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.


See Dr. Kassir's RealSelf reviews

Rhinoplasty: Questions & Answers

Can the nose be lengthened to reduce the distance between the upper lip and the columella?

Yes, this can certainly be done via the application of cartilage dorsal grafts to weigh the tip down and create the illusion of a longer nose and minor trimming of the columella.

I had bad acne breakouts following removal of the tape. What should I do?

This is especially common due to the blockage of sebaceous glands on the skin by the tape. Common acne regimens should be fine to help alleviate this.

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.

How sick do people typically feel after general anesthesia, and how much blood loss is typical?

Because surgeons often use lidocaine mixed with epinephrine in surgical areas to constrict blood vessels, blood loss is typically minimal during these types of procedures. Some blood may escape into the throat and into the stomach, which can cause vomiting and nausea. However, a gauze pack is usually placed in the back of the throat to catch the majority of the blood.

How long will a fractured nasal bone take to heal?

Because there isn’t a great deal of muscle pulling on the nasal bone, unlike other bones in the body where fractures might occur, nasal bones can be left alone to heal perfectly fine and surgery is not necessary unless it results in some sort of functional or cosmetic deformity (deviated septum, etc.). The cast is removed after 7 days and patients are told to avoid strenuous exercise for about 6-8 weeks because blood pressure increases can make nosebleeds more likely.

Can a typical African-American nose be modified to a Middle Eastern nose (pointy but with a drooping tip)?

Unfortunately, due to the thick nasal skin associated with an average African-American nose, it is very unlikely that even the most skilled surgeons can complete this transformation without risking the nose being unnatural looking. The nostrils and the tip can be narrowed and the nasal bridge can be augmented, but not to the extent that many will desire.

What’s the ideal age for a rhinoplasty?

This is a variable benchmark that depends on the physical maturity of the patient’s nose (operating on a still-developing nose can impede nasal growth), the emotional maturity of the patient, etc. But, generally speaking, after 15-17 for women and 16-18 for men is the ideal.

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).

Will putting pressure on an area induce bone resorption there?

Unfortunately, it is not that easy. Single finger pressure cannot induce bone resorption.

Will the cartilage graft used in my rhinoplasty soften up eventually?

The reason why patients are often told that rhinoplasties take up to a year or so to fully heal is due to the healing of scar tissue and cartilage grafts which are often used during the procedure to give more support to the tip of the nose. However, if rib cartilage was used, then this may remain noticeably more firm than the rest of the cartilage in the nose (which is why rib cartilage is used as a last resort).

When will cartilage reabsorb after a rhinoplasty?

Cartilage reabsorption in a graft is not ideal as this cartilage was placed in an effort to support the area in which it was placed. Some reabsorption does take place following a year post-op, but not significantly enough where it would cause issues.

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.).

Can rhinoplasty correct a wide nose without touching the nostrils?

The ala base (the middle part of the nose) can definitely be corrected in a rhinoplasty without any impact on the nostrils.

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.

Does swelling fluctuate post-rhinoplasty?

It does not fluctuate really, as much as it subsides gradually. Most of the swelling goes down within the first 10 days, with pretty much all of it disappearing within 3 or so months. Full healing should take place after a year or so.

How do I ask my doctor about getting a rhinoplasty in addition to my septoplasty?

This is very simple as both procedures are often performed concurrently, although the septoplasty will be covered by insurance and the rhinoplasty will most likely not be. However, check if the surgeon has experience with both surgeries and is board-certified.

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.

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.

How long post-rhinoplasty should I wait to have sex?

It is best for patients to avoid any form of strenuous activity, including sex, for at least 3 weeks post-rhinoplasty in order to reduce the risks of cut down on swelling and mitigate the risks of hematoma and post-operative bleeding.

Is an 8mm to 1cm reduction on the bridge possible in a rhinoplasty?

