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

What is the difference between silicone and Gore-tex implants?

Both silicone and Gore-tex implants are synthetic, with the former being constructed from siloxane molecule chains and the latter being composed of polytetrafluoroethylene. Gore-tex, while tending to shrink over time (unlike silicone, which is stabilized via a capsule), is also stabilized by the surrounding tissue, but tends to be more difficult to remove if infection occurs. I prefer personally to use the patient’s own cartilage as a first resort rather than these synthetic materials.

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.

How can I get rid of bruising under my eyes post-rhinoplasty?

Unfortunately, other than the tips which your surgeon probably gave you (avoiding blood thinners like aspirin, not smoking, etc.), there is little else that you can really do to reduce bruising as it is part of the body’s natural healing process.

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

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

How can I treat a ski-slope nose and upturned tip post-rhinoplasty?

Patients who have these conditions after a rhinoplasty will most likely be in need of a revision rhinoplasty where cartilage grafts are reintroduced to give more support to the tip and fillers are introduced to augment the bridge.

Will a bulbous nose that developed during pregnancy return to normal?

It is unlikely that, especially after a year since the pregnancy was completed, bulbous noses which developed in those nine months will return to normal. At that point, any corrections will have to come from rhinoplasty.

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.

What can I do for a drooping columella post-rhinoplasty?

A drooping columella can be addressed by removing a small section of skin and cartilage from the area and then simply patching up the area.

How long will breathing be difficult post-rhinoplasty?

Especially during the first several weeks post-rhinoplasty, swelling in the nasal area and crusting of blood and mucus will cause congestion of the nasal airway and thus inhibit breathing. This swelling will begin to subside, however, and will improve after 2 weeks.

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.

How can an ethnic nose be made thinner at the tip?

Quite often, this is done by suturing the nasal cartilages in a more narrow fashion and bringing it cartilage grafts from the septum or the ear for additional support. However, the problem which surgeons often have with ethnic noses is that ethnic noses tend to have thicker skin which does not drape nearly as nicely over skin as thinner skin does. Thus, the results may not look quite as apparent.

When does the splint come off?

Uusally, splints are removed 1 week after surgery.

When will internal swelling subside post-rhinoplasty? I want to breathe!

In some cases, rhinoplasty patients will experience a permanent decrease in breathing due to factors like smaller nostrils, formation of scar tissue on the inside wall of the nostril, etc. Generally, though, breathing difficulties should subside within 2-3 months post-rhinoplasty, but may dissipate as soon as 2-3 weeks.

Can a deviated septum, if it isn’t broken, be bent back into place?

Unfortunately, no. Cartilage, while being highly elastic and bendable, is not necessarily easily movable (at least in a permanent fashion). Deviated septums can only be corrected with a septoplasty.

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.

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 I do certain exercises/massages to help elevate the tip of my nose?

Unfortunately, there are no easy fixes for tip elevation like exercises or massages and the only option which is known to surgeons today to correct droopy tips is a full rhinoplasty which will help elevate the cartilage within the nose and reposition the muscle (depressor septi) which is responsible for the drooping.

Can I re-break my own nose in order to straighten it?

This is highly inadvisable as patients often do not know the precise motions which are required to set the nose in a perfectly straight manner. It is recommended that patients with a deviated nose go to a professional to have it fixed.

Can I get a cheaper rhinoplasty by residents at a university?

It is certainly possible for these arrangements to be made. However, one must remember that rhinoplasty is one of the most difficult procedures in the plastic surgery world and is ideally conducted by a doctor with a great deal of experience and the proper credentials in order to ensure a good result.

There is significant swelling in my tip post-rhinoplasty. Should I be worried?

Due to the repositioning of cartilage which occurs extensively in the tip of the nose during rhinoplasty, the tip is one of the most prone areas to swelling post-rhinoplasty. Patients should not be concerned if the tip appears swollen for a longer period of time than other areas of the nose post-rhinoplasty.

Can I reduce the angle of my pig-like nose?

Derotation of the tip via the release of ligaments in the nose and addition of cartilage grafts to weight down the nose can indeed help here.

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.

How much will rasping cost?

Rasping is considered a rhinoplasty procedure and thus may cost anywhere in the neighborhood of around $3,000-$6,000, depending on the anesthesia used.

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.

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 I have an upper lip lift at the same time as my rhinoplasty?

Generally I would remain cautious about this, because traditional upper lip lifts can leave a scar that presents problems when combined with 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.

Are grafts safe for adding definition to the tip of my nose?

Yes, natural grafts from the patient’s own cartilage represent the least risk for infection, as opposed to silica, Gor-Tex and other materials.

Can I get a small button-nose from rhinoplasty?

It is certainly possible for patients to achieve a button-nose from a rhinoplasty procedure. However, surgeons also have a responsibility to maintain overall facial aesthetics during a rhinoplasty procedure and may not wish to create a nose which does not belong on a particular face. Our goal during a rhinoplasty is to modify the nose and correct for defects, meaning that the nose you will have at the end will still maintain a semblance of the nose that you had.

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.

What can be corrected via non-surgical rhinoplasty?

Non-surgical rhinoplasty which generally consists of the use of fillers to disguise minor defects can be used to correct issues like overly scooped noses (ski slope-style noses), saddle noses (boxer’s noses), pollybeak noses, slightly asymmetrical noses, and others.

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

Is Swelling after Nasal Trauma an indication of permanent damage?

