Rhinoplasty Table of Contents

Rhinoplasty Before & After

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What are the Benefits of Rhinoplasty?

Cosmetic Benefits

  • Reduces the size of the dorsal hump on the nose bridge
  • Narrows an overly wide nose structure
  • Create a more attractive look for a large, hanging, or bulbous nasal tip
  • Corrects a pinched-looking nose tip
  • Reshapes overly large or wide nostrils for a more refined look
  • Improves overall facial harmony and proportionality
  • Balances your facial features
  • Improves overall self-confidence

Functional Benefits

  • Corrects a deviated septum for healthier breathing function
  • Can reduce snoring and mouth-breathing
  • Restores a broken or crooked nose
  • Can improve sleep quality
  • Improves overall quality of life
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You’re A Candidate For Rhinoplasty If You:

  • Are at least 14/15 years of age (female) or 16/17 years of age (male)
  • Have reached full physical maturity
  • Are in good overall physical and mental health
  • Have realistic expectations from the procedure
  • Don’t have a history of bleeding disorders
  • Don’t have underlying medical conditions that preclude you from the procedure
  • Don’t smoke, or you’re willing to stop smoking
  • Need a revision rhinoplasty to undo the results of a botched nose job
  • Have a nasal obstruction or a deviated septum that prevents you from breathing properly
  • Have a crooked nose due to accidents, trauma, or injury
  • Are unhappy with how your nose looks
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Additional Types of Rhinoplasty

Ethnic Rhinoplasty

Ethnic rhinoplasty is a nose-reshaping procedure tailored to preserve the unique features of your ethnic identity and heritage. Dr. Westreich avoids "cookie-cutter" treatments, ensuring your nose job maintains these distinctive markers. While many inexperienced surgeons adhere to Eurocentric standards and Western notions of beauty, Dr. Westreich provides a personalized ethnic rhinoplasty based on your specific goals and background for optimal and individualized results.

Revision Rhinoplasty

Revision rhinoplasty is a subset of rhinoplasty procedures that addresses external deformities, cosmetic concerns, or functional problems caused by a previous rhinoplasty procedure. Basically, you need a revision rhinoplasty if you’ve had a botched nose job that’s left you with poor cosmetic or functional results. In this case, Dr. Westreich will create a revision rhinoplasty treatment plan to undo the results of the primary rhinoplasty and provide the results you originally wanted.

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Cost of Rhinoplasty

Cosmetic rhinoplasty isn’t covered by insurance. However, portions of a functional rhinoplasty to fix a deviated septum (or other medical conditions) can be eligible for insurance coverage, though the amount of coverage will depend on your specific insurance plan. We provide a detailed overview of your costs with and without insurance coverage during your consultation.

The overall cost of your nose job in NYC will depend on the following factors:

  • Medical tests
  • Surgeon’s fees
  • Anesthesia fees
  • Medications
  • Facility fees
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    The work he has done on my rhinoplasty is everything I wanted. I did not want my nose to look like it had any work done, I just wanted to reduce the size in certain areas. He really listened to everything I wanted.

    Louise Z.

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    The Rhinoplasty Procedure

    Your rhinoplasty procedure is catered to address your specific needs and the challenges of your nose. The procedure is performed at our state-of-the-art surgical center under local or general anesthesia, depending on your unique needs, and concludes within 2 to 3 hours. The specific steps involved in the procedure differ from one treatment plan to the next. However, the following is a broad overview of the steps involved:

    • Anesthesia: The surgeon delivers local anesthesia, general anesthesia, or intravenous sedation, depending on your specific treatment plan.
    • Incision: Incisions will be made within the nostrils (closed rhinoplasty) or across the columella, the tissue separating the nostrils (open rhinoplasty). The skin covering the nasal bones and cartilage with both closed and open approaches will be raised to work on the underlying structure.
    • Reshaping: The nose structure will be reshaped and adjusted according to your unique needs. In some cases, excess bone and cartilage will be removed to reduce the nose size. In other cases, cartilage grafts from the septum, ear, or ribs might be used to change the shape and support areas of cartilage weakness.
    • Correction: If you have a deviated septum, it will be straightened to improve your breathing.
    • Closing: After the necessary changes are made, the nose surgeon will redrape the nasal skin and close the incisions.

