Rhinoplasty

_{*According to the American Academy of Facial Plastic and Reconstructive Surgery}

Dr. Newman takes special care to develop realistic expectations among patients and will only recommend rhinoplasty if it can truly meet your goals. Rather than using imaging software that can produce unrealistic expectations, Dr. Newman can present before-and-after photos of previous cases to help you gain a better understanding of what you can hope to achieve. 

Wide Bridge or Hump

A wide bridge or significant hump is one of the most common reasons for a patient to elect to undergo a nose job. A nose job for a wide bridge can be performed for cosmetic purposes or to repair the internal structure of the bridge and make breathing easier. This type of nose job can take from one to two hours to complete, depending on your specific circumstances.

If you have a hump on the bridge of your nose, Dr. Newman will use a special tool to reduce the size of the hump. To correct a wide bridge, Dr. Newman will fracture the bones and, in some cases, remove excess cartilage. He will then move the bones together, creating a narrower bridge and a more refined appearance.

Wide Nostrils

The flair or width of the nostrils is another common concern among patients who undergo nose job procedures. Dr. Newman can create a narrower nose by changing the way the skin lies at the bottom of the nose. In a procedure known as “minimizing wedges”, aka alar base resections, Dr. Newman removes small wedges of skin from the base of the nostrils, where they meet the cheeks. Dr. Newman then carefully closes the trimmed area with fine sutures, eliminating the risk of visible scars. With the nostrils positioned closer together, the flare of the nostrils is reduced, the tip appears more refined, and the entire nose appears more slender.

Enlarged Tip

Many of our patients feel that the tips of their noses are too large, project too far forward, or hang down too far. This issue is relatively simple to fix by trimming the cartilage in the tip and reshaping it. Additionally, trimming the septum, or the thin partition between the nostrils, can improve the angle of the nose to the upper lip, eliminating the “hooked” quality that some noses possess.

Breathing Difficulties

Turbinectomy is sometimes recommended to open the nasal air passages. The procedure reduces the projections of the turbinate – internal structures that warm and add moisture to the air flowing through the nose. Septoplasty is often a solution for a septum that has deviated to block the air passages. 

For most patients, the majority of the swelling subsides within the first month or two. However, it may take up to a year for swelling in your nose to fully resolve and reveal your final results. Over this time, you may notice gradual changes to your appearance.

The changes made during rhinoplasty remain fairly consistent over time. Your features do tend to change as you age, so it is important to use proper sun protection and maintain a healthy lifestyle to help maintain your results.

Closed Nose Surgery

In the closed version of rhinoplasty, several incisions are made within the nose. The locations of the incisions will depend on the type of modifications being made in your nose surgery. No incisions are made on the outside of the nose. The skin is then disconnected from the bone and cartilage, which may be restructured, partially removed, or augmented to attain the desired shape. This closed nose surgery technique requires a skilled surgeon because the inner structure of the nose is difficult to see without making external incisions. One main advantage of the closed rhinoplasty technique, though, is that you are left with no visible scars. Dr. Newman opts to perform closed nose surgery for most of his patients; however, he will use whichever method is the most appropriate for your situation and desired outcome.

Open Nose Surgery

In certain cases, Dr. Newman chooses to use the open method of nose surgery. In open rhinoplasty, an incision is made in the vertical strip of skin between the nostrils, which is called the columella. With this technique, the nasal skin can be elevated and the inside of the nose exposed. Thus, the major advantage of the open approach is that it makes the anatomy of the nose visible in its natural position. This technique is particularly helpful for fixing problems with the nasal tip and septum. In most cases, the incisions across the columella heal quite nicely, leaving no telltale scarring. Whichever technique is used, nose surgery is usually performed under general anesthesia on an outpatient basis.

Male Rhinoplasty

Male rhinoplasty surgery by Dr. Fredric Newman is tailored to complement distinctly masculine characteristics, such as a stronger jaw and heavier brow. He can help you reach your goals while maintaining an appearance that is uniquely yours. 
 

Ethnic Rhinoplasty

Rhinoplasty is considered one of the most challenging facial procedures, and requires the expertise of a skilled surgeon. When it comes to nose surgery for patients of Asian, African American, Hispanic or Middle Eastern descent, the doctor needs more than just surgical skills. Your plastic surgeon should also have sufficient experience with patients from diverse ethnicities to understand the structural differences and the aesthetic requirements of different cultures.

Dr. Fredric Newman is skilled at preserving the unique characteristics of non-caucasian patients while enhancing the aesthetics of their nose.
 

