Rhinoplasty

Rhinoplasty NJ or nose job NJ: Dr. Kassir is a rhinoplasty surgeon in NJ and a leading rhinoplasty expert. Find rhinoplasty answers and see results from one of the best reviewed rhinoplasty surgeons in NJ.

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About Rhinoplasty

by Ramtin Kassir, M.D., F.A.C.S. | Learn More About Dr. Kassir

What is Rhinoplasty?

Rhinoplasty, or cosmetic nasal surgery, improves the shape and size of the nose. The procedure can remove a hump, change the shape of the nasal tip, and straighten the nose. The size and shape of the nostrils can be changed. The goal of rhinoplasty is often to achieve better harmony between the nose and the other facial features. Dr. Kassir is a triple board certified surgeon who has performed thousands of rhinoplasty surgeries for his patients and is considered to be one of the best Rhinoplasty surgeons in New Jersey.

Rhinoplasty has become one of the most popular facial plastic surgical procedures in recent years as more and more people seek to change the appearance of their noses. Many are unhappy with the nose they were born with while others have had the shape of the nose distorted from an injury. Disorders of nasal breathing and sinusitis often complicate the situation. A range of techniques are used to fully address the desired change in appearance as well as to improve nasal breathing and correct chronic sinus infections. Sinus surgery, if indicated, is done with endoscopes to avoid any visible incisions.

Rhinoplasty may be performed under general or sedation anesthesia on an outpatient basis. Most health insurance plans still provide some coverage for functional nasal surgery and sinus surgery.

Good Candidates For Rhinoplasty

Are you thinking about having a rhinoplasty surgery? Healthy teenagers and adults who wish to have an improvement in their nasal appearance are good candidates for the rhinoplasty procedure. The decision about having the rhinoplasty operation is a very important and personal one. You should first consult with Dr. Kassir at his surgical clinic in the Wayne, NJ, or Ridgewood NJ office before deciding on the operation. For most patients that undergo this nose job procedure, the results are life changing. Patients describe an increase in confidence and boost in self-esteem. The ideal NJ candidates for rhinoplasty are:

  • You are unhappy with the size and/or shape of your nose.
  • You have breathing problems limited to your nose.
  • You suffered an injury that has altered the look of your nose.
  • You have breathing problems.
  • You are over the age of thirteen.
  • You have good physical and emotional health.

How Much Does a Rhinoplasty Cost in NJ?

Rhinoplasty costs vary by surgeon experience and geography. It can range from $10,000 to $17,000, depending on what is being done. Revision rhinoplasties are on the higher end. Some insurances cover the functional parts of the surgeries (straightening a crooked septum, opening up sinus pathways, etc).

Does Insurance Cover Rhinoplasty?

Insurance may cover some of the functional aspects of rhinoplasty. In other words, those procedures that improve breathing:

  • opening sinus drainage pathways (endoscopic sinus surgery),
  • shrinking large turbinates (turbinate reduction),
  • straightening a crooked septum (septoplasty),
  • valve surgery (placing cartilage grafts to stabilize the breathing passage).

Different Kinds of Rhinoplasty Procedures:

Dr. Kassir performs many different kinds of rhinoplasty procedures in NJ, including:

Revision Rhinoplasty: Revision Rhinoplasty is performed when the initial rhinoplasty procedure is unsatisfactory.

Teen Rhinoplasty: Dr. Kassir is an expert in Teen Rhinoplasty in New Jersey.

Ethnic Rhinoplasty: Dr. Kassir commonly performs African American rhinoplastyAsian rhinoplastyHispanic rhinoplasty, and Middle Eastern rhinoplasty.

Celebrity Rhinoplasty: Dr. Kassir is a leading expert in celebrity rhinoplasty.

What to Bring to Your Rhinoplasty Consult:

  • Your desired surgery date
  • A list of the vitamins, medications, and ointments you use
  • Any medical history, your insurance card (to check for partial coverage), and any reported breathing issues
  • Your own edited photo (any angle you want changed)
  • A portfolio of reference photos and goals that Dr. Kassir can use to craft your digitally edited image
  • Knowledge of Your Financing Options (Private, Care Credit, Alphaeon, Credit Care, or a Combination)
  • Excitement! A new nose can change your life. You make look younger, cuter, happier, and even less tired with the nose that was meant for you. This is exciting and we want you to be just as excited as we are. 

Rhinoplasty: Questions & Answers

Is it bad to bump the nose following rhinoplasty?

It is important that patients keep in mind the fragility of the nose following the rhinoplasty, especially considering the osteotomies (purposeful breaks in the nose) which were likely created during the procedure. Thus, keeping the nose protected is a top priority. By bumping their nose, patients risk septal hematoma (accumulation of blood in the nasal septa) which must be treated in the ER.

Can cartilage shift even after a patient is recovered from a rhinoplasty and healed?

