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Beverly Hills Rhinoplasty

What is rhinoplasty?

Rhinoplasty is a surgical procedure that alters the size and/or shape of your nose. Often referred to as a “nose job,” rhinoplasty is among the most common plastic surgery procedures.

Dr. Lahar uses rhinoplasty to correct numerous issues, including:

  • Nose profile
  • Problems with width at the bridge of the nose
  • Nostril size or positioning
  • Nasal asymmetry
  • Bulbous or enlarged nasal tip
  • Breathing problems

The best thing about this procedure is the ability to create a customized outcome. During your consultation you can sit down with Dr. Lahar and discuss the changes you’d like to achieve, and he can explain the options to move you closer to your ideal nose profile.

What is the difference between septoplasty and a rhinoplasty?

Rhinoplasty Beverly HillsTreatment of the nose can involve both a cosmetic and a functional change. Some people have breathing problems associated with their nose and are strictly looking for a better quality of life. Others are unhappy with the appearance of their nose and aim to have an improved aesthetic profile.

Strictly speaking, a septoplasty addresses deformities in the nose involving the cartilage that divides the nostrils from one another. If the septum is bent from trauma or just plain bad luck (genetics), it can impede the breathing in the nose. This is why plastic surgery of the septum can improve breathing.

I also address three other main areas for potential breathing restriction: overgrown bony turbinates (bony outpouching within the nose), the internal nasal valve, and the external nasal valve. I find that if all the areas are addressed, nearly everyone with nasal breathing problems finds their symptoms to be improved.

Rhinoplasty is a general term for any adjustment of the nose whether functional or cosmetic. However it is generally applied to the cosmetic component of nose surgery. This involves elevating the skin on the nose, adjusting the structures underneath the skin, and then re-draping the skin down over the new nose shape.

My aim is to talk to the patient about their goals and to assess the areas that I can improve for them. Many times, patients come in with cosmetic concerns, but do not realize that they have a coincidental obstruction of their breathing that they have been living with for their whole life!

Almost always, these functional and aesthetic concerns can be addressed at the same time. Depending on the patient’s insurance status, the functional portion of the surgery may be able to offset the total cost of the surgery. The cosmetic portion, however, is not covered by insurance.

How is a rhinoplasty performed?

Rhinoplasty is done under general anesthesia in an accredited facility to help the patient rest comfortably throughout your procedure. Depending on the particular goals of the patient I may use a small incision on the skin between the nostrils and in the interior of the nostrils to access the underlying cartilage and bone.

I then lift the skin and focus on making adjustments to the nasal structure. This includes the nasal bone or cartilage to alter the size and contouring of your nose. I will also address any structural abnormalities that may be causing breathing restrictions. Once I am happy with the results, I close the incisions.

If there are any external incision lines, they run across the small span of skin that runs between your nostrils. This incision, called a columellar incision, heals incredibly well and is not very noticeable within several months.

About Nicholas Lahar, M.D. – Lahar Plastic Surgery

Nicholas Lahar, M.D. - Lahar Plastic Surgery

Lahar Plastic Surgery

Nicholas Lahar, MD

Plastic Surgeon located in Beverly Hills, CA

If you’re unhappy with the size or shape of your nose or have trouble with breathing through your nose, rhinoplasty offers a solution. Nicholas Lahar, MD, of Lahar Plastic Surgery, has extensive training in surgical procedures that enhance the appearance of your nose and has helped many men and women in Beverly Hills, California, feel better about their appearance. To explore the possibilities in more detail, call the office today to book a consultation. Online scheduling is also available and takes just moments to complete.

Rhinoplasty recovery

After surgery, you will go home with a small cast on your nose and paper tapes covering your nose to help reduce swelling and the chance of injury to your new, beautiful nose. Inside your nose, there will be small soft plastic splints that will help to reduce swelling in the first week. If you have incisions on your nose, they will be well hidden.

Your biggest responsibilities will be to take it easy and relax, keep your head elevated to reduce swelling and pressure in your nose, avoid blowing your nose, avoid extreme facial expressions, and keep the nose and nostrils clean with gentle salt water rinses.

It’s also important to take the medications you are prescribed. Be sure to mention any medications you currently take prior to your visit.

You may have some bruising around your eyes depending on whether the bone was adjusted as part of your surgery. This should resolve within a week if it occurs at all.

Although nose surgery can appear dramatic, it is actually very well tolerated and people go home the very same day and experience little pain. They may have some discomfort from the swelling, but most patients are pleasantly surprised that they are quite comfortable.

