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Rhinoplasty

What is a Rhinoplasty?

Rhinoplasty is the surgical term for a nose job, and is a procedure through which a patient can alter the look and structure of their nose. Patients who are self-conscious about the size, width, or shape of their nose seek Dr. Westreich’s professional expertise to correct a wide range of unwanted nasal characteristics. For example, a rhinoplasty can:

  • Straighten a crooked nose
  • Re-define a bulbous or rounded nasal tip
  • Narrow the size of nostrils that appear wide and flared
  • Reduce a high profile or Dorsal Hump

The surgery also has important implications for patients who suffer from a deviated septum that affects their ability to breathe normally and comfortably. Your nose is an important feature of your face and has the ability to greatly alter your overall appearance. With some of the best rhinoplasty NYC has to offer, Dr. Westreich performs each procedure to meet your needs and aesthetic goals. Together, you and Dr. Westreich will construct a nose that best suits your face, gender, and ethnic identity.

Before Nose Job NYC

Before

After Nose Job NYC

After

Ethnic rhinoplasty NYC

While rhinoplasty surgery is not be planned based on ethnicity alone, patients can look at these categories and gain some insight into what their nose may require based on their individual genetic background. At a consultation, your specific anatomy and desires will be taken into account throughout the decision making process. Your ethnicity may provide hints as to what you may need, but Dr. Westreich treats these as general guides and not predetermined answers. That way, patients can avoid ‘cookie-cutter’ noses and get the outcome that best suits them.

In general:

  • Caucasian noses

    Reduction techniques are more common in this group. Noses tend to require less grafting, as the cartilage is typically strong. Profile-plasty without tip work is common. Tip-plasty is recommended for position changes (lifting or dropping a tip) or more substantial narrowing in that region. Septoplasty and nasal valve surgery is very important for breathing restoration or retention.

  • Asian noses

    Tend to have small and soft cartilage elements, as well as short nasal bones and moderately thick skin. These cases often require grafting in both the bridge and the tip for comprehensive narrowing. Profile grafting alone may be appropriate for some patients of Asian descent. Septal cartilage grafts are limited by size and ear cartilage or silicone is often recommended for bridge augmentation. Septoplasty tends to be less relevant and inferior turbinate surgery is more likely to achieve breathing improvement.

  • African American noses

    These are typically very similar to Asian noses in the need for grafting of the bridge and tip. The cartilage tends to be very soft and the skin can be severely thick in certain patients. Turbinate surgery, rather than septal surgery, is also the main functional intervention. Skin thinning is often recommended as part of the surgery and injections are often required post operatively to achieve sufficient thinning and narrowing. Augmentation using septal, ear, or rib cartilage and/or silicone is typically required in order to ‘push through’ the thick skin and allow the nose to look narrow on front view. Alar base or nostril reduction, is also commonly recommended.

  • Hispanic or Latino rhinoplasty

    There is a great deal of variation among Hispanic noses. Elements of Caucasian, Asian, and African American nasal anatomy can be seen and the surgery needs to be tailored to the specific patient’s anatomy. Typically tip-plasty with limited cartilage grafting is the most common recommendation. Limited profile polishing for a small bump is commonly suggested. Septal surgery, valve surgery, and turbinate surgery can be suggested as functional strategies.

The ideal candidate

Patients typically consult Dr. Westreich to modify aspects of their nose that are affecting their self-perception in a negative way. The ideal candidate is someone, male or female, that has reached full physical maturity and that is in good overall health. It is important that the patient is mentally and physically ready to have a nose job, so that the nose has fully developed and that the patient has realistic expectations of the results of surgery.

The surgery

Your NYC nose job is catered specifically to your needs and to the complexity of the changes to be made to your nose. Dr. Westreich wants you to be fully relaxed at all stages of this potentially life-altering decision, including during surgery. A rhinoplasty performed at our state-of-the-art NYC facility typically takes about two to three hours and is performed with the administration of either local or general anesthesia, as determined on a patient-by-patient basis. You can sleep comfortably knowing that when you wake up, you will be one step closer to attaining the nose of your dreams.