    Rhinoplasty Techniques by Dr. Westreich

    Nasal Tip Plasty

    Nasal Tip Plasty involves reshaping the cartilage of the nasal tip. Two paired horseshoe-like cartilages make up the tip of the nose. The length, width, bending contour of those cartilages, and symmetry determine the look. Some nasal tips will narrow with a small amount of cartilage removal, while other tips will need sutures, grafts, or other techniques to more dramatically change the shape. The nasal tip is a 3-dimensional structure that must be sculpted to achieve significant and necessary changes in the 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 bridge (made up 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 for patients with weak cartilage. Patients must have a nasal tip that will balance well with the new profile, as this area of the nose is not manipulated in profile only procedures.

    Polish Rhinoplasty

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

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    What Can I Expect From My Nose Surgery Recovery?

    Swelling and bruising are normal after rhinoplasty. Initially, you may experience bruising around the eyes, nose tenderness, and facial puffiness. Cold packs and prescribed medications can help manage these symptoms.

    Dr. Westreich uses Exparel to provide pain relief for up to three days post-surgery, reducing the need for narcotics and enabling a quicker recovery. This allows patients to return home sooner and experience less nausea and constipation.

    You will go home with a splint on your nose for about a week. Most patients find the recovery uncomfortable rather than painful.

    Plan to take a week off work or school and avoid strenuous exercise for 2-3 weeks. Positive results will appear gradually and may take up to a year to be fully visible.

    Rhinoplasty Recovery Tips

    • Use a saline nasal spray to keep your nostrils moist and a decongestant spray (Afrin or Neosynephrine) to keep the nasal airway open.

    • Apply ointments on the incision lines to allow quicker healing and steroid cream to decrease inflammation.

    • Use Arnica and Bromelain caplets to reduce the bruising amount and decrease the duration of bruising.

    • Take low-dose steroid pills because they have an anti-inflammatory effect and decrease swelling.

    • Apply ice packs around the eyes and cheeks to prevent or reduce swelling.

    • Sleep with your head elevated and limit your activities for the first 3-5 days.

    • Eat a diet that contains a high level of antioxidants (Berries, Figs, Wild Honey), vitamins C and E, and protein.

    • Drink lots of water to stay hydrated.

    • Follow all other recovery guidelines provided by the surgeon.

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    Risks & Complications

    As with any surgery, a rhinoplasty does have associated complications and risks. Such risks include specific risks from anesthesia administration, excess bleeding, the collapse of the nasal structure, scarring, and results different from expected. Though present, these risks should not be a deterrent to your decision to undergo rhinoplasty as they are uncommon. You can further minimize these risks and complications by selecting the most reputable plastic surgeons with excellent track records.

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    Non-Surgical Rhinoplasty: The Ideal Alternative

    Non-surgical rhinoplasty entails the injection of hyaluronic acid (HA) fillers, which results in a transformation similar to classic rhinoplasty results, albeit temporarily. Dermal fillers change the shape of your nose for up to 1 year and beyond, making it ideal for individuals who want to achieve cosmetic enhancements without permanent adjustments or cosmetic alteration. A non-surgical rhinoplasty is a great option with less risk potential, minimal side effects, and no downtime.

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    Rhinoplasty FAQ

    How do I prepare for rhinoplasty?

    Is rhinoplasty painful?

    Will my health insurance cover rhinoplasty?

    How do I prepare for rhinoplasty?

    • Complete all recommended pre-operative tests and medical clearance
    • Stop smoking
    • Avoid medications that can increase the risk of bleeding
    • Arrange for a friend or family member to bring you home on the day of surgery
    • Bring loose clothing that closes in the front for after surgery
    • Prepare your home with prescriptions, a humidifier, plenty of pillows, groceries, and a list of activities to keep you occupied

    Is rhinoplasty painful?

