Rhinoplasty (Nose)

About Rhinoplasty (Nose Job)

Individuals who are unhappy with the shape and/or size of their nose should consider having a rhinoplasty (nasal surgery) to address the characteristics of their nose that they would like to change. A rhinoplasty may also be beneficial to individuals who are experiencing breathing difficulties due to functionality problems within the nose. Dr. Sam Gershenbaum is a plastic and reconstructive surgeon who frequently performs rhinoplasty, rhinoplasty revision, and non-surgical rhinoplasty procedures to address cosmetic and functional issues at his cosmetic surgery center in Miami, FL.

See Before & After Rhinoplasty Photos from Dr. G’s patients.

How the Nose Affects Facial Proportion

When considering an individual’s profile, the chin and the nose are significant balancing features of the face. For this reason, many of the residents in and around Miami who are unhappy with the size, and shape of their nose choose to have a rhinoplasty with award-winning surgeon Dr. Gershenbaum. Additionally, some of Dr. G’s patients choose to have nasal surgery in conjunction with a chin augmentation. These two procedures are frequently combined to improve the proportions of an individual’s face.

Issues that a Rhinoplasty Can Address

In Miami, nasal surgery is frequently utilized to address conditions resulting from birth defects, natural causes and traumatic deformities. Rhinoplasty plastic surgery may involve assisting an individual with attaining the external appearance that he or she desires as well as addressing internal structures that are misplaced and making breathing through the nasal passages difficult.

During nasal surgery, Dr. Gershenbaum can:

• Remove a bump
• Increase/Decrease the projection of the nose
• Correct a crooked nose
• Narrow the nose
• Increase/Decrease the size of the nose
• Correct a drooping or hanging tip
• Relieve airway obstruction

While performing nasal surgery, Dr. G can correct deformities of the nose by adding to, taking away, reshaping and/or rearranging the cartilage and bones within the nose.

Dr. Gershenbaum uses two rhinoplasty approaches:

1. A Closed Rhinoplasty

When Dr. Gershenbaum uses a closed rhinoplasty approach, he only creates incisions inside the patient’s nose. This approach is ideal for minor issues such as narrowing the patient’s nasal bridge or removing a hump.

2. An Open Rhinoplasty

This is the approach that Dr. G usually prefers. An open rhinoplasty is used to address more extensive issues. This approach involves internal incisions as well as an incision across the patient’s columella (the skin located between the nostrils). The columella incision connects the internal incisions.

Why Does Dr. Gershenbaum Prefer the Open Rhinoplasty Approach?

Dr. G believes that the open rhinoplasty approach allows him the exposure he needs to provide his patients in Miami with accurate, precise and more predictable results than the closed rhinoplasty does. For the most part, the tiny scar that results from an open rhinoplasty is nearly invisible. Furthermore, using the open rhinoplasty approach allows Dr. Gershenbaum to narrow the nostrils.

Nasal Improvement Through Rhinoplasty – What a Patient Can Expect

Several factors affect the degree of improvement a patient can expect following nasal surgery with Dr. G in Miami.

These factors include the:

• general structure of the patient’s nose;
• the quality of his or her skin; and
• operative plan that is used.

At Dr. G Cosmetic Surgery Center in Miami, our goal is to improve and enhance the patient’s natural nose in a way that compliments his or her face, as opposed to giving the patient an entirely new, totally restructured nose.

Who Should Consider a Rhinoplasty with Dr. Gershenbaum in Miami?

The results of nasal surgery are permanent and can be beneficial to individuals who are unhappy with the way their nose looks as well as for those who are having difficulty breathing through their nasal passages.

Those who should consider nasal surgery with Dr. G include:

• Individuals who are unhappy with the way that their nose looks and/or are having difficulty breathing through their nose (due to functional issues with their nasal passages) should consider scheduling an initial consultation for a rhinoplasty with Dr. Gershenbaum.
• People of all ages: Dr. Gershenbaum can even perform nasal surgery on individuals in their mid-teens, as long as they are no longer actively growing.
• Individuals who are healthy and have realistic expectations related to what Dr. G can accomplish with a rhinoplasty.