Unfortunately, yes. Cartilage makes up the framework of the nose in addition to the nasal bones, so with time, slight shifting does occur here and there. Patients with crooked noses will often find that cartilage and nasal bones have a “memory” and tend to grow in ways that were similar to the original deviation, so touch-ups may be necessary.

Does a crooked nose necessarily mean a deviated septum?

Not necessarily. While a deviated septum could create a crooked nose, problems in the alignment of the underlying cartilage (upper lateral, specifically) or bone may also play a part in creating a misshapen bridge. It is recommended that patients be professionally evaluated in a surgeon’s office.

Will my nose rotate upwards as the swelling heals post-rhinoplasty?

It depends where the swelling is. In some patients, there is swelling in the supratip region which weighs down the nose and causes it to droop. The subsiding of the swelling will thus cause the nose to correct itself and rotate upward.

What are the pros and cons of grafting during a rhinoplasty?

The pros of using grafts are mainly that it acts as additional support for maintaining the results of a rhinoplasty, particularly procedures which elevate the tip, and should not be avoided when they are warranted. By the same time, cartilage grafts should be used judiciously as they might NOT be needed and may actually lead to unevenness in the nose (which is why patients requiring cartilage grafts should go to an experienced surgeon).

What is the purpose of rasping the nasal dorsum?

The reason surgeons will rasp a nasal dorsum is that they wish to correct small dorsal humps that do not require osteotomies to fix. It is analogous to sanding a surface or filing nails in order to create an even, smooth surface.

What can I do about blackheads developing on my skin post-rhinoplasty?

Many times, the surgical tape applied post-rhinoplasty will trap sebaceous fluid underneath the skin, prompting acne breakouts. In this case, it is necessary for patients to be gentle in their cleaning, using mild exfoliators and asking their surgeon for advice.

Why is my nose larger on the bridge than before my septoplasty?

During septoplasties, surgeons will perform purposeful re-breaking of the nose (osteotomies) in an effort to correctly align the nasal bones, so a larger bridge on the nose may be the result of residual swelling from this.

Can I travel to Mexico to have a rhinoplasty done?

It is my recommendation to have a rhinoplasty done as close to home as possible. While there may be perfectly competent surgeons in Mexico, there is a chance for potential complications and issues in the post-rhinoplasty period which are best addressed by going to the surgeon who performed the procedure in the first place. This may prove difficult if the surgeon is in another country.

My nose is sensitive and clicks following a hit to the face. Is it broken?

These symptoms seem to point towards a broken nose. A CT scan may be necessary and a plastic surgeon should be seen immediately so that the nose can be corrected before it begins to grow in a dysfunctional manner.

Can nasal bones shift back after an osteotomy?

Sometimes, it is possible for a couple nasal bones to shift here and there which is why patients, especially within the first month post-op, should be extra careful not to disturb any areas on the surgical site.

Is the “work-ready” benchmark of 1 week post-rhinoplasty apply to more physically active jobs?

Depending on the degree of modification to the nose and the procedures performed, patients will generally be work-ready within 6 days to 2 weeks post-op. However, 2 weeks is usually the max, unless patients will be doing a heavy amount of exercise in which case, they are recommended to wait 4-6 weeks.

Can Laser Septo Control Correction correct a deviated septum?

Unfortunately, no. This is probably another market gimmick designed to dupe less-informed customers.

Who or what determines what kind of nose is possible for me during rhinoplasty? Can I get any nose I want?

The type of nose which you get post-rhinoplasty depends on your surgeon’s skill and what you bring to the table (existing nose, genes, etc.). The goal of surgeons is to modify an existing nose and correct for any defects which bother/inconvenience a patient, not substitute one nose for another. Giving your surgeon pictures of what your ideal nose, although not always possible to recreate exactly on the face of a patient, will give him/her a good idea of what you want.

Is a long nose only shortened by rotating the tip?

It depends on the nose which the surgeon is starting with. This type of technique is ideal for patients who have the combination of a droopy tip and a long nose. However, if the tip is normally rotated, there is no need to mess with it and the issue would be better resolved by shortening the septum and bringing the inferior tissues upward. Consultation with a surgeon is probably the best way to determine a patient’s course of action here.

Can rhinoplasty be done under local anesthesia?

It depends on the procedure. In our offices, we generally like to use general anesthesia to protect the patient’s airways, but tip rhinoplasties (which only work on the very bottom of the nose and do not involve the breaking of nasal bones) can be done under local anesthesia.

Can I use a tampon or pad during anesthesia for a rhinoplasty?

The only risk associated with tampon use during a rhinoplasty procedure is toxic shock syndrome, which is only an issue if you foresee not being able to change a tampon on a regular basis. Tampons themselves should not interfere with the anesthesia in any way.

Can I have fractured cartilage in spite of a negative X-ray?

Definitely. X-rays only show fractures in hard tissues such as bones and not soft connective tissue, like cartilage. Evaluation by a surgeon is probably the best avenue to determine whether cartilage is indeed fractured.