This is doubtful. The typical removal for a rhinoplasty ranges anywhere from 4-6 mm. Some patients may warrant more, but the surgeon should make sure that he/she has a definitive plan of what to do with loose skin and whether the nose still remains proportional to the face.

Can implants be infected years post-rhinoplasty?

While it is rare for these cases to occur, they do occur once in about a thousand times. Generally though, if the patient bolsters their immune system with antibiotics, it will go a lot way to preventing infections.

Do all surgeons use splints and packing post-rhinoplasty?

Generally, surgeons will use splints in the first week post-op not only to protect the delicate nasal tissues immediately after the surgery, but also as a reminder for patients to be extra careful in the first few days post-op. Packing has generally gone by the wayside due to discomfort/breathing issues felt by the patient and has given way to internal splints.

When do my nasal packs dissolve?

Every surgeon does something different when it comes to post-rhinoplasty nasal care. Personally, I do not use nasal packing. This is a question best answered by your surgeon as he/she will know what materials your packs were made of.

What is the best scar cream after an open rhinoplasty?

This should probably be best addressed by your surgeon, but personally, I believe time is probably the best healer for scars especially if it is soon post-op.

When can I return to yoga post-rhinoplasty?

At around 4 weeks out or so, patients can resume light to moderate activity like yoga as long as it is not strenuous and they pay attention to any swelling which may occur (and stop activity immediately once this is noticed).

When does the splint come off?

Uusally, splints are removed 1 week after surgery.

What is the cost of tip reshaping?

Depending on the certification of the surgeon, the area in which the surgery is conducted, etc., costs can vary in the neighborhood from $6,000 to $10,000.

Will taping my nose down after a rhinoplasty help bring it down?

Swelling at the tip can derotate the nose (rotate it upwards). I would not touch the results and wait for the swelling to subside.

Can you change the shape of your nose non-surgically?

Unfortunately, changing the shape of your nose requires movement and repositioning of the underlying skeleton and cartilaginous structure. Fillers and other non-surgical tools will typically only camouflage defects like a dorsal hump, etc by filling it areas around the defects.

Is there a way to thin wide nostrils without surgery?

Generally, no. Depending on the width of the nostrils in relation to the rest of the nose, patients may either require a Weir/alar base reduction (if it is just the nostrils that are the issue) or may require a full-on rhinoplasty in which osteotomies are performed in addition to the reduction of the nostrils in order to thin the bridge of the nose as well.

Did I accidentally crack my cartilage by squeezing a blackhead?

It is doubtful, as it takes a substantial amount of force to actually fracture cartilage or bone tissue. Get it checked out by a plastic surgeon to make sure though.

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.

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.

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 do I get natural rhinoplasty results?

The best tip for achieving a natural rhinoplasty look is first to find an experienced surgeon that is board-certified in plastic surgery AND specializes in these types of procedures. The second tip is to not set your expectations unrealistically high. Very often, patients will come in demanding a “Kim Kardashian nose” or something like that when it is impossible for me as a surgeon to make it look natural. What rhinoplasties do is essentially modify an existing nose to correct defects, not substitute one nose for another. Our goal as surgeons is to simply enhance the nose you already have.

Can I make the bridge of my nose lower and flatter (Asian nose)?

A typical “Asian” nose can indeed be crafted via a shaving down of the bridge, especially the radix (the top part of the bridge), and conducting osteotomies to realign the nasal bones in an appropriate manner.

I have a crooked columella months post-op. What is wrong?

Unfortunately, this may require a revision rhinoplasty. It seems that there may have been deformities in the columellar cartilages (medial crura) that were not addressed in the rhinoplasty you underwent or a septal deviation. It is best to consult with your surgeon regarding your options at this point.

Do I have scar tissue or swelling after removing my nasal implant?

This may be fibrous tissue that can take up to a year to fully heal. Consult your plastic surgeon to ask his opinion.

What can be done to fix nostril flare while smiling?

