Rhinoplasty or Nose Job

Rhinoplasty is a cosmetic procedure aimed at modifying the appearance of the nose. Through various individualized steps during a rhinoplasty, specific aesthetic concerns can be addressed. Some patients desire removal of a hump, while others look for narrowing of the bridge, refining the tip, shortening the nose or rotating the tip. Other patients may want a higher bridge, narrower nostrils or a tip that does not descend when they smile. In all cases, the results should be natural and harmonious with the overall appearance of each patient, and the breathing ability should be maintained or enhanced.

Factors that affect the outcome of rhinoplasty include: the quality and position of the nose cartilages, the size and shape of the nasal bones, quality and thickness of the nasal skin, pre-operative nasal symmetry, the technical ability of the rhinoplasty surgeon and post-operative wound healing.

During your consultation with Dr. Khosh to discuss rhinoplasty in Manhattan, he will listen to your concerns about the appearance of your nose. He will perform a careful examination of your nose, internally and externally, and assess your breathing function and sinus-nasal health. Dr. Khosh offers computer imaging to demonstrate the potential rhinoplasty outcome, to stimulate discussion and to promote meaningful communication in regards to your desired cosmetic outcome.

Some of the rhinoplasty surgeries performed at our practice include:

Rhinoplasty Specialist

Dr. Khosh is uniquely qualified rhinoplasty specialist based on his training, experience and double board certification in Facial Plastic Surgery and Otolaryngology. He has intimate knowledge of the functional anatomy of the nose, which enables him to provide cosmetic improvement of the nose without sacrificing breathing function. He is an expert in both the endo-nasal or closed approach and external or open approach for rhinoplasty. In appropriately selected patients, Dr. Khosh performs non-surgical rhinoplasty as a simple office procedure without the need for anesthesia. Dr. Khosh meticulously tailors your rhinoplasty to your specific needs with the ultimate goal of achieving a beautiful and natural appearing nose.

Contact our office today to schedule your consultation or if you have any questions regarding a rhinoplasty or nose job prcoedure.

Case Study

This 40 year old lady requested rhinoplasty in Manhattan to address a nasal hump, and refine the nasal tip. An open rhinoplasty approach was used to remove the nasal hump and and to modify the tip.

  • Patient: 40 year old lady who was interested in rhinoplasty in New York.
  • Problem: Nasal hump, wide and poorly defined nasal tip.
  • Procedure: Rhinoplasty through an open approach.

*Disclaimer: These Are Actual Results For Patients Of Dr. Maurice Khosh. Plastic & Cosmetic Surgery Results Can Vary Between Patients.

Frequently Asked Questions About Rhinoplasty

Who is a good candidate to undergo rhinoplasty?
Any female older than 16 and any male older than 17, who is in relatively good state of health and has reasonable expectations from cosmetic nasal surgery. Those with moderate skin thickness (not too thick and not too thin) and strong nasal cartilages can expect better results.

Who is a poor candidate for rhinoplasty?
Patients with complicated medical problems such as poorly controlled asthma, high blood pressure, or diabetes, and those who have unrealistic expectations from cosmetic surgery.

Does Dr. Khosh sub-specialize in rhinoplasty?
Dr. Khosh is a well-known expert in rhinoplasty in Manhattan and the New York Tri-State area. He is double board certified in Facial Plastic Surgery and Otolaryngology, and can address the breathing function as well as the aesthetic appearance of the nose. Dr. Khosh handles challenging nasal reconstructive procedures that are referred by other specialists. He performs revision rhinoplasty and rhinoplasty following facial trauma or a cancer ablation, utilizing techniques such as: bone grafts, ear cartilage grafts or rib cartilage grafts.

What are the different approach techniques for rhinoplasty?
There are two main approaches for performing rhinoplasty, closed and open. In the closed approach, all incisions are inside the nose. In the open approach, nearly all incisions are internal except a well-hidden incision in the bottom of the midline part of the nose. Dr. Khosh is proficient in both methods.

How does Dr. Khosh determine which approach to use for rhinoplasty?
Dr. Khosh chooses the surgical technique based on a patient's features and desired effect. In revision rhinoplasty, typically an open approach is employed since it offers better visualization of the nasal cartilages and bones. In primary rhinoplasty, open approach is only undertaken when significant nasal tip work is desired or when notable asymmetry is present.

What kind of anesthesia does Dr. Khosh use for rhinoplasty?
General anesthesia; this technique allows for complete control of patient's breathing and it translates into the safest method of providing anesthesia. Additionally, general anesthesia avoids the risk of patient coughing or moving during surgery.

What kind of pain or discomfort should I except after rhinoplasty?
Surprisingly, there is little discomfort with rhinoplasty. Some surgeons use packing inside the nose, which is uncomfortable and painful. Dr. Khosh does not ascribe to use of packing. Most patients do not need any pain medication past the third day.

What is the typical recovery after rhinoplasty?
Recovery after rhinoplasty is generally quick. It is quite rare to develop extensive bruising such as you may have seen on an extreme makeover show. Most bruising is resolved after five days. External tape and casts, as well as any internal stents, are removed after six days. Patients may return to work with in ten days. However, the final results may take up to six months to appear.

How do you make the tip the nose smaller?
The shape, size, and position of the nasal tip is created by a pair of boomerang shaped cartilages in the lower nose known as the lower lateral or alar cartilages. Alterations in the shape and size of these cartilages create a corresponding change in the appearance of the nasal tip. Trimming of the alar cartilages, placing stitches to bend the cartilages, and using supportive cartilage grafts allow precise alterations in the appearance of the tip of the nasal tip.

How do you remove a hump from the nose?
The nasal bridge or the dorsum of the nose is composed of paired nasal bones and their matching, attached cartilages (upper lateral cartilages). Removing a nose hump requires exposure of the upper lateral cartilages and the nasal bones through an incision inside the nose, and shaving of the bones and cartilages.

How do you narrow the bridge of the nose?
When narrowing of the nasal bridge is necessary, a small chisel is used to cut the nasal bones so that they can be pushed towards one another. A nasal hump can be removed at the same time as described above.

How long will I be bruised after a nose job?
Bruising after any type of surgery is due to leaking of blood under the skin. In rhinoplasty, bruising is most commonly associated with shaving or chiseling of the nasal bones. In most nose job surgeries, bruising is resolved within ten days. This duration is affected by the extent and duration of the operation.

Can the cast on my nose get wet after my nose job?
I use a plastic cast after rhinoplasty. Initially, a tape is applied to the nasal skin and the plastic cast is then attached to the tape. This type of cast may get wet. I inform my patients that they may shower and get the cast wet. However, I recommend against swimming.

When can I wear makeup after a nose job or rhinoplasty?
Make up can be worn as early as two days after rhinoplasty. Obviously, no make up can be applied to any visible incisions around the nose. However, makeup and concealer can be applied around the eyes and cheeks.

Related Procedures

Rhinoplasty is commonly performed with septoplasty (correction of a deviated septum) and turbinate (internal nasal membrane) reduction to enhance breathing. In some revision rhinoplasties, and in rare primary rhinoplasty procedures, repair of the nasal valve may also be warranted to ensure good breathing. In order to achieve balance in the face, chin augmentation may be recommended during a rhinoplasty consultation. Sinus surgery can be safely combined with rhinoplasty, in individuals with chronic sinus issues.