When can I go out in the sun post-rhinoplasty?

It is recommended that patients wait at least 4-6 weeks before going out into environments with high sun exposure. However, even then, it is advised that patients avoid direct sunlight contact with their surgery site and wear plenty of sunscreen, as the trauma undergone by the nose during rhinoplasty causes it to be much weaker and number and thus prone to burns and discolorations from UV rays.

What are some alternatives to surgery?

Although strategies for nasal beautification are not as effective or long-term as a full rhinoplasty, they can be good short-term fixes. The main alternative to surgery is the use of fillers like Restylane or Radiesse which camouflage defects by filling in areas around the site of defect. But, these must be used judiciously because, otherwise, the patient risks having too much filling in areas where it is not necessary.

Can I correct asymmetrical cartilage deposits?

It is difficult to answer this question, primarily because it is unclear where the cartilage deposits are. In the simplest case, a tip rhinoplasty can be performed via small incisions through which the excess cartilage will be shaved. However, there may be more complicated procedures which need to be performed.

My external splint fell off post-rhinoplasty. What should I do?

If it has not been a week post-rhinoplasty, I would recommend contacting your surgeon immediately. Splints are generally made to stay on for at least a week post-rhinoplasty.

Can the cartilage be fractured without breaking the bone in the case of nasal trauma?

It is certainly possible for nasal trauma to fracture cartilage and cause deviation of nasal tissues without actually breaking the bone. In this case, separation of the cartilages in the nose may be necessary for evaluation and cartilage grafts will be introduced to supplement weaken structures.

Can I remove the scabs in my nose post-rhinoplasty?

I would not recommend removing the scabs directly as it could lead to infection. Patients who wish to breathe better can apply saline or a water/hydrogen peroxide mix in order to relieve the crusting, but gentleness is key.

Can I use a Q-tip to clean the inside of my nose post-rhinoplasty?

After a period of a few weeks post-rhinoplasty, patients can begin to clean their nose gently with saline or a hydrogen peroxide/water mixture. However, it is crucial that they remain gentle while doing so, applying a slight rotational, rather than a pushing, motion.

How visible are the scars from a nose job?

In closed rhinoplasties, all incisions are made within the nostrils and thus the scars that form are generally imperceptible unless Weir reductions are also done to reduce nostril size. Open rhinoplasties, however, will also make use of an incision at the columella (the thin strip of skin between the nostrils) which risks more apparent scarring. However, in the hands of an experienced surgeon, even this scar will heal nicely.

What does ibuprofen do for swelling?

It is advised that patients avoid taking NSAIDs like ibuprofen simply because of the risks of bleeding which occur as a result of using them.

Why is my nose tip still swollen after surgery?

As stated in other queries, the true results of a rhinoplasty do not materialize fully until after a year post-op. Residual swelling particularly in the tip is extremely common among rhinoplasty patients, so no concern is necessary if this condition persists.

How much does alar base reduction cost?

If done under local anesthesia, this procedure will typically run within the $2000-$3000 dollar range. However, this cost can vary depending on geographic area, the patient’s choice of anesthesia, etc.

I’m having breathing problems and uneven nostrils post-rhinoplasty. Should I have revision rhinoplasty?

Depending on the timing post-rhinoplasty, this may be a simple case of residual swelling within the nostrils which can push around structures and block the nasal canal, leading to the two issues which you described.

Does the nasal tip drop after rhinoplasty?

Of course, after the surgery, the nose ages just like the rest of the body and drooping does occur. However, this only occurs at a gradual rate and is unlikely to look unnatural. For patients concerned with the possibility of an upturned nose following surgery, it is important to recognize that there will be significant swelling in the columella region (the bottom part of the nose where the incision was made) that will cause upward rotation of the nose, but this will dissipate over time.

How do I know when my nose is done developing?

Generally, when it comes to noses, there is no “magic number”. However, it is generally safe to consider rhinoplasty at ages 15-17 for girls and 16-18 for boys.

What is your opinion on gortex nasal implants?

It is a general consensus among surgeons that they prefer cartilage over man-made implants simply because there is less risk of infections and other complications.

Do you recommend Afrin nasal spray post-rhinoplasty?

Afrin should generally only be used when patients are flying, that is, when the changing pressures of take-off and landing increase the risk for nasal issues. Afrin simply decompresses the nasal passages, so patients post-rhinoplasty are better advised to use saline spray to clean their nose, etc.

Is keloid scarring post-rhinoplasty a risk?

Keloid scarring post-rhinoplasty is so exceedingly rare that I usually advise patients to not even worry about it.

Can thick skin impact recovery post-rhinoplasty?

At times, it can. Other than the issue of not draping over the cartilage and bone post-rhinoplasty, thick skin also presents other complications including subdermal fibrosis, increased risk of scar tissue, and fluid retention. However, this question is difficult to provide a general answer to and is probably best answered via an in-house examination if a patient with thick skin wishes to have rhinoplasty surgery.

