Rhinoplasty

Rhinoplasty NJ or nose job NJ. Dr. Kassir is the best rhinoplasty surgeon in NJ. Find rhinoplasty NJ answers and see results from one of the best New Jersey rhinoplasty surgeons.

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About Rhinoplasty

by Ramtin Kassir, M.D., F.A.C.S.

Do you have any problems breathing through your nose or do you have chronic nose or sinus complaints? Has a prior injury made your nose out of proportion to your other facial features?

Rhinoplasty or nose job surgery, is the surgical procedure that involves changing the shape and size of the nose. Dr. Ramtin Kassir MD performs this procedure for his New Jersey patients that involves reshaping the nasal bones and cartilages to produce a balanced and harmonious nose that blends with the person's facial features.


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 and NYC.

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, 799 Park Avenue, NYC, 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 and NYC 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 fifteen.
  • You have good physical and emotional health.

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 rhinoplasty, Asian rhinoplasty, Hispanic rhinoplasty, and Middle Eastern rhinoplasty.

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


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Rhinoplasty: Questions & Answers

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.

Does massaging the nose after rhinoplasty help?

It is generally recommended that, unless done by the hands of a surgeon, patients avoid massaging the nasal area post-op. This is because the subtle pressures of the hand may create shifts in the nasal structure that could cause major problems later on

Can cartilage be added to my nose to give it shape?

Absolutely, this can be done with a graft. In rhinoplasties, cartilage grafts are the main types of grafts used and are taken, in order of preference, from the septum, the bowls of the ear (cymba or the cavum), or the ribs.

Can rhinoplasty correct flaring nostrils?

Nostril flares can be corrected with procedures like the alarplasty/alar base reduction in which the nostrils are narrowed and an alar base resection is performed with the help of a crescent-shaped wedge removal in the nostril wall. However, this procedure is rather difficult as it entails extreme precision in order to reduce the likelihood of asymmetrical nostril development.

Why do I have upper eyelid swelling post-rhinoplasty?

Especially if an osteotomy was performed, this is a perfectly normal symptom of a rhinoplasty. Patients are advised not to concern themselves if something like this were to happen.

How can I tell if I have thick nasal skin?

The best way to evaluate thickness is probably by pinching individual portions of the nose from top to bottom and examining how thickness increases going in this direction. Thick skin is generally relevant in the tip and tends to be rather oily. If the patient easily manipulate the skin over the tip, it is thinner.

I’m coughing up bloody phlegm after my rhinoplasty. Am I dying?

Especially in the case of a combined rhinoplasty and septoplasty/turbinate reduction, patients can expect to cough up bloody phlegm in the weeks post-rhinoplasty. However, this should not be an ongoing problem and should correct itself soon afterward.

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.

What is alar flaring?

The ala refers to the lower sides of the nose where the nose joins the cheek and alar flaring refers to an ala that has more curvature than necessary and does not slope gently to meet the cheek. This makes the patient look more angry, as this is a typical evolutionary sign of anger.

Can I cause an infection by picking my nose post-rhinoplasty?

Generally speaking, patients should take care not to exert any pressure on surgical areas post-rhinoplasty. If the crusting bothers patients that much, they may be better served with saline spray.

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.

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.

Can a wide, flat nose be fixed via rhinoplasty?

A wide, flat nose is typically among certain ethnic communities, particularly those of East Asian or African-American ancestry. Cartilage grafts from the septum or the ear will often help adjusting the nose in order to give it more “height” and protrusion and this can be done during a rhinoplasty.

How long does tip hardness last?

Surgeons generally advise their patients to count on ¾ of the swelling post-op to dissipate within 3-4 weeks post-op and then for the rest of the swelling to disappear within the course of a year post-op.

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.

What causes polly beak deformity?

Polly beak deformity, the common name given to supra-tip fullness, can be seen due to excision of dorsum just above the tip and also from poor nasal tip projection, both of which give the impression of an unnatural curve at the tip.

Can shaving the nasal bones reduce the width of the nose?

Theoretically, yes. However, this is a relatively temporary fix and also makes the lower nose look much wider and misshapen. In cases where the bridge is seen as too wide, a full rhinoplasty may be required, complete with osteotomies (which break the bone in a purposeful manner).