Dr. Newman’s Ethnic Rhinoplasty Experience

Successful ethnic rhinoplasty can reshape your nose and alter its structure. This procedure can create aesthetic balance and improve function, while preserving distinctive characteristics that complement your face. At The Aesthetic Surgery Center, Dr. Newman has extensive experience working with a diverse range of patients for personalized facial surgeries. This background, coupled with his advanced training, allows him to treat each case with an individualized approach. Dr. Newman is sensitive to your unique needs and preferences, and can help you achieve results that highlight your natural beauty.

There is no one-size-fits-all solution in rhinoplasty for ethnic patients. For example, African American patients might want narrower nostrils or a narrower nose in general. But a pinched nose tip can look unnatural on a broad-featured face, and your doctor should provide correct guidance on the best goals for your features. This allows patients to manage their expectations realistically. 

A successful ethnic rhinoplasty should preserve the distinct facial characteristics of the patient, while enhancing their natural beauty.

Unique Procedures

Like other forms of rhinoplasty, ethnic rhinoplasty can alter and reshape the cartilage, skin, and bone of your nose. Depending on your unique needs, these alterations may be subtle or dramatic, while retaining your ethnic features. A successful ethnic rhinoplasty should preserve the distinct facial characteristics of the patient, while enhancing their natural beauty. 

An ethnic rhinoplasty with Dr. Newman procedure may:

• Build the prominence of the nasal bridge
• Refine the tip of the nose
• Smooth bumps in the bridge of the nose
• Reshape the nostrils, or make them narrower at the base
• Make a broad nasal bridge narrower 
• Improve breathing function

Revision Rhinoplasty

While the majority of nose surgery candidates experience satisfying results and report improved self-confidence and body image, rhinoplasty is a complex and difficult procedure after which some patients require a second operation. Dr. Fredric Newman is well known in his field for his skill in performing revision rhinoplasty. Patients undergo revision rhinoplasty, also referred to as secondary rhinoplasty, when the first procedure results in cosmetic or functional problems that need to be improved or repaired. This corrective procedure can be even more challenging and delicate than the primary rhinoplasty and requires a surgeon with specialized knowledge of the operation. A great deal of effort is put into revision rhinoplasty at The Aesthetic Surgery Center, where Dr. Newman has operated on patients who have had as many as seven previous surgeries performed by less skilled surgeons. Don’t give up: many different things can be done if you have had one or more damaging or unsatisfactory rhinoplasty surgeries.

Revision Rhinoplasty for Cosmetic Reasons

Many patients choose to undergo their initial rhinoplasty surgeries because they feel their noses are too wide, crooked, long, or pointy, or that they have distractingly large humps or bulbous tips. Due to the fact that rhinoplasty is such an individualized operation, it can be argued that it is the most difficult cosmetic surgery procedure to perform well. Among the mistakes that might lead a patient to undergo a revision rhinoplasty are:

• Removal of too much tissue from the nasal tip.
• Asymmetry – the surgeon failed to perform the same technique on both sides of the nose.
• Crooked Nose – the surgeon failed to address a deviated septum, or attempted to narrow the nose to the extent that the sidewall collapses inward.

Some other cosmetic issues that might cause a patient to request revision rhinoplasty are unsightly bumps and dips, excessive scarring, or a nose that is too thick or thin. Revision rhinoplasty may fix these problems by filing down bumps and augmenting areas that are too concave or small with implants or donor tissue from another site on the patient’s body. Since previous surgery may have resulted in the excess removal or twisting of supporting bone and cartilage and a buildup of scar tissue, Dr. Newman will carefully replace any missing structure and reposition cartilage in a way that perfects both the size and shape of the nose.

Revision Rhinoplasty for Functional Reasons

The size and proportions of the nose play a huge role in facial aesthetics, but these features are also inextricably linked to the nose’s function. Thus, in certain cases, the damage from a previous nose surgery may not be purely cosmetic. Nasal collapse, difficulty breathing, nasal drip, and headaches are some of the complications that could make a revision rhinoplasty necessary. These impediments can be physically and emotionally traumatic for the patient, as they may hinder his or her self-esteem, social life, and physical activities. Often, insurance will cover all or part of your rhinoplasty cost if you are having revision rhinoplasty to address a functional issue.

Importance of Using a Surgeon Skilled in Revision Rhinoplasty

The revision rhinoplasty procedure is a very specialized surgery, so you will need to be sure your surgeon has the skill and experience necessary for giving you a beautiful outcome. Dr. Newman places a strong emphasis on maintaining the structural support of your nose, ensuring that function, as well as outward beauty, is maintained. Dr. Newman encourages his patients to engage in careful consideration before deciding to go ahead with any cosmetic procedure, and will take the time to fully understand your goals and desires for your new nose.