This is a problem that is better addressed on a case by case basis, but generally, I would say that patients who experience swelling after a nasal injury will find that most of their problems will be solved with some ice. However, it is best to go to a qualified surgeon for evaluation in order to check for nasal fractures.

How can I correct my broken nose?

Correction of a broken nose involves a procedure known as open reduction which involves the creation of osteotomies (controlled fractures) to realign the septum of the nose. In some patients, spreader grafts might be necessary to ensure that the nose does not collapse during or after surgery.

Does my nose spreading (when I smile) get better as the post-rhinoplasty period goes on?

Unfortunately, nostril over-spreading during smiling or even while resting is not something which is fixed by a typical rhinoplasty. Although post-op swelling may contribute to this, patients who are dissatisfied with their nostrils post-rhinoplasty may want to consider alar base reduction.

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 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).

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.

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.

Is it a problem if I have been sneezing a lot post-rhinoplasty?

Try to sneeze through your mouth as much as you can post-op simply because trying to suppress a sneeze through the nose can lead to pressure issues that can alter the results of the rhinoplasty and lead to nosebleeds.

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.

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.

Can cartilage bumps/humps form post-dorsal hump surgery?

Yes this is possible as this is part of the body’s natural healing process. Trauma on the nasal bridge will activate chondrocytes (cartilage progenitor cells) to increase their production, but this is usually very minor.

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.

Would I be turned down for rhinoplasty if I have a bifid tip?

Absolutely not, unless it presents a significant medical issue during the surgery (which is unlikely). In fact, the bifid tip can even be fixed during the procedure by suturing the lower tip cartilages closer together and then filling in the resulting dip in the nose with filler or cartilage.

There is a bad smell in my nose post-op. What is wrong?

A nasty smell inside the nose following surgery may just be the result of dried, crusted blood development or extraneous mucous which infiltrated the area, both of which are perfectly normal post-op conditions that can be corrected with saline spray. However, a consultation with a surgeon may be advised in order to evaluate for a possible infection.

How Much Does Rhinoplasty Cost?

Rhinoplasty costs vary by surgeon experience and geography. It can range from $9500 to $15000, 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).

Important considerations:
1. Can you breathe through your nose? Do you have sinus problems? If so, then these should be addressed at the same time as the rhinoplasty. You want a great looking nose that functions well, otherwise it is a waste.
2. How many rhinoplasties does your doctor perform, and how many revision surgeries?
3. It is your face, don’t compromise on quality!

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.

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.

Why does my upper lip look longer after my rhinoplasty?

Without an in-house examination, this is difficult to assess. Removal of fullness at the base of the nose may cause the illusion of a longer lip, as can the unhinging of some muscles at the upper lip which control movement.

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.

I was hit in the nose months ago and now I have a dorsal hump. Is it permanent?

Unfortunately, trauma to the nose activates osteocytes (bone-producing cells) and chondrocytes (cartilage-producing cells) to add their respective materials to the injury site, thus resulting in a dorsal bump. Sometimes, these areas are subsequently reabsorbed by the body. However, sometimes, they are not and, if this absorption is not apparent even months after the trauma, it is likely to only be solvable via surgical methods.

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.

Can rhinoplasties affect my singing voice?

Correction of a nasal septum deviation during rhinoplasties will definitely cause a change in the voice, the extent of which can vary, due to change in airflow and the subsequent effects it has. However, unless the septum is being manipulated, it is unlikely that other types of rhinoplasty would affect the voice in a noticeable manner.

My nose is runny after rhinoplasty. What should I do?

This is a condition called vasomotor rhinitis which can be resolved with sprays like ipatroprium bromide or atropine. Consultation might be necessary, however, to make sure it is not part of a more serious issue.

How can I remove a post-rhinoplasty scar?

Unfortunately, scars cannot be permanently removed in the way that patients would like to see. However, they can be mitigated via cortisone injections and, long-term (after the healing process is complete), via laser resurfacing and dermabrasion treatments.

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.

I still have problems smelling one month post-rhinoplasty. Is this permanent?

Generally, problems with smelling post-op are the result of swelling in the nose and should resolve gradually within a year post-op.

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.

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.

How does weight loss/gain affect the appearance of the nose?

While weight loss or gain may affect the appearance of the nose in relation to other structures (as the face gets thinner, the nose takes up a greater proportion of the face and thus looks “bigger”), the nose itself has little fat within it and is not actually affected in terms of size by changes in overall fat for the patient.

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.

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 fix a short upper lip?

Often, a short upper lip is related to a droopy tip as the depressor septi muscles impact both. Cutting these muscles and releasing the upper lip can help the tip lift up and thus allows the upper lip to show slightly more.

I have bumps on my nose almost a decade post-rhinoplasty. Is it scar tissue developing years after my procedure?

It is unlikely that this is scar tissue. More likely, this is caused by the thinning of the skin with aging that makes the results of the rhinoplasty more apparent years after the procedure has been performed.

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

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.

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.

Why do I have pain in my palate post-rhinoplasty?

This pain is likely a result of the endotracheal tube which was placed in your windpipe during the rhinoplasty, a measure of precaution against breathing difficulties under general anesthesia.

My upper lip and tip of my nose are not moving after my rhinoplasty. Why?

Numbness following a rhinoplasty is not uncommon, but a consultation with the surgeon is probably necessary just in case. Speculation would seem to indicate that the numbness in the tip of the nose is caused by the resection of the depressor septi muscle, the symptoms of which will probably dissipate after three months. The numbness in the upper lip is most likely the symptoms of nerve aggravation which will also resolve itself as time goes on.

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.

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 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.

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.

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.

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