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Rhinoplasty

Rhinoplasty

The nose can truly define a person’s looks, so much so that if a person has a nose that’s not proportional to their other facial features, their entire facial harmony can be thrown off-balance. An ill-proportioned nose can be remedied with rhinoplasty, a plastic surgery procedure that sculpts and shapes the nose into a more pleasing shape. But nose surgery is far from being just an aesthetic procedure; it changes the very structure of the nose. As such, the rhinoplasty surgeon needs to have a respect for the patient’s unique anatomy and the skill to preserve the patient’s ability to breathe.

It’s takes a true expert in facial plastic surgery to create breathtaking results, which is why so many patients from the Calabasas, West Hills, Hidden Hills, Woodland Hills, and Westlake Village areas choose Dr. Hershcovitch for their rhinoplasty. Dr. Hershcovitch isn’t just an expert in ENT surgery—he’s also an expert in facial plastic surgery. As a double board-certified surgeon, Dr. Hershcovitch has extensive experience with facial surgical procedures, as well as the artistry to create natural-looking results. With Dr. Hershcovitch, your new nose will look harmonious, balanced, and uniquely right for you.

Dr. Hershcovitch also has extensive experience with ethnic nose reshaping, another challenging subset of this procedure. Dr. Hershcovitch helps each patient achieve their aesthetic goals while retaining their unique characteristics. He understands that people of different backgrounds have different standards of beauty, and Dr. Hershcovitch strives to meet the patient’s goals with a combination of reduction and augmentation techniques. No matter who the patient is, one of Dr. Hershcovitch’s main goals is to create natural results.

How to Prepare for Your Rhinoplasty

Before your rhinoplasty can actually take place, a general consultation will be scheduled with Dr. Hershcovitch beforehand. He will discuss with you several factors that will help determine your candidacy for rhinoplasty surgery as well as the desired changes to your nose.

Your first meeting will generally consist of the following:

  • Expectations: When first sitting down with Dr. Hershcovitch you will discuss what you expect to achieve from getting rhinoplasty. This is a time when it is important to be open and honest when discussing your appearance and surgery goals. There are several factors that play into your overall facial symmetry. For example, you may have a smaller chin giving the illusion of having a bigger nose and thus may be advised to consider an alternative procedure to reach your aesthetic goals. A personalized facial profile with Dr. Hershcovitch will aid in making better cosmetic surgery decisions. Learning about your motivation and goals for rhinoplasty will also help Dr. Hershcovitch better assess your surgery candidacy.
  • Past medical history: Any previous history of nasal obstruction, surgeries, and medications you’re currently taking will be taken into account. Medical conditions that lead to uncontrollable bleeding (ex. hemophilia) may require extra consideration when choosing to perform surgery.
  • Health assessment: While your nose will be the focus of your encounters with Dr. Hershcovitch, your present overall health will be a factor in order to proceed with rhinoplasty. This will include performing a full physical exam as well as obtaining basic blood tests. Dr. Hershcovitch will then focus on factors that may affect the outcome of rhinoplasty, such as the thickness of your skin, the strength of the cartilage at the end of your nose, and how your breathing may be affected after the procedure.
  • Photographs: Dr. Hershcovitch will have “before photos” taken at various angles that will not only serve as a reference point of how your nose originally looked but also allow you to see your nose from an objective point of view. Computer software may also be used to manipulate the photos to give you an idea to how your nose may look post-surgery.
  • Surgery Preparation: When rhinoplasty is finally scheduled a few precautions will be advised. Two weeks before surgery, avoid medications containing aspirin or ibuprofen (Motrin, Advil, etc.) as they may increase bleeding. Some herbal supplements (Ginkgo Biloba, Ginseng, Ginger, St. John’s wort, Dong Quai, Ephedra, Feverfew, and/or Omega 3 fatty acids) should also be avoided due to the increased bleeding risk and other operative complications.

Double Board Certified Facial Plastic Surgeon

How Your Rhinoplasty Is Planned

Depending on your needs, Dr. Hershcovitch will meticulously plan a unique approach for your rhinoplasty. Dr. Hershcovitch will often perform a bony hump reduction, a tip refinement, a narrowing of the width of the nose, and more maneuvers to achieve a proportional form.

There are two different kinds of surgical methods for this treatment: open and closed. With a closed procedure, Dr. Hershcovitch will make all the incisions inside the nostrils, so they’re hidden entirely. A closed rhinoplasty is typically used for a straightforward procedure like hump reduction. With this surgical approach, patients can look forward to less swelling, a quicker recovery, and a shorter operating time.

