Question 1

What causes a “unitip” deformity in rhinoplasty? Is it fixable with revision rhinoplasty?

Accepted Answer

Uni tip in rhinoplasty may occur in a novists’ hand and occurs when the two nasal tip domes are brought together too tightly; this will result in elimination of your tip defining points and the natural aesthetics of the tip.

Question 2

How long does it take for a “curve” or “slope” to fully show after surgery?

Accepted Answer

It can take upto 3 months for the nasal dorsal swelling to resolve; if you are desiring more of a slope, it may be possible to promote more of a curvature by ensuring that scar tissue does not build up. This requires steroid injection and manual compression in the early postoperative period.

Question 3

What is the risk of rib cartilage rhinoplasty?

Accepted Answer

Two things you should know about rib graft rhinoplasty. First, for dorsal augmentation, we mince the cartilage into tiny particles that are used to make a burrito. this allows for avoidance of any warping, etc. Second, you should consider using cadaveric rib graft which avoids needing to harvest your own.

Question 4

Can’t breathe through nose 2 weeks post-op. When will I be able to breathe or has too much cartilage been taken?

Accepted Answer

In general, rhinoplasty surgery should allow you to breathe better. What is concerning is that you had a closed rhinoplasty to fix your tip; when fixing your tip, it is typically necessary to open the nose (i.e. open rhinoplasty) to optimize nasal tip reshaping.

Question 5

Can a radix reduction and thinning be performed with closed rhinoplasty method?

Accepted Answer

The radix is the upper aspect of the nose and is usually the narrowest and lowest point; this is often used as the baseline used to bring the rest of the nose down to the radix for example. If your radix is to large, it will be lowered and narrowed with the rest of your nasal dorsum. Please put up a photograph so we can appreciate your concerns.

Question 6

Can a callus occur if I had closed rhinoplasty method and my nose wasn’t broken but shaved?

Accepted Answer

Residual nasal hump may develop after closed rhinoplasty and I feel is caused by residual bony dust that remains following rasping. This can be corrected in the office with local by performing a re-rasping.

Question 7

Is breaking my nose and a dorsal implant necessary?

Accepted Answer

Dorsal onlay implants are no longer the state of the art since the introduction of diced cartilage onlay grafts. This cartilage can be purchased for only 400$ and prevents need to harvest cartilage from your rib. Results are consistent and excellent.

Question 8

Am I a candidate for a rhino? I have thick skin.

Accepted Answer

Thick skin can be thinned out to remove the subdermal fat which will allow the skin to redrape onto the underlying cartilage scaffold. In addition, thick skin requires strong underlying cartilage grafts that help sharpen the created highlights.

Question 9

Is there any way of adding cartilage back to a shortened septum?

Accepted Answer

Spetal shortening is used to make a long nose shorter or a downturned nose upturned. If this is overdone, a septal extension graft can be added to correct the deformity; this graft can be purchased from an organ donated rib graft for approximately 500$ making it an excellent choice.

Question 10

In theory, can a rhinoplasty change every aspect of the nose: dorsal hump, tip, nose width and nose shortening?

Accepted Answer

Yes, all aspects of your nose can be made better with a rhinoplasty.

Question 11

After a radix reduction, can the nasal bone appear crooked from frontal view because of complications?

Accepted Answer

The radix is typically the lowest part of the nasal dorsum and used as the base to bring the hump etc. down to. So your question is concerning with regards to whether you are using the correct terminology. Rarely, do we bring down the radix as well as the dorsal hump which can be done to make the nose look shorter. Bringing down the hump and/or radix should not affect or create crookedness. In fact, if there is any crookedness, this maneuver allows us the opportunity to correct crookedness.

Question 12

Why are noses overly rotated up during/ after rhinoplasty?

Accepted Answer

The nose angle with the upper lip has been defined for decades . This angle is called the nasolabial angle and in females should be set to 100 to 105 degrees. If it is over-rotated i.e. 110 degrees then this is an error in surgery.

Question 13

What procedure/process during rhinoplasty will cause a piggy nose tip and an overall shorter nose?

Accepted Answer

Tip rotation and shortening of the nose are maneuvers that are very well documented and performed when a long nose or a down turned tip needs to be rotated or nose shortened. the ideal nasolabial angle which is the angle created by your tip and lip should be 105 degrees for the female and 95 degrees for the male. Of the three maneuvers, the middle crura to septal suture can created rotation.

Question 14

Does taping after rhinoplasty hold any true benefit?

Accepted Answer

Taping of the nose is critical to keeping swelling down. When the tissues swell, proinflammatory cells are forbidden from entering the tissues; pro-inflamatory cells then recruit fibroblasts that deposit collagen which can then create scar tissue in your nose. Scar tissue build up is probably the number one cause of hump recurrence. Please listen to your doctor and comply with postoperative instructions. We don’t just wing these decisions, they are based on decades of experience.