When does swelling subside after the nostrils are narrowed?

With most alar base reductions, the swelling usually resolves completely within about a month post-op.

I had septal cartilage harvested to build my tip, but now it’s too long. What can I do?

Chances are the surgeon who built your tip add a cartilage graft. To return to the preoperative stage, the graft can be easily removed.

Why do some surgeons recommend massages post-rhinoplasty and others don’t?

Surgeons disagree over massage simply because of the underlying issue of whether pressure from the massage could alter the structure of the nose which was determined during the surgery. Some will claim, however, that it reduces swelling. There is not enough proof to really support either side, so it is more of a practice which passes from mentor to student.

Can I have breast augmentation and rhinoplasty at the same time?

As long as the patient is healthy enough to have both procedures at the same time and the surgeon of choice is qualified to do both procedures, there does not seem to be a problem with doing them together. However, care must be taken to avoid infection and this is done by choosing a well-qualified surgeon.

When does smell and taste come back after a tip-plasty and turbinate procedure?

Taste and smelling will generally be disturbed, particularly if work was done around the septum, for a period of a couple of months to a year. Speaking to an ENT might be the best option for figuring out how to hasten this process.

Can rhinoplasty surgery have a negative impact on my breathing?

Generally, in rhinoplasty surgeries, form and function come hand in hand; that is, creating an aesthetically pleasing, well-balanced nose will generally result in a nose where breathing and other functions are brought up to speed as well. Certainly, badly performed rhinoplasties can alter breathing, but the trick to avoid this is to find a surgeon who is qualified and has the proper credentials.

Can I shower after my cast was removed post-rhinoplasty?

Patients can shower after the splint is removed one week post-op. However, they are advised not to apply too much pressure while cleaning the nose.

How can my post-rhinoplasty callus be reduced?

Generally, it is normal for these types of humps to be present over the first several months post-op. However, if the bump is still present after several months post-op, it may be reduced via a rasping procedure that will only require local anesthesia and a few minutes in your surgeon’s office.

What are these white bumps inside my nose post-rhinoplasty?

Patients days into the post-op process may see white bumps that are representative of sutures that have not fully dissolved/healed yet.

Can pregnancy make my nose swell more after rhinoplasty?

It is common for nasal swelling to occur in women during pregnancy, regardless of whether or not they had a rhinoplasty procedure done. This is due to fluid retention.

Do rhinoplasty results really take a year to show?

In general, full healing (that is, full dissipation of the swelling from the procedure) will take up to a year to heal properly. However, the bruising and swelling which results varies widely depending on if osteotomies were performed, the type of rhinoplasty performed, etc. The majority of the swelling, however, in most cases will resolve itself within 4 months and the nose will generally be presentable to the public without significant issues within 1-2 months.

Can picking my nose cause nostril asymmetry?

It has been shown that repetitive stretching and pulling of the skin can cause irregularities, but this only occurs with constant pressure. Nostril asymmetry is more often caused by an irregularly shifted nasal midline that can be repaired surgically.

How much will hanging columella reduction cost?

This will vary within the $3,000-$5,000 range.

My nose tip dropped too much post-rhinoplasty. What can I do?

Depending on the time frame, I would wait until a year post-op to begin considering revision surgery. However, further support in the tip may be necessary via a strut graft.

What should I do for a flat nasal bridge?

If the flat bridge is from fractures, then osteotomies can be done to narrow a wide nose. If congenital then osteotomies may not be enough and dorsal onlay grafts may be necessary.

Can I smoke marijuana before/after my rhinoplasty?

My best advice would be to avoid doing this at least 2 weeks before and 2 weeks after surgery.

I want a smaller nose. Do I need a rhinoplasty?

In the case of reduction rhinoplasty, it is important for patients to keep their expectations realistic. The nose must be modified in a way that maintain the patient’s natural look and keeps it proportional to the surrounding facial structures. In addition, thick skin may also be more difficult to handle as it is more elastic. Consulting a surgeon is necessary to answer further questions.

How can I tell if I have thick skin on my nose or just excess cartilage?

This is probably best evaluated by your surgeon. However, for a rough method of evaluation, you can feel the difference between thick skin and cartilage by feeling your cheek and then feeling your ear. Thick noses can contain a mixture of both, however.

Can a broken nose be fixed under local anesthesia?

This can be done, especially if the broken nose is corrected within a week of the original trauma. However, if the broken nose is on a child, sedation or general anesthesia may be more appropriate given the painfulness of the needles.

What type of anesthetic is used during a rhinoplasty?

During a surgery such as this, a top priority among surgeons is the patient’s comfort and safety. Thus, we suit the anesthesia to your needs and wants. Patients can choose from local anesthesia (patient is fully awake and the area is numbed), local sedation (patient is given local anesthetic plus a sedative so that he or she falls asleep during surgery), or general anesthesia (patient is fully sedated and given a breathing tube). Patients with health problems may be recommended for the first two options as general anesthesia puts more strain on the heart and the lungs.

