Primary Rhinoplasty Beverly Hills
Rhinoplasty provides a way to refined or reshape different features of the nose in order to enhance its overall appearance. Both women and men in Beverly Hills and Toronto who are unhappy with the way their nose can benefit from undergoing rhinoplasty performed by facial plastic and reconstructive surgeon Dr. Jumaily.
What Is Rhinoplasty?
Rhinoplasty (also known as nose reshaping or nose job surgery) is a surgical procedure which is performed to change the shape of the nose for cosmetic reasons, breathing difficulty or both. The “non surgical rhinoplasty” or “5 minute rhinoplasty” is a different technique and is discussed separately under the “non surgical rhinoplasty” section. Men and Women of all ages and ethnicities seek rhinoplasty to improve this central feature. Rhinoplasty is one of the most commonly performed cosmetic procedures but also one of the most difficult and therefore, there are many approaches, techniques and philosophies that have been developed.
Approaches of Rhinoplasty: Closed vs open rhinoplasty
Closed rhinoplasty means the cartilage and bony structures of the nose is accessed with incisions that are placed inside the nose. There are marginal incisions, transcartilaginous incision, intercartilaginous incisions, and transfixion incisions. A combination of these incisions are used to gain exposure to the nasal tip structures, the bridge, and bones. Looking through these incisions, the tip cartilages can be cut, sutured and strengthened. Grafts can be added to the tip, or bridge. The bones can be moved as well. The advantage of this approach is lack of scar on the columella (the skin between the nostrils).
Closed rhinoplasty can be done a little quicker since there is less incisions to close. Some surgeons believe there is less swelling and recovery after closed rhinoplasty but this is controversial. The same swelling is expected whether the rhinoplasty maneuvers are performed open or closed. Some surgeons refer to it as ‘finesse’ rhinoplasty but there is no more ‘finesse’ or skill needed to do the rhinoplasty using the closed approach versus the open approach. There are disadvantages or downsides to the closed rhinoplasty approach. The surgical exposure is not as good as in open rhinoplasty and hence of the tip and septal work can be more limited or difficult.
Open rhinoplasty involves making an incision in the columella (skin between the nostrils) as well as incisions inside the nose. The skin is then separated and lifted off the underlying structures. It allows the surgeon to see the cartilages directly and freely, with more freedom to manipulate and shape the cartilages. The open approach allows an assistant to help the surgeon which can be very valuable when positioning grafts. The disadvantage of the open approach is the scar. However, this incision when closed well heals invisibly and we almost never hear any patient complain about it. Ultimately, the same maneuvers can be performed open or closed, it just depends on surgeon preferences and biases.
Dr Jumaily is beyond amazing and very talented his hands are like gold. He dedicates so much time and puts attention on your needs. He has such a good heart and makes you feel at ease. His staff are so amazing. I absolutely recommend. – Anonymous
The Rhinoplasty Expertise of Dr. Jumaily
Dr. Jumaily’s philosophy in rhinoplasty is based on several important factors. To begin, Dr. Jumaily listens to the patient’s concerns and desires. After assessment, Dr. Jumaily will provide a detailed explanation of the best course of action to achieve the patient’s goals while always striving to provide a realistic idea of the outcome. Dr. Jumaily utilizes a meticulous and gentle technique which minimizes swelling and bruising and speeds recovery. The goal is to achieve natural results that last a lifetime and minimize complications and revisions. The rhinoplasty is preferably performed under deep intravenous sedation, instead of the more commonly used general anesthesia but general anesthesia is available for patients who need it and/or want it. This lighter form of sedation is comfortable, safe and significantly reduces common side effects of anesthesia recovery, such as nausea, headaches, and fatigue.
Dr. Jumaily’s priority is patient safety and satisfaction, therefore patients are able to reach us anytime to ensure all questions are answered and all concerns addressed immediately.
How long does a rhinoplasty take to perform?The amount of time it takes to perform a rhinoplasty depends on many factors. On average it can take from1 hour to 6 hours depending on surgeon technique and preferences, the required changes, the difficulty of the anatomy, amount and type of grafting etc. As a patient, the length of surgical time should not be a major deciding factor if you are healthy.
How should I expect to feel after rhinoplasty?Most patients go home on the day of surgery. You will have tape and a cast over your nose. You will have a gauze under your nose as well. You may see some swelling and bruising around the eyes which usually peaks on the second day. You will be able to eat some food. The discomfort is mild to moderate and most patients only need pain medicine for first 2 days.