Why did my surgeon ask me to remove the splint myself post-rhinoplasty?

This is very unusual for surgeons to ask for patients to remove the splints themselves, simply because tugging on the splint and the still-delicate nasal tissue underneath can drastically alter the results of the procedure.

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.

What should I do about an infection post-rhinoplasty?

This is probably best addressed by having an evaluation with your surgeon. He/she will likely take a culture of any drainage which may occur and prescribe antibiotics to fight the infection. Do not try to treat it on your own.

I do not have a good credit score and so, cannot use CareCredit to fund my rhinoplasty. Anything I can do?

Unfortunately, while surgeons would be open to helping you, it is important that you find a way to pay them for their service. I would recommend that patients achieve a degree of financial stability prior to scheduling surgery, especially since revision procedures may be needed.

I removed a dissolvable stitch after a rhinoplasty by accident. Should I be concerned?

Given that stitches will generally dissolve within 5-7 days post-op, there shouldn’t be any problem with accidentally pulling out a stitch. No concern is necessary, but be careful not to remove more.

Is it possible to refine the sides of my nose with a rhinoplasty?

It really depends on the problem and this matter would be best addressed with an in-house consultation with the surgeon. However, this can be done via osteotomies.

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.

What is the cost of a deviated septum plus rhinoplasty surgery?

Again, the costs of a rhinoplasty surgery will vary depending on a number of factors including geographic area, qualifications of the surgeon, equipment used, etc. However, a general ballpark for this type of surgery may entail somewhere between $5000 and $10,000. I would advise patients to place less priority on cost and more on the qualifications of the surgeon, because corrective surgery is often much more expensive than first-time procedures.

I have breathing problems and a cracking noise in my nose. What’s wrong?

This problem is probably best addressed by an examination in a qualified surgeon’s office. However, pure speculation indicates that this may be an issue of the nasal conchae or caused by septal deviation, both of which require surgical solutions.

Can I make my nostrils smaller without surgery, especially after a recent rhinoplasty?

Without surgery, there is no option of reducing nostril size. This procedure consists of taking skin from the inside of the nostril via removal of a crescent-shaped wedge. However, it is recommended that patients wait at least a year post-rhinoplasty to have other changes made on the nose.

Can I clean out dried blood one day post-op?

Most surgeons will recommend that patients utilize saline solution and apply it to problem areas via Q-tip, and then use another Q-tip to then absorb the remaining crusted blood loosened by the first Q-tip.

Can facial exercises post-rhinoplasty hurt the nose after rhinoplasty (e.g. Smiling, lifting the cheeks, etc.)?

This should not have a major effect on the rhinoplasty procedure. However, patients are advised that in the period of a couple weeks post-op, the nasal bones still aren’t fully solidified and should be treated carefully.

I have a hole in my septum, but it does not go through all the way to the other side. Is it a septal perforation?

This may be a question best answered by your surgeon, but a hole which does not go all the way through the septum does not constitute a septal perforation.

How long should I not drink alcohol prior to surgery?

As a benchmark, try to avoid anything that increases the risk of excessive bleeding during surgery starting 1-2 weeks prior to surgery. This includes alcohol, herbal supplements, fish oil, and non-steroidal anti-inflammatory medicines like ibuprofen

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.

Can I remove a dorsal hump/bump via non-surgical methods?

Sometimes, dorsal humps can be disguised via the use of fillers around the hump so that it does not stand out as much as it did. However, this method generally increases the overall size of the nose and thus only works well for those with smaller noses. Those with larger noses will unfortunately require a much larger operation like a rhinoplasty where osteotomies are performed.

Can I correct allergies with rhinoplasty?

It is true that the lining of the nose swell and thicken in response to allergies and this can block the nasal passages, leading to congestion and other allergy symptoms. A rhinoplasty can help make the air space bigger so that the tissues have to swell more to cause symptoms, BUT this will not help the condition of the allergies.

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.

When can I get a nose piercing post-rhinoplasty?

Because of the risks of infection and complications associated with getting a nose piercing early in the post-rhinoplasty healing process, I would wait at least 6-8 weeks post-rhinoplasty to have this done.

Can a bulbous nose be made smaller?

