Rhinoplasty

Aesthetic (cosmetic) surgery of the nose, called nose reshaping or rhinoplasty, can improve the shape, size and general appearance of your nose. The goal of a rhinoplasty is to enhance the balance between your nose and your other facial features. In many cases, there is a functional aspect to nasal surgery: breathing properly through the nose is essential to normal cardiovascular physiology, normal sleeping habits, and other aspects of daily life.

Since the beginning of his practice, Dr. Gerut has been dedicated to the pursuit of perfection in rhinoplasty, which many surgeons feel is the most difficult cosmetic surgery to perform–so difficult, in fact, that many plastic surgeons in New York do not perform rhinoplasty! Over the years Dr. Gerut has earned a reputation for excellence in rhinoplasty, drawing patients from all over the US. As a result, a large portion of his practice is nasal surgery.

Ideal Candidates for Rhinoplasty
Healthy men and women, and teens aged 16 and older, are appropriate candidates for nose surgery in the following instances:

• your nose appears too large for your face
• there is a bump on the nasal bridge when viewed in profile
• your nose seems too wide when viewed from the front
• the nasal tip droops or plunges, the tip is thickened or enlarged
• your nostrils are excessively flared
• your nose is off-center or crooked
• previous injury has made your nose asymmetrical
• you have trouble breathing through your nose

During your rhinoplasty consultation with Dr. Gerut at his Long Island plastic surgery office, your expectations and desires will be discussed in great detail. Close attention will be given to ensure that the appearance of your nose is in harmony with your face. If your new nose “fits” your face, it will look natural even if significant changes have been made. Dr. Gerut believes that it is very important that rhinoplasty results are as natural as possible. If people can tell you had surgery, it is either because your nose looks unnatural or even if it looks natural, it does not fit your face. The nose is the “centerpiece” of the face and a proper rhinoplasty provides more than a cute or handsome nose. A proper rhinoplasty is a cute or handsome nose that fits your individual facial features as perfectly as possible. You might love the appearance of a certain model’s or actor’s nose and it may look perfect on their face; but it may not look good on your face.

Who should decide what you look like after rhinoplasty?
If your concept of a good looking nose is different from Dr. Gerut’s, who should be happy after your surgery? Clearly you, not Dr. Gerut. Knowing how to do surgery does not make a surgeon an expert on what you want to look like. For more than 20 years Dr. Gerut has carefully worked with his patients to give them the nose they want. To that end, Dr. Gerut will carefully plan your rhinoplasty outcome to be as certain as possible that you are pleased with your postoperative appearance.

As with all facial procedures, Dr. Gerut believes that the results of a rhinoplasty should look as natural as possible. The best way to judge your results is this: friends, family and business associates notice something different about you, but aren’t able to tell you exactly what has changed. That’s the result of a beautiful rhinoplasty!

Dr. Gerut chooses from two techniques when performing rhinoplasty: open or closed.
The open technique requires an incision at the base of the nose (the area of the nose just above the lip), which, when healed, will be invisible at a conversational distance. The open technique enables Dr. Gerut to more accurately modify the nasal structures, as it allows him to see “inside” the nose to a degree that’s not possible in a closed rhinoplasty. It’s an invaluable technique to refine the nasal tip or modify a hump (called a dorsal hump) in the nose. Open rhinoplasty is often the nose reshaping method of choice in a revision rhinoplasty, as well. Closed rhinoplasty is done through the nose without any external incisions. It’s effective in most nose reshaping procedures and can produce excellent results.

How Rhinoplasty Is Performed
A rhinoplasty is an outpatient cosmetic surgery procedure performed in the fully accredited and licensed surgical facility in Dr. Gerut’s Long Island plastic surgery office. His patients benefit from the fact that Dr. Gerut has worked with the same surgical team, including anesthesiologists, for many years. Attention to detail and patient comfort and safety are paramount.  Depending upon the technique chosen (open or closed), after general anesthesia has been given, Dr. Gerut will manipulate the internal structures of the nose to create the most pleasing appearance. This can involve removing or rearranging the internal cartilage and/or inserting bone or other material to support the nose. At the completion of the procedure, a splint and plastic bandage will be applied to hold the nasal structures in place during healing. The splint will protect your nose while you sleep and shield it from accidental bumps. You may also have a small gauze bandage beneath the tip of your nose. Most patients go home after an hour or two.

Recovery from Rhinoplasty
The amount of time it takes for recovery varies greatly from one person to the next. Recovery after rhinoplasty is rather quick for most patients. Generally, rhinoplasty is painless; patients may feel throbbing or soreness after surgery but rarely is there pain, even if the bones are broken. Changing the shape of the bones may cause bruising, which can be treated with ice packs. Most patients feel good within a day or two but many stay home for a week because the bandage (a triangular plastic “cast”) stays on for a week to control the swelling. Dr. Gerut rarely uses packing. Instead, he places a series of dissolving sutures inside the nose. It takes a bit of time to do this but offers a much more comfortable postoperative experience. Regarding bruising, generally men will bruise more than women because men have thicker bones. Careful attention to details during the surgery as well as the anesthesia, recovery room care and postoperative care can minimize postoperative bruising. There are many over the counter products that supposedly prevent bruising and swelling. If you wish to take arnica or Bromelain or other such items, Dr. Gerut will allow it but there is no proof at all that these things provide any benefit at all.

For several weeks or longer, patients are asked to massage the nose to achieve an optimal result. Every surgery causes swelling. People with thick skin usually swell more than those with thin skin. Depending on your skin thickness, age and individual circumstances, postoperative swelling may be an issue. Postoperative massage can make a significant difference in your final appearance. Dr. Gerut will instruct you how to do it, as early massage is essential to a good result.

As most patients have heard, it takes a year until you see your “final nose.” Obviously, the process is gradual so as time goes by, the nose slowly transforms into its final appearance. Many patients are impatient and wish for this process to be faster but one advantage of the lengthy swelling is that you will not look like you had surgery. The swelling will make your nose look like it did before surgery and people that see you regularly will not notice the gradual changes over time. During this first year, you will have “good nose days” and “bad nose days”. This will vary with salt intake, menstrual cycle and other things. When you have a good nose day, it is a preview of your final result. Please be patient as these variations can last more than a year.

When can I resume my normal activities?
Straining, bending and lifting should be avoided during early postoperative period. In many instances, you may be able to return to work within a week or ten days after surgery. Most normal activities can usually be resumed within a week. Exercise or heavy lifting at work must wait at least two weeks. It will be a year before you can expose your reshaped nose to lots of direct sunlight. Your nose will be sensitive during the first year and you must be conscientious about using a sun block to protect your skin. If the bones of your nose were altered, you can wear glasses but ONLY if they have cushioned “shoes” that rest on the nose.

Occasionally, a touch-up procedure may be desired to further improve the results. If this is the case, the additional procedure is usually less extensive than the original operation.

How long will the results last?
Other than the changes that most people experience in their nose with aging, the results of rhinoplasty are permanent, unless you injure your nose.

The results of rhinoplasty can have a positive effect on the way you feel about yourself. If you’re concerned about the size or shape of your nose, board-certified New York plastic surgeon Dr. Zachary Gerut is here to help you. Call us at 516-295-2100 or complete our online consultation form to learn how you can get the look you’ve always wanted!