems (such as those caused by a deviated septum). The two procedures can be combined for patients who have difficulty breathing but who also desire cosmetic changes.

If you’re thinking about getting a nose job, there are many factors to consider before making a decision. What are your options? What does nose surgery entail? What are the risks? And, of course, what can you expect in the way of results?

Your surgical outcome, and your overall surgical experience, depend primarily on the surgeon you choose. The rhinoplasty surgeons on our renowned team here at Beverly Hills Sunset Surgical Center International by Meraas are among the world’s finest. Board-certified, highly skilled and experienced, trusted by celebrities and other discerning women and men. Their reputations also reflect their personal pride in using their skill and artistry to help each patient achieve a nose they love.

Rhinoplasty

Types of Rhinoplasty

An accomplished rhinoplasty surgeon can reshape your nose just a little or entirely change its outward appearance, depending on your aesthetic goals. You may want to:

  • Make it more symmetrical
  • Make it larger (or smaller) overall  
  • Make the bridge wider or narrower, or more elevated
  • Change the size of one or both of your nostrils

A nose job can change the way your nose looks straight on, but it can also change your profile if your nose has a noticeable hump or depression on the bridge. Rhinoplasty can also address just the tip of your nose, if it is enlarged, bulbous, drooping, upturned or hooked. Sometimes less prominent depressions and asymmetries can be smoothed using injectable dermal fillers instead of surgery.

The goal is always overall harmony — a facial appearance that is pleasantly proportioned — because none of us has a perfectly symmetrical face. Your nose may be small compared to the rest of your body, but it is complex — composed of multiple parts that come together to create its external appearance as well as its internal functionality. Rhinoplasty is an individually tailored procedure, so your surgeon can make any of the structural alterations listed below. For many people, the procedure actually involves a combination of these options.

Straighten

Straightening a nose that is visibly crooked can give your face a balanced look. Most people who have a crooked nose got it via an injury at some point in their life. A broken nose often results in a deviated septum – the cartilage that forms the internal centerline of your nose. In some cases, though, crooked nose may be genetic. It might also be a birth abnormality, or even the result of a previous rhinoplasty. Crookedness can be corrected by nose surgery, along with breathing problems you probably suffer if you have a deviated septum.

Reduce Overall Size or Width

If your nose seems too wide at the bridge or generally too large for your face, nose surgery can create a slimmer appearance. If the bridge is not elevated (which is typical in some ethnic groups) that can actually make your entire nose look wider. So can an unintended result of previous surgery.

Reduce Projection

Sometimes a nose viewed in profile appears too long because it projects too far from the face, even this may not be so noticeable from the front. We can sometimes correct this issue with just a tip refinement rather than a more extensive procedure.

Smooth The Lines

Rhinoplasty can smooth the ridge along the top of your nose, to get rid of those little humps, bumps and depressions so many of us have. Your nose will look sleeker.

Tip Refinement

If the end of your hose is bulbous, upturned, droopy, pointy, or hooked, tip refinement can correct that. While this technique addresses only the end of your nose, it can often vastly improve overall shape and balance. Some people find that tip refinement has helped to make their entire face seem slimmer.

Most nose surgery involves altering internal nasal structures, often including bone. However, tip refinement only reshapes or removes cartilage, so the surgery goes much faster than other types of rhinoplasty.

Change Nostril Size

Nostrils that are visibly different in size or shape, flared, or which appear upturned can make your nose seem overly large compared to the rest of your face. For some patients, nostrils can be modified nicely using only tip refinement techniques.

Elevate The Bridge

A number of ethnic groups have identifiable nose characteristics. For some, Asians for example, there is no elevation to the bridge of the nose (at the top between the eyes). Others have a pronounced bridge. Rhinoplasty can raise the bridge of your nose. If you’re looking for just a little change, it may be possible to achieve the result you want without surgery, using dermal fillers.

Septoplasty: Rhinoplasty for Deviated Septum

Nose surgery can dramatically improve nose function as well as its appearance. Septoplasty and nasal valve surgery can correct breathing problems caused by injury or genetic defects or structural abnormalities inside the nose. These reconstructive techniques are used to straighten a deviated septum, repair a collapsed valve (which can occur on one or both sides), or remove internal protrusions, depending on exactly what is causing your breathing difficulties.