Question 15

My major alar cartilage on right nostril has curved in, is this normal?

Accepted Answer

What you are showing is your intercartilagenous incision that was used to do your rhinoplasty. This is an incision that is healed with slight scarring. This is totally normal. What you need to be concerned about is what does your nose look like from the outside.

Question 16

What causes my nostril holes to be different sizes and how could it be fixed?

Accepted Answer

Often this deformity is caused by skin tightness that cannot be easily released. A cartilage graft may be able to tent this up but this maneuver is not definitely going to work. In summary, I would recommend that you not worry about this deformity as it is not easily correctable. As long as you like the rest of your nose, I would pass on this one.

Question 17

Am I a good candidate for a more turned up, smaller less bulbous nose?

Accepted Answer

You will benefit greatly from open tip rhinoplasty to refine your tip shape as well as to lower and narrow your nasal dorsum. Your tip rotation can be discussed during your consultation but the female nasal tip rotation should be approximately 100 to 105 degrees with respect to the naso-labial angle. Your current nasolabial angle is very close and my not require further manipulation but this can be confirmed during your examination.

Question 18

Can I have a BBL, TT, lipo and rhinoplasty all at once?

Accepted Answer

Yes you may have a rhino, TT, and BBL at the same time. Just make sure that you choose your plastic surgeon carefully. Best BBL results are achieved with Vaser liposuction. Rhinoplasty involving tip improvements requires an open rhinoplasty so make sure that your chosen nose surgeon is an expert of open rhinoplasties. Optimal tummy tucks require specific surgical maneuvers that will establish waistline narrowing, proper muscle plication, low incision lines, and an innie belly button. A skype or facetime consultation with a body and nose contouring specialist would be helpful to providing you accurate information.

Question 19

Should I do rhinoplasty or brow lift first? How long do I have to wait in between?

Accepted Answer

I would work from high to low so do the browlift first followed by the rhinoplasty. Otherwise, I would try to do both cases at the same time.

Question 20

Nodule(?) bump on nose after 6 months rhinoplasty – Is this a reaction of some sort because of rhinoplasty?

Accepted Answer

In 2019, you should not be using silicone implants when you have organ donated rib cartilage grafts in your armemantarium. you are definitely having a reaction to the silicone implant. I would highly recommend removal of the implant and replacement with rib cartilage graft.

Question 21

What option is best for me? I would like my nose slimmer , smaller and more narrow

Accepted Answer

In addition to undergoing a traditional open rhinoplasty you should also consider choosing a doctor who is experienced in defatting your nasal tip region (removing the fat under the skin) as well as having alar rim reduction. These two maneuvers will be critical to providing you a smaller overall nasal tip appearance.

Question 22

Could it be necrosis or infection?

Accepted Answer

For a definitive diagnosis, you really need to see your nasal specialist so that you can have an examination of the internal nares.

Question 23

How long is the silicone sheet meant to stay in nose after rhinoplasty?

Accepted Answer

The doyle splint is intended to keep the nose aligned and to keep the internal mucosal surfaces away from each other until they are healed. We keep the splints in place for one week only.
In general I am not a fan of silicone nasal implants as they will eventually extrude usually after a few decades. I prefer organ donated rib cartilage for more complex nasal surgeries requiring generous volume replacement. This change can be made at anytime. If you are looking to see the results of your final rhinoplasty procedure, you should wait a good year.

Question 24

I feel my nose needs to be ‘pulled back up’ and lifted higher with a better bridge bone?

Accepted Answer

You can undergo open to rhinopasty to correct your nasal tip aesthetics and positioning and to narrow your alar rims and make your nostrils neater. Please consider a virtual consultation with a nasal specialist.

Question 25

Suggestions to fix ethnic nose. What kind of surgery would you think work?

Accepted Answer

Your nose definitely can benefit from an open tip rhinoplasty which will improve your nasal tip position, tip shape, alar rim flaring, and overall aesthetics. A virtual consultation with a nose specialist will help you appreciate what is possible.

Question 26

What is the simplest way to reduce the roundness of my bulbous nose? Is it just a matter of taking out some fat? Maybe Kybella?

Accepted Answer

The simplest way to fix the bulbous tip is to do a open tip rhinoplasty that can be done in the office under local if all you want is the shape of your tip improved from rounded to one that has more highlights.

Question 27

What is the best way to make my nostril smaller to make my nose more symmetric?

Accepted Answer

The best way to make the nostril smaller is to get an internal wedge excision. This procedure will make your nostril more symmetric while hiding incision lines typically visible with the traditional external weir excision.

Question 28

Closed or Open Rhinoplasty Revision for Drooping Tip?

Accepted Answer

A drooping tip can occur when the tip is malpositioned or when there is supratip fullness. A malpositioned tip requires an open rhinoplasty but a supratip fullness can be corrected with a closed rhinoplasty. In order to determine which option is best for you, we can do a Same-Day Virtual Consultation or you can send us photos.

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