The nose is the central feature of the face, and consequently one of the most prominent and defining features. The nose should blend into the face and not draw attention. A nose that is disproportionate or unbalanced with the rest of the face can distract from the more sensual features, such as the eyes and lips, and from one’s natural beauty.
Rhinoplasty is the preferred treatment for patients who are unhappy with the appearance of their nose. Whether you were born with a minor nose deformity, suffered a nasal fracture or experienced poor results from a previous nose job, rhinoplasty can be an excellent solution for these issues. Even a slight alteration using rhinoplasty can significantly improve a patient’s self-confidence.
Dr. Stong is dual board certified in Otolaryngology Head and Neck Surgery and Facial Plastic Surgery and Reconstructive Surgery. His elite training and proven success in plastic surgery makes him an ideal rhinoplasty surgeon. Dr. Stong uses advanced surgical techniques to delicately reshape and redefine the nose and create a more harmonious and attractive facial appearance. During rhinoplasty or any nose surgery, you can trust that he is careful to preserve the function of the nose and even improve breathing when possible.
Rhinoplasty in Adults
In adulthood, the nose undergoes changes that can make your nose appear as if it has grown larger. The skin of your nose may thicken and the nasal tip may droop and widen. Rhinoplasty effectively addresses these unwanted signs of aging by reducing the size of the nose, re-sculpting the tip or bridge, narrowing the span of the nostrils, or altering the angle between the nose and the upper lip. It is one of the most requested cosmetic surgery procedures, especially among men.
Rhinoplasty can improve the following nasal features:
- Large nose
- Crooked appearance
- Nasal hump
- Bulbous tip
- Wide nostrils
Dr. Stong carries exceptional skill in both open and closed rhinoplasty techniques, including Asian rhinoplasty. He combines his surgical artistry and a keen eye for facial harmony to successfully perform your rhinoplasty and correct the nasal features that are distracting from your natural beauty. We proudly serve patients that come from all over the country and the Metro Atlanta area including:
- Johns Creek
- Peachtree City
- Sandy Springs
- Virginia Highlands
If you have any further questions surrounding rhinoplasty, including your candidacy for the procedure or what you can personally expect with rhinoplasty results, please contact Kalos Facial Plastic Surgery, LLC today. You will find that although Dr. Stong is an exceptionally talented and distinguished plastic surgeon, he values a compassionate, patient-centered approach when it comes to redefining your beauty. We always take the time to listen to your specific concerns and goals before explaining the treatment options that are available to you.
- Is rhinoplasty right for me?
Based on a visual exam and thorough consultation, Dr. Stong will determine your candidacy for rhinoplasty with consideration to several factors, including the degree of deformity, skin type, ethnicity, and age. He will explain and choose his surgical technique based on these factors and the patient’s desired goals. Rhinoplasty can be done by an open or closed approach.
Additionally, Dr. Stong uses digital morphing software in all consultations to communicate with patients about their rhinoplasty results. These images are also used in surgical planning and during surgery to ensure patient expectations are closely met while shaping the nose.
- What is an endonasal or closed rhinoplasty?
The closed rhinoplasty technique, also known as scarless rhinoplasty, uses incisions on the internal lining of the nose to avoid any incision or scars outside the nose. The endonasal technique or closed approach is limited by the amount of nasal tip work that is needed. It is less precise when it comes to shaping the tip, yet it is ideal in patients who primarily want the hump or bridge taken down.
- What is an open structure rhinoplasty?
Open rhinoplasty typically involves a small incision at the base of the nose between the two nostrils at the columella (the area of your nose between your nostrils). The columellar incision hides very nicely in the shadow of the undersurface of the nose and heals very well, making it imperceptible to others.
- What is the benefit of an open versus closed rhinoplasty?
Open rhinoplasty provides better visualization of the nasal cartilages and bones, allowing for the absolute best control in shaping and strengthening the nasal structures. For these reasons, open structure rhinoplasty is generally preferred over closed rhinoplasty and gives more precise post-operative results.
- What is a Tip Plasty?