If you need nasal repair and also wish to make cosmetic changes, your surgeon can address those goals in a single surgery. We want you to be happy with your appearance, but it is critical for your personal health to restore proper breathing.

Revision Rhinoplasty

There are times when a patient is not entirely satisfied with the results from a primary rhinoplasty. If that’s the case for you, revision rhinoplasty may be helpful. Revision can address aesthetic issues if you still aren’t quite pleased with how your nose looks. It can also correct breathing problems you now have post-surgery. This can happen if an overly aggressive procedure causes your airway(s) to collapse.

We recommend you wait at least a year after your initial nose surgery before undergoing revision, to be sure your nose has entirely healed. Final rhinoplasty results take time to fully develop, and it can take some time for swelling to fully subside. We understand that patients are impatient when it comes to seeing results, but you don’t want to decide prematurely that you are unhappy with what you see.

It’s also important to note that revision rhinoplasty is a more complex surgery than the initial procedure. The length of time and process for recovery are the same, but the surgery itself will take longer, and there is a somewhat greater risk of infection. The physicians who are part of our BHSSCI practice are surgeons to the stars because they get things right the first time. You don’t have to be a Hollywood celebrity to appreciate that!

Open vs. Closed Rhinoplasty

Medical and technology advancements have changed the way we perform nose surgery. Closed rhinoplasty is an older technique in which all incisions are made within the nose. There is no chance of visible scarring, but the surgeon must perform delicate movements without being able to directly see the surgical site.

Open rhinoplasty is a more advanced technique that gives the surgeon direct visual access to the site as work progresses. This is possible because the surgeon makes a tiny external incision at the base of the columella. That’s the soft structure that forms the center base of the nose, between the nostrils and airways on each side. Making the incision enables the surgeon to gently lift away the skin to see underneath.

The open procedure takes a little longer due to the extra steps involved in making the incision, lifting and later replacing the skin, and suturing the incision, but the results can be far more precise. With full visibility, the surgeon can better control each movement and also see if any unexpected procedural adjustments are needed to achieve the best possible results.

Even with open rhinoplasty it is highly unlikely you will have a visible scar, thanks to the small size and placement of the incision.

What Does Rhinoplasty Surgery Involve?

At BHSSCI, we perform rhinoplasty as an outpatient surgery, at our state-of-the-art clinic. There is no need to stay overnight in a hospital. Even so, you will have to ask someone else to drop you off and pick you up following surgery. Usually patients are ready to go home about an hour and a half after the procedure is complete. Your surgeon may recommend that someone stay with you through the first night.

The Surgery Follows These Steps:

  • You will receive general anesthesia, so you will be asleep during the entire procedure. General anesthesia is very safe for patients in good health, however, if you have concerns about this we encourage you to bring them up during your initial surgical consultation.
  • Your surgeon will make the incision. If your surgical plan involves altering your nostrils, the surgeon may make another small incision in the natural crease on each side of your nose.
  • Your surgeon will sculpt your nose to achieve the aesthetic results you discussed during your consultation. Depending on the type and scope of changes you desire, sculpting may require removal of cartilage or bone or addition of cartilage grafts (used to increase size or modify shape).
  • Grafts are not necessarily required, but in certain circumstances they can help provide better shaping and support inside your nose. Some people have particularly thin skin, in which case a graft might be visible after swelling has gone down. A skilled surgeon will recognize this possibility, though, and work to prevent problems by using thinner or smaller grafts or by covering them with a natural material such as collagen.
  • If grafts are needed, we usually take cartilage from the septum. However, it is also possible to use ear or cadaveric cartilage.
  • If you are having a septoplasty (surgery for a deviated septum), your surgeon will straighten the septum and then reduce projections inside your airways that may be restricting your breathing.
  • When cosmetic and/or reconstructive work is complete, your surgeon will gently re-drape the skin and then close the incision(s).
  • Some surgeons inject a steroid to help improve rhinoplasty results. If used conservatively, this additional procedure is safe.

Before Your Surgery

Good overall health ensures the best possible surgical experience – before, during, and after. If you are a smoker, you will have to quit at least two weeks before your surgery and continue to not smoke during your recovery period. If you drink alcohol, you will have to forgo that as well, starting at least one week before surgery. On the positive side, exercising is excellent. In fact, if you don’t exercise regularly, doing so before surgery can actually boost your recovery.