At one week, I will see you in the office to remove the cast, the tape, the internal splints, and any stitches that may require it. This is a very exciting day because you will see your new nose for the first time. However, you will need to know that this will not be the final size of the nose. You will almost certainly see an improved appearance that matches your goals, but the swelling that occurs can last about a year for first time rhinoplasty surgeries and a year and a half or even more for a revision case.

The main swelling will decrease in about two weeks but you will see subtle changes during the healing period. Patience is key.

Procedures Combined With Rhinoplasty

Rhinoplasty is frequently combined with blepharoplasty, facelift, injectables and chin augmentation to help improve the overall profile of the patient. A small chin will actually make a relatively normal sized nose appear bigger due to an optical illusion that the brain sees.

If the nose is reduced, it can still appear large and unbalanced with the overall facial features if the chin is small. Chin augmentation can be performed at the same time by placing a small silicone spacer underneath the muscle in the chin.

Another option is to place filler into the chin and jaw line to improve its projection and balance with the nose. The choice of chin augmentation technique is dependent on the severity of the small chin.  Filler is better suited for mild cases and a chin implant is more appropriate for larger deformities. Very occasionally, orthognatic (jaw surgery) may be needed to create an appropriate facial profile.

Facial fat grafting can also be used to augment and increase the volume in the face where it may be lost. As we age, not only do the tissues droop, but they also lose volume as well. These can change the appearance of the nose and face. I perform a full facial analysis for any case in order to fully understand how I can help achieve the best results possible.

Rhinoplasty FAQs

A revision rhinoplasty, sometimes called a secondary rhinoplasty, occurs when a patient has a second, third (or more!) rhinoplasty procedure because they are unhappy with the results of their first rhinoplasty. It becomes increasingly difficult the more surgery that has occurred previously around or on the nose. Some of the aspects making it more difficult include increased scarring, higher risk of wound healing problems and infection, and decreased availability of cartilage to use to help strengthen the nose. Because of the difficulty, it is important to find an experienced surgeon to address a revision rhinoplasty case. In addition to being a more difficult surgery, there may be an increased chance that rib cartilage may need to be harvested or used to help create a strong support for the nose. Rib cartilage can be obtained safely from the patient themselves or donor rib can be used to avoid an extra incision. The final shape from a revision case can take a little bit longer to come as there is more healing that is required.

Men and women of color sometimes want to change certain aspects of their nose, yet want to retain the characteristics linked to their heritage. Many of the classic rhinoplasty teachings were focused on Caucasian noses. These techniques are generally used to reduce the size of the nose such as reducing the “hump” or making the tip smaller. However there are clear anatomic differences between various races that require different approaches from the traditional techniques. These may require actually building up the nasal bridge or increasing tip support and projection as opposed to a desire to make the nose smaller. My goal is to create an outcome that enhances appearance while also preserving the ethnic identity.

Preservation rhinoplasty is a relatively old concept that has become popularized again with improved techniques. It involves using techniques that reduce the amount of surgical trauma that the nose experiences during surgery. There is less elevation of the skin, and specialized tissue handling to minimize injury to the tissues. The goal is to reduce the amount of swelling and healing that needs to occur while still achieving beautiful results. There are multiple ways that preservation rhinoplasty techniques can be used and they are great in combination with traditional open rhinoplasty techniques. I am pleased to offer techniques that will help to reduce the swelling and experience after surgery using preservation rhinoplasty techniques.

While I am very attuned to helping a patient reach their goals it is quite difficult to exactly match the appearance of a particular person. As a rhinoplasty surgeon, my goal is to create a functional, beautiful nose that draws attention to the eyes.

Certainly, the further from a goal appearance they are at baseline, the more challenging it is to achieve that final result. This is not necessarily a failure or shortcoming of the surgeon, but just from the difficulty in controlling all aspects of the rhinoplasty procedure.

A nose job is measured in millimeters and sub-millimeters and variables such as the strength of the cartilage harvested, the healing process of the patient, and the surgical technique are just some of the factors that add variability to the surgery. Ultimately, I find nose surgery to be one of the most challenging and rewarding surgeries.

If you’d like to learn more about what to expect when undergoing surgery or have questions about your potential results, set up a time to come in and meet with Dr. Lahar. He can explain the procedure in detail and help you understand how this approach can move you closer to your aesthetic goals.

Online scheduling is available, or you are always welcome to call to set up your visit.

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