Rhinoplasty

Conveniently located to serve the areas of New Jersey and New York

nose surgery short hills

A rhinoplasty, or nose job, is a surgical procedure that is performed to improve nasal aesthetics, function, or both. The human nose is a small yet incredibly complex organ made up of intricate interlocking structures. As a result, any alteration demands deep knowledge of nasal anatomy, meticulous attention to detail and surgical precision. This procedure is one of the most commonly performed surgeries in the United States, with the American Society of Plastic Surgeons and American Society of Facial Plastic and Reconstructive Surgery reporting that over 350,000 rhinoplasties were performed in 2020 alone! However, given the central location of this facial feature, it’s essential to choose a plastic surgeon that specializes in these delicate operations. Rhinoplasties are considered one of the most difficult facial surgeries to perform and have one of the highest rates of revision.(1) Quite simply, the stakes are high! Dr. Alexander Ovchinsky is widely considered to be one of the best rhinoplasty surgeons in New Jersey and New York. In addition to performing hundreds of these procedures every year, he also makes frequent contributions to medical publications and shares his expertise with residents and fellows as a faculty member at Mount Sinai, NYU and Robert Wood Johnson, one of the leading teaching institutions for this specialty. To experience his dedication to patient care and outstanding results, schedule a personal consultation at Plastic Surgery of Short Hills. You can reach his New Jersey offices by calling (973) 379-010, his Brooklyn offices by calling (718) 646-1234, or fill out this simple form at your convenience. 

About

Rhinoplasty manipulates bone, cartilage, and soft tissue in a procedure that is carefully customized to meet the patient’s needs, so no two rhinoplasties are the same. Adjusting the bridge, tip, and or nostrils can effectively refine or redefine the way the nose looks, and create better balance, symmetry, and respiratory function.

Types of Rhinoplasty

  • Cosmetic rhinoplasty improves the nasal shape to harmonize the proportions of the face.
  • Functional rhinoplasty alleviates breathing difficulties, such as airway blockages caused by a deviated septum.
  • Reconstructive rhinoplasty rebuilds a nose damaged from injury or corrects a congenitally malformed nose.
  • Revision rhinoplasty corrects unwanted results from earlier nasal surgery.

Before & After Photos

Before and After Photos

Benefits of Modern Rhinoplasty

Modern understanding of nasal anatomy has allowed surgeons to develop more sophisticated techniques and achieve better outcomes than ever before. The nose contains a complex network of tissues that were still being identified until fairly recently. However, nasal surgeries have been performed for millennia, with the first recorded rhinoplasty detailed on a papyrus dating back to Ancient Egypt!(2) 

Nasal Anatomy

Nasal Bones: The top-most part of our nose is formed by two small nasal bones that extend from between our eyes, and connect to the maxilla. 

Upper Lateral Cartilage: The upper lateral cartilages form the upper right and left sides of our nose, and have a small layer of overlap with the nasal bones, which forms the dorsum, or bridge of the nose. 

Alar Cartilage: Just beneath the lateral cartilage, we find the alar cartilage. These two pieces of cartilage meet in the very center of our nose, where their curved areas called crura form the tip of our nose, and allow it to project outwards. 

Septal Cartilage: The septal cartilage bisects the right and left sides of our nose, running down its center, and divides the nasal cavities.

Soft Tissue Envelope: Encasing the bone and cartilaginous structures of the nose is the soft tissue envelope. This is composed of several different layers of muscle, connective tissue, nerves, blood vessels, and skin. 

Nasal Mucosa: the thin layer of tissue that covers the inside surface of the nose.

The specific aspects of the nose that are manipulated during a rhinoplasty depend on the patient’s unique anatomy and goals for surgery.(3) This may include reducing the size of the dorsal hump, or bridge of the nose, which is one of the most popular requests. Other patients may be unhappy with the shape of the tip of their nose, and nasal tip surgery, or tip plasty, is performed. This can reduce a bulbous nose, lift up a droopy tip, correct a tip that has become overly pointed or collapsed after previous surgery, or narrow the width of the nostrils.