After Your Surgery

Immediately following your surgery, there will be a cast across the bridge of your nose, and there will be intranasal stents inside your nostrils. The cast will be there for a week, but the stents will be removed within 3-7 days. The bottom line, though, is that you will not get even an early peek at your new nose for a week or so.

You will also experience some bruising and swelling for 2-4 weeks. It’s not uncommon for some slight swelling to persist for as long as 6 months to a year, as your nose gradually heals and the changes are fully revealed. Plan on about 2 weeks down time, after which you can return to work or other non-strenuous daily activities. Some patients are able to return to work sooner, but it will be a month before you can get back to strenuous exercise.

Before you leave the surgical center, our team will provide you with detailed written instructions on how to care for your surgical site, when to schedule follow-up visits for bandage and stitches removal, etc.

Rhinoplasty produces virtually permanent results. However, keep in mind that your body changes as it ages, including your face. The best way to maintain a youthful appearance and protect your new nose is to use sunscreen religiously and to observe other healthy lifestyle choices.

Ethnic Rhinoplasty

Every individual is just that – uniquely themselves. That includes your nose, although some of us have a more “ethnic” nose than others. It shows off our heritage through subtle or more obvious traits such as wide nostrils, a dorsal hump, a bulbous tip, or no elevated bridge between our eyes. Certainly, we are all proud of our ancestry, but that doesn’t mean you can’t modify your ethnic nose if that’s what you want. Ancestors aside, it is, after all, your nose.

Interestingly, however, more and more men and women are choosing to make only small changes, to slightly reshape their nose in a way that does not deny their ethnicity.

There are three factors that can make ethnic rhinoplasty more challenging:

  1. Darker skin tends to be thicker. That applies whether you’re of Middle Eastern, Indian, African, or Hispanic descent. If you nasal surgery involves subtle structural changes (especially tip refinement), thicker skin can conceal those changes. However, an exceptional surgeon can very delicately thin the skin on the underside, so the changes made to your nose can be revealed.
  2. Most people whose nose has a large, bulbous tip also have a comparatively short septum. If your surgeon will need a bit of cartilage to make structural changes, it is usually taken from the septum. But if yours is short, there may not be enough cartilage available, and that could limit surgical options. Any procedure that makes your nose narrower on the outside also makes your airways narrower, which can increase the risk of breathing problems later on.
  3. If you are considering surgery to elevate the bridge of your nose, be aware that old-style surgery used silicone implants, which can increase risk of infection. At BHSSCI, we use only the most advanced, cutting-edge techniques. So we use natural cartilage (nasal, ear, or cadaveric) to raise the bridge. If you are looking for only a little elevation, we might recommend a “liquid nose job” instead, using dermal filler injections to add volume. Fillers are fast and simple, but they are not permanent.

Rhinoplasty Costs

Surgical procedures are individually tailored for each patient, so the cost varies from one patient to another as well. At BHSSCI, the cost of a primary rhinoplasty can range from about $15,000 to $40,000, depending on the complexity of the procedure and the length of time it takes to complete the work. (For example, a tip refinement will not so complex, whereas surgery that involves both cosmetic and reconstructive changes is most challenging.)

Your total fee will include a variety of costs such as:

  • Surgeon’s fee
  • Anesthesia fees
  • Surgical facility or hospital costs
  • Post-surgery medications

The cost of revision rhinoplasty can be higher, because the surgery is more complex. Existing scar tissue from previous surgery can make the procedure more difficult to perform, and it can increase the risk of infection. Your surgeon may have to undo the work done initially and start over to make the changes you desire.

We will provide you with a detailed cost breakdown before you make a final decision to have rhinoplasty. BHSSCI does not accept health insurance.

Rhinoplasty Results

Realistic expectations are the key to happiness for any kind of cosmetic surgery. There is no such thing as the perfect body, or the perfect nose. That doesn’t mean you can’t have a “better” nose, whether you want a different look or you just want to breathe freely. (Or both.) The most attractive nose is one which blends harmoniously with the rest of your features and the overall shape and structure of your face. 

Beauty is truly in the eye of the beholder, so if you want to change the nose you behold in the mirror, we’re here for you. Small alterations or dramatic change, achieving a look you like better can do wonders for your confidence and self-image. What result could be better than that?

Rhinoplasty is appropriate for patients of all ages. While surgical alterations are permanent, your face will continue to change naturally as you age.