Absolutely, and this is usually done with an open rhinoplasty. The base of the nose is narrowed and support is brought in via septal or ear cartilage to make the tip sturdier.

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.

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.

What is a revision rhinoplasty?

A revision rhinoplasty refers to a rhinoplasty procedure which is used to correct the results of a previous rhinoplasty which had a negative impact on the patient, functionally and cosmetically. Unfortunately, given the high degree of difficulty inherent in a rhinoplasty procedure, it tends to have a relatively high rate of revision (8-10% of cases require revision). As a result, patients should be careful in choosing their surgeon and make sure they have all the proper qualifications and experience to do the surgery.

How can I reduce my droopy tip?

The tip can often be corrected via repositioning of the depressor septi muscles as well as repositioning of the cartilage at the tip already and cartilage grafts.

Why is my tip drooping post-rhinoplasty?

This may simply be the result of swelling post-rhinoplasty. However, this is best evaluated within 6-12 months post-rhinoplasty.

Is one week off from work enough recovery time post-rhinoplasty?

Yes, this should be enough time (7-10 days) to return to work post-rhinoplasty. However, patients must realize that bruising and swelling will still be apparent in this period of time. Therefore, if appearance is important, taking a couple more days off may be advisable.

Can I go to an ENT doctor for revision rhinoplasty advice?

It seems like a logical place to start. ENT doctors are generally familiar with the anatomy/issues of the nose, but facial plastic surgeons are probably the best bet for people looking for a specialist in these fields. Even better would be a surgeon specializing specifically in revision rhinoplasties.

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 much will a tip rhinoplasty cost?

Though the figure varies widely, a typical tip rhinoplasty will run in the range of $6,000-$8,000. However, do not let cost guide you and seek a board-certified surgeon who specializes in these procedures because having to spend for a revision surgery is more expensive than just doing it right the first time.

Why do I have a whistling nose post-rhinoplasty?

If work was performed on the septum (septoplasty, harvesting of cartilage from the septum), there is a chance that this may be the result of a septal perforation. However, it is best not to jump to conclusions as it may also just be a large mass of crusted blood and mucus in the nose (especially if it is early in the post-op period). This is best addressed by examination by the surgeon.

Does picking your nose cause changes in nasal structure?

It does indeed. Patients, especially those considering having surgery, must work to stop themselves from obsessive nose-picking which can lead to problems post-rhinoplasty. Obviously, poking yourself in the nose so many times especially post-rhinoplasty will lead to changes in nasal structure.

How long does cartilage grafting from the rib take to heal?

Though general work-ready recovery time from a rhinoplasty takes about a week or so, grafting from the rib can cause soreness for at least a couple of weeks and it is best to avoid even light exercise for at least 6 weeks or so.

Should my nose continue to grow in my 20s?

Nasal growth typically ends in a patient’s 20s, but other changes may be responsible for making the nose seem larger. Acne outbreaks and rubbing the nose due to allergies may thicken the nasal skin and changes in the underlying nasal bones and cartilage may cause drooping of the tip.

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 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.

Will my nose continue to grow after a nose job?

For most patients, nose growth will stop when they reach their 20s. However, rhinoplasties can be performed at ages 15-17 for women and 16-18 for men because growth is a gradual process and the nasal area can adapt and age with the rest of the body.

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.

How long does swelling take to subside post-rhinoplasty?

Swelling is variable from patient to patient depending on factors like age, smoking habits, etc. However, as a general rule, 2-3 weeks is the benchmark for when most of the swelling subsides, at which point the remaining swelling will only be visible to the patient and his/her surgeon. The remaining swelling will gradually dissipate in the next 6-12 months.

Is there a problem if my splint is crooked?

The purpose of the splint post-rhinoplasty is to protect the nose and also ensure a decrease in post-procedure swelling. However, even if the splint is crooked, the surgical tape underneath it is probably applied correctly. Consult with your surgeon about this, though.

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.

Why do I have a bulbous, upturned tip post-rhinoplasty?

If this question is posed within a year post-rhinoplasty, both the bulbousness of the nose and the upturned appearance of the tip are probably both due to post-rhinoplasty swelling. These will all be resolved gradually within a year post-rhinoplasty.

