NOSE & SINUS

Primary Rhinoplasty

Rhinoplasty, more casually referred to as “nosejob surgery,” is one the most common cosmetic surgeries. It enhances facial harmony, balances the proportions of the nose, and can improve the functionality of the nose. It is also acknowledged by plastic surgeons as one of the most difficult procedures, as the nose is a highly complex three-dimensional structure that is not only is it the most prominent aesthetic feature of the face, but it is responsible for vital breathing functions. Dr. Melyssa Hancock and Dr. Nathan E. Nachlas understand the importance of nasal form and function, allowing them to give each Rhinoplasty patient a natural looking nose that looks as beautiful as it functions.

Frequently Asked Questions

Many cosmetic surgeons perform rhinoplasty, but only a select few truly specialize in correcting both the form and the function of your nose. Melyssa Hancock, M.D. and Nathan E. Nachlas, M.D. are Board-Certified in Otolaryngology-Head and Neck Surgery and Facial Plastic and Reconstructive Surgery and have earned reputations as nose surgery specialists. They take a unique, artistic and comprehensive approach to each patient’s Rhinoplasty, so that each Rhinoplasty patient achieves a proportional, natural looking nose that looks as beautiful as it functions.

Rhinoplasty is performed to reshape the nose in a number of ways, including removing a hump, narrowing the nostrils, altering the angle of the tip, or narrowing the bridge. Some of the most common reasons for pursuing a Rhinoplasty include:

• Dissatisfaction with the cosmetic appearance: Most candidates for Rhinoplasty fall into this category. Cosmetic nasal defects include a variety of concerns, ranging from personal dislike for the appearance of the nose to genetic deformities that are viewed as socially and culturally unattractive. These patients will typically have an idea of what their ideal nose would look like and hope that Rhinoplasty can help them achieve it.
• Injured nose: Some candidates for Rhinoplasty may have had no concerns about their noses until an unexpected injury occurred. While injuries most often occur at sporting events, any number of causes may injure the nose so significantly as to permanently mar its appearance or functionality. Individuals with injured noses can have their nasal functionality and appearance restored with Rhinoplasty.
• Poor nasal function: While most candidates for Rhinoplasty desire cosmetic correction, other candidates seek to correct poor nasal function. With Rhinoplasty, the internal nasal structures can be adjusted and manipulated to allow for improved nasal breathing. When performed solely to improve nasal function, the procedure may be called Septoplasty. Rhinoplasty can be performed for both purposes to improve nasal function and appearance.

The decision to undergo Rhinoplasty is extremely personal. If you feel that the appearance of your nose is affecting your confidence, social life, or success in your profession, you are probably a candidate to undergo surgery to reshape your nose, or improve breathing function, or both.

From a technical standpoint, you may be a candidate for Rhinoplasty if you display one or more of the following characteristics:
• Bump or hump on the bridge of the nose
• A nose that is too wide or too narrow
• Crooked or twisted nose
• Large (Bulbous) nose tip
• Upturned nose
• Droopy nose
• Long nose
• Disproportionate nostrils

There is no ideal age to undergo Rhinoplasty surgery. To determine if now is a good time for nose surgery, it is crucial to consult with Dr. Hancock and Dr. Nachlas.

During your consultation, Dr. Hancock and Dr. Nachlas will analyze your facial features, review your medical history, and discuss your goals of Rhinoplasty surgery. If you are determined to be a good candidate for nose surgery, a customized treatment plan will be developed for you. Alternatively, if you do not qualify for a Rhinoplasty procedure, alternative treatment options will be offered.

Rhinoplasty is accomplished by altering the internal nasal framework which lies beneath the skin of the nose. Dr. Hancock and Dr. Nachlas access the interior of the nose either through incisions made within the nostrils – called a Closed Rhinoplasty – or through a small incision along the underside of the nose – called an Open Rhinoplasty. At the same time, procedures to correct a deviated septum, sinus issues, and other airway problems can be performed. When the internal work is complete, the skin is repositioned over the new nasal framework and sutured closed.

An Open Rhinoplasty is distinguished from a Closed Rhinoplasty by the placement of a small incision across the bottom of the nose. This allows previously unattainable access to the structures at the bottom of the nose, such as the tip. Intricate grafting procedures not readily performed in traditional rhinoplasty techniques are possible with the open rhinoplasty approach. This approach is not for every rhinoplasty patient, and Dr. Hancock and Dr. Nachlas will individualize their approach for each patient. No matter how simple or extensive your nose surgery, Dr. Hancock and Dr. Nachlas provide the same attention to detail, dedication, and quality of care to each patient and will recommend the appropriate surgery to give you the most aesthetic and functional rhinoplasty results.

If you are ready to have your nose analyzed by a top Rhinoplasty surgeon in the country, request your consultation with Dr. Melyssa Hancock or Dr. Nathan E. Nachlas, double Board-Certified Facial Plastic and Reconstructive Surgeons and respected nose surgery specialists in Boca Raton.

Closed Rhinoplasty and Open Rhinoplasty are two generalized terms used to describe approaches that surgeons use to correct the outside of the nose. Closed Rhinoplasty is done totally within the nose with no external incisions. In an Open Rhinoplasty, the surgeon uses an incision across the bottom of the nose to increase access to certain areas of the nasal framework.

Closed Rhinoplasty is particularly applicable in patients who have a fairly symmetrical nose, desire minor corrections to the appearance of the nose, and/or have a nasal tip that is already in correct proportion. This minimally invasive technique has the advantage of quicker healing and less operative time. It is a procedure done entirely inside of the nose, correcting the framework with small incisions through the internal lining.