Recovering After Rhinoplasty

Swelling and bruising are completely normal and even expected after a rhinoplasty. Dr. Westreich advises all his patients to plan accordingly, as the recovery period is a crucial aspect of a rhinoplasty. You will likely need to take off from work or school to rest for the first week of your recovery, and should refrain from strenuous physical exercise for at least 2-3 weeks after your nose job. Positive results will be seen gradually, and can take a full year before completely visible.

Long Term Healing of Rhinoplasty

Rhinoplasty NYC

Complications and Risks

As with any surgery, a rhinoplasty does have associated complications and risks. Such risks include specific risks from the administration of anesthesia, excess bleeding, collapse of nasal structure, scarring and results different from expected. Though present, these risks should not be a deterrent from your decision to undergo a rhinoplasty as they are uncommon across the board.

Why Dr. Westreich?

As a double-board certified facial plastic surgeon, Dr. Westreich takes pride in being able to give his patients a new, aesthetically-pleasing nose. When seeking to make such an important change in your physical appearance, it is essential that you look for the best in the field in which to place your trust. The focus of your initial consultation visit will be to familiarize you with Dr. Westreich’s approach and technique, as you work together to achieve the mutual goals of your new nose. Dr. Westreich will happily address any concerns, questions, or comments during this initial visit, and will seek to build a strong, lasting relationship as he has with each of his past patients.

Dr. Westreich’s practice is devoted to cosmetic and reconstructive procedures on the face and neck. Because of his background in Otolaryngology (ENT), he has a special interest in functional nasal preservation and correction. A practice emphasis is on nasal surgery of all varieties and surgery for facial rejuvenation.

Consequently, he is able to offer a wide array of nasal surgery options, including closed approach rhinoplasty (endonasal), open rhinoplasty, revision rhinoplasty, profile- plasty and tip-plasty, deviation correction, and subtle polish procedures.

Dr. Westreich has originated many rhinoplasty and septoplasty techniques, such as Foundation Rhinoplasty and Rhinosculpting which have been published in medical journals and textbooks on facial plastic surgery. He has given courses and lectures at major medical conferences for the American Academy of Facial Plastic Surgery and other medical societies.

Dr. Westreich has previously been recognized as a leader in facial plastic/ENT surgery and was most recently listed in NY Magazine’s Best Doctors for 2014 and 2016.

Techniques by Dr. Westreich

Nasal Tip-Plasty

Nasal Tip-Plasty involves reshaping the cartilages of the nasal tip. Two paired horseshoe like cartilages make up the tip of the nose. The length, width, and bending contour of those cartilages, as well as their symmetry, determine the look of that region. Some nasal tips will narrow with a small amount of cartilage removal, while other tips will need sutures, grafts, or division techniques in order to drastically change their shape. The nasal tip is a very 3-dimensional structure, which should only be modified in order to achieve significant and necessary changes in nasal tip appearance.

Profile-Plasty

Profile-Plasty involves reducing a bump on the bridge of the nose. Removal of cartilage and bone from the top of the nasal septum and nasal bones can be required for profile reduction. After removal, nasal structures need to be brought together again in the midline with osteotomies. Spreader grafts may also be necessary in patients with weak cartilages. It is important that patients have a nasal tip which will balance well with the new profile, as this area of the nose is not manipulated in profile procedures.

Polish Rhinoplasty

This describes a procedure often used for deviated noses that also have functional blockage. Since all areas of the nose are typically involved in deviation (including bone and cartilage), re-breaking the nose is often required. When crooked structures are moved, it is important to polish and trim them smooth. Camouflage grafts and other structural grafts may also be required to give the nose an even appearance.

Dr. Westreich Nose Specialist NYC

Rhinoplasty Consultation with Dr. Westreich, NYC

Our consultation process is thorough and sometimes requires more than one visit. Consultations are typically about 45 minutes in length. Patients routinely arrive and fill our medical forms and then meet with the patient coordinator to discuss their goals. Photographs are taken, which are then used to generate a potential imaging result for you (imaging is not performed for all types of plastic surgery consultations). All imaging in our practice is done by Dr. Westreich. While imaging is only an approximation of your surgical result, Dr. Westreich feels that it is more exact if based on a specific surgical plan, which has to be created by the surgeon, not his or her staff. After the imaging is complete, Dr. Westreich will speak to you and confirm what you are looking to accomplish with the surgery and then perform a medical exam.