Tip plasty is the rhinoplasty procedure that refers to shaping the nasal tip only. Many patients are unhappy with the appearance their nasal tip because it draws attention or distorts the overall look of the nose. In general, a desirable nasal tip is one that has a soft triangular shape, without sharp angles. One that is too round or wide can make the entire nose appear larger and a drooping nasal tip can make the nose appear too long. Tip plasty can restore proportion and blended balance to your nose. Tip plasty alone is not commonly performed because the bridge and width of the nasal bones often need to be changed in order to blend the tip of the nose with the bridge and create an overall more harmonious nasal appearance.
Dr. Stong is experienced and knowledgeable in a wide variety of tip plasty techniques, including those that refine the width, reduce or improve fullness and rotate the tip position. Even a slight refinement of the tip can make profound improvements in your overall nasal appearance and restore appealing facial balance.
- Why is a lower lateral cartilage cephalic trim performed?
This technique is especially beneficial to patients who have a bulbous nasal tip, or one that is too broad or round in relation to the rest of the nose. The cephalic portion of the lower lateral cartilage refers to the upper edge of the cartilage that is opposite of the nostril rim. Dr. Stong routinely performs a cephalic trim to reshape a bulbous tip. This technique also creates a slight upward rotation of nasal tip and helps blend the tip with the bridge of the nose.
- How is the tip rotated or nose shortened in rhinoplasty?
Depending on the degree of rotation needed, a variety of rhinoplasty techniques can be employed to improve a drooping tip or a nose that is too long. A long nose can be significantly improved by simply raising the nasal tip. Examples of these nasal rotation and shortening techniques are a cephalic trim, or trimming the upper lateral cartilage, and a caudal septal trim, or trimming the lower edge of the septum, which creates significant rotation to the nasal tip.
The tongue-in-groove (TIG) technique is often used in combination with other rhinoplasty procedures. This technique is used to correct excessive columellar show and when extensive rotation of the nasal tip is required. It also allows for increased nasal tip projection if the tip is set back too far. The tongue in groove involves suture fixation of the columella’s medial crura to the caudal septum, which provides long-term, stable support.
- Why are intradomal and interdomal sutures placed in the tip?
The nasal tip is compromised of two domes. Sutures may be used to reshape these domes and narrow or tighten the tip. These suture techniques are commonly used to correct a bulbous or bifid nasal tip. Intradomal sutures refer to sutures within each individual dome. Interdomal sutures refer to sutures between the two domes.
- Why are shield grafts and cap grafts necessary?
Cartilage grafting is used frequently in both primary rhinoplasty and revision rhinoplasty procedures. Shield grafts and cap grafts are used to refine and help project the nasal tip. Open rhinoplasty is the most ideal technique for graft placement within the nasal tip, as it allows for more precise placement and fixation and prevents potential shifting of the grafts. A shield graft is a versatile tool that can improve tip projection and define the nasal lobule. Thicker-skinned patients are typically better suited for this type of grafting.
- Why is a columella strut used?
Columella struts are cartilage grafts that are harvested and sutured in between the medial crura of the columella (or the fleshy external end of the nasal septum). Columella struts are used to stabilize and strengthen the tip. They add tip support, maintain tip projection and create a more durable nasal tip. Columella struts are almost always used in open rhinoplasty when putting the tip back together during the tip shaping portion of the rhinoplasty surgery.
- When is rib grafting necessary in rhinoplasty?
There are numerous cartilage grafting techniques that can be used to reshape the nose. Rib cartilage is infrequently used, particularly in primary rhinoplasty. However, when extensive amounts of cartilage are required to effectively change the nose, a rib graft may be necessary. This may be taken during the surgery from the patient themselves or an irradiated cadaver rib graft may be used also. Rib grafting may also be considered in revision rhinoplasty cases where the septal cartilage has already been removed and when ear cartilage is not available. If harvested from the patient themselves, a rib graft can make the recovery period longer and more difficult.
- Why is a septoplasty performed with a rhinoplasty?
