Archive for the 'Rhinoplasty Philosophy' Category

Should you massage your nose after rhinoplasty?

In general, it is best not to massage your nose after rhinoplasty as it is possible, although unlikely, that vigorous rubbing or manipulation in the first few weeks could pop a delicate stitch and disturb the corrections made or affect the cosmetic result. Some people habitually rub the tips of their noses. Recognize that this will not likely ruin the result but may cause more irritation and swelling.

That being said, your nose is not glass after surgery. In fact, it can often feel quite stiff and wooden for a period of several months after surgery. Rolling over onto your nose during sleep or lightly bumping your nose will not make it end up on the side of your head. So, you don’t have to walk around in a bubble after surgery.

After about a month, the skin starts to wrap around the cartilage, and the bone is pretty much set, so contact to your nose is less likely to cause any shift or problems with healing. Likewise, a small rind of fibrous tissue or scar has started to form that will likely hold the cartilage in place even if a stitch were to loosen at this stage.

Some surgeons recommend ‘nasal exercises’ which essentially amount to light lymphatic drainage. These will not be harmful but may not do much either. Instead, we ask patients to tape the nose at night for the first month to help skin contract and push out swelling. If you have any questions about nasal massage, ask your surgeon for his or her preferred routine after surgery.

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The Profiles Perspective: Our Belief that Synthetic (Alloplastic) Materials Should Not Be Used in Rhinoplasty

At Profiles, we have always held the standard and belief that when doing rhinoplasty and revision rhinoplasty, there is a hierarchy we can follow when grafting material is needed. Ideally, whenever possible, we use septal cartilage. It allows us to replace any missing cartilage or to build support using tissue that is essentially identical to the normal cartilage we find in your nose. In some cases, the septal cartilage is too thin and flimsy and unsuitable for use; even in primary cases. And in revision rhinoplasty, the quantity and quality of remaining septal cartilage may be inadequate for reconstruction.

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Rib Cartilage in Rhinoplasty Surgery: The Beverly Hills Profiles Perspective

If you are reading this post, you likely had previous rhinoplasty and have now seen a revision surgeon who has recommended that you have rib cartilage removed during your revision surgery. The use of rib cartilage in revision rhinoplasty has become increasingly popular over the last many years as revision rhinoplasty surgeons continue to seek out alternative sources of cartilage for grafts that are often necessary during revision.

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Steroids and Rhinoplasty

Please note: We are happy to see that our blog is of some help to many of you who are considering or recovering from rhinoplasty. While we would like to address your concerns directly, we are not able to dispense medical advice over the internet. Your own surgeon is your best resource in the first weeks and months after surgery. If, after 5-6 months, you continue to feel unhappy with your result, feel free to contact us via our practice site and we can arrange time to discuss your concerns. All the best for a happy outcome.

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Don’t focus on a specific procedure in rhinoplasty

December 16th, 2009 | Category: Rhinoplasty Philosophy

It is only natural when you are reading and learning about rhinoplasty for you to be drawn to a particular idea of what needs to be done to your nose to achieve the rhinoplasty results you are hoping for. This is especially true of revision patients who have been ‘burned’ before and want to do everything possible to make sure that their outcome this time around is a decidedly different and positive experience. We have prospective patients coming to see us every week who have pretty well-developed pre-conceived ideas, like they don’t want an open incision or they must need a rib graft to fix their noses. A lot of this stems from having heard or read about a poor result with a particular procedure or from hearing mixed messages from surgeons about how they would approach their surgery. In fact, these are really not mixed messages at all, but actually just reflections of each surgeon’s individual style that developed from personal experience. Read more

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Ethmoid bone grafts in Rhinoplasty and Revision Rhinoplasty

Recently we’ve seen a number of people who have asked about the use of ethmoid bone in revision rhinoplasty. Each had previously undergone a nose job that had over time either resulted in loss of tip support- resulting in a droopy nasal tip- or had a twisted nose which had been partially corrected but over time had twisted again- resulting in a crooked nasal tip. Read more


Rhinoplasty and Nostril Narrowing at the same time

We have recently heard from a couple of prospective patients who are concerned about having open rhinoplasty to narrow the tip and a nostril narrowing procedure (alar base reduction) at the same time. They had been to see other surgeons who had advised against this because of fear of risk to the blood supply of the nasal tip. Read more

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Achieving definition in ethnic rhinoplasty

We often see ethnic patients wanting a more defined nose. Many ethnic noses tend to have thicker skin. Achieving the definition, narrowing, and refinement you desire has everything to do with how that thick skin wraps around the cartilage structure underneath. If the cartilage structure is well-defined and well-supported, you can achieve excellent definition. If the cartilage lacks shape, your tip will look the same- bulbous, wide, full, and lacking in shape. On top of that, ethnic patients often have a thicker layer of tissue under the skin that lays on top of the tip cartilage. In these cases, it is necessary to carefully ‘thin out’ the thicker pad of tissue under your skin so that the newly-defined cartilage can show through. Read more


Loss of identity after rhinoplasty

June 04th, 2009 | Category: Revision Rhinoplasty,Rhinoplasty Philosophy

Everyone who has suffered a poor Rhinoplasty result experiences a range of negative emotions. All are understandably unhappy about their noses and fearful of misplacing their trust once more. Yet, there are some who experience a more extreme reaction, a few of whom we’ve seen recently. Read more

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Rhinoplasty, Tip grafts, Increased Projection and the Apparent Nasal Bump

March 20th, 2009 | Category: Rhinoplasty Philosophy

Occasionally we get young and often times older patients who present and tell us that after years of staring at their profile in the mirror that they are now noticing a bump when they did not have one before.

In most cases this apparent bump is due to a loss in tip projection.  As we age, we lose some tip support and for some the result is a tip drop and an apparent bump. Many of you may have noticed a grand parent who seems to have a nose that had grown over the years and has developed a bump. The fact is that the nose has not actually grown. As the tip has lost support, it has started to droop resulting in a longer nose and oftentimes in a new bump.  See our online textbook for more details (the Aging Nose) Read more

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