What part of the ear is cartilage harvested from in a rhinoplasty?

Generally, surgeons will look for cartilage grafts in the septal area as a first resort and will only use grafts in the ear when this is not available. However, if ear cartilage is harvested, it is taken from the central depression in the ear called the concha where the incisions are well hidden either from the cymba (the top part of the depression) or the cavum (the lower part of the depression).

Can a nose be made longer?

The nose can be made to appear longer via downward rotation of the tip or the introduction of extension cartilage grafts. However, this is a much more complicated procedure than shortening of the nose and so must be done by an especially well-experienced surgeon.

When can I go diving after a rhinoplasty?

It is advised that light exercise be postponed until 3 weeks post-rhinoplasty and more heavy contact sports be postponed until 6-8 weeks post-rhinoplasty. For diving specifically, due to the risk of potential nose bleeding (and the problems with wildlife that might ensue), I would recommend waiting at least 8 weeks for the nose to fully heal.

Is light sniffling and nose breathing 1 day post-op fine?

As long as you don’t force either, both of these minor exercises of the nose should not do any permanent damage to the results.

Do bones swell post-rhinoplasty?

No, the bones do not swell. The tissues around them, like the skin and other softer tissues, do though.

Should I have an open or closed rhinoplasty?

Patients should generally not concern themselves with the technique of open or closed rhinoplasty as much as the skill of the surgeon, as the results of both are very much comparable in many cases.

My nose should be healed years post-rhinoplasty, so why do I still experience some swelling when I consume alcohol and/or cigarettes?

This is nothing to worry about. After a year post-op, the nose is more or less fully healed. Therefore, the swelling which occurs when cigarette smoke is in the air is probably more of a sign of inflammation or slight allergy due to the irritation of cigarette smoke. Minute swelling can also be caused by alcohol which is a vasodilator that causes the nose to become thicker (“drinker’s nose”).

Can I take Zyrtec-D prior to my rhinoplasty?

I would advise against it because of one of the ingredients in Zyrtec-D known as pseudoephedrine which is a stimulant that can increase blood pressure and heart rate, thus creating a slightly increased risk of bleeding during and post-surgery. Contacting your surgeon and the anesthesia department of the hospital where you will be having this procedure done is the best option here.

I have a cartilage-like growth on my lower nose years after rhinoplasty. What is it?

This sounds like a shifted cartilage graft. It might be best for you to evaluate this with your surgeon.

Does weight gain impact rhinoplasty results?

No, not at all. Nasal tissue has very little fat, so weight gain or loss will not impact the results of a rhinoplasty.

Can I reduce my large nose to a much smaller nose?

It is important for patients to recognize that surgeons have a responsibility to modify the nose in a way that makes it look natural in relation to the rest of the surrounding facial features. Thus, while surgeons can reduce a nose via manipulation of the underlying cartilage and shortening of the septum, it must look aesthetically pleasing.

How long is my tip numb following rhinoplasty?

Generally, numbness in the tip should begin to improve within 6-12 weeks following the procedure, but may take up to a year to fully resolve itself.

Does the nose get thinner with age?

Over time, the tissue of the nose (skin, etc.) will begin to thin gradually. However, this does not alter the general width of the nose, that is, the features molded by the cartilaginous and bony framework, so the nose does not get thinner in this respect.

What does a nasal valve collapse surgery entail?

Generally speaking, this procedure involves the use of cartilage grafts to strengthen the cartilage on the inner nasal wall and to widen the openings. Collapse of the internal nasal valve requires a spreader graft, which is more intensive. Collapse of the external nasal valve may be alleviated with a smaller graft.

How much of a difference can rhinoplasty make for a bulbous nose?

A tip rhinoplasty is, in most cases, the best course of action for a bulbous nose because it can reduce the tip area without changing the nasal bones. However, it is important for the patient to realize that true results will not materialize until about a year or two after the procedure is completed, so patience is a major key here.

Can I use silicone for nose bridge augmentation?

Most surgeons, including myself, would prefer to use the patient’s own cartilage either from the septum or the ear as this has the largest potential for long-lasting results.

When can I do intensive cardio post-rhinoplasty?

It is probably best to wait 4-5 weeks or so before beginning “Insanity-type” cardio workouts simply because of the risk of increasing blood pressure and inducing nosebleeds.

My nostrils flare too much when I smile. What can I do?

Patients with this condition may benefit from a Weir excision in which skin from the inside of the nostril is removed and the hole is tightened to prevent excess spreading during smiling. However, even non-surgical options like Botox could help with this problem by relaxing the muscles that spread the nostrils.

Why is my healing process so slow after my alarplasty?

Like most rhinoplasty procedures, it will take a full year before all the results of an alarplasty show. In the meantime, it is best for patients to stay out of the sun, avoid smoking and just generally follow the doctor’s instructions.

Does using a nasal splint longer than a week help?

