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

What is tip refinement?

Tip refinement is, to put it in general terms, the re-contouring and re-shaping of the nose tip for better appearance. This usually involves the addition/removal of cartilage from the tip and the suturing of the results, in addition to the use of cartilage grafts for people with thick skin to heighten the nasal tip.

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

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

Is there a risk in flying post-rhinoplasty?

Generally, a week is enough time to fly again post-rhinoplasty (2 weeks for turbinate or septal surgery). Spraying the nose with Afrin ½ hour before take-off and landing will likely help.

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.

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.

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.

Can I travel to Mexico to have a rhinoplasty done?

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

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.

Can I get a free surgery if I have been referred to a cosmetic surgeon by my doctor?

Unfortunately, this is highly unlikely. Insurance will likely pay for any functional defects like a deviated septum or enlarged turbinates which result in breathing difficulties, but any cosmetic changes will likely have to be paid out-of-pocket.

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

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

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

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

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.

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.

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 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).

When can I drive after a rhinoplasty?

It is recommended that patients, who are subjected to general anesthesia during a rhinoplasty (at least in my office), have someone drive them home post-op and care for them for the first 24 hours post-op. Patients should try not to drive for at least 3-5 days post-op.

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.

Can the fatty tissue in my nose be thinned out?

Many ethnic patients, particularly African-Americans, have thickened nasal tips as a result of excess fibro-fatty tissue. During a rhinoplasty, this tissue is removed and cartilage is harvested from the ear, etc. to shape the tip.

Does weight gain impact rhinoplasty results?

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

When can I wear glasses post-op?

It is recommended that, if patients have contact lenses, that they utilize those rather than glasses for at least 4 weeks post-op. However, if glasses are the only vision correcting tool available, they can be worn over the splint. When the splint is removed, however, patients are recommended to tape their glasses to their forehead or acquire a common pharmacy device which allows the glasses to rest on the cheeks.

Are rhinoplasties necessarily obvious?

It is important for patients to recognize that, as surgeons, our goal is to modify an existing nose and correct defects during rhinoplasties, rather than substitute one nose for another. If the surgeon you chose was competent, the rhinoplasty should enhance your overall appearance and give your face a degree of greater harmony.

Should I get an inferior turbinate reduction in addition to my rhinoplasty to help with breathing?

This procedure can certainly be beneficial for those undergoing rhinoplasty because it helps clear the airways, not to mention that due to its functionality (necessity), it is generally covered by insurance.

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.

Do rhinoplasty results really take a year to show?

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

Can picking my nose cause nostril asymmetry?

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

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.

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.

Can I smile after a rhinoplasty?

While smiling may cause a certain degree of discomfort post-rhinoplasty due to edema and other fluid buildup, patients are safe to smile all they want.

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.

How can I correct a pollybeak deformity?

A pollybeak deformity generally requires a revision rhinoplasty in which there is a reduction of cartilage in the supratip region and potential cartilage grafts to support the tip.

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.

What is a “good” male nose?

Male noses generally have straight bridges without deviation/curvature, thicker skin at the tip, and are generally a bit larger than female noses.

Can rhinoplasty make my nose flatter?

Although this is a rather uncommon request when it comes to rhinoplasties, it can certainly be accomplished via rasping or even an osteotomy to flatten the bridge of the nose. However, given that most people would prefer a thinner nose, I would suggest consulting with your surgeon before having any procedures done.

Can removal of a hanging columella cause the nostrils to appear wider?

Although it may seem like the weight of the cartilage in the columella may help “pull the nostrils back” in terms of flaring, this is not true. In the hands of a good surgeon, a hanging columella can be easily corrected without changing the other aspects of the nose, including width of the nasal bridge/tip.

Long-term cocaine use caused a hole to develop in my nasal membranes. What can I do?

First of all, it is important that patients who are serious about achieving a permanent solution to this type of problem lay off cocaine, which is a major vasoconstrictor (narrower of the blood vessels). Vasoconstriction of the nasal membrane blood vessels causes nasal membranes to die, thus leading to the development of holes, etc. Reconstructive nasal surgery may be done with the use of grafts but the chance of success is much lower than typical rhinoplasties.

Can rhinoplasty surgery have a negative impact on my breathing?

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

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.

Can I smoke post-op?

Nicotine in cigarettes is a powerful vasoconstrictor (causes narrowing of the blood vessels) and must thus be avoided in order to speed up the healing process post-op. It is recommended that patients wait at least 4 weeks or so post-op to resume smoking again, but not doing so is even better.

How safe is rhinoplasty?