What are the chances of nasal infection with Gore-Tex implants?

Gore-Tex has a good track record and, for that reason, is still highly used in nasal as well as cardiovascular surgery. However, I generally prefer using my patient’s own tissue for nasal augmentation.

What can be done to improve a typical “East Asian” nose?

The most common complaints I hear from East Asian patients is that they have low definition on their nasal bridges and their tips. The nasal bridge issue is often solved with the help of grafts/implants which make the bridge more prominent, while the tip projection is improved with cartilage grafts in a tip-plasty procedure.

Is it strange to have extensive bleeding and oozing days post-rhinoplasty?

Given the freshness of the trauma endured by the nose during rhinoplasty, it is perfectly normal for patients to experience bleeding and oozing. Patients should contact their surgeon and ask about the protocol for cleaning the nose, as it varies from surgeon to surgeon.

Can I have a rhinoplasty with a cold?

Generally, it is best for the patient to be as healthy as possible prior to an elective surgery like this. Many surgeons will not risk a bacterial infection during a rhinoplasty as there is a possibility for complications.

I’m having dorsal hump removal via rasping. Should I be ready for public presentation in 8 weeks?

Probably. The majority of the swelling will probably have subsided by then.

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.

Is thick skin a problem for rhinoplasty?

Rhinoplasties can definitely be performed on patients with thick skin. However, there may be some limitations. Rhinoplasties work by lifting up the skin, adjusting the underlying muscle and cartilage, and then re-draping the skin. However, the skin needs to be tight in the last step which may be difficult to do for patients with more elastic, thick skin, so extra thinning of the underlying tissue might be needed.

Is rhinoplasty necessary to correct for a minor dorsal hump?

This is probably best evaluated by a surgeon’s examination. However, sometimes, rhinoplasty may not be necessary as injectable fillers can disguise the bump in question.

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).

I have a bump in my nose several months post-rhinoplasty. Why?

Although this may still be residual swelling, it is most likely hard bone tissue which unfortunately must be fixed via a revision rhinoplasty. Talk to your surgeon about your best options at this point.

I have alar retraction after my rhinoplasty. What can be done?

This probably can be best solved with the use of cartilage grafts or, as a second resort, injectable fillers.

Do celebrities get better nose jobs?

This is an excellent question because it addresses a great misconception in the plastic surgery world. Bad surgeons exist in any area, even in Hollywood, so do not use price alone to evaluate a surgeon’s competency prior to scheduling a surgery with them. Recommendations for ideal surgeons for rhinoplasties include board certification in plastic surgery/otolaryngology, specialization in nasal surgeries, and experience in doing your specific type of surgery. I would personally recommend looking at their before and after catalogue to see if their work is satisfactory for your needs.

Can steroid injections help if I have a hard tip following surgery?

Steroid injections about a year or so post-op can definitely help with any residual swelling and can soften up the tissue in problem areas, but have your surgeon complete these procedures.

Is the late 40s too late to have a rhinoplasty?

No, not at all. Anytime after ages 15-17 for women and 16-18 for men is perfectly reasonable to have a rhinoplasty. However, the key is finding a board-certified surgeon specializing in nasal procedures that has before-and-after work to your liking. Please do your homework in figuring out who is best for you and do not let pride guide you.

Can I correct my deviated septum and do a rhinoplasty together?

Absolutely. Septoplasty and rhinoplasty procedures are often performed hand-in-hand because they work in essentially the same neighborhood. If the surgeon you are planning on working with is qualified and experienced, I would definitely check in to investing in one complete procedure because it carries less recovery and surgical time.

How is a male rhinoplasty different from a female rhinoplasty?

Generally, the same techniques are done regardless of the sex of the patient. However, the goals are different, as ideal male and female noses are obviously different. Males are usually better suited with a more defined bridge, a greater degree of tip projection, less tip rotation (90 to 95 degrees is suitable), and greater width in the middle of the nose. Females can tolerate more tip rotation, subtle dips in the supratip region, etc.

Can rhinoplasty correct a narrow nose?

Yes, this can be done. Bilateral spreader grafts can help to widen the upper nose and shaping sutures can be used to help rotate the tip cartilages away from the midline of the nose, thus creating the illusion of a wider nose.

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