Every rhinoplasty demands careful consideration on the part of the surgeon, and Dr. Ovchinsky specializes in creating carefully tailored results.

Male Rhinoplasty

nose job for men short hills

 Rhinoplasty is performed on people of all genders, but special attention is required for men desiring this surgery. Dr. Ovchinsky works closely with his male patients to ensure that their nose retains a masculine appearance, and balances well with their other facial features. 

Ethnic Rhinoplasty

 A patient’s ethnicity determines much about the anatomy of their nose, such as the proportions and skin thickness. It’s vital to perform a rhinoplasty that will preserve the unique ethnic attributes so that the patient achieves natural-looking results while still meeting their aesthetic goals. Dr. Ovchinsky specializes in African American, Hispanic, and Asian Rhinoplasties, as well as those required for patients of other specific ethnicities. 

Transgender Rhinoplasty 

Transgender Rhinoplasty is often one of the most difficult forms of rhinoplasty to perform because of the inherent differences in male and female nasal structure, and the changes patients desire while transitioning. Dr. Ovchinsky performs facial feminization surgery for trans women, taking care to preserve the structural integrity of the nose and natural-looking proportions while also creating a softer, more refined nasal shape. Trans men often require cartilage grafts or other adjustments to augment the length and angles of the nose for a more rugged, masculine appearance.

Teen Rhinoplasty

Rhinoplasty can be performed on patients under 18, given that they have parental consent and that their facial features are fully developed. This surgery can give teenagers a much-needed boost of confidence during this difficult stage of life. 

Regardless of a patient’s motivations or unique set of circumstances, recent developments in rhinoplasty allow surgeons to preserve the crucial framework that forms the nose. This approach is known as preservation rhinoplasty or structural rhinoplasty. Avoiding over aggressive excision ensures that the results are longer-lasting, and reduces the likelihood of complications.

A more conservative approach also results in less trauma to the nasal tissues, which means patients enjoy less discomfort and a faster healing process after surgery.(4)

Candidates

There are many factors that must be considered to determine whether a patient is a good candidate for rhinoplasty. Nasal anatomy, skin type, history of prior nasal surgery, ethnic background, and age will not only influence the surgical approach but have an important impact on the results. The best way to learn more about whether you’d make a good candidate for rhinoplasty is to schedule a personal consultation with Dr. Ovchinsky at Plastic Surgery of Short Hills.

Personal Consultation

rhinoplasty short hills

As with any plastic surgery procedure, good communication between the patient and a doctor is an essential part of planning for rhinoplasty. Your initial consultation will be an honest and informative conversation so that you can learn more about the procedure, and Dr. Ovchinsky can get to learn more about your lifestyle, medical condition, functional status of the nose and aesthetic goals.  

He’ll take the time to listen carefully to your concerns and desires, not only with respect to what you want to be changed but just as importantly, to what you wish to remain the same! Today, patients have the added benefit of computer imaging. Being able to see what kind of results are possible is an enormous help in the dialogue between you and your surgeon. Dr. Ovchinsky utilizes a digital imaging system to help guide the discussion, and to ensure that you reach a positive, mutual understanding of what your rhinoplasty can achieve. 

Preparation

After Dr. Ovchinsky has determined the best approach for your rhinoplasty, he’ll review the details of the surgery and explain the process so that you’ll feel comfortable and excited about moving forward with your procedure. You’ll also be given a detailed list of instructions to ensure that your surgery goes smoothly and that you make a speedy recovery.

