Rhinoplasty | Nose Job
Rhinoplasty NJ. (The surgery of the nose) General Principles and Concepts:
Rhinoplasty with submental liposuction establishes balance and harmony to this face.
I am always baffled when I see someone sending a picture that shows only the nose, asking for advice about rhinoplasty, as if it didn’t matter how the rest of the face looks like. The nose is an integral part of the face and any change in the shape of the nose has to relate to the rest of the face. For example the tip of the nose may look wide in a narrow face, but the same tip could look perfectly acceptable in a wider face. One the profile view, the chin, and the nose relate closely. The upper lip philtrum height relates closely to the shape of the nose as well. This is why I see so many patients requesting a lip lift after a rhinoplasty. The technical aspect of rhinoplasty are well understood by most rhinoplasty surgeons, but the artistic aspect and how the nose relates to the rest of the face are less appreciated. Surgery of the nose often involves the reduction of the dorsal hump, refinement of the tip, and establishing an ideal relation between the tip and the dorsal height by elevating the tip and maintaining or increasing its projection. The width and flaring of the nostrils are also changed if needed. Rhinoplasty involves changing the internal bony and cartilaginous structures of the nose keeping in mind the functional consequences that these changes might engender. The discussion of potential functional implications of rhinoplasty is extremely important. Improving form and function has to be the priority of the surgeon performing rhinoplasty. Maintaining the airway should be a primary goal as we plan on cosmetic changes in the shape of the nose.
Rhinoplasty NJ
The rhinoplasty procedure is one of the most interesting and challenging plastic surgery procedures. The procedure has gone through an evolution during the last thirty years that is truly remarkable. It takes experience, precision, and artistry to achieve great results. Dr. Rafizadeh has been one of the most prominent Rhinoplasty specialists in New Jersey for over 30 years. He is mindful of what the patient wants to achieve and what is safely achievable. As always, Dr. Rafizadeh takes time with all patients during their nose job consultations to answer all questions. He has great respect for the structures of the nose, especially the tip cartilages, since careful handling and preserving this particular area of the nose is key for long term results.
Nose Plastic Surgery NJ
Dr. Rafizadeh conceptually divides the nose into an upper part (which is bony) and a lower part (which is made of cartilage). The bone forms an arch that makes the nasal bridge. Below this area, the upper lateral cartilages form a cartilaginous arch that is a continuation of the bony arch. The shape of the tip is related to the lower lateral cartilages that are a pair (shaped like an inverted U). Dr. Rafizadeh’s experience and specialization in Rhinoplasty help him achieve outstanding results.
The Nose
The inside of the nose is divided by a bony and cartilaginous structure called the septum. On each side of the septum, there are two pairs of curved structures called the turbinates. The role of these turbinates is to humidify and warm the air like radiators. When the septum has deviated and the turbinates are enlarged, it is difficult to breathe through the nose. The patients instead breathe through their mouths. Mouth breathing is not physiologic and makes the airways dry and irritated. To treat the problem, the deviation of the septum needs to be corrected and the turbinates reduced. In many patients, especially if they had a previous rhinoplasty, their lower lateral cartilages are collapsed against the septum. This blocks the airway as they breathe in. Dr. Rafizadeh takes a reconstructive approach and places a cartilage graft called the spreader graft to open this area and not only help the breathing but improve the pinching of this area above the tip. This would improve the shape.
Form and Function
When the hump is removed and the nasal bones are moved together, one has to make sure that the lower half of the nose has internal support (spreader grafts). When the cartilaginous arch of the nasal dorsum is interrupted by hump removal, the upper lateral cartilages can collapse toward the septum and make the lower part of the nose too narrow. This not only would look bad but will create difficulty breathing because a valve (internal valve) develops and obstructs the airway when the patient breathes in. Spreader Grafts are made out of a piece of the septal cartilage that has to be carefully harvested, cut, and measured. Then these cartilages are placed between the upper lateral and the septum to prevent collapsing and the internal valve problem. I some cases the front part of the upper lateral cartilages are turned in as spreader flaps to maintain the width below the lower half of the nose and maintain the patency of the airway.
Post Rhinoplasty
After the rhinoplasty surgery is complete, there will be a splint over the nasal bridge taped to the cheeks and the forehead. This will remain in place for a week. If the nasal bones are moved, there could be some bruising by the eyelids. When surgery is done inside the nose, for example, on the septum, Dr. Rafizadeh leaves a plastic tube in each nostril for twenty-four hours while the packing is in place to allow the patient to breathe. The results are visible when the splint is removed. Ninety-five percent of the swelling is gone within a month, but that last 5 percent could take months or years. That is why the long term results could be different than what one could see in six months. Once again, Dr. Rafizadeh’s experience and thousands of successful procedures have earned the prestigious Patient’s Choice Award for his precision and dedication to Rhinoplasty and other procedures.
Rhinoplasty Surgeon Morristown NJ
When I see a patient for a rhinoplasty (Nose Job) consultation, after careful history taking and examination, I go over all these issues with them. Then I will use computer imaging to show them what I have in mind and what my aesthetic goal or endpoint is. Computer simulation is the best way to know if my plans correspond to what the patient has in mind, and we both are in full agreement with my plan. The typical rhinoplasty requires the dorsum (hump) to be reduced, the nasal bones to be brought together to recreate the arch after the hump removal and some degree of work on the tip. If the tip were adequate in shape, we would not change it. The best results, in the long run, are achieved when the tip has not been modified. I only work on the tip if it is needed or if it requires a very conservative refinement, however, tip work is required when it is asymmetric, too wide, under projecting or projecting too far.