A septoplasty is almost always part of a rhinoplasty, particularly if bridge work is being done. A deviated septum is corrected during the rhinoplasty to improve breathing. If cartilage grafts are being used in the operation, then the septal cartilage is the preferred donor area. Additionally, when taking down a cartilaginous dorsal hump, the upper lateral cartilages are divided from the septum to adjust the height of the bridge accurately and effectively. Even when no cartilage is removed from the septum, the septoplasty will often still be performed as part of the procedure with the cartilage being left intact. Rhinoplasty is a delicate operation that requires a surgeon’s specialized knowledge, skill, experience and artistic eye. Dr. Stong carries dual board certification in Otolaryngology and Facial Plastic Surgery, therefore patients can trust that he is able to create a beautifully shaped nose with dedicated emphasis on preserving or improving nasal breathing.
- Why is a chin implant used in rhinoplasty?
When visually interpreting the features of the face, the brain processes the projection of the nose in relation to the projection of the chin. Consequently, if a patient has a weak chin, then it can create the illusion that the nose sticks out too far from the face. The ideal chin projection is defined in relation to the projection of the lower lip. In men, the chin should ideally project to the same extent as the lower lip. In women, ideal chin projection may be a couple of millimeters behind the lower lip. Using a chin implant to restore chin projection can balance the perceived projection of the nose from the face, which is an important aspect when planning rhinoplasty.
- What patient factors affect the outcome of rhinoplasty?
Certain patient factors directly impact rhinoplasty results. These include the quality or strength of the lower lateral cartilages, the size and shape of the nasal bones, quality and thickness of your nasal skin as well as your current degree of nasal symmetry. In general, patients with moderate skin thickness and strong nasal cartilages tend to have better results.
- What are the primary determining factors for recovery from rhinoplasty surgery?
Recovery from rhinoplasty is directly related to the type of technique that was used and the extensiveness of the surgery necessary to obtain excellent results. Post-operative physical restrictions and healing time will vary depending on whether a closed or open technique was used, whether the nasal bones were broken, as well as the amount of nasal tip work performed. In general the patient can expect to feel and look much better within 7 to 10 days.
Healing is faster if the nasal bones do not need to be broken. Endonasal (closed) rhinoplasty tends heals faster than open structure rhinoplasty. However, as previously mentioned, this technique is somewhat limited in its ability to achieve ideal post-operative results, particularly if the nasal tip is being reshaped.
- Is the nose packed during surgery and what is the postoperative course like?
Many surgeons routinely pack the nose, but Dr. Stong almost always avoids packing the nose to allow for a more comfortable recovery period. There is typically only moderate bruising around the eyes, which usually resolves within 7 to 10 days. In an open rhinoplasty, sutures are removed from the columella in 4 to 5 days. Any external tape and the cast are removed at 1 week. Patients usually feel comfortable returning to work within seven to ten days after the cast has been taken off. However, the final results may take up to one year to settle out after the healing process has finished.
- Is it safe for my teenager to have rhinoplasty?
Yes, Dr. Stong does perform rhinoplasty for teens. However, it is offered with careful consideration, especially to their specific age. Teen rhinoplasty should be performed after the patient has completed their growth spurt, which is typically between 15 and 17 years of age. If you have a teen whose misshapen or asymmetrical nose is a source of embarrassment or peer ridicule, Dr. Stong will consult with the parents and patient to discuss the procedure and help set goals for rhinoplasty. We feel that it is very important to educate teens on what to expect after the procedure as well as confirm that the patient wants the surgery, not the parents.
- Who is a candidate for revision rhinoplasty?
If your nose job was performed poorly, Dr. Stong performs revision rhinoplasty. We have many patients that travel to Dr. Stong to have a previous nose job corrected. Revision rhinoplasty can fix the deformities that may be left behind after a prior nasal surgery. Your revision may be as simple as removing additional bone or cartilage or it may require more involved restructuring techniques. In general, it is important to get the rhinoplasty right the first time, and that is why choosing a qualified surgeon is so important. Dr. Stong uses his talented artistry and unrivaled skills in plastic surgery to refine your nasal features to create a more softened and balanced appearance. As with all of his rhinoplasty procedures, Dr. Stong carefully considers both the aesthetics and function of your nose when planning the revision procedure.