A Rhinoplasty Primer: How to Get the New Nose You Want (and Avoid the Nose You Don't Want!)

Michael Suzman, MD

Article by
New York Plastic Surgeon

Rhinoplasty, which some refer to as nose job surgery, is one of the more common plastic surgery operations. When it is performed well and heals nicely, the results can make a dramatic improvement in one's appearance and self esteem. However, when the results do not match a patient's expectations, the outcome can have a negative impact on appearance and esteem. Even small changes in a nasal tip or a "bump" can have a very positive impact on a person's overall facial appearance. Most patients today want a natural appearing nose that matches their facial features- not a completely "new" nose that may be too small or not match their facial features. Gently sculpting nasal shape may result in changes that can lead to dramatic improvements in how someone's face is perceived. Often patients report feeling less self-conscious and more comfortable with their appearance. It is no surprise that rhinoplasty is one of the most common plastic surgery procedures. With a good result, it is virtually impossible to tell if someone has had surgery. However, most patients have seen some poorly done noses and are justifiably nervous about the same thing happening to them. Here are some simple things to know to help you get the new nose you want and not an artificial looking nose that screams "Nose Job!".

First, you must know the changes you want to achieve. The more clearly you can identify what features to change, the easier it is to communicate with your surgeon. For example, a patient who says that they want to make the tip less wide and the bump in the nose more straight, is off to a good start in communicating with the surgeon. Contrast this to a patient who simply says, "I do not like my nose, it is way too big". This patient has a far greater likelihood of ending up with a nose that is far different from their expectations. Think about what changes you want, put these thoughts into words, and discuss it openly with your doctor. Also, do not be afraid to mention changes you do not want to see, such as an overly upturned tip.

Next, you must know your surgeon. It sounds like a simple thing to know, but you would be surprised how many physicians call themselves plastic surgeons, yet only had months or a year of surgery training in cosmetic surgery. A fully board certified surgeon who is a member of the American Society of Plastic Surgeons has over 5 years of surgery training after medical school. Experts agree that rhinoplasty surgery can be one of the most difficult plastic surgery operations to master. Patients are often surprised to learn that it can be even more challenging and breast surgery tummy tuck surgery or facelift surgery. Yet it can also be one of the most creative and artful operations. Choose a surgeon who specializes rhinoplasty and has a passion for the operation. Make sure you are comfortable with the surgeon's personality and your interaction with her/him. Also make sure you are comfortable with the demeanor, professionalism and behavior of the office staff and the general office environment. Problems with any of these areas should set of more questions. Make sure your surgeon has the credentials and experience required to deliver care safely. Fortunately their area hundreds of outstanding rhinoplasty surgeons in the country. It may just require that you meet with two or three to find the right one for you! Where I work in the New York City metro area, there are some outstanding surgeons to choose from as well as some with less than stellar credentials.

Third, you should know what your expected outcome should look like. Ask to see photos of previous patients with similar noses. This is a great way to see real results that your surgeon has accomplished. If they meet your expectations of a good result, terrific. If they do not, then consider going elsewhere!. Also ask if your surgeon can use computerized simulation of your result. I find this to be an extremely effective way to communicate with patients about achievable outcomes. While these tools do not guarantee actual results, they do give you a general idea of the kinds of results your surgeon hopes to achieve. While reviewing your photos on the computer, you have a chance to see different changes and whether they are right for you.

You should also know your operating facility. Any surgery has real risks, however rare. Be sure to have your surgery performed in a nationally accredited surgery center. The common agencies that certify operating facilities are: AAAHC, AAAASF, and JCHO. Make sure your surgeon has plastic surgery credentials at a nearby hospital in case of emergency. If they are not credentialed to perform rhinoplasty at the local hospital, then they should not be performing nose plastic surgery on you.

Another thing to know is your nasal breathing. Nasal surgery can improve. or rarely worsen nasal breathing. Previous allergies, injuries or sinus problems can all impact nasal air flow. Sometimes fixing the septum or internal nasal structures are required to keep your breathing passages clear or correct blocked passages.

Finally, know your insurance and out-of-pocket costs. Changing your nose shape is considered cosmetic surgery, is in not covered by insurance. Fees range by surgeon, experience, and part of the country. Typically rhinoplasty costs between $7-15,000. For patients with breathing problems or recent severe injuries, treatment of related parts of the procedure can be covered by insurance. Talk with your plan representative and your surgeon's office.

We wish you success in your pursuit of an improved nose.

Michael. S. Suzman, M.D., FACS
Westmed Plastic Surgery
Westmed Medical Group
Westchester, NYC, Greenwich Plastic Surgeon