In the hands of a well-experienced, competent surgeon, rhinoplasty carries with it only the typical risks of any major surgery. With that said, in these circumstances, you are more likely to have an accident on your way TO the surgery than to have complications during the surgery itself. However, it is the patient’s responsibility to find a surgeon who is board-certified in plastic surgery and has experience with these procedures.

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

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

Is a crooked nose more costly or painful to fix?

Not at all. The procedure of a rhinoplasty often entails osteotomies if necessary, that is, the purposeful breaking of the nasal bones to ensure their correct repositioning. Therefore, there is no additional cost and the “pain” is no more than a traditional rhinoplasty, which is basically none at all.

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.

Why do I have asymmetrical swelling post-rhinoplasty?

Generally, it is normal for patients to experience asymmetrical swelling, that is, one side of the nose healing faster than the other. I would not worry too much, but take care to see your surgeon as this may be the result of simple fluid accumulation (edema) which will heal itself over time.

Can trauma to the nose cause a dorsal hump?

It is possible for a hit to the nose to cause the development of a small dorsal hump due to the slight separation of the upper lateral cartilages from the bone which can occur. This can be corrected via cartilage grafting. However, it is important to also recognize that trauma to the nose may just create swelling that may look like a dorsal hump, so it is important to ice the area in question and evaluate.

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 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.

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).

I have pain months post-rhinoplasty. Is it infection?

Generally, patients should not experience excessive pain and tenderness post-rhinoplasty and should check for redness, swelling or discharge at the surgical site (could be signs of infection).

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.

Can injury cause the formation of a hump?

This is definitely possible as trauma to a bone-dense area induces the deposition of calcium in that area in the body’s effort to strengthen that particular site of injury.

Can the cost for a septoplasty and a rhinoplasty be lowered if they are done concurrently?

In some cases, surgeons will offer discount rates to do both at the same time, but patients should be wary of surgeons who are offering TOO much of a discount. As the old saying goes, “If it’s too good to be true, it probably is”. This surgeon may not be properly certified. In any case, though, septoplasties are generally covered by insurance so costs can be lowered in this manner.

Can I run 2 weeks post-rhinoplasty?

Any activity which increases blood pressure (even light exercise) can present a problem in terms of swelling. I often recommend to my patients that they refrain from running until at least 3 weeks post-rhinoplasty.

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.

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.

Can pregnancy make my nose swell more after rhinoplasty?

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

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.

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 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.

A hump is forming on my nose post-rhinoplasty. Why?

A hard bump forming on the nose is an indication of a minor bone callus which will eventually resolve itself within six months. In some cases, a minor revision may be required to shave it off if it is not resolved by that point.

How much will hanging columella reduction cost?

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

Can I fly with a broken nose?

Yes this is fine. I would recommend carrying Afrin spray and applying it 30 minutes prior to takeoff and landing to mitigate the risk of nosebleeds.

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.

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.

Does any real healing take place after a year post-op?

At one year post-op, patients should generally be close to their final results or should be there already. Patients with thick skin may take a little longer to fully heal and reveal their final shape, however.

There is a lump on my nostril following rhinoplasty. What is it?

Patients who find a knot forming on the nostril, thus making one of the nostrils look more rounded than the other, may have a bossa of the nasal tip which is a collapse of the lower lateral cartilages upon themselves. This can easily be corrected via revision surgery.

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.

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.

How to choose your Rhinoplasty surgeon

You should inquire about the following when choosing a surgeon:

1. Credentials: Is he a Board Certified Facial & Plastic surgeon? Is he aslo an ENT? How long has he been in practice? First and foremost you need someone who is well trained.
2. Gallery of Work: When you see their before and after gallery does it impress you? There are no guarantees, but the past is a great predictor of the future. You should consider whether the surgeon has experience with your ethnic type.

3. Simulated results: Computer technology allows the surgeon to virtually adjust your nose. This will show you the philosophy that shapes the surgeons style. Pay attention to how your surgeon describes what he would like to do.

3. Reputation: What does their previous/current patients say? Read some reviews and testimonials about the surgeon and their work.
4. Talents: Is your surgeon artistically inclined ? You want a surgeon who can not only manage the technical aspect, but that they will give you the best looking nose possible.

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.

How can I augment the philtrum and the radix?

I would generally recommend filling out these areas via the transfer of septal or ear cartilage.

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.

I have redness on my nose post-rhinoplasty. Is it infected?

Redness on the nose surface post-rhinoplasty, especially in the first weeks post-op, are generally the result of irritation of the skin by the nasal tape. However, consultation with the surgery may be necessary if patients feel that irritation of the skin is not the issue.

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.

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.

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.

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