    You’ll be under general anesthesia during the procedure, so you won’t feel any pain or discomfort. Most patients rate the pain as a 2-3/10, as Dr. Westreich also uses Exparel to increase your comfort, providing numbing for up to 3 days.

    Will my health insurance cover rhinoplasty?

    Rhinoplasty performed solely to address cosmetic issues is not covered by health insurance. However, when Rhinoplasty is performed to correct a breathing problem caused by structural abnormalities, a portion of the procedure may be covered.

    Problem Solution 1 Solution 2 Solution 3
    Dorsal Hump Profile-plasty to straight or concave bridge Augmentation of radix or supratip Partial reduction
    Droopy Tip or smiling concerns Suture Tip-plasty Cartilage grafting (columellar strut, other tip grafts) Premaxillary grafting and/or Shaving of the caudal (bottom) septum
    Deviation Osteotomy (rebreaking the bones) Spreader grafting Foundation Rhinoplasty or Tip-plasty
    Bulbous Tip Suture Tip plasty Cartilage grafting (columellar strut, other tip grafts) Cephalic trim
    Undefined nose Suture tip-plasty with grafting Osteotomies Midline contour grafting (pate, temporalis, fat)

    Why Choose Rhinoplasty Surgeon Dr. Westreich in NYC?

    Dr. Westreich is an incredibly talented, compassionate, and experienced cosmetic surgeon with specialized training in all facial cosmetic and reconstructive procedures. He completed his postgraduate training in Facial Plastic Surgery and Otolaryngology, otherwise known as Ear Nose and Throat (ENT), at the prestigious Mt. Sinai Hospital in New York City. He has also been listed by New York Magazine as one of the top plastic surgeons in New York for several consecutive years and has been recognized as a Top Doctor by the prestigious Castle Connolly Group. Dr. Westreich has received many other awards and accolades throughout his career. 

    What truly sets Dr. Westreich apart is his approachable bedside manners combined with his artistry and understanding of nasal surgery techniques and aesthetics. His sculptural rhinoplasty techniques (many of which he pioneered) are based on the vision of an artist and will focus on creating highlights and shadows, as well as natural proportions, in order to ensure your result will appear as if you were born with it. If you want to find out more information, please schedule a private consultation with Dr. Westreich today.

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    Rhinoplasty for Dorsal Hump

    Dorsal humps refer to cartilage and irregularities of the nasal bones that cause a hump. Rather than having a straight or a sloped nose, an individual’s nose becomes convex. Dorsal humps do not cause any health issues; however, some people undergo a Profile Rhinoplasty in order to correct it. Causes of a dorsal hump include:

    • Genetics: Some people inherit the condition. A genetically inherited dorsal hump often becomes more visible during puberty.
    • Trauma: Injury on the nose may result in the development of a dorsal hump.
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    Types of Rhinoplasty Techniques

    Open Rhinoplasty

    Open Rhinoplasty typically leaves a nearly invisible scar on the columella (the skin between the nostrils) and is commonly used as an approach for Rhinoplasty. The same surgery can be performed through both open and closed approaches. Due to his expertise in using the closed approach, the Open Rhinoplasty approach is used only for specific technical reasons in Dr. Westreich’s practice.

    Closed Rhinoplasty

    During a closed rhinoplasty procedure, the surgeon performs the surgery through the nostrils without visible incisions. Through the nostrils, the surgeon can modify the cartilage and bones, add grafts and sutures, and have a full view of the nasal anatomy. Dr. Westreich prefers using a Closed rhinoplasty approach for several reasons:

    • Patients often heal quicker compared to open rhinoplasty.
    • The tip-profile relationship is easier to establish and predict using a closed approach.
    • The blood supply to the nasal skin is preserved using the closed approach, which can result in less scarring and thinning of the skin over time.

    Non-surgical Rhinoplasty

    Results obtained from a non-surgical rhinoplasty last between six months and two years. The procedure requires only topical anesthesia and 15-30 minutes to complete. Patients with prior nasal surgery should be aware of an increased risk of vascular blockage using non-surgical Rhinoplasty. Certain areas of the nose also carry a higher risk of complications with filler injection.

    Rhinoplasty Videos

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