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

I have a crooked nose that is causing breathing difficulties. Is this covered from insurance?

This will most likely be covered by insurance and is usually resolved via turbinate surgery, septoplasty and/or spreader grafts (if the nose is collapsed inward and causes breathing issues).

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.

How soon after giving birth can I have a rhinoplasty?

Theoretically, a patient can have a rhinoplasty as soon as 3 months afterwards. However, they must consider whether they will have the time or energy for a cosmetic procedure at this time. In addition, as the narcotics used during the rhinoplasty procedure may pass into breast milk, it is important for mothers to pump and store breast milk in anticipation for the procedure.

Why has my swelling not gone down months post-rhinoplasty?

Again, as I answered with many of my patients, swelling especially in the tip and nostril area following a rhinoplasty will resolve itself almost completely after a year post-rhinoplasty, with most of the swelling being gone around 3-4 months post-rhinoplasty. It is key that patients remain calm and wait out the results.

I have disproportionate swelling on my columella. Is this normal?

It could be. Many surgeons who make a columellar incision will find that whatever side the incision is made on will tend to swell more than the other side. However, if the columella appears to have shifted, it may require the resectioning of septal cartilage.

How is rhinoplasty different for Hispanic patients than other patients?

In general, Hispanic patients tend to have thicker (oilier) skin than Caucasian patients, broader faces and wider nostrils/nasal bridges, weaker cartilage, and a greater proportion of nasal humps. With all these considerations, it is important that surgeons understand the aesthetic goals of their Hispanic patients and tailor their surgical goals to their patient’s needs.

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.

How can I fix my wide nasal bones?

By wide nasal bones, I will assume that you are referring to the bridge of the nose which can be fixed by a controlled osteotomy in which the nose is broken purposefully by surgical instruments and then angled inward to narrow it.

What are the chances of developing unsightly scar tissue and other complications post-rhinoplasty?

When done by an experienced surgeon, rhinoplasties do not develop scar tissue to the extent where revisions are necessary. Even when scarring does develop, though, cortisone injections can help. Again, the best way to prevent complications is to seek out an experienced surgeon.

How can I massage my nose after nasal fracture reduction surgery?

I would advise against massaging the nose after this procedure simply because of the effect it could have on the movement of bones and cartilage in the surgical site.

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.

What is the structure that separates the nostrils on the underside of the nose?

This flap of skin between the nostrils is called the columella.

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 do sutures take to dissolve post-rhinoplasty?

Typically, external rhinoplasty sutures can be removed after 7 days by the surgeon or will dissolve in that period. However, internal rhinoplasty sutures may take several weeks to dissolve.

Can I reduce my nasal bridge height while still looking natural?

Decreasing bridge prominence can be accomplished via rasping and potential osteotomies (if the dorsal hump happens to be large). Tip rotation may also help in this case, which can be done via the manipulation of the lower cartilages.

What should I do about scabs inside my nostrils post-op?

Nasal vestibulitis (the development of scar/scab tissue in the nostrils) is a common occurrence post-op, especially for patients with a history of seasonal allergies. It is suggested that patients with this condition see their doctors, who may suggest applying OTC hydrocortisone with a Q-tip to site of scar development (this will generally fix the problem within a week).

There is a red spot on my nose post-rhinoplasty. Should I be worried?

I would demonstrate some concern and consult with my surgeon. This could be inflammation due to a suture or graft material.

How can I minimize skin care complications post-rhinoplasty?

Because the surgical tape and cast applied to the skin in the week after rhinoplasty traps sebaceous fluid within the pores of the skin, it is common for patients to experience acne breakouts in this time period. Having a facial prior to the surgery may be the best way to combat this as it cleans out the pores beforehand.

How soon does skin start thinning after a silicone implant post-rhinoplasty?

Thinning of the skin is one common problem with silicone implants, which is why I am often hesitant to use them. It is best to have the implant removed before it begins to extrude.