When can I go back to work/school after rhinoplasty?The cast will come off at around day 7 post operatively. At this point the bruising should be minimal and swelling should be unnoticeable in most cases. Most patients go back to work/school after 7-10 days. By 14 days in most people, no one will notice you had surgery.
Is it useful to bring a picture of someone/friend/actress/model whose nose I want?Having a photograph of your ideal nose or the nose that you like can help you communicate your ideas to us because it is hard to explain it by words sometimes. Keep in mind, however, that no one can change your nose to someone else’s nose. Your nose will always be your nose, we can change it and improve it, sometimes the change is significant to give it the features that you like and fit your face. The nose is a complex structure and has complex relationships with the other facial structures that sometimes cannot be modified. To summarize, bring photos so we know what you like and we will give you the best possible nose you can have.
I have thick skin on my nose, can it be made thinner?The only part of the nose that cannot be changed is the skin. Sometimes we can thin the skin out slightly but patients with thick skin need special technique and have limitations in terms of tip definition. You can still have a beautiful nose but it may not look like the nose of a thin skinned person.
Can sleeping on your stomach (with nose on pillow) do damage to results of Septorhinoplasty?
View on RealSelfAt the beginning it will be uncomfortable to sleep face down so you won’t do it. As it heals (2-4 weeks), it will be less tender and you can sleep however you like. Usually this is not a problem. Your nose should be strong enough to withstand sleeping
Will it be risky to get a nose job and forehead reduction at the same time?Rhinoplasty and forehead reduction can be done together without compromising the outcome of either. You will have more swelling in the nose from the forehead work but it will all resolve with time.
Stiff Upper lip and covering upper teeth at rest 3 months after rhinoplasty. Why?
View on RealSelfWe often hear from patients that their upper lip feels stiff and even looks a little lower than before. Most of the time this resolves by 6 months.
Nose tip becomes even more bulbous at day 7, Why?
View on RealSelfYour nose and tip can definitely swell after the tape and cast are removed. The nose may look wider and bigger than original nose this early. The swelling will come down day by day and week by week. Don’t judge the aesthetics this early on, give it some time to heal.
Why do you think the results didn’t match my simulation?
View on RealSelfThe simulation is a communication tool to help the surgeon and the patient discuss the expectation of surgery. The surgeon has to use their judgment when doing the simulation to not draw a perfect nose but rather draw what is possible to do. Of course there are variables when it comes to healing and individual variations that may make the final result different from simulation.
Can I go in the sun after getting a Nose Surgery?
View on RealSelfGenerally speaking, we say it’s ok for a little sun exposure from normal daily activities but do not get a sunburn on your nose. So use lots of sunscreen, hat, staying in shade.
How long does it take to recover from a rhinoplasty?
View on RealSelfRecovery from the surgery, incision, bruising etc depends on the individual and the extent of the procedure. However, generally speaking the sutures and cast come out at 1 week. Visible bruising is usually gone by 7-10 days. The incisions are small and hidden so they will not be noticeable after 10-14 days. You can apply make up to hide any minor redness or bruising at the 1 week mark. Swelling is what takes the longest to resolve. Your nose will look ‘unoperated’ at 2 weeks so no one will know you had surgery. The swelling can take up 12-18 months to fully resolve.
Does the nose always change a great deal over a year? I’m 7 wks post-op, and I like my results already.
View on RealSelfIf you like your nose already then keep the positive attitude and enjoy it. The changes that occur over the year are subtle and a good rhinoplasty will give you a strong stable nose for a lifetime. Follow up with your surgeon as scheduled.
Rhinoplasty with possible chin surgery?
View on RealSelfRhinoplasty can make really nice changes to the profile. However, in some patients the chin is too small which makes the nose look big and overprojected (too long). For these patients we recommend chin augmentation to create a harmonious and balanced profile. Chin augmentation is one of the most commonly procedures to be combined with rhinoplasty.
What is the best thing to do for stitches to heal properly after rhinoplasty? Should I keep them covered?
View on RealSelfIncisions heal best if they are kept moist. We recommend using Polysporin (bacitracin) ointment for the first three days after surgery at least three times per day, then switch to Vaseline to avoid irritation from antibiotic ointment. After the stitches are removed around day7, then you can switch to a scar gel. There are many brands of scar gels on the market to choose from.
Would you use closed or open rhinoplasty in my case?
View on RealSelfThe choice of open vs closed approach to the rhinoplasty depends on surgeon preference and the extent of work that needs to be done. Some surgeons use exclusively closed or exclusively open depending on their philosophy and how they trained etc. The approach is less important than what is actually done during the procedure.