Nasal flaring, depending on the severity of the problem can definitely be fixed with solutions like Botox (for small-scale procedures) or with larger-scale operations like a Weir’s reduction or an alarplasty.

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.

How can I clean the outside of my nose post-rhinoplasty?

It is important that, when a patient’s surgeon gives him/her the OK to begin cleaning the outside of the nose, they remain gentle. Generally, patients will use sterile solution like alcohol on gauze/cotton.

How much does a hump filing cost?

It is difficult to determine the cost of reducing a hump because patients will have different requirements. Small humps will require smaller procedures, but typically, the cost to reduce a hump is synonymous with the cost of a rhinoplasty which will cost in the neighborhood of $8000-$10,000.

Do bones swell post-rhinoplasty?

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

Is there any fat in the nose, or is it bone and cartilage?

There is a small proportion of fat in the nose within the lateral alar sections, but this is nowhere near where surgeons typically operate. The nostrils, the bridge, and other typical surgical sites for rhinoplasty are generally bone and cartilage, meaning that weight gain or loss does not have a major impact on the results of a rhinoplasty.

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 harmful is cocaine post-rhinoplasty?

Because cocaine acts as a powerful vasoconstrictor, it decreases blood supply to nasal tissues and thus inhibits the healing process and even causes these tissues to be necrotic and die. I would highly advise AGAINST using it simply because of hearing cases where patients run into an array of issues post-rhinoplasty, including septal perforations.

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.

How can I fix a crooked nasal cartilaginous bridge?

This condition can be fixed by manipulating the upper lateral cartilages and performing a septoplasty which will inevitably require an osteotomy. However, upper lateral cartilages may need to be bolstered via a cartilage graft from the septum or the ear. It is best to consult your surgeon for the best course of action.

Did a nasal fracture cause my headaches?

It is definitely not uncommon for patients who experience nasal fractures to experience headaches. It is best for these patients to go to a well-qualified surgeon to plan their best course of action.

What is this bump on the inside of my nose post-rhinoplasty?

At long periods of time post-rhinoplasty (a year or so), bumps on the inner wall of the nose will most likely be scar tissue which can alleviated with the help of steroid injections or a simple excision under local anesthesia. However, short-term bumps may be sutures that need to be taken out or swelling that will dissipate by themselves.

Can I have rhinoplasty while pregnant?

Absolutely not. There is no telling what the anesthesia or the medications needed prior to and post-rhinoplasty will do for the baby.

When can I get my septum pierced post-rhinoplasty?

I would suggest not getting it pierced. Because of its importance in breathing and the possibility of cartilage reabsorption after surgery (which can potentially undo the results of the procedure), the septum is best not touched post-op.

When can I have a facial after a rhinoplasty?

Due to the trapping of sebaceous fluids in the pores due to the surgical tape, it is common for patients to experience acne breakouts post-op. You should be ready for gentle cleaning at around 1 month post-op, but, if the nose is still sore, wait a couple more weeks beyond that.

How can I correct an over-upturned nose?

This can be corrected via an incision within the nose that will free up the tip and allow it to drop down naturally. Additional reinforcements may be needed in the form of cartilage grafts at the base of the septum. Trimming the cartilage near the tip of the nose may also provide the loss of support and thus the derotation which is desired.

Do non-surgical fillers have long-term effects?

Surgical fillers have been FDA approved for use on the face for wrinkles, but surgeons have been using them for a long time for nasal injections (off-label use, of course). I am not aware of any particular diseases which result from the use of fillers, but there have been reports of patients who are unhappy in the long-term with the use of fillers and would rather have rhinoplasties done to correct the original problem.

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.

What does cutting the depressor septi muscles do for my smile long-term?

Over the long-term, these muscles will heal and your smile should come back just fine. However, because cutting the depressor septi prevents the tip from drooping, there will be some loss of sensation in the upper lip area which will cause movement issues in the upper lip (and resulting problems when smiling) for a period of a few weeks.