Not usually. One must remember that the nasal splint goes OVER the surgical tape underneath, and both of these measures are used to reduce swelling post-rhinoplasty. At 7 days post-rhinoplasty, the nasal bones and cartilage are usually stable enough to not require the splint anymore.

Should a rhinoplasty surgeon be an ENT doctor?

The surgeon doesn’t necessarily need to be an ENT doctor. Both otolaryngologists and plastic surgeons are perfectly capable of doing rhinoplasties, but patients should take care to check their credentials. If the doctor is board-certified with plenty of experience doing your specific types of surgery and satisfactory before-and-after galleries, you should be in good hands.

Why is my nose still bulbous 2 years post-rhinoplasty?

Especially in thicker-skinned individuals, this could very easily be caused by the maturation of scar tissue which can contract and thus pulls the nostril sides downward, giving the appearance of a bulbous nose. Unfortunately, the only alleviation for this condition comes in the form of a revision rhinoplasty. Steroid injections would help initially when the scar was beginning to form.

There is still swelling years post-rhinoplasty. Is something wrong?

This may be something that is best evaluated by your surgeon, but the likely cause of this is poor lymphatic drainage and scar tissue which may have accumulated.

I delayed my splint removal by a couple of days. Is that bad?

Absolutely not. Surgeons will typically wait for about a week before removing the splint for safety reasons, but delaying it will not impact results at all.

How can I fix my hanging columella and how much will it cost?

A hanging columella is treated very simply under local anesthesia in which the surgery basically consists of trimming the columellar cartilage to an appropriate length. It is a very easy procedure that should not cost more than $3000 or so to do.

How can I fix my pointy nose?

A rhinoplasty is probably the best option for patients looking to decrease the projection of their nose and adjust their tip cartilages in an appropriate manner.

Are uneven nostrils normal post-rhinoplasty?

As I tell my patients, it is key that they remain patient in the post-rhinoplasty period. The first few weeks post-rhinoplasty will be accompanied by a great deal of swelling and bruising that will skew the appearance of the surgical results and make them look significantly worse than they actually are. It is best to wait at least 6-8 weeks to evaluate for asymmetry.

I still bleed from nasal scabs years post-rhinoplasty. Is that a problem?

This could be attributed to nasal vestibulitis which can treated with hydrocortisone cream. However, it may also be necessary to cauterize the areas of bleeding as the nasal lining might be overly thinned.

My baby’s nose is flat. Should I be concerned?

Especially during puberty, there will be a great deal of growth and changes in the nasal area. Parents should refrain about worrying about a child’s nose until well into their teenage years.

When can I wear makeup after a rhinoplasty?

Because of the inherent difficult in keeping the splint dry when there is makeup next to it, it is recommended that patients wait until the splint is removed (1 week post-rhinoplasty) before applying makeup.

Will my tip drop years post-rhinoplasty?

After a rhinoplasty, the nose behaves just like any part of the body in that it follows a natural aging process. Tip drooping is a significant part of the aging of the nose and even applies to noses that have undergone rhinoplasties. Consider this: Rhinoplasties turn back time in terms of nasal aging, but they do not freeze it.

When should I blow my nose post-rhinoplasty, and why shouldn’t I do it before then?

Blowing the nose prematurely can result in bacteria getting into the internal incision sites. In addition, pushing on the nose during the blowing process may cause shifts in the cartilage and bone which the surgeon worked so hard to avoid. Patients can safely blow their nose 1 week or so post-op.

What is an I-implant versus an L-implant?

An L-implant shapes the columella area (bottom of the nose) and the dorsum area, while the I-implant only shapes the dorsum area. Patients may want to reconsider getting these silicone implants, however, and may want to instead opt for natural cartilage from the septum or the ear.

I removed blackheads from my nose by squeezing it post-rhinoplasty. Did I damage anything?

Unless the manipulation occurred within the first few days post-rhinoplasty, there is little to worry about for patients who did this. Temporary swelling may occur, but this is nothing to worry about. However, I would recommend against squeezing them in the future because it could cause bacterial infection.

Can Flonase cause MORE swelling post-rhinoplasty?

In reality, Flonase via its active ingredient fluticasone is expected to reduce swelling, but can cause the opposite reaction in 1/100 or so of its patients. However, I would advise against using any unnecessary sprays and perhaps just sticking with saline. Consult with your surgeon about this, though.

How do I remove this dried blood from my nose post-rhinoplasty?

Post-op cleaning procedures are best addressed by the surgeon who performed the procedure. However, patients who have significant amounts of dried blood on the inside of the nose should have most of this debris removed by the surgeon, and then use saline nasal spray at home to maintain a clean nose.

Would I know if I accidentally pulled out a stitch post-rhinoplasty?

While pulling out stitches by accident does not always cause pain, it is probably best for patients to speak with their surgeon if they suspect that a stitch was pulled out. Removing one stitch accidentally will not necessarily cause any damage, but evaluation will not hurt.