Before Your Rhinoplasty

  • Quit smoking or using any nicotine product in the weeks leading up to your surgery, and for the duration of your recovery.
  • Avoid taking medications that may increase chances of bleeding and bruising at least one week prior to surgery, such as Ibuprofen, Advil, Motrin.
  • Arrange a ride home after surgery.
  • Prefill prescribed medications so that you have them on hand when you return home. You’ll be prescribed pain medication to manage any discomfort and antibiotics to avoid the risk of infection.
  • Make sure that you have soft foods to avoid discomfort from chewing.
  • Have comfortable button-down shirts, as you’ll need to avoid pulling tight shirts over your head during the initial phase of your recovery.

Procedure

Rhinoplasty is performed under general anesthesia so that the patient is resting comfortably for the duration of the procedure. The details of your surgical plan will determine the approach and surgical techniques that Dr. Ovchinsky employs during your rhinoplasty.

Dr. Ovchinsky is equally versatile in either the “closed” or “open” rhinoplasty techniques. In the closed technique, all incisions are concealed inside the nostrils. In open rhinoplasty, most of the incisions are also made inside the nostrils except for one small incision over the columella – the narrow strip of the nasal skin at the bottom of the tip. The selection of one approach over another is based on the patient’s nasal anatomy and surgical goals. Dr. Ovchinsky will perform the technique that will allow him to achieve the best possible results.

Recovery

Once the procedure is complete, you will be able to return home. You will need someone to drive you and assist you during the first day of recovery.

After your surgery, your nose will be dressed in bandages and a firm white plastic nasal splint to protect your results. You will need to wear this the first week or so of the recovery period to assist with your healing. Some bloody discharge can also occur for the first few days, but rarely is there any severe bleeding. Bruising and swelling are to be expected and will dissipate over time. Dr. Ovchinsky almost never uses nasal packing after the surgery, which dramatically reduces postoperative discomfort. 

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, and you may want to adjust your social calendar accordingly. Strenuous activity will need to be avoided for a minimum of four weeks. 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 to three weeks. 

You’ll return to Dr. Ovchinsky’s office for a follow-up appointment a week after your surgery, which is when the stitches and nasal splint are typically removed. We’ll typically schedule additional follow-ups at one month, three months, six months, and 12 months after the surgery. Of course, all patients are encouraged to call or make an appointment at any time if they have specific problems or concerns as they heal.

How Much Does a Rhinoplasty Cost in New Jersey?

Because rhinoplasties are carefully tailored to the patient’s goals and anatomy, the price of a rhinoplasty varies slightly from patient to patient. Following your consultation, you will receive a written quote for the cost of the discussed procedures.

FAQ

What sort of risks or complications can occur with rhinoplasty?

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.

How much time off from work or school will I need after rhinoplasty?

Most rhinoplasty patients find that they can return to work or school in about one week. Those who don’t mind wearing a nasal splint in public and don’t do any physical work may return sooner. Patients should avoid strenuous activities for about three weeks and should avoid contact sports and potential trauma to the nose for at least two months.

References

  1. Bussi, M., Palonta, F., & Toma, S. (2013). Grafting in revision rhinoplasty. Acta Otorhinolaryngologica Italica, 33(3), 183–189. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3709529/
  2. Bagheri, S. C. (2012). Rhinoplasty: current therapy (1st ed., Vol. 24). Saunders.
  3. Anderson, K. J., Henneberg, M., & Norris, R. M. (2008). Anatomy of the nasal profile. Journal of Anatomy, 213(2), 210–216. https://doi.org/10.1111/j.1469-7580.2008.00924.x
  4. Daniel, R.K. (2018). The Preservation Rhinoplasty: A New Rhinoplasty Revolution, Aesthetic Surgery Journal, 38(2). 228–229, https://doi.org/10.1093/asj/sjx258
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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

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Dr. Ovchinsky’s Recent Book Chapter on Revision Rhinoplasty

Chapter 1 2 3 4 5 6 7 index

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Comparison of Permanent Versus Absorbable Suture in the Tonguein- Groove Technique in Endonasal Rhinoplasty