Chances are good that you know at least one person who’s had a nose job. The American Society of Plastic Surgeons says that rhinoplasty is the third most popular cosmetic surgery, with more than 200,000 patients opting for the nose procedure every year. Whether it’s right for you depends on a number of factors, including the cosmetic and structural issues you’re looking to change, your budget, and the amount of time you can take off for recovery.
Case 34: Hispanic Rhinoplasty in this patient meant removal of a high dorsal bump on profile and correction of a droopy-appearing tip. On front view, there is correction of a left nasal bone fracture and refinement of the nasal tip. All of this was done while still maintaining her unique individuality and while bearing in mind the various challenges Rhinoplasty in Latino patients present- thicker skin and softer cartilage.
The consultation is your chance to get acquainted with the doctor and find out if you two see eye to eye. It is also your opportunity to explain why you want to have rhinoplasty and what your particular goals are. You will sit down with the doctor and tell him or her about your nose and what you would like to change. If you've had any previous nasal surgery or have broken your nose in the past, the doctor will want to know about that, too. If you have pictures of noses you like, bring them along so the doctor can get an even clearer idea of what you're hoping for. The doctor will examine your nose and explain what changes can be achieved and how the procedure will be performed.
Case 96: To see how well our results last, see these photos of our patient 8 years after rhinoplasty and facial fat transfer! Her rhinoplasty involved softening her look and removing the convexity on the bridge that made her tip look downturned. Fat transfer under the eyes has stood the test of time and really helped to reduce her under eye hollows to noticeably brighten her appearance.
Many patients choose to combine rhinoplasty with a facelift for dramatic results and an overall more youthful appearance. This procedure can treat creases and sagging skin, particularly around the eyes, cheeks, chin, and mouth. There are several types of facelifts, and patients can choose a mid, mini, or lower facelift to address specific areas of concern. Through carefully concealed incisions, the doctor raises the facial muscles, removes unwanted fat deposits, and trims away extra skin. Following a facelift, patients may look significantly younger.
Case 34: Hispanic Rhinoplasty in this patient meant removal of a high dorsal bump on profile and correction of a droopy-appearing tip. On front view, there is correction of a left nasal bone fracture and refinement of the nasal tip. All of this was done while still maintaining her unique individuality and while bearing in mind the various challenges Rhinoplasty in Latino patients present- thicker skin and softer cartilage.
Hospitals are the most expensive choice of facility. In Manhattan, fees can reach $6,000 and beyond for a single procedure. Though it is the most costly option, a hospital is also the best equipped to facilitate surgery involving a patient who is prone to excessive bleeding, or has other conditions that increase the risk of complications. You can expect your doctor to closely examine your medical history to determine if surgery in a hospital is necessary.
Augmentation rhinoplasty is another popular type of nose reshaping surgery. During this treatment, the doctor performs bone or tissue grafting to build up the nasal tip and/or bridge. In many cases, he or she uses cartilage from other parts of the nose, usually the nasal septum. However, if a patient does not have enough tissue in this area, the doctor may use rib bone, cartilage from other areas, synthetic material, or other biological tissues.
Spread of toxin effects. The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice, trouble saying words clearly, loss of bladder control, trouble breathing, and trouble swallowing.
Asian, Latin, and African American rhinoplasties require a special skill set. Surgeons say the challenge lies in reshaping and resizing the nose while retaining its distinct features and keeping it proportional to the face. “Typically, African American, Asian, and Latin noses have flat bridges and wide tips,” says Dr. Miller. “The number-one goal is to create a new tip [through cartilage grafting] that has better support.” Patients also often request a reduction in nostril size. 
Case 22: This young woman was happy with her profile but wanted to reduce nasal width, tip boxiness, and nostril flare on front and three-quarter views. The combination of narrowing her bridge, tip refinement, and nostril reduction helped bring her nose into balance. At the same time, fat transfer to the under eye hollows did a fantastic job of brightening her eyes and giving her a more youthful look.
Case 46: A hump and hanging tip cause the nose to dominate otherwise beautiful features in this young woman. In this case, a tip lift, hump reduction, and tip refinement preserves some of her rounded appearance, very naturally enhancing her pretty eyes. On the bottom view, we see a good example of how open rhinoplasty incisions should heal virtually undetectably when done with care.
Unfortunately, despite a surgeon's best efforts, in some cases a patient may be unhappy with the results of his or her surgery. This can result from numerous causes, including surgical error or unrealistic expectations on the patient's part. Because the final results of rhinoplasty can take up to a year to develop, patients should not panic if their noses have not taken their ideal shape in the first few months. If a patient is unhappy with the nose even after the final shape has stabilized, there are options for treatment and correction. Depending on the extent of changes that need to be made, a surgeon may recommend non-surgical nose reshaping or secondary (revision) rhinoplasty.
If you don't know what nasal packing is, consider yourself lucky. Nasal packing is gauze placed deep inside the nose, usually to prevent or stop bleeding. Dr Rival uses nasal packing in only about 5% of all his rhinoplasty surgeries. Sometimes in very deviated noses he may place plastic splints inside the nose to maintain a straight septum for 5 to 7 days.

Case 16: A crooked and overprojected nose draws the eye away from other beautiful features. In this pretty young woman, you can see how rhinoplasty transforms her face. Even at this early 3-month point, we see that her nose is more feminine and no longer dominates her otherwise delicate features. And, at the same time, it is balanced and ethnically-appropriate.
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