An Initial Consultation for a Rhinoplasty with Dr. Gershenbaum

• When an individual arrives for an initial consultation at Dr. G Cosmetic Surgery Center in Miami, he or she needs to provide Dr. G with information about previous surgeries, medical treatments, health conditions and current medications.
• Dr. Gershenbaum will want to know if the patient takes herbal supplements, vitamins, smokes, drinks alcoholic beverages and/or uses recreational drugs. To ensure the safety of the patient and the best surgical outcome possible, it is imperative that patients are upfront with Dr. G concerning each of these matters.
• Dr. G will want to know if the patient is experiencing difficulty breathing through his or her nose. He will also ask what specific concerns the patient has regarding the appearance of the nose.
• Dr. Gershenbaum will examine the nasal cavities and the septum: He will be looking for swelling, deviations of the septum and inflammation of the turbinates (spongy, curved bones that protrude into the nasal passages and are separated by the septum).

Examination of the Internal and External Nasal Valves

Dr. G will ask the patient to inhale through his or her nose while he observes both the internal and external nasal valves. If Dr. Gershenbaum notices any collapse, he will address this problem during surgery to improve the patient’s ability to breathe through his or her nasal passages.

Examination of the External Nose

During the examination of the patient’s external nose, Dr. G will:

• look for humps on the bridge of the nose that need to be reduced;
• palpate the nasal bones, feeling for curvatures, asymmetries or irregularities;
• study and palpate the nasal tip to determine its fullness, support and width;
• analyze the angle of the tip: an under-rotated or ‘droopy’ tip must be rotated up and an over-rotated, ‘snub’ nose tip needs to be brought down; as well as
• determine if a nasal tip moves when the patient smiles or speaks (if so, strengthening of the tip during surgery may be necessary).

If, following the initial consultation at Dr. G Cosmetic Surgery Center in Miami, Dr. Gershenbaum and the patient determine that a rhinoplasty can accomplish what he or she desires, Dr. G may take photos of the patient’s nose. He may use these pictures while he creates the patient’s surgical plan. Furthermore, following the nasal surgery, he can use these pictures as a means to show the patient what changes he made during the rhinoplasty.

While nasal surgery can successfully address numerous issues, patients need to realize that, as with any cosmetic surgery procedure, there are limitations as to what this procedure can accomplish. Therefore, keeping the lines of communication open is essential to ensuring the patient receives optimal results. Dr. Gershenbaum and his staff encourage patients to ask questions about their rhinoplasty procedure. Dr. G’s goal with each of his patients is to build a mutual trust and rapport. For this reason, patients need not be concerned about voicing their expectations.

Customized Treatment Plans with Dr. Gershenbaum in Miami

Each patient is unique; therefore, treatment plans are tailored to meet the needs of the specific patient being served. A patient’s ethnic background as well as various characteristics must be taken into consideration when creating his or her treatment plan.

These characteristics include:

• Facial shape
• Skin type
• Facial proportion

The final result achieved through nasal surgery should provide the patient with a completely natural-looking nose that does not appear as if it was attained through surgery.

Preparing for a Rhinoplasty in Miami

• The majority of patients will be asked to have some routine tests prior to their surgical procedure. These tests typically include blood work. Depending on the patient’s age and health, Dr. Gershenbaum may request that a patient makes an appointment with his or her general practitioner to receive a medical clearance for surgery.
• Patients must discontinue taking certain herbal supplements, medications and vitamins for at least two weeks before their nasal surgery. Furthermore, certain foods need to be avoided for the same length of time. Click here to view a list of these products and foods. Unless these items are avoided, excessive bruising around the eyes and the nose is likely.
• To decrease the incidence of swelling, alcoholic beverages must be avoided for at least five days before nasal surgery.
• Patients who smoke must discontinue smoking for at least four weeks before and four weeks after their nasal surgery. This is extremely important because smoking negatively affects the body’s ability to heal itself.

The Rhinoplasty Procedure

At Dr. G Cosmetic Surgery Center in Miami, nasal surgery is performed as an outpatient procedure. This procedure usually takes two to three hours. To ensure the patient remains comfortable throughout his or her rhinoplasty, anesthesia is administered. Dr. Gershenbaum discusses his anesthesia recommendations with the patient before his or her procedure: Options include general anesthesia or local anesthesia with I.V. sedation. Since nasal surgery is an outpatient procedure and patients receive anesthesia, they need to arrive at the surgery center with a driver.

The actual steps of nasal surgery are determined by which aspects of the patient’s nose Dr. Gershenbaum is addressing.

Following surgery, patients should expect to have a nasal splint, nasal packing and stitches. Dr. Gershenbaum will remove the packing within two to four days and the splint within five to seven days. The internal stitches are dissolvable and external sutures are removed within five to seven days. Bruising and inflammation around the eyes, cheeks and nose are common.