When performing open surgery, an incredibly tiny incision will be made in the columella, a tiny strip skin on the bottom of the nose that divides each nostril. Once the incision is made, Dr. Hershcovitch will lift the skin, manipulate the cartilage and the bone, and  redrape the skin in a way that will look aesthetically pleasing once the skin has healed. While some patients like the hidden incisions of the closed technique, they should know that the incision will only be visible if someone was looking directly up at the patient’s nose. An open technique also allows for better access to the nose’s inner structures, making it easier for Dr. Hershcovitch to achieve more extensive changes like reshaping the tip of the nose. Dr. Hershcovitch will also make sure to redrape the skin in a way that reduces tension on the incisions and thus reducing the probability of scarring.

 

The technique chosen will depend on your current nasal anatomy and your aesthetic goals, so Dr. Hershcovitch will discuss each technique extensively with you.

Recovery from Rhinoplasty

Dr. Hershcovitch is deeply invested in every patient’s recovery; it’s why he monitors each patient after they wake up from the procedure before sending them on their way. Rhinoplasty is an outpatient procedure, so patients will be able to go home on the same day as their surgery. Patients will also need a trusted friend of family member to drive them home and look after them for the first 24 hours of their recovery.

Dr. Hershcovitch doesn’t pack the nose after nose surgery because it’s often extremely uncomfortable for the patient. Instead, patients are given a cast and occasionally, nasal splints, to wear. The nasal splints will be removed a few days after the procedure. The cast will be removed after 5-7 days. Patients will sometimes be given absorbable material in the nose to protect the mucosa tissue in the those, and that material dissolves on its own a few days.

Patients will experience bruising, soreness, headaches, and swelling. They might also not see their full results until a majority of the swelling dissipates, and this usually occurs after a month. Residual swelling might take up to a year to completely disappear. Learn more about revision rhinoplasty.

Tips Promoting a Speedy Recovery

It is normal to experience slight bleeding and mucus drainage for a few days after the surgery. The following are some additional recommendations that can help expedite the healing process.

  • Don’t rest eyeglasses or sunglasses on your nose for at least four weeks post-surgery to prevent unwanted pressure on your nose.
  • Use a high SPF sunscreen (at least SPF-30) when outdoors on your nose and surrounding area to prevent irregular discoloration of the skin.
  • Strenuous activities, such as jogging or aerobics, should be avoided for several weeks post-surgery.
  • Do not blow your nose until your nose has significantly healed.
  • Extreme facial expressions should be avoided for an initial couple of weeks to ensure proper healing of your nose.
  • Be wary when pulling down clothing over your head, such as when wearing T-shirts or button-less clothing, as you may inadvertently injure your nose. Instead, opt for wearing clothing that fastens in the front.
  • Don’t smoke. Smoking has been shown to slow the healing process after surgery and may increase the chances of developing an infection.

Even though you will notice a dramatic improvement with your nose’s appearance when the bandages first come off it is important to keep in mind that the appearance of your nose will continue changing slightly for about six months to two years post-surgery.

If rhinoplasty has been something you have been thinking about to improve your appearance and enhance your self-confidence, few plastic surgeons match the experience and expertise of Dr. Matt Hershcovitch.

Frequently Asked Questions About Rhinoplasty

If your procedure is purely cosmetic, it will not be covered by insurance. If you interested in fixing certain functional issues, that part of the procedure may be covered.

While you’re recovering from nose surgery, it’s essential that you protect the healing treatment area at all costs. Here are some tips for ensuring the nose is left undisturbed as much as possible:

  • For the first three days, you should regularly apply ice packs to the and cheek area. Avoid putting pressure on the healing nose.
  • Make sure to change the dressing placed on the top lip; it’s meant to catch the discharge that normally occurs after surgery. Contact our office if the dressing is soaked through every 15 minutes.
  • Don’t get the cast or any of the dressing wet while you’re bathing. You can have someone wash your hair while your face is kept dry, take a bath without submerging your head, or shower from the shoulders down
  • Protect your nose at all times—especially when you’re bathing
  • Don’t wear glasses for at least a month. If you need glasses, you can tape them to your forehead
  • Don’t blow your nose for at least two weeks after your rhinoplasty

If you’ve had an open rhinoplasty, a minuscule scar on the strip of skin under your nose may be left. Early in your recovery, the scar will be red and somewhat raised, but after a few weeks it will flatten, soften in texture, and eventually fade. This scar will not be easily visible once healed.

Dr. Hershcovitch requires that all patients be fully matured by the time they undergo rhinoplasty. Many patients’ noses mature completely at around age 15, but it’s essential that Dr. Hershcovitch examines every patient before undergoing the procedure.

Cosmetic nose surgery will not stop the aging process, which will change the way skin sits on bone and cartilage framework.  With all those factors in mind, results will be permanent.

Schedule Your Rhinoplasty Consultation Today

If you’re in the West Hills and Westlake Village areas and have any questions or wish to schedule a rhinoplasty consultation with Dr. Hershcovitch, please call our office.

West Hills: 818-888-7878 | Westlake: 805-371-0004