Rhinoplasty Before and After

How do you know what realistic expectations look like? One of the best ways is to look at before and after photos of actual rhinoplasty patients. Of course, you won’t find anyone who looks exactly like you. We each have a unique combination of facial structure, skin type, nose shape and size. But looking at pictures of other people can give you an excellent idea about what a nose job might do for you.

The more you understand the possibilities, the more clearly (and realistically) you can envision changes to your own nose. And the more clearly you can convey your desires to your surgeon.

The more before and after photos you review, the better. It is most important to look for people similar to you – in age, gender, ethnicity, and the elements of their nose they desired to change. You can find a multitude of photos on the internet, and that’s a good starting place. However, the most important thing you want to know is what can this prospective surgeon do for me? 

You will literally be putting your nose in someone else’s hands, and that requires trust in their technical skills and artistic talent. So ask to see before and after photos of your prospective surgeon’s own patients.

Reviewing photos will help you understand what rhinoplasty can and cannot do, so you can make a well-informed, confident decision about whether nose surgery is right for you. You will also be confident that you’ve teamed up with the right surgeon, one who can help you achieve the results you desire, whether it’s an enhanced appearance or better breathing.

Rhinoplasty

Rhinoplasty

Am I a Good Candidate for Rhinoplasty?

Simply put, rhinoplasty can be life-changing. It can revise the appearance of your nose (and, as a result, your entire face). It can put an end to lifelong breathing problems. Almost any adult is a good candidate for rhinoplasty, as long as you are old enough that your face is no longer growing (typically around age 18). At the other end of the spectrum, there’s no such thing as “too old for a nose job.”

Regardless of age, you should be in good overall health, a non-smoker, and have those realistic expectations we talked about earlier. And speaking of expectations, rhinoplasty is a good idea only if you’re choosing change to make yourself happy. No one but you should dictate how you feel about your nose or if you should alter it in any way.

Beyond cosmetics, correcting breathing problems is life-changing in a more literal way. Inability to breathe properly leads to annoying snuffling and snoring, but it also deprives your body of the oxygen it needs to function well and stay healthy. People who have chronic difficulty breathing can develop dangerous secondary health issues.

Alternatives to Rhinoplasty

Earlier, we mentioned a procedure called a “liquid nose job.” The name sounds somewhat silly, but the treatment is very real. Under certain circumstances, we can sometimes use dermal fillers to add volume or smooth the surface appearance, rather than resorting to surgery. There are several benefits to a liquid nose job:

  • You might not need anything more than dermal fillers to smooth bumps, fill in depressions, lift a droopy tip, or even rebalance your nose if it is just slightly crooked.
  • Fillers can provide modest temporary change, a great option for those who don’t feel ready for surgery. You can see what your new nose could look like, then decide if that’s what you really want. Surgery later on is always an option.
  • If you’re still young and your face is still growing, rhinoplasty is not recommended. Fillers can provide a safe alternative, making temporary changes until you’re old enough for nose surgery.

A liquid nose job is not appropriate for everyone. However, we often use dermal fillers in conjunction with surgical techniques to achieve more precise results for rhinoplasty patients. While they can add a nice finishing touch, fillers must be renewed over time because their natural ingredients are slowly absorbed by the body.

Because dermal fillers require regular renewal, a liquid nose job may ultimately cost more than rhinoplasty, depending on your aesthetic goals and your age.

Rhinoplasty Risks

Every type of surgery comes with risks and potential complications. In general, these are issues such as bleeding, infection, and possible adverse reaction to anesthesia. In regard to rhinoplasty, major risks include:

  • Disappointing results. We’ve talked a lot about realistic expectations because no surgery can create the perfect nose. Your post-surgery nose may still have a slight bump on the bridge or it may still be slightly asymmetrical, but it can be dramatically improved.
  • Internal scarring. This can restrict airways, but we minimize the risk by using temporary splints for additional support immediately following surgery.
  • Infection – rare in normal healthy patients. At BHSSCI, patient health and safety are our top priorities, so all our surgeries are performed in our state-of-the-art surgical center.
  • Recurring nosebleeds.
  • Persistent numbness in or near the nose.
  • Persistent pain, swelling, or bruising.

During your personal consultation, your surgeon will discuss all the risks as well as benefits and make sure you fully understand them before going ahead with rhinoplasty. Surgery is very personal, so only you can make the final decision.

