NJ Nose Job - Rhinoplasty
Dr. Ovchinsky has been named as “Best Rhinoplasty Doctor in NJ” in both 2018 and 2019 by New Jersey Monthly Magazine.The nose, being the most defining central feature of the face, has a very significant impact on how a person looks. Even a slight alteration in nasal shape and structure can often greatly improve one’s appearance. Dr. Ovchinsky, a double board certified facial plastic and head & neck surgeon, will provide you with the highest level of expertise in both esthetic and functional rhinoplasty. This dual training allows Dr. Ovchinsky to know the nasal anatomy and function literally “inside out” and to be able to encompass esthetic and functional (breathing) improvements in one procedure without compromising either. It cannot be overemphasized that good communication between a patient and a doctor is essential in planning of rhinoplasty. Nasal anatomy, skin type, history of prior nasal surgery, ethnic background, and age are important factors to be considered in preoperative discussion. During the preoperative evaluation, Dr. Ovchinsky will both listen carefully to your concerns and desires, not only with respect to what you want changed, but also to what you wish to remain the same. Today, computer imaging is an enormous help in the exploration and dialogue between you and your surgeon. By utilizing the imaging system, Dr. Ovchinsky would be able to greatly facilitate the discussion and mutual understanding and show you a realistic view of what can be accomplished by surgery. Dr. Ovchinsky is equally versatile in either the “closed” or “open” rhinoplasty techniques. In the closed technique, all incisions are concealed inside the nostrils.
Here is a very happy patient talking about his rhinoplasty experience.
Nasal Tip SurgeryMany patients present for rhinoplasty because they are unhappy with the appearance of the nasal tip: it may be too big or bulbous, sticking out too far away from the face (over-projected), droopy, or excessively pinched and collapsing (especially common in patients who had prior rhinoplasty surgery). While there are many nasal tip techniques involving modification of the nasal tip cartilages, with time certain techniques may result in excessive narrowing or asymmetries of the nasal tip with or without nasal obstruction.
Dr. Ovchinsky’s techniques rely primarily on preservation of the tip cartilage strength, precise suture placement and the use of cartilage grafts to create a naturally appearing and stable nasal tip contour, no matter whether this is your first nose job or a revision.
Nasal DorsumDorsal hump reduction is one of the most commonly performed procedures in rhinoplasty, usually resulting in a much more pleasing profile and smaller appearing nose. While removal of the dorsal hump may seem like a fairly straightforward procedure, it is very important, especially in cases with very prominent dorsal humps, to provide the nose with an extra support in order to prevent future weakness and collapse of the dorsal cartilages.
In many instances, especially in cases of prior nasal trauma, nasal bones may be shifted to one side or another, thus causing nasal deviation and asymmetry. This problem can be successfully corrected during rhinoplasty. It is very important to carefully examine these noses internally prior to surgery since most of them have septal deviation as well. The correction of septal deviation should never be neglected. If uncorrected, it may lead to incomplete improvement of nasal deviation and persistence or worsening of nasal obstruction after the surgery.
Before and After Photos
Rhinoplasty, also known as a nose job, is a cosmetic procedure that involves changing the size and shape of different areas of the nose as a way to enhance its overall appearance. By making changes to areas like the bridge, tip, and nostrils, rhinoplasty can be performed to effectively refine or redefine the way the nose looks.
There are 4 distinct types of rhinoplasty:
- Cosmetic rhinoplasty improves the nasal shape and its proportion to the rest of the face.
- Functional rhinoplasty alleviates breathing difficulties.
- Reconstructive rhinoplasty rebuilds a severely damaged or congenitally malformed nose.
- Revision rhinoplasty corrects a suboptimal result from earlier surgery.
In general, individuals who are unhappy with the appearance of their nose and desire to change it to better suit their aesthetic needs are good candidates for rhinoplasty. Some may be unhappy with certain features, such as a prominent hump on their bridge or a large round nasal tip. Others may feel like their nose is simply too large for their face.Rhinoplasty can also be performed to correct deformities and damage caused to the nose by injury or trauma.
Open rhinoplasty is a surgical approach that involves making a small incision underneath the nose on the small section of flesh known as the columella. This allows the surgeon to lift the tissue so that they have a better view of the surgical area, along with easier access. With closed rhinoplasty, incisions are made inside the nose through the nostrils, minimizing surgical marks.
The procedure is performed under general anesthesia, so no pain will be experienced during surgery. Some pain and discomfort can be expected during the first part of the healing process. Any pain can be managed with medication provided following your rhinoplasty.
While rhinoplasty is most commonly used for aesthetic purposes, the techniques employed can also be utilized to help improve the patient’s ability to breathe through their nose. This is done by removing obstructions in the nasal pathway, straightening the pathway, or making the pathway slightly larger so that it becomes easier for air to pass through it.