Nasal Surgery – The Recovery

• Bruising usually subsides within two weeks, the majority of visible inflammation dissipates within several weeks. Although the visible inflammation dissipates rather quickly, it may take up to twelve months for all of the nasal swelling to resolve itself.
• It is not uncommon for patients to experience numbness for a few months following surgery. In addition, breathing benefits achieved during a rhinoplasty procedure may not be evident for several weeks or months following nasal surgery.
• The majority of Dr. G’s nasal surgery patients in Miami state that they experienced discomfort more so than pain following their procedure. Nonetheless, Dr. Gershenbaum prescribes his patients pain medication for use while they recover from their rhinoplasty.
• Following nasal surgery, most patients are moving around within two days and returning to work or school within 10 days.
• After nasal surgery, patients are required to avoid strenuous activity for approximately six weeks.
• Once the patient’s nose has healed, Dr. G may take additional photos so as to compare the patient’s pre-surgical photos to his or her post-surgical photos. These photos will remain within the patient’s medical file.
• For the majority of patients, the results achieved during nasal surgery are life changing. Many of Dr. G’s patients in Miami state that they feel more confident and notice an improved sense of self-esteem following their nasal surgery.

Potential Nasal Surgery Complications

Complications during and after a rhinoplasty are extremely unlikely. However, potential complications include (but are not limited to) bleeding, poor wound healing, infection, anesthesia risks, increased or persistent deformity, scarring, the need for a revision surgery and/or breathing difficulties.

If you reside in or plan to visit South Florida and you are interested in learning more about nasal surgery and/or a chin augmentation, contact Dr. Sam Gershenbaum at 305.933.1838 or via our online contact form. Dr. G’s dedication to his patients, experience and perfectionism have made him one of the top, award-winning plastic and reconstructive surgeons in Miami.

Typical Reasons for Rhinoplasty Include:

Conditions requiring rhinoplasty may be a result of natural causes, birth defects or traumatic deformities. Frequently, patients who desire rhinoplasty are concerned that their nose appears too large or out of proportion to the face. The nose and chin are important balancing features of the profile, and can often affect one’s appearance. A small, flattened or receding chin may also be a contributing factor to a patient’s complaint of an “unattractive profile.” For these reasons, chin enlargement or augmentation or a chin implant may be considered and discussed at the time of the nasal surgery consultation as this procedure is frequently performed at the same time as rhinoplasty to improve and balance the facial proportions.

• Decreasing or Increasing the Size
• Removing the Bump
• Narrowing the Nose
• Increasing or Decreasing the Projection
• Correction of a Crocked Nose
• Correction of a Hanging or Drooping Tip
• Relief of Airway Obstruction

Before performing rhinoplasty at our practice in Miami, Dr. Gershenbaum always works with the patient to agree on a treatment plan. The objective of nasal surgery varies with each individual patient, and the ideal nose varies from face to face depending on skin type, ethnic background, facial shape and proportions. The end result of rhinoplasty should reflect the agreed upon plan, and the nose should be completely natural in appearance. It should never look “operated.” Rhinoplasty can be performed after the mid-teens, when the growth spurt has ended.

Deformities of the nose can be corrected by adding to, removing, reshaping and/or rearranging bones and cartilage. Rhinoplasty can be accomplished through a closed technique, where incisions are made inside the nose only. Dr. Gershenbaum performs closed nasal surgery with more minor rhinoplasty procedures, such as removing a nasal hump or narrowing the nasal bridge.

For more extensive rhinoplasty procedures, Dr. Gershenbaum generally prefers an open approach, in which an incision is also made across the columella (the skin bridge between the nostrils), which connects the internal incisions. Dr. Gershenbaum believes this approach to rhinoplasty is unparalleled for exposure and accuracy for precision work with greater predictability in results. The resultant scar is generally near imperceptible. It is also at times desirable to narrow the nostrils, which generally leave near imperceptible scars as well.

The degree of nasal improvement through rhinoplasty depends on the basic structure of your nose and skin, as well as on the operative plan that is applied. At the Aventura Center in Miami, the goal is not to give you a new nose, but to improve and enhance your old nose in a natural way that compliments your face.

Scheduling Your Miami Facelift

Rhinoplasty procedures are performed in an outpatient surgical facility located on the outskirts of Miami. Rhinoplasty can be comfortably performed using local anesthesia with I.V. sedation or under general anesthesia. It generally takes 2 to three hours. Afterwards there is usually a nasal splint, sutures (stitches) and nasal packing. Nasal packing is removed in two to four days. The splint is removed in five to seven days. Internal sutures dissolve by themselves and external sutures, if used, are removed in five to seven days. Swelling and bruising around the eyes, nose and cheeks are common. Bruising is usually gone in one to two weeks.