What should I look for in a surgeon to insure breathing won't worsen and nose won't collapse after a rhinoplasty? (Photo)

I am of middle eastern descent have a large dorsal hump as well as an asymmetrical, droopy tip. Will I need grafts? I really want my nose to be more aesthetically pleasing to my face but I'm nervous that my nose will not function as well as it does now.
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Doctor Answers 16

What should I look for in a surgeon to insure breathing won't worsen and nose won't collapse after a rhinoplasty?

I would look at credentials, before and after pictures, and reviews to gain a glimpse into these issues.

Kenneth Hughes, MD

Beverly Hills, CA

What should I look for in a surgeon to insure breathing won't worsen and nose won't collapse after a rhinoplasty?

Hello and thank you for your question and photos. A skilled and experienced surgeon should be able to deliver a natural result that is structurally efficient as well as aesthetically pleasing. I suggest choosing a board certified plastic surgeon with fantastic credentials, many years of experience, impressive before and after photos, and great patient testimonials. During the consultation, it is important to establish good communication; you want to choose a surgeon who makes you feel comfortable and who is confident that they can deliver a great result. Grafts are generally used to help with support and function; an exam will help determine what would be necessary for you to achieve the best outcome. I hope this information helps, and I wish you the best of luck.

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 44 reviews

Preserving function while improving nasal aesthetics

A properly done rhinoplasty should NOT interfere with your breathing. The key is a combination of correcting any preexisting problems in the nose like a septal deviation, turbinate hypertrophy, nasal valve narrowing, etc. that could be an issue with a smaller post-op nose and also recognizing and preserving important structural components of the nose during surgery.Though I may be biased, my usual recommendation is to find a surgeon who is both board certified in facial plastic surgery or plastic surgery and ALSO board certified in ear, NOSE, and throat (otolaryngology) to minimize your chance of any functional problems with the nose later.All the best,--David C. Pearson, M.D.Pearson Facial Plastic Surgery®

David C. Pearson, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

What should I look for in a surgeon to insure breathing won't worsen and nose won't collapse after a rhinoplasty? (Photo)

Dear Rhinoplasty Reader,Thank you for your question! You would make an excellent candidate for Rhinoplasty.  When choosing your surgeon for Rhinoplasty make sure he or she is Board Certified in Facial Plastic and Reconstructive Surgery.  Here at Shumway Cosmetic Surgery we have done thousands of ethnic Rhinoplasty and have our own accredited surgery center.  All procedures are done under IV sedation and takes approx. two to three hours.  With an open approach, your dorsal hump will be shaved down, the length can be shortened and the tip can be gently tilted upwards to give you a more feminine appearance.  If you have trouble breathing with a deviated septum or enlarged turbinates, these can be corrected at the same time so your breathing should improve.  You will have a cast and taping on the outside of your nose for approx. 10 days.  Most of the swelling is down after a couple of weeks but full healing can take up to a year. With a skilled surgeon performing your procedure and close follow up care,  you should not run the risk of your nose collapsing.   Best of Luck!

Robert Shumway, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Look for a surgeon expert in the airway, but you also need one who's excellent at changing the appearance

First of all, see the "Web reference" link, just below my response. I made a couple of computer morphs from your photos, and animations of those morphs, showing the changes that are possible in truly expert hands. I elevated the tip of your nose, lowered the bump on the bridge, and brought the entire nose closer to your face.

In the animations, you'll be able to see that I also carved down the very top part of your nose, where it begins, just below your eyebrows. On a nose like yours, that change is very important, or your profile might look like a Roman statue after surgery, with your profile line going from the forehead onto the nose without a little dip at the top of the nose. I hope I explained that okay.

Harming the airway with a rhinoplasty is quite uncommon, so unless you have something unusual going on with your nose, I wouldn't consider it much of a risk. A facial plastic surgeon who has training in ear, nose, and throat would typically have an excellent understanding of airway issues.

However, the possible changes to the appearance of your nose, such as the changes I demonstrated in the morphs, require very advanced techniques, techniques that most plastic surgeons cannot handle. Be sure to read the section in the "Web reference" link on how to stay out of trouble while searching for a rhinoplasty surgeon.

Steven M. Denenberg, MD
Omaha Facial Plastic Surgeon
4.8 out of 5 stars 37 reviews

#rhinoplasty results

From your photos, it does appear that you could benefit from a rhinoplasty procedure. However, detailing the specifics of the operation is impossible without an in-person exam. That being said, in general grafting is normally recommended to help maintain an airway or preserve the final shape of the nose over time. 

You should see a board certified rhinoplasty surgeon in your area to get a formal opinion through and in-person consultation.
Best of luck,
Vincent Marin, MD
San Diego Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 43 reviews

What should I look for in a surgeon to insure breathing won't worsen after a rhinoplasty?

Thank you for your question and photographs. In the hands of an experienced and board-certified plastic surgeon the risks of collapse or breathing difficulties is quite small. Removing a large bump and shortening a nose like yours has potential great benefits but your airways do need to be protected by appropriate procedures such as placement of spreader grafts and possible work on your turbinates. In the hands of an experienced surgeon these issues will be dealt with and anticipated.
It's equally important to become but at that your surgeon will create a natural looking proportion nose that matches your facial features. Please review the video above for some information that may be helpful. Good luck and best wishes.



Jon A Perlman M.D., FACS
ABC TV Extreme Makeover Plastic Surgeon
Certified, American Board of Plastic Surgery
Beverly Hills, Ca.

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Rhinoplasty Candidate

Dear shems013, In the hands of an expert rhinoplasty surgeon you should not have any breathing difficulties after your surgery. During rhinoplasty surgery it is important that the surgeon not only does a natural looking nose for patients of ethnicity but also makes sure that the nose is fully functioning. A large majority of my clientele have ethnic noses similar to yours. During consultation you would be able to review many photographs of noses like your own, you can also have digital imaging performed to show you the proposed changes and once the desired nose is agreed upon then a full discussion of the techniques used to attain the desired result will be reviewed. You have beautiful features which are currently overshadowed by your dorsal hump and long asymmetrical tip. I rarely find any need to use grafting on a primary rhinoplasty procedures and would see no reason you would need them. Once your concerns are addressed with rhinoplasty surgery you should have a beautiful and natural looking nose that accentuates your facial aesthetics and brings a nice overall balance to your face. This procedure is a very rewarding procedure for young ladies like yourself with very favorable and often life changing results. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 199 reviews

Rhinoplasty for a nose that has normal breathing and won't collapse after rhinoplasty?

Rhinoplasty for a nose that has normal breathing and won't collapse after rhinoplasty?  The good news is this does not happen when  a patient selects a very experienced rhinoplasty surgeon who does natural looking noses. The horror stories that you hear are patients selecting an inexperienced surgeon and poorly trained.  Look at  before-and-after pictures and meet with surgeons whose noses look good to u and talk with their patients.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 32 reviews

Looking for nose surgeon

You would make an incredible candidate for rhinoplasty which would make your overall external nose smaller to match your face and to make it softer and more feminine. You do not have to make the internal nares smaller and affect your breathing. Please make a consultation so that you can get morphing of your nose to get a glimpse of what we will be striving for. Please see examples below.

Arian Mowlavi, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 44 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.