There is hollowing under my eyes post-rhinoplasty. Did I do something wrong?

Likely not. This is probably just residual swelling. Give it time to heal.

Why is my nose tip still crooked post-rhinoplasty?

Swelling in the tip, the hardest-hit area in terms of trauma, tends to persist for about a year and can distort the appearance of results. Please be patient in evaluating your results.

Will rhinoplasty affect my voice?

Generally no, other than during the initial period when there will probably be some nasal congestion that occurs (but this should clear up). The biggest concern in terms of vocal sound will be from the intubation needed to keep breathing up during general anesthesia application.

Can I laugh or smile following a septorhinoplasty?

Of course! Patients are told to avoid strenuous activity like exercise for 6 weeks or so post-rhinoplasty, but smiling and laughing does not go under this category.

There is dead skin on my nose post-rhinoplasty. Can I scratch it off?

During the first couple of weeks post-rhinoplasty, it is probably best to advise against moving or disrupting the nasal structure in any way. It would be best for patients to ask surgeons for their recommendations in these cases.

How much does the nose grow during the teenage years?

As you probably learned in your middle school health classes, puberty is a time of great changes for the body and, as such, it is also a time of great changes for your nose. Before nasal growth stops permanently in one’s 20s, it progresses extensively in the teenage years and features which stood out before on the nasal area will stand out further (bumps will grow, etc.).

Why can’t I have the smaller nose which I want?

It is important for patients to recognize that, sometimes, a nose can be reduced to the point where it is simply not natural-looking in relation to the rest of a patient’s facial features. We as surgeons have a responsibility to not only fulfill a patient’s needs, but to stay realistic. Think of this way. We do not substitute one nose for another, but rather modify existing noses and correct defects. We maintain your original nose but tweak it, rather than giving you a new one.

Does the nose become smaller following rhinoplasty surgery?

Due to the contraction of scar tissue as well as the reduction of residual swelling, the nose does indeed decrease in size over the course of the post-rhinoplasty period to match the expectations (hopefully) of the surgeon and the patient.

How much is dorsal hump removal?

Dorsal hump removal is generally a component of rhinoplasty and thus the costs of it will be very much in line with that of a typical rhinoplasty. As stated before, geographic area, equipment used, and other factors deeply impact the cost of these procedures, but an average rhinoplasty will run somewhere in the area of $5,000 to $10,000.

What is a bilateral turbinectomy?

A turbinectomy is a procedure which reduces the size of the nasal turbinates which are curved bony structures on the nose which contain mucous membranes. Enlarged turbinates may block nasal airways and so can be removed (bilateral means removal on both sides of the nose).

Why does the skin thicken after a rhinoplasty?

Unnatural thickening of the nose, other than from swelling, may be caused by the buildup of scar tissue underneath the skin, particularly if the patient has had multiple rhinoplasties. This can be solved by cortisone or Kenalog injections.

If I already have a broken nose, do I need to wait longer before getting a rhinoplasty?

Absolutely not. Because rhinoplasties often require osteotomies anyway, I would recommend that patients, if they do have a broken nose that they wish to have repaired, come after 5-7 days but no later than 2 weeks post-injury. At the 2 week mark, the bones will have already begun to heal and it may be more difficult for surgeons to correct the original defect.

How can evaluate if my septum is swollen?

This can usually be done with a nasal speculum in a surgeon’s office which can distinguishes healthy septum tissue (pink color) from inflamed septum tissue (red color).

Did sunburn do permanent damage on my nose post-rhinoplasty?

In the first 6 weeks post-rhinoplasty, blood supply to the nose is relatively weak and the surrounding nasal structures (cartilage, bone, etc.) are noticeably less strengthened. It is thus best to avoid sun exposure as much as possible. With that being said, minor sunburn is not going to ruin your rhinoplasty. Just be more careful.

Rhinoplasty Recovery Time and Downtime?

“At 2 weeks 80% of your swelling will be gone, at 2 months 90%.”

Social life Recovery

1. You will wear an external nose splint and tape for 1 week to protect and set the nose during this initial stage of healing. Removing it too early may cause damage and can ruin the surgical work.
2. Your nose will be “noticeably” swollen for 1-2 weeks. By the end of the 2nd week a casual observer won’t be able to notice without careful inspection or knowledge that you had surgery.
3. Bruising resolves in 1-2 weeks, and varies by the patients tendency to bruise. Over the counter Arnica may help reduce bruising.

Physical Recovery
Swelling in some areas may take several months to a year to “completely” resolve (the majority will be gone 2 months). You will be following up with Dr. Kassir until you have your final nose.

What is an open roof deformity?

An open roof deformity occurs when surgeons attempt to rasp (file) away a larger dorsal hump. Think about this situation as taking away the top 1/3 of the roof of a house, where you leave a rectangular hole in the middle. This is essentially what an open roof deformity looks like, and it can be resolved by osteotomies which are controlled fractures of the nasal bones that allow them to be angled inward to cover up the hole.