My nasal tip is still swollen. Why?

Patients will often find that residual swelling is pronounced particularly in the tip. This is generally a pretty heavy surgical site during the rhinoplasty procedure and will be subject to the greatest proportion of the swelling. Regardless, patients need not worry as residual swelling gradually dissipates over the course of a year.

When will my ear recover if cartilage was harvested from it during the rhinoplasty?

Patients can sleep on the ear in question within a week or two after the cartilage is harvested, but it may continue to be mildly painful for around 3-4 months, after which it heals completely.

Should I rasp the nasal bone by the eye area where my surgeon claims that there is a bone bruise?

This is probably best answered by an examination with your surgeon. Nasal bones could easily be rasped via a limited incision, but ask what your surgeon thinks about this operation and whether it is feasible.

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.

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.

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.

There is too little of an angle between my columella and my upper lip. What can I do?

This correction can be accomplished very easily under local anesthesia. Here, the tip of the nose is rotated upwards and held in place via sutures and the columella is trimmed slightly.

Why is the nose broken during rhinoplasties and is it done all the time?

An osteotomy (controlled breaking of the nasal bone) is not performed in all rhinoplasties, but rather is only performed in cases where the upper portion of the nose needs narrowing. This occurs when a dorsal hump is shaved down, when there is septum deviation correction, and when a wide nose needs to be generally narrowed.

How long does it take for dissolvable stitches to dissolve?

Generally, dissolvable stitches will dissolve at an average of around 3 weeks post-rhinoplasty.

Can rhinoplasty scar tissue be corrected/fixed?

While slight scarring is common for rhinoplasty procedures, unsightly scarring in the sites of external incisions, etc. is relatively rare and may warrant aggressive treatments like kenalog (steroid) injections. However, a consultation may be needed for this.

I have heard of a quick fix nose job in ethnic communities which focuses primarily on nostril width and doesn’t concern itself with osteotomies. Is this an alternative to a traditional rhinoplasty?

Surgeons can reduce the size of the nostrils via an alar base reduction/Weir reduction in which a thin, crescent-shaped patch of skin is removed from the nostril and the hole is stitched. However, it is advised that, before going ahead with this surgery, patients not only choose an experienced surgeon, but also consider whether they truly want to do JUST this surgery. Often, nostril reduction is accompanied by a thinning of the upper nose as well which needs to be done with osteotomies.

Do I need to pack the nose following rhinoplasty?

Generally, the nasal packing (gauze which would line the inner nostrils) which doctors would often use post-rhinoplasty has been replaced with internal splints that prevent the formation of scars and septal hematoma. This is also supplemented by an external splint which puts more pressure on the skin and guides it into place on top of the underlying cartilage and muscle tissue.

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.

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.

The columella is hanging post-rhinoplasty. Is this bad?

As stated in other questions, the columella area is a primary incision site during the surgery and undergoes more trauma than other portions of the nose in the procedure. Lymph flow may be disrupted in this area causing fluid buildup (edema), but this will resolve itself over time.

What is your opinion of Gore-Tex and silicone in a rhinoplasty?

Personally, I am more partial to avoiding man-made materials during rhinoplasty which can often pop out post-op and, in the case of Gore-Tex, have a high probability of infection. I prefer to use septal cartilage from the patient’s nose or, if that is not available, from the patient’s ear because the body is accustomed to it.

How much bleeding is there post-rhinoplasty?

Because during the surgery lidocaine mixed with epinephrine is injected into the surgical sites to constrict the blood vessels, there should be relatively little bleeding post-op. Oozing is typical on the first day if osteotomies are performed, but this is usually absorbed by nasal packing/drip pads.

Can I workout the day BEFORE surgery?

Yes this should be fine. As long as no workouts are done after surgery and the blood pressure is kept normal, do whatever you want prior to the surgery.

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