Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
Send us all your questions or requests, and our expert team will assist you.
The consultation is a rigorous diagnostic session during which the surgeon evaluates nasal anatomy and respiratory function. It begins with a detailed history of nasal trauma, allergies, and previous surgeries. The surgeon examines the nasal cavity using a nasal speculum or an endoscope to assess the septum and turbinates.
Externally, the surgeon analyzes the nasal angles, skin quality, and symmetry. They palpate the nose to assess the strength of the tip support and the length of the nasal bones. This tactile exam distinguishes between bony and cartilaginous deformities.
Modern consultation relies heavily on 3D imaging technology, such as the Vectra system. This creates a high-resolution, three-dimensional model of the patient’s face. The surgeon can manipulate this model to simulate surgical outcomes by adjusting dorsal height, tip rotation, and projection.
This simulation serves as a crucial communication tool. It allows the patient to visualize realistic goals and helps the surgeon understand the patient’s aesthetic preferences. It aligns expectations, ensuring the patient and surgeon are working toward the exact visual blueprint.
The quality of the nasal skin is a primary determinant of the final result. The surgeon assesses the thickness and sebaceous nature of the skin. Thick skin may require stronger structural support to show definition, while thin skin requires careful smoothing of grafts to prevent visibility.
The skin’s elasticity is also tested. The surgeon checks the skin’s recoil to ensure it will redrape properly over the smaller framework. Patients with poor elasticity are counseled on the limitations of size reduction to avoid loose, redundant skin.
The surgeon stages the integrity of the cartilage. They perform the “Cottle maneuver” to check for valve collapse and palpate the caudal septum. Determining the strength of the existing cartilage dictates whether the surgeon needs to harvest extra graft material.
If the septal cartilage is weak or has been previously removed, the surgeon discusses alternative donor sites, such as the ear (conchal cartilage) or the rib (costal cartilage). Identifying the need for grafts pre-operatively prevents surprises during surgery.
Nicotine is a severe vasoconstrictor that compromises microcirculation. In rhinoplasty, the skin of the nose is elevated and relies on a delicate blood supply to heal. Smoking increases the risk of skin necrosis, poor scarring, and infection significantly.
A strict cessation protocol is enforced. Patients must stop all nicotine products including vapes and gum for at least 4 to 6 weeks before and after surgery. This ensures the blood flow is robust enough to support the healing of the nasal skin envelope and mucosal lining.
A comprehensive medical evaluation ensures the patient is safe for general anesthesia. This includes blood work to check for clotting disorders and anemia. Patients with a history of severe nosebleeds or bruising may require specific coagulation studies.
The surgeon reviews all medications. Blood thinners, including aspirin, ibuprofen, and herbal supplements like fish oil, must be stopped 2 weeks before surgery to minimize bleeding. A dry surgical field is essential for the precision required in rhinoplasty.
Rhinoplasty has one of the highest rates of Body Dysmorphic Disorder (BDD) among cosmetic procedures. The surgeon carefully assesses the patient’s motivations and realistic expectations. Patients who focus on microscopic flaws or expect surgery to fix life problems are not good candidates.
The goal is to ensure the patient seeks improvement, not perfection. The surgeon evaluates emotional stability and the ability to handle the recovery process, which involves swelling and temporary distortion of the face.
For patients with functional complaints, the consultation includes a detailed airway evaluation. The surgeon may identify allergic rhinitis or sinusitis that contributes to the blockage. While rhinoplasty fixes the structure, medical management may be needed for the mucosal lining.
The surgeon checks for internal valve collapse during deep inspiration. This functional staging ensures that the surgical plan addresses not only the appearance of the nose but also its airflow dynamics.
If the patient requires structural grafting, the consultation covers the donor sites. Septal cartilage is the first choice. If insufficient, ear cartilage is the second option, harvested via a small incision behind the ear.
For major reconstruction, rib cartilage may be needed. The surgeon explains the small incision on the chest and the recovery associated with rib harvest. Consent for these additional sites is obtained during the preparation phase.
The logistical plan is finalized. Patients are advised on the recovery timeline: 1 week off work, 2 weeks for bruising to fade, and 6 weeks for bone healing. They are instructed to arrange for a ride home and a caregiver for the first 24 hours.
Preparation includes getting supplies like saline spray, a cool mist humidifier, and button-down shirts to avoid pulling clothes over the nose. Planning ahead helps reduce stress and makes the first days after surgery easier.
The surgeon analyzes the nose in the context of the entire face. A weak chin can make a nose look larger (relative projection). The surgeon may suggest a chin implant or genioplasty to balance the profile.
The surgeon also looks at the shape of the forehead and the fullness of the midface. The goal is to make sure the new nose matches these features. This way, the nose will look natural and not out of place.
Send us all your questions or requests, and our expert team will assist you.
We use 3D imaging technology (Vectra) to capture a photo of your face and digitally sculpt your nose. This allows you to see a simulation of the potential results and helps us agree on the aesthetic goals before surgery.
Most plastic surgeons who specialize in rhinoplasty are trained to treat the airway. However, if you have severe chronic sinus infections or complex allergies, we may coordinate with an ENT specialist to address those issues simultaneously.
If you have had a previous nose job or a severe injury, you might not have enough septal cartilage left. In these cases, we will discuss using cartilage from your ear or a small portion of your rib to build the necessary structure.
Yes, but you will need to prepare for after surgery. You cannot rest glasses on the bridge of your nose for about 6 weeks while the bones heal. You will need to switch to contact lenses or use a special brace to keep your glasses from resting on your nose.
Fish oil, along with Vitamin E and aspirin, acts as a blood thinner. Taking it before surgery increases the risk of bleeding and bruising. We require you to stop these supplements 2 weeks beforehand to ensure a safe surgery and faster recovery.
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