Imaging is presented as a tool for the surgeon and patient to agree upon the direction of the surgery and can be refined during the consultation. Alternatives may be presented to you when medically indicated (partial versus full rhinoplasty, chin implants, skin treatments rather than surgery, fillers, lasers, etc.) and possible surgical outcomes will be discussed. Patients should expect to leave their consultation with a solid idea of projected outcome, cost, potential risk, and scheduling possibilities. In fact, most patients schedule their procedure after their first appointment in our practice. Patients with multiple procedures, complicated surgical plans, or those having difficulty deciding on their goals may be asked to return for a second consultation.

Rhinoplasty FAQs

What is rhinoplasty?

Rhinoplasty, more commonly known as a nose job, is a cosmetic nose surgery that reshapes or changes the appearance of the nose. Rhinoplasty can change the nose’s size, width, and profile, reshape a bulbous, droopy, or upturned tip, and address nostril shape and size, among other modifications.


How do I prepare for a rhinoplasty procedure?

As with any surgery or medical procedure, a comprehensive medical evaluation will be done before undergoing surgery. Candidates for a New York rhinoplasty should take measures to be in the best health possible. It is important to speak with your surgeon about your overall health, including any concerns you may have. For example, if you smoke, you should consider stopping. Not only does smoking compromise your optimal baseline health, but it also slows down the healing process. It is recommended that patients stop at least a month before the procedure and continue to quit for at least a month following surgery. In addition to the medical evaluation, establishing clear communication with your surgeon about your aesthetic goals and expectations will maximize your chances of achieving realistic and satisfactory results.


What happens during the procedure?

First, a general anesthesia will be administered to ensure your comfort. Careful incisions will be made either across the narrow strip of tissue that separates the nostrils, or in the lining of your nostrils (referred to either the open and closed technique, respectively). After the incisions are made, the surgeon can remove or sculpt the cartilage in order to reshape the structure of the nose. When the nose has been reshaped, the incisions will be closed and a nasal splint will be placed to add support while the nose heals.


What happens after surgery?

In general, there is little pain after surgery. However, a patient may feel pressure due to swelling, which accompanies every rhinoplasty procedure. Once the initial swelling subsides and the nasal splint is removed, a patient can see the initial results. Because the swelling takes time to completely disappear, breathing can be difficult for about 3 weeks after the surgery. It can take up to a year to reach a full recovery and see the final contour of the nose.


How long is the recovery time?

For the first week, you will have to wear a nose splint. Some patients may have some bruising around their eyes after surgery, which could last up to two weeks. Strenuous activity should be avoided for about two to three weeks, after which all normal activity can generally be resumed safely. During recovery, it is important to advise your doctor if you have any unusual symptoms.


Are there any risks?

Although rhinoplasty is a generally safe procedure, it is important to discuss potential risks with your surgeon. Common risks and complications include infection, poor healing, adverse reaction to the anesthesia and bleeding. Be sure to ask questions, such as the frequency of complications and how they are handled – being informed can help you make decisions and feel at ease.


How much does rhinoplasty cost?

Costs associated with rhinoplasty often include medical tests, surgeon’s fees, anesthesia fees, and prescriptions for medication – and these costs can vary based on geographic location. In NYC, self-pay rhinoplasty can range from $10,000-15,000. Cosmetic rhinoplasty does not address functional problems, such as a deviated septum, so is not covered by insurance. If medically indicated, insurance can cover certain parts of your surgery and reduce the overall cost of surgery. Before you commit to surgery, you should consult your health insurance provider to discuss possible coverage and out of pocket insurance expenses.

If you are considering nose surgery, Dr. Richard W. Westreich, a New York-board certified Facial Plastic Surgeon, specializing in Facial Cosmetic, Reconstructive, and Nasal Surgery, can help you understand the benefits and side effects of rhinoplasty. With a private office located in Manhattan, NY, Dr. Westreich offers his patients convenient, individualized attention. Contact us today at (646) 494-9048 to learn more about one of the best nose job NYC has to offer.


969 Park Avenue #1C New York, NY 10028

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