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.

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.

My nose looks bigger post-op. Why?

It is perfectly normal for swelling to be apparent for up to a year post-op, so residual swelling particularly on the tip area several months post-op is perfectly normal and should not be a concern. Your surgeon did not do “anything wrong”.

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.

Are dark circles under the eyes post-rhinoplasty normal?

This is an indication of blood trapped in the lower rim of the eye, which will eventually dissipate after a period of 6 months or so.

How can I fix this dent in my nose?

Generally, dents from damage to cartilage can be fixed via the introduction of fillers into the region.

My nose is too upturned post-rhinoplasty. What can I do about this?

Especially for patients post-rhinoplasty, upturning and swelling of the nose is perfectly normal for at least 6-8 weeks and may persist for up to a year (on a more gradual scale, of course). As I like to tell patients, you don’t really know how well a rhinoplasty turned out until at least 6-8 months in and you don’t see the full extent of the results until at least 1 year post-rhinoplasty.

How long can I use saline rinse post-rhinoplasty?

Saline rinse is generally advisable for the first 2 weeks post-rhinoplasty simply to clear crusting blood and excess mucus deposits within the inner wall of the nostril. However, it is best to follow your surgeon’s recommendations regarding nasal cleaning post-rhinoplasty.

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 non-surgical options which mimic rhinoplasty procedures?

Unfortunately, there are not any non-surgical options which get as much mileage as an actual rhinoplasty. However, for certain cases, injectable fillers like Restylane can be used to smooth out rough edges (ex. Fill areas around the bump on a bridge to make the bump seem less conspicuous) for lesser cost. These might be helpful for people with overly scooped noses (ski slope noses), noses with small humps, etc (in other words, people who need areas filled, rather than reduced).

Can I simply make my nose smaller by shortening the tip?

Sometimes, surgeons will simply rotate the tip upwards in order to give the illusion of a smaller nose. However, this does not always work with most patients and instead gives the appearance of a pig-like nose. Unfortunately, long pointy noses can also be corrected with a rhinoplasty procedure in which the septum and the surrounding structures are reduced.

Can an ENT surgeon perform a rhinoplasty and turbinate reduction surgery?

Certainly. Surgeons may often perform turbinate reduction surgery hand-in-hand with rhinoplasty procedures (with the consent of the patient, of course) in an effort to reduce nasal congestion.

Will a nose job affect my smile?

The cutting and stretching of nerves around the tip and the upper lip/teeth during a rhinoplasty will definitely cause a general numbing of the area, particularly if the surgery in question was a revision rhinoplasty where extensive cutting of scar tissue occurred. However, these symptoms are very temporary and will probably dissipate within 2-3 weeks post-rhinoplasty.

My nose is far too triangular (bridge is too straight) following my rhinoplasty. What can be done?

This is somewhat unusual, as most patients favor a straight, less bumpy nose. However, patients can have this issue corrected via cartilage addition to the area or even injectable fillers.

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 long will it do to see the results of alar base reduction?

Unlike traditional rhinoplasties, the results of an alar base reduction should be almost immediate. There may be redness for the first week or so, but swelling and other issues should not be apparent to the extent of a rhinoplasty.

There is some nostril asymmetry following my rhinoplasty. Should I be concerned?

Not at all. Again, swelling is a perfectly normal part of the post-rhinoplasty healing process and will take up to a year to fully dissipate (especially in the tip and nostril area). Therefore, most imperfections seen post-rhinoplasty are merely the result of swelling and will also disappear.

How bad is smoking marijuana within the first week post-rhinoplasty?

Unlike cigarette smoke, marijuana smoke presents no dangers of nicotine, a potent vasoconstrictor which has the ability to cause necrosis of nasal tissue. However, it does have carbon monoxide which limits oxygen to the surgical site and may lead to tissue death there. In addition, the coughing induced by marijuana can lead to internal bleeding post-rhinoplasty.