Rhinoplasty Recovery

We know you want the smoothest, shortest recovery period possible. We’re here to help with that, and we’ll give you detailed post-op instructions. The best way to ensure all goes well, and quickly, is to be proactive about your own health. Get plenty of exercise before surgery. If you smoke, you must quit at least two weeks in advance, and you can’t smoke after surgery, either. Smoking restricts blood flow, which is crucial for healing.

Immediately following your surgery, there will be stents inside your nostrils and possibly a cast across the bridge of your nose. We will remove these in a week, which is when you’ll get your first look at your revised nose. It won’t look that great, because it will take 2-4 weeks for bruising and swelling to dissipate. Residual swelling may not go away completely for several more months. But you’ll be back to work or other normal daily activities within a couple of weeks.

If your surgery involves only tip refinement, the recovery process will be as outlined above but much shorter. And if you chose a liquid nose job instead of surgery, you may have a bit of swelling or bruising right after your injection but there will be no downtime. Many patients refer to dermal filler appointments as “lunch hour” treatments.

Will I Have Scars from Rhinoplasty?

Closed rhinoplasty leaves no scars because incisions are made only inside the nose. The more refined open technique we use here at BHSSCI does involve an external incision, but it is tiny and placed at the base of the columella where the scar is not likely to be noticeable.

Follow Your Doctor’s Orders!

The written post-surgery instructions we give you to take home are not meant as suggestions. In order to recover as quickly and positively as possible, you must follow these instructions exactly. If you don’t you risk delay, infection and even potential damage to your surgical site or results.

We already mentioned the importance of exercise prior to surgery. Exercise is good after your procedure, too, as long as you don’t overdo it. You’ll probably feel pretty good, but you want your body to focus on healing. So a bit of moving around gets your blood flowing – which is good – but too much will redirect blood away from your nose.

So minimize your movements for the first week or two. No heavy lifting, no bending over that lowers your head, no strenuous exercise. Then you can gradually return to your normal routine.

Choosing the Right Rhinoplasty Surgeon

We’ve already mentioned how critical it is to choose the right surgeon to perform your rhinoplasty. You are putting your face in the hands of someone whose experience, skill, and artistic talent will determine the results you see. Here are some tips to help you pick the rhinoplasty surgeon who is right for you:

  • Verify that they are board certified in facial plastic surgery.
  • Ask about their specific rhinoplasty experience, especially in addressing your specific aesthetic and/or breathing problems.
  • Ask to review before and after photos of their patients who had concerns similar to yours.
  • Ask for references, and look for online ratings and reviews from former patients.
  • After all that, it comes down to comfort and trust. You’re choosing a medical partner to make a lifelong change in your facial appearance, improve your breathing, or both.

During Your Rhinoplasty Consultation

One-on-one consultation enables you to meet your prospective surgeon, and for them to meet you. Don’t feel shy about asking lots of questions, because that’s your job as a potential patient. If you’re nervous, we get it. Our job is to give you all the information you want and need, so you can make comfortable decisions. That means we’ll ask lots of questions, too. We will discuss: 

  • Your goals for aesthetic change and/or breathing improvement
  • Any medical conditions you have or medications you currently take
  • Your use of tobacco, drug and/or alcohol
  • Any previous surgeries you have had

This helps us get a good picture of your current health status, so we know you are a good candidate for rhinoplasty surgery. Your surgeon may also examine your face and take photographs or even some measurements. The best part? You will work together to explore how surgery can help achieve your goals, the outcomes you can reasonably expect, and potential risks.

About BHSSCI

Among the more than 25 world-renowned doctors who comprise our practice at Beverly Hills Sunset Surgical Center, there are several of the finest rhinoplasty surgeons available. They are trusted and recommended by Hollywood celebrities and numerous other former patients, big names and regular folks alike, all of whom wanted one thing: the best surgeon to help them achieve the best possible result.

We would be delighted to welcome you, too, as a patient at BHSSCI. You will receive the ultimate in care and comfort, not only from your surgeon but from our entire medical and support team.

Conclusion

There is a lot to think about when you’re considering rhinoplasty. We hope reading this material has been helpful, but we are sure you have more questions. Whether your question is “when can I schedule my surgery,” or you still need more information, we encourage you to contact our team at BHSSCI.

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