Dr. Newman is often sought out to do revision rhinoplasty. This is a delicate process because it repairs the work of a prior surgery. To better see Dr. Newman’s talent in performing revision rhinoplasty, view before and after photographs of his plastic surgery patients.

Should I Consider a Revision Procedure?

Dr. Newman can evaluate your revision rhinoplasty candidacy during a consultation. He will conduct a thorough examination and listen carefully to your concerns and goals to determine if the surgery is right for you. Patients who are looking to correct the results of their rhinoplasty may be concerned with:

• Too slight or subtle of a refinement
• Effects that look unnatural, such as a small tip of the nose that stands out against otherwise broad features
• Trouble breathing through one or both nostrils
• Results that fail to complement a patient’s unique ethnic background
• Aesthetic results that have become distorted over time, such as the collapse of the bridge

Often, the need for revision surgery arises from poor communication between the patient and doctor. The doctor might impose his or her own idea of what constitutes balance, or try to achieve results that the patient wants, but do not look completely natural. Choosing the right surgeon is a crucial step when seeking a revisional surgery.

Evaluating Your Candidacy

In addition to wishing to correct the results of rhinoplasty surgery, patients will need to be in good general health and not smoke. Conditions such as poorly controlled diabetes that could raise the risks associated with surgery will need to be addressed before you are eligible for revisional rhinoplasty. You should be committed to attending several follow-up visits at our practice and also have realistic expectations for the results you can achieve.

Developing Expectations

Dr. Newman spends an extensive amount of time in the consultation process. He will be completely honest with you about what he can do, as well as what he cannot do. Revisional procedures carry an increased risk of complications. Although there is a significant probability that Dr. Newman can improve your results, you could simply "break even," and there is a very rare chance the surgery will result in a worse outcome. Until Dr. Newman gains access to the nasal structures, it may be difficult to tell how much scar tissue has formed, which can affect your results.

Nose reshaping surgery requires a high degree of skill, and revision rhinoplasty is even more complex. Dr. Fredric Newman has decades of experience in this area, leading many patients to seek his help.

It is important to discuss your options in the event that the procedure fails to adequately address your concerns. In very complex (and extremely rare) cases, Dr. Newman may recommend an additional operation.

About Non-Surgical Treatment

Using dermal fillers to complement your facial features and create a more balanced look can be an effective alternative to surgical rhinoplasty treatment. Non-surgical rhinoplasty alternatives give patients the option to reshape the nose using hyaluronic acid fillers or collagen-stimulating fillers. Many patients who want subtle adjustments can benefit from this option because it is a simple procedure that takes less than an hour and provides virtually instant results.

Dermal Fillers and Their Uses

Dr. Newman offers various injectable skin treatments to reduce the signs of aging, increase volume, and enhance your appearance. He will help you choose the best option for your needs based on a discussion of your goals and an assessment of the state of your nose. 

How Are Dermal Fillers Used to Shape the Nose?

Non-surgical treatment cannot reduce the size of the nose or correct functional issues, but can be very effective in improving the shape and contours of the nose. Many patients may believe that the nose will look bigger if injected with fillers, but are often surprised to find that an even, more symmetrical nose enhanced with injectables can actually appear smaller, complementing your other features.  Dr. Newman is able to meticulously alter specific areas of the nose to create desired results. Fillers can:

• Build up a flat or low nasal bridge
• Reshape a crooked tip
• Fill a depressed area
• Improve nostril size
• Conceal the effects of injuries to the nose
• Redress unsatisfactory results from a previous rhinoplasty procedure

Patients should bear in mind that using facial fillers is only a temporary solution. A traditional rhinoplasty is often a better recommendation for those clients who want a dramatic, permanent change to the nasal contours and size. Depending on your facial features, Dr. Newman may also recommend ethnic rhinoplasty to achieve your aesthetic goals. You can depend on Dr. Newman to conduct a careful analysis of your nose, the underlying nasal structure, and your goals in order to determine which treatment will truly offer you the greatest benefits.

Benefits of Noninvasive Alternatives to Rhinoplasty

There are several benefits of using dermal fillers for nasal contouring. Since this method uses injections, significant cosmetic improvements can be achieved with little to no pain. A non-surgical nasal enhancement avoids the risks of surgery, and patients do not have to wait for long periods to see the results or fully recover. Because the results are not permanent, you can safely undergo retreatment that allows you to enhance your features as you age. 

Patients can generally return to work the day after treatment and can see the results immediately. 