Did I make a mistake by waiting too long to fix a broken nose?

Not fixing a broken/deviated nose immediately does not necessarily make it impossible to correct the original defect, but it definitely makes it more difficult. Nasal fractures are best treated within 10-14 days of the original injury before the nasal bones begin to reset in the newly established manner.

What can be done about the callus which developed after my rhinoplasty?

Generally, calluses which develop after a rhinoplasty will heal naturally and resolve themselves gradually within 1 year post-rhinoplasty as the body reabsorbs the bone and cartilage in the callus. If this does not occur, however, the bump can be rasped (filed) away.

Can the bridge of the nose be narrowed without touching the tip?

Yes this can definitely be done. However, patients must consider whether tip work may be necessary to make all details of the nose proportional to each other.

I have an inverted-V deformity post-rhinoplasty. What can I do?

Often, surgeons will attempt to avoid these type of deformities post-op by placing spreader grafts in the nostril. In cases where this occurs, revision rhinoplasty may be required with cartilage grafts taken from the septum or ear as support.

How long do silicon implants in the nose last?

Implants, unless they shift and create unpleasant nasal shapes or become infected, are built to last for the remainder of a person’s life

What is the best way to fix Pollybeak deformity?

A pollybeak deformity (the name given to supra-tip fullness in a patient) can be corrected often by removing some septal cartilage and reinforcing the tip of the nose —- which tends to drop —- via the placement of a cartilage graft. Steroid injections may also help as the deformity may be the result of excess scar tissue.

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.

Can a Headbutt cause a permanent bump on the bridge of the nose?

Generally, patients will be aware if a nasal fracture has occurred immediately after a trauma. In most cases, bumps on the nose following trauma are a result of soft tissue damage particularly in the periosteum (where the nasal blood supply is housed) and will degrade eventually.

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.

My nasal implant is showing and stretching my skin. Should I keep it in?

This is a common complication with nasal implants, and the best course of action would probably be to have the nasal implant removed before it impedes blood flow, extrudes through the skin, etc.

Why do I have a dented nose post-rhinoplasty?

Certain patients may be predisposed to having this deformity post-rhinoplasty because of the way in which the tip cartilages are aligned prior to surgery. Patients may have them angled upward so that, even the removal of some cartilage can cause dents. However, this problem can be fixed with cartilage grafts or even fillers like Restylane or Radiesse.

What can be done to correct a crooked nose?

Most often, the optimal correction procedure for a crooked nose particularly after trauma is open rhinoplasty where the nasal fracture is reduced, potentially with cartilage graftings to even out the area surrounding the break.

Can I do an augmentation on the bridge of my nose and a sinus surgery at the same time?

Theoretically, yes. However, I would be cautious because the sinuses are very open to the external environment and can be breeding grounds for bacteria (thus leading to sinus infections). This can lead to infections in the rhinoplasty surgical site which would just lead to unnecessary complications that can be better avoided by spacing out the two surgeries appropriately.

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.

Can steroids correct nasal asymmetry?

Absolutely not. Steroids are simply used to correct tough skin like scar tissue and other abnormalities post-rhinoplasty, but should not be used on normal tissue/skin because of the risk of atrophy that can be disastrous for post-rhinoplasty results.

I have a bump on my bridge. Will it need surgery to be corrected?

This is probably left best to the discretion of your surgeon, as it depends on the bump’s size. Smaller bumps may not require surgery and may be easily camouflaged with the use of fillers like Restylane. However, larger humps will require a full rhinoplasty with osteotomies (breaking of the bone in a purposeful way).

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.

When should the cast be removed post-rhinoplasty?

The cast, which is kept on to reduce swelling and post-rhinoplasty bleeding, should ideally be removed 6-7 days post-rhinoplasty by an experienced surgeon.

How long does bruising persist after a rhinoplasty?