When can I play soccer post-rhinoplasty?

Patients can conceivably begin playing contact sports at a period of 6-8 weeks, with most surgeons suggesting waiting until the first 8 weeks simply because of the risk of bumping/breaking the nose in contact sports like football or soccer.

How can I correct my bulbous tip and upturned nose?

Correction of the bulbous tip would be the easier problem and can be solved by thinning the lower lateral cartilages in the tip and stitching them together to create a narrower defined tip. An upturned nose is more difficult and can be corrected in several ways, including the use of grafts or weakening the suspension elements of the nose and repositioning/securing the tip in a more preferable position by suturing the tip cartilages to the skin.

How can I fix a natural ski-slope nose?

A natural ski-slope nose may be best addressed by inducing less projection of the tip (deprojection) and perhaps placing some septal or ear cartilage along the patient’s supratip area to introduce fullness into the area.

Will I experience empty nose syndrome after a rhinoplasty and turbinectomy?

Both of these procedures were likely performed to correct a breathing defect. If by empty nose syndrome (which is not a real condition) you mean that the turbinates have been fully removed, this is not likely unless your surgeon went hyper-aggressive on the turbinate removal —- which is not medically advised at all. I would not worry about this.

Are there any side effects of a rhinoplasty?

The most common side effects of a rhinoplasty are relatively mild and include bruising and swelling which dissipates within weeks to months following the procedure. Some much rarer risks include bleeding (which is more of an issue for patients with a history of using blood thinners and NSAIDS), scarring which can be corrected with steroid injections, and potential infections which can be mitigated in the hands of an experienced surgeon.

Did my rhinoplasty age me unnaturally?

It is unlikely that patients who have a rhinoplasty done demonstrate signs of premature aging (crow’s feet, wrinkles, etc.) that can be traced back to the procedure. Often, loss of volume to the face due to weight loss or other more obvious factors like sun exposure or smoking are to blame for signs of aging, in which case the aging can be disguised via fat grafting and other measures.

Is a growing dorsal hump normal in the 20s?

Probably not, as nasal growth tends to stop soon after puberty (15-17 for girls, 16-18 for boys). This may be the sign of a callus formation, or the buildup of cartilage and bone.

Is reduction of my bulbous tip going to a problem with my thick, oily skin?

For patients with rhinophyma (excessively large sebaceous glands which cause the nose to appear large), it is important to recognize that the results of a rhinoplasty will not be as dramatic as a rhinoplasty on a patient with thinner skin. However, sebaceous glands can be reduced with a CO2 laser procedure, which can help with the results of the rhinoplasty a little bit.

How does the nose change as you grow older in terms of height?

What people often see as the nose “growing” as they become older is a simple drooping of the tip which creates the illusion of elongation.

Is “Nose Secret” an effective rhinoplasty replacement?

Many gimmicks like these work to simply temporarily compress nasal tissues, but do not lead to any substantial changes. There is no substitution for professional work when it comes to optimizing nasal structure.

Is it safe to cough and sneeze post-rhinoplasty?

It is recommended that patients, when sneezing or coughing post-rhinoplasty, use their mouth as much as possible in order to relieve unneeded pressure from the nose. Especially during the first week, take care not to blow your nose if not necessary.

Can I have Jennifer Aniston’s nose?

This depends on how her nose works with your existing facial features and how similar your noses are. It is always good to bring in pictures to your surgeon’s office to get him/her a sense of what you want your final result to be. However, patients must realize that celebrity noses do not necessarily look good on every face and that the surgeon can only modify existing noses, not create new ones.

Can rhinoplasty make my upper lip bigger?

Because of the close relationship between the nose and the upper lip, changes in the nose caused by a rhinoplasty CAN influence how the lip looks. For instance, heightening of a drooping nasal tip and removal of a hanging columella can make the upper lip longer. However, there is no direct change in the structure of the lip during this procedure.

I have an asymmetrical nose from squeezing blackheads. What can be done?

It is unlikely that simply squeezing a nose caused any major form of nasal deformity. However, if the nose is indeed asymmetrical, the patient have a consultation with a board-certified, plastic surgeon to determine what can be done.

Why does my nose whistle when I breathe post-rhinoplasty?

Whistling in the nose post-rhinoplasty is generally caused by a small opening, usually a minor septal perforation (hole in the septum of the nose). This may have been caused by the harvesting of septal cartilage and should be evaluated by your doctor.

Can rhinoplasty correct asymmetrical nostrils?

Asymmetrical nostrils may be the result of an uneven septum which can easily be corrected with a rhinoplasty procedure. However, in the case that they are not, rhinoplasties can correct them still, but the procedure is much more difficult and involves the cutting away of skin from the nostril area.

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Disclaimer: This site only provides information about cosmetic surgery and this information is not meant to be taken as medical advice. For more information about plastic surgery, contact Dr. Kassir.