The Procedure

The procedure for non-invasive nose refinement is performed in our office after Dr. Newman has taken detailed and precise measurements of your nose. He will discuss the areas you wish to address and how best to achieve your goals. After applying a topical anesthetic to maintain your comfort, Dr. Newman will inject the filler in small amounts, targeting precise areas to achieve the results you want. 

Patients can generally see results immediately, with more specific refinements becoming apparent after a week to two weeks. Because swelling and bruising are rare and typically only minor, most patients can return to work the day after treatment. We advise patients to avoid heavy eyewear for two weeks following the procedure to allow the filler to integrate with your skin. Results usually last about a year, which gives you the freedom to make appropriate alterations to your nose as your face changes with time, and to retain a natural look. 

Rhinoplasty FAQ

Dr. Fredric Newman believes patient education is essential to the success of plastic surgery. He has created this rhinoplasty FAQ to help you gain a base understanding of the capabilities, recovery time, and other aspects of the procedure:

What can rhinoplasty accomplish?

Rhinoplasty can provide subtle refinements or alter the shape and size of the nose significantly. Asymmetry and other issues can be addressed by reducing bumps in the bridge of the nose, changing the angle of the nasal tip, reducing large nostrils, and performing other techniques. Rhinoplasty can also serve a practical purpose by straightening a deviated septum (the cartilage that serves as the central supporting structure of the nose) to improve breathing. Dr. Newman's goal is to harmonize the nose with other facial features, and he can provide refinements that look entirely natural and proportionate. He is adept at treating men, women, and patients of various ethnicities. 

Will I have noticeable scarring?

Dr. Newman can provide open or closed rhinoplasty (meaning incisions are placed either inside or outside the nose), but recommends closed rhinoplasty whenever possible since this approach leaves no visible scars. When an open surgery technique is necessary, it may result in a very small scar on the columella, the tissue that connects the nostrils at the base of your nose. In Dr. Newman's hands, the resulting scar is extremely discreet.

How much does rhinoplasty cost?

The cost of rhinoplasty, including anesthesia and facility fees, will vary based on the extent of your surgery and your choice of surgeon. In general, you can expect to pay more for surgery performed by an experienced surgeon. However, this added investment can help to ensure that you are satisfied with your results, and that you will not require a costly revision surgery. Insurance plans will sometimes cover a portion of the costs if surgery is necessary to correct a deviated septum or address the results of an injury. To help place rhinoplasty within your budget, Dr. Newman offers no-interest financing options.

What can I expect during surgery? 

Rhinoplasty is an outpatient procedure that Dr. Newman usually performs under light general anesthesia. A simple rhinoplasty takes just over an hour. Most rhinoplasty surgeries are complete in under two hours. Patients do not feel any pain during the procedure. You will be groggy from the anesthesia. Therefore, you should arrange for a friend or loved one to drive you to and from your appointment, and to stay with you overnight following surgery. 

Dr. Newman's goal is to harmonize the nose with other facial features, and he can provide refinements that look entirely natural and proportionate. 

What is the recovery period like? 

You will leave the office with a splint on your nose and a small soft pack inside each nostril. During recovery, bleeding is normal within the first 24 hours, and you will need to breathe primarily through your mouth for a few days. Swelling is also normal, but you should not experience significant pain. Pain medication will be provided as needed. You can expect to return to normal, non-strenuous activities within a week. 

Are there risks?

Every surgery involves risks, including infection and unsatisfactory results. However, you can greatly reduce these risks by choosing the right surgeon. 

What if I want to revise unsatisfactory results provided by another surgeon?

Dr. Newman performs revision surgeries for patients who are unhappy with the results of a past procedure. He can help if you are experiencing structural issues or breathing problems, or if you simply do not like the appearance of your previously altered nose. 

Are there any non-surgical alternatives?

Most patients' goals for nasal refinement can only be achieved through rhinoplasty. However, dermal fillers can be used to make small changes in the appearance of the nose. For the right candidates, Dr. Newman can use injectable treatments to improve shape and contour, conceal injuries, and enhance symmetry.

Choosing a Surgeon

Nose reshaping surgery requires a high degree of skill, and revision rhinoplasty is an even more complex procedure. As a result, many facial cosmetic surgeons do not enjoy the procedure, and are fairly inexperienced at it. Every type of surgery carries a degree of risk, but if your surgeon enjoys performing the procedure, you can expect better results. Dr. Fredric Newman has decades of experience in nose reshaping surgery, leading many patients to seek his help in revising rhinoplasty results. He is passionate about restoring his patients' quality of life with his personalized care.