Bruising from rhinoplasty as a general rule will mostly fade away within 2-3 weeks post-rhinoplasty. In the majority of cases, however, it will disappear even sooner (within 1-2 weeks).

Can wearing glasses cause alterations in your nose shape growing up?

This is unlikely as the glasses only exert very slight pressure.

I have overprojection and a hard tip following placement of a cartilage graft and a columellar strut. Is that normal?

If the cartilage graft was taken from the rib, this is a perfectly normal symptom as rib cartilage tends to be sturdier compared to septal or ear cartilage. Also, depending on the timeline post-op, this may be a normal part of the healing process and may resolve itself over time.

What are the pros and cons of steroid injections post-rhinoplasty?

Steroid injections are introduced in patients to prevent the buildup of scar tissue that can actually deform the tip. However, while helpful, it can also cause atrophy of surrounding tissues and overthinning of the skin if not used judiciously.

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.

What types of pre-op testing is necessary for a rhinoplasty?

There is no real universal answer for this as it varies from surgeon to surgeon. Often, surgeons will like having blood work because it may reveal potentially complication-causing conditions that patients will either not disclose or forget to reveal prior to the procedure. Again, this is a question best answered by your surgeon.

I popped a suture in my nose after my rhinoplasty. Is that bad?

Messing up one suture will probably not do a significant amount of damage. However, consult with your surgeon just in case.

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.

What causes dorsal hump formation?

Dorsal humps are usually an accumulation of bone and cartilage which is generally inherited, although trauma to the nose may also cause it (punch to the face, etc.).

When can I play contact sports post-rhinoplasty?

I would recommend waiting 6-8 weeks simply because of the risk which a bump to the nose can have on the results of a rhinoplasty.

How long should I wait post-rhinoplasty to get steroid injections?

Kenalog injections can be safely administered 4-6 weeks apart as early as one month following the rhinoplasty procedure.

Why do I have blood in my eyes following my rhinoplasty?

It is a relatively common occurrence for patients to have broken capillaries in the sclera of the eye (the white of the eye) following a rhinoplasty, a condition known as a subconjunctival hemorrhage. Unfortunately, this bleeding tends to last for up to four weeks. However, if bleeding continues past that period or leaks into the iris (colored part of the eye) or affects vision, let the surgeon know immediately.

Will putting pressure on an area induce bone resorption there?

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

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.

Is the removal of splints following a rhinoplasty painful?

Nowadays, when the packing used for rhinoplasties is less than it used to be, the removal of splints should not cause any major discomfort for the patient.

How long will my nose feel stuffed up post-op?

Easier breathing will generally come 10-14 days post-op and will continue to improve for 6-8 weeks afterwards.

How long does swelling last post-rhinoplasty?

Most, if not all, of the swelling will disappear by the one-year post-rhinoplasty mark. However, the majority of the swelling should be gone within 3-4 months post-rhinoplasty.

Can a 16-year old girl get a rhinoplasty?

The surgeon and the girl’s parents must consider this question and evaluate whether the patient is physically and emotionally ready for the procedure. However, at 16 years old, a female patient would be within the “safe zone” of having a rhinoplasty done.

Should I have the dorsal hump on my nose corrected with open or closed rhinoplasty?

Either approach would work, with the open approach having more bruising and a more noticeable scar. However, it is important for patients to consider whether they also need changes in addition to the dorsal hump (e.g. Droopy tip, etc.) which could better be fixed by the open approach.

What should I ask my doctor during my rhinoplasty consultation?

Excellent question. Some things to ask your surgeon before you allow him to operate in order to determine whether he/she is worth your time could include:
What board certifications do you have?
How many rhinoplasty surgeries have you performed, especially within the last year?
May I see before and after pictures of your work, particularly with my type of surgery?
How much will this surgery cost? And how many revisions have you had to do on your work and what does that cost?
What sort of anesthesia do you use for my type of procedure?
Which hospital are you affiliated with?

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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.