How long after rhinoplasty can I get tear trough filler?
View on RealSelfThe time to treat the tear troughs with filler is when you feel the swelling is resolved and troughs are back to baseline after surgery. This can take a couple of weeks or a couple of months depending on you and the rhinoplasty. When your tear troughs look like your ‘before’ pictures then you can go ahead.
Is there still swelling 8 months post rhinoplasty?
View on RealSelfThere may be some swelling that can change the appearance of your nose in the next few months but this change will be relatively small. What you see now is likely very close to what it will look like at the one year mark. Generally speaking, revisions are done after one year to ensure no more swelling is present and nose has taken its final form so the revision surgeon knows exactly what to modify, how much etc.
Is it safe to take Accutane after rhinoplasty?
View on RealSelfAccutane after rhinoplasty is generally safe AFTER the nose is healed. The operating surgeon will decide when your nose is healed enough to start accutane. Like any treatment it has risks and benefits and these must be weighted to come to a decision.
Can I laugh 4 days after rhinoplasty?
View on RealSelfYou will certainly feel stiff when trying to move your face/laugh after a rhinoplasty which is normal. You will not harm anything if you talk or laugh. If it is uncomfortable then don’t do it but otherwise you can use facial expressions as you normally would.
What type of stitches are used in a Rhinoplasty?
View on RealSelfSutures are used under the skin and to close the incisions. The sutures inside the nose are either long lasting dissolving sutures (more frequent) or very fine permanent sutures (less frequent). The sutures on the skin are usually dissolving stitches that dissolve at one week.
Thick nose skin in Rhinoplasty, is it possible to get a defined tip?
View on RealSelfThick skin is not a reason never to do rhinoplasty but it does add a limitation to the degree of refinement that can be achieved. If the nose is shortened, the thick skin will not take the shape of the underlying structure and will look boggy and without definition. Therefore, for patients with thick skin, we would recommend not shortening the nose too much but rather focus on creating a strong structure under the skin to enhance definition. Think of it as a sheet (thin skin) vs a comforter (thick skin): you need a strong prominent structure under the comforter to create refinement and shape.
Can I fix my nose without a surgical rhinoplasty?
View on RealSelfIf surgery is not a good option for you (whatever the reason may be), then a non surgical rhinoplasty may be a procedure to consider. In a non surgical rhinoplasty (nose job) filler is used under the skin of the nose to fill in depressions, add height, refine broad areas etc. It is a temporary solution but the filler is long lasting (~1 year) and there is no downtime and recovery. It has rare risks like everything else but generally it is safe for most people.
What are percutaneous osteotomy vs intranasal osteotomy?
View on RealSelfBoth osteotomy approaches separate the nasal bones from the maxillary bone. The bones don’t go anywhere but they become mobile so they can be moved and positioned where the surgeon wants them. The approaches achieve the same results. Some feel the transcutanous osteotomy is more controlled. Also it was shown to have less bruising and swelling than traditional osteotomies. Transcutanous osteotomy is done through a tiny 2mm incision on side of the nose that heals invisibly usually.
I keep getting a string like substance coming out of my nose post rhinoplasty.
View on RealSelfThere can be an absorbable suture (stitch) that is slowly dissolving and unravelling. Keep your nose clean with saline irrigations.
Is it possible to do a Rhinoplasty and a lip lift at the same time?
View on RealSelfYou can certainly do both at the same time even if the rhinoplasty is done via the open approach. The complication rate is NOT any higher than doing the procedures separately. This was actually studied and presented recently. Obviously, it should be done by someone who is experienced in both procedures.
Can you ever get your septum re-pierced after an open rhinoplasty?
View on RealSelfUsually there is no problem re-piercing the septum after healing has completed with permission of your surgeon. Talk to your surgeon and get clearance to go ahead. You may have to wait 6-12 months before you do that. If there is rib cartilage or other grafts you certainly need clearance from the surgeon to pierce it.
Rhinoplasty is a highly personalized procedure. Dr. Jumaily formulates a custom procedure plan based on each individual patient’s needs and goals for the procedure. Cost will vary from patient to patient. Dr. Jumaily can address any questions you may have regarding price and payment options for rhinoplasty during your initial consultation.
Schedule a Consultation with Dr, Jumaily
If you have any questions about rhinoplasty or any other procedure we offer and would like to schedule a consultation with Dr. Jumaily, please call 310-285-0929 or email [email protected] and we would be happy to help you. Our offices are conveniently located to serve patients in Beverly Hills and Toronto.