Dr. Melyssa Hancock and Dr. Nathan E. Nachlas are proficient in both techniques and individualizes their approach for every patient. The Open Rhinoplasty procedure has advantages for patients with severely deformed noses or significant problems with the tip of the nose. In this approach, Dr. Hancock and Dr. Nachlas can directly sculpt and correct asymmetries in the tip and skeleton of the nose to maximize the structure of the framework.

The disadvantage of the Open Rhinoplasty is that there is a small incision across the bottom of the nose, which fortunately, heals extremely well and is nearly imperceptible within weeks of the surgery. The procedure can take somewhat longer than the Closed Rhinoplasty approach. Swelling of the nose takes longer to disappear after the closed approach. Despite these disadvantages, it is the procedure of choice in patients who meet the indications for Open Rhinoplasty as addressed above to ensure the best possible long-term result.

Dr. Melyssa Hancock and Dr. Nathan E. Nachlas will discuss during your consult the applicability of either approach to your situation.

A Rhinoplasty is used to reshape or resize the nose while a Septoplasty is used to straighten the nasal septum due to a deviated septum. A deviated septum may make it tough to breathe through the nose, and a Septoplasty is commonly used to treat this issue.

Dr. Hancock and Dr. Nachlas will perform a Septoplasty procedure to straighten crooked cartilage and bone in the nose. It improves nasal breathing as well as sinus function and can also help a patient reduce snoring.

A Rhinoplasty and a Septoplasty are not identical. With Rhinoplasty, an individual can reshape or resize his or her nose. The procedure does not, however, allow an individual to correct a deviated septum.

When necessary, a Septoplasty and Rhinoplasty may be performed in conjunction with one another, under one anesthetic, and with one recovery period.

For individuals who want to address a deviated septum, a consultation with Dr. Hancock or Dr. Nachlas is key. As top Septoplasty and Rhinoplasty surgeons in South Florida, Dr. Hancock and Dr. Nachlas can help you determine if a Rhinoplasty, Septoplasty, or both are best for you.

Many cosmetic surgeons perform Rhinoplasty, but only a select few truly specialize in correcting both the form and the function of your nose. Melyssa Hancock, M.D. and Nathan E. Nachlas, M.D. are Board-Certified in both Otolaryngology-Head and Neck Surgery and Facial Plastic and Reconstructive Surgery and have earned reputations as nose surgery specialists.

Each patient who visits Dr. Hancock and Dr. Nachlas for Rhinoplasty undergoes a thorough evaluation of the entire nose. The external anatomy, as well as the internal anatomy (septum, sinuses, and turbinates) will be carefully examined to be sure that your nose surgery will correct both the appearance and the function of the nose. Often, a combined Rhinoplasty and Sinus Surgery (Total Nose ApproachTM) is performed to ensure that you look and feel better following nose surgery.

Other nose and sinus procedures commonly performed during the same session as a Rhinoplasty include:
Balloon Sinuplasty (for chronic sinusitis)
Turbinate Reduction (for breathing)
Nasal Sculpting (also for breathing)
Removal of nasal polyps

Absolutely! Dr. Hancock and Dr. Nachlas may recommend Rhinoplasty surgery be performed in combination with one or more of the following facial rejuvenation procedures:
Facelift: Reverses the visible signs of aging in the face such as jowls and sagging or loose skin
Neck Lift: Reduces or removes loose or sagging neck skin, excess fat in the lower face or chin, and other visible signs of aging in the neck
Brow Lift: Treats drooping brows and deep wrinkles of the forehead, restoring a smoother, more youthful contour to the upper portion of the face
Eyelid Surgery (Blepharoplasty): Eliminates excess skin from the upper eyelids and removes under-eye bags and redundant skin from the lower eyelids
Submental Liposuction: Eliminates excess fat causing the appearance of a double chin and improves the contours of the chin and jawline
Botox: Smooths fine lines, wrinkles, and furrows caused by excessive muscle movements
Dermal Fillers: Enhances the facial appearance without surgery by restoring volume to create a more youthful facial contour
Platelet Rich Plasma (PRP) Hair Loss Treatment: Stimulates new hair growth and improves the health and strength of existing hair

Dr. Hancock and Dr. Nachlas want to help each of their patients achieve a balanced, natural-looking facial appearance. If they believe you may benefit from a Rhinoplasty performed in combination with other facial rejuvenation procedures, they will tailor your treatment plan accordingly.

Results and recovery are subject to numerous variables, including age, skin thickness, bone structure, facial proportions, previous injuries, and other factors. Immediately after surgery, most patients experience swelling, bruising, and nasal congestion. Over the course of the initial surgery recovery period, which ranges from about 7-10 days, these symptoms will improve. After this initial period, a patient can resume everyday activities like working or going to school. Typically, patients return to work or school in about one week and are “restaurant ready” within 2 weeks. Swelling and bruising will have diminished enough for most people to return to work or run errands without anyone noticing anything is off. Strenuous activity, heavy lifting, and other physical activities may be limited for the first 3-6 weeks after surgery. The best nose job results occur if a patient understands the rhinoplasty recovery process.

Dr. Hancock, Dr. Nachlas, and the rest of the Nose and Sinus Institute team will ensure that you fully understand the recovery process and are well-prepared for the Rhinoplasty recovery prior to treatment. You will be provided detailed instructions about post-Rhinoplasty surgery care and recovery support. Dr. Hancock and Dr. Nachlas are also happy to respond to any concerns or questions you may have at any point during the recovery cycle.

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