People who know you well and are familiar with the appearance of your nose will be able to tell there is a difference. If the open approach is chosen, a majority of the incisions are still made internally where they will be hidden, and the small incision made on the outside of the nose should be difficult to detect.
It is important for the nose to be finished developing before undergoing surgery. If further development or growth occurs after the surgery, then it can compromise the results of the rhinoplasty. On average, the nose is finished growing at age 16 for boys and age 15 for girls.
Once the procedure is complete, you will be able to return home. You will need someone to drive you home and assist you during the first day of recovery. A nasal splint will need to be worn for the first week or so of the recovery period to assist with healing. Bruising and swelling are to be expected and will dissipate over time. Strenuous activity will need to be avoided for a minimum of four weeks.
Most patients can return to work and a majority of their normal activities after around one week. However, some bruising and swelling may still be visible, which can make some people feel self-conscious.
As surprising as it may sound, recovery from rhinoplasty surgery is not a very painful one. Patients may expect some discomfort as the head and nose may ache during the first few days after surgery. Most of the post-operative discomfort is typically related to nasal congestion for a week or so after surgery, and feels like a head cold. Pain medications are commonly prescribed for after the surgery to be used on as needed bases.
Swelling and bruising are common, and patients may experience some nasal discomfort. Some bloody discharge can also occur for the first few days, but rarely is there a severe bleeding. Stitches and nasal splint (white firm plastic) are usually removed within one week. Though some subtle swelling of the nose can take as much as a year to fully fade out, the majority of swelling will clear up in about two weeks. Dr. Ovchinsky almost never uses nasal packing after the surgery, which dramatically reduces postoperative discomfort.
Dr. Ovchinsky usually prescribes a prophylactic antibiotic to be taken for 1 week after the surgery. Pain medications are prescribed to be used on as needed bases. Dr. Ovchinsky also recommends to use Saline nasal spray starting the following day after the surgery to gently irrigate the nose.
Most rhinoplasty patients find that they can return to work/ school in about one week. Even sooner return to work/ school is possible for those who don’t mind appearing publically wearing nasal splint and don’t do any physical work. Patients should avoid strenuous activities for two to three weeks and should avoid contact sports with a potential trauma to the nose for at least 6-8 weeks.
If external incision is made, it is closed with very fine sutures which are usually removed in about one week after the rhinoplasty procedure. Internal incisions are closed with absorbable sutures and don’t require any suture removal.
Dr. Ovchinsky usually sees his rhinoplasty follow up patients at 1 week after the surgery, at which point nasal splint and sutures are removed. The subsequent follow ups are at 1 month, 3 months, 6 months and 12 months after the surgery. All patients are encouraged to follow up at any time in the interim if they have specific problems or concerns.
Although not common, some of the potential complications that can occur with rhinoplasty are as follows: bleeding, infection, adverse anesthesia reactions, septal perforation or hematoma, persistent or worsened cosmetic problem or nasal obstruction, poor scarring, and the need for additional surgery. Dr. Ovchinsky will oversee your care until complete healing has occurred and satisfactory, realistic results have been obtained.
Although our patients are generally out and about within 10 days of the procedure (sometimes within a day), the tissue concealed beneath the skin of the nose takes about a year to heal completely from surgery. Of course this healing process happens indiscernibly and does not affect patients’ life style.
Because rhinoplasty is a complicated procedure and neither you nor your surgeon can fully control your healing process, there is a chance you may need to have some post-surgery touch- up/ revision procedure. About 10 percent of rhinoplasty operations require touch-up procedures, ranging from small touch ups in the office to a full revision surgery in the hospital.
The cost of the surgery is determined by the complexity of the operation, whether the surgery is primary or revision, and whether there is an insurance based component of the procedure. All patients get a detailed surgical quote at the end of their consultation visit which is tailored to their specific circumstances.
Though some amount of coverage may be available for rhinoplasty procedures performed for functional (breathing improvement) purposes, most rhinoplasty procedures are considered cosmetic and are not covered by insurance. The determination whether there is a place for insurance coverage is usually done at the initial consultation and is primarily based on patients’ symptoms, history and physical examination findings.
Financing is available for many plastic surgery procedures. Our office manager/ patient coordinator will go over available payment options at the end of your consultation visit.
Dr. Ovchinsky’s research work on rhinoplasty techniques was presented at the Annual Meeting of the American Academy of Facial Plastic and Reconstructive Surgery in Dallas, TX, October 2015
Comparison of Permanent Versus Absorbable Suture in the Tonguein- Groove Technique in Endonasal Rhinoplasty