Rhinoplasty (nasal surgery / nose job) – One of the most commonly performed cosmetic surgical procedures is rhinoplasty. Sometimes, patients refer to this as a “nose job.” Certain patients are displeased with the size, shape or configuration of the nose given to them by nature; other patients are unhappy because they have a crooked nose, a hump on the nose or other abnormalities as a result of trauma (nasal fractures, blunt injuries to the nose, etc.). Regardless of the cause of the undesirable nasal contour, there are effective techniques for recontouring the nose and giving it a more aesthetically desirable shape.
Dr. Handel specializes in “natural looking noses.” For many years, plastic surgeons would perform the same operation in virtually all of their rhinoplasty patients, often removing too much bone and cartilage, sometimes, shortening the nose too much giving it an excessively “upturned” appearance, and also causing problems with the nasal airway. Fortunately, in recent years, there has been an evolution in the approach to rhinoplasty. Dr. Handel has adapted the newer techniques into his practice. These techniques are designed to remove the problem that bothers the patient (excessive nasal dorsal hump, excessively wide nose, flaring nostrils, etc.) but to result in a very “natural appearing” nose.
Typically, the surgery is performed entirely through incisions on the inside of the nose (in the nostrils) so there is no external scarring. This is known as a “closed rhinoplasty.” Another option is to combine the closed rhinoplasty incisions with a small horizontal incision across the columella (base of the nose), which gives increased exposure to the underlying bony and cartilaginous structures. This type of operation is known as an “open rhinoplasty.” Dr. Handel has decades of experience with both open and closed rhinoplasty and will recommend the approach that he feels will work best in your particular situation.
Sometimes, patients have breathing abnormalities as well as cosmetic concerns. The nasal airway may be compromised because of a crooked or “deviated” nasal septum. At other times, there is scarring and vestibular atresia from previous rhinoplasty surgery. Certain patients, particularly those with chronic allergies, have enlarged turbinates. Each and every one of these abnormalities that can contribute to compromised airflow through the nose can be treated by Dr. Handel at his Beverly Hills Cosmetic Surgery Clinic at the same time as the aesthetic rhinoplasty.
Rhinoplasty typically is performed under general anesthesia on an outpatient basis. The operation does not result in very much (if any) postoperative pain. There is usually tape and a plastic splint on the outside of the nose that remain in place for about a week. After these are removed, patients have to be careful for an additional two weeks to avoid any injury or trauma to the nose that might displace the newly reconfigured structures. The risks of rhinoplasty are small; most patients achieve very good results with very few complications. At times, patients are not completely satisfied with the appearance of their nose and request additional minor changes. These usually can be performed safely on an outpatient basis. Only about 5% of patients who undergo rhinoplasty request an additional revision.