Rhinoplasty, or cosmetic nose surgery, is one of the few surgical procedures that is considered to have the greatest potential to change your life, according to psychologist, Dr. T. Pruzinsky, and plastic surgeon, Dr. M. Edgerton. As such, your nose has a significant impact on how you are perceived by yourself and others. The nose is a dominant feature of the face. Dissatisfaction arising from its contour, size and shape can have a detrimental impact on your psychological well being and the way in which you interact with others. You don’t have to stare at what you consider to be an ugly nose-cosmetic rhinoplasty is designed to achieve a more aesthetically pleasing nose that is proportionate, thereby creating overall facial harmony. In a single localized procedure, you may experience great improvement regarding the attractiveness of your face, your self-fulfillment and happiness.
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How to improve the size, shape and profile of your nose
- Rhinoplasty is a cosmetic surgical procedure that can reshape and resize any part of your nose, making it more proportionate.
- The surgery is customized to preserve your ethnic heritage.
Rhinoplasty is a cosmetic surgical procedure that can address a number of aesthetic defects of the nose. Almost anything that may be of concern to you regarding its appearance can be treated, such as length, prominence, projection and width. The results of even the slightest of alterations can have a dramatic effect. The most satisfying outcome, however, is typically a change that accomplishes a delicate balance and harmony with other facial features. This involves preservation of the unique qualities of your nose, as determined by such factors as genetics, ethnicity and gender, because most patients still want to be recognized following surgery— they just want to look better!
The most important way in which a successful outcome of rhinoplasty is measured relies almost entirely on you, the patient. Successful results from nose jobs are based not just on the level of improvement you experience as related to your aesthetic appearance, but also on how your nose job results have improved your psychosocial state in terms of self-esteem, confidence, body image and overall quality of life.
Consider the proportions of the entire face for a better result
Most of us believe that their aesthetic treatment should target specific facial features, however, the best results can only be achieved when a more holistic approach is taken.
Many people who are unhappy with their appearance believe that altering their nose will provide the kind of improvement they desire. A study conducted by the University of Verona, Italy, and published in JAMA Facial Plastic Surgery has found that this approach may not have the desired effect. Instead, the study found that the best results are achieved when a patient’s nose and chin are treated together.
The researchers looked at the ratios responsible for creating what is called an “aesthetically proportionate” face. What they found is that the most aesthetically pleasing faces were based on the proportions of the chin, nose, and neck. The study concluded that any patient with a small chin would achieve the best results through a combination of both a nose job and chin augmentation (genioplasty) surgery. Aside from the aesthetic benefits, undergoing both procedures simultaneously also minimized both recovery time and cost.
Achieving better facial proportions
Dr. Fialkov understands that, as the above study proves, patients receive the best results when the face is treated as a whole. Altering a large nose, small chin, or flat cheeks isn’t nearly as effective as improving the balance of the entire face. Patients benefit most when a number of small, subtle adjustments are made to the entire face instead of a large procedure that looks to alter a single feature. Rather than receive a drastic nose reduction, for instance, a person would have a better, more natural looking outcome when a more balanced approach is taken.
Dr. Fialkov achieves exceptional aesthetic improvements by carefully analyzing each patient’s facial structure. The most important areas to consider are the chin and the nose, features that can be classified as either overly projected, under projected, or in proper balance already. The size of a small chin can make a nose look larger and vice versa. Dr. Fialkov assesses the relationship between the facial features on a case by case basis before creating a treatment plan.
I would have done it earlier.
Your rhinoplasty surgeon
Dr. Jeffrey A. Fialkov has been honoured with a number of awards recognizing his work by such professional organizations like The British Association of Plastic Surgeons and The Canadian Society of Plastic Surgeons. Also serving as Associate Professor of the Division of Plastic Surgery at the University of Toronto, Dr. Fialkov’s experience fosters a refinement of surgical skill to such a level that fully qualified plastic surgeons from Canada, the United States, Europe and the Middle East come to him for additional subspecialty training in advanced complex surgical technique. Proven surgical skill, natural artistry and a sincere dedication to achieve your goals qualifies Dr. Fialkov to perform your rhinoplasty.
A rhinoplasty in Toronto can change your life for the better. Call (416) 256-5614 to book your consultation with Dr. Fialkov.
A natural, ethnically compatible shape and size of nose is extremely important in a given person’s appearance. While improving the aesthetics of the nose, Dr. Fialkov is careful not to make alterations that appear unnatural. This includes over “Westernizing” a patient. Since each person’s face is different, the same surgical techniques cannot be used for every rhinoplasty patient. When planning the procedure, a number of different factors must be considered, such as individual face shape and nasal characteristics. Ethnic background may also be a factor.
Every patient who undergoes a nose job is unique. Their particular facial features, health and expectations determine what surgical techniques are applied to achieve the most desirable enhancement. While every patient is different, many Asian patients share several key nasal and facial characteristics (these may or may not apply to you).
Nasal tip projection and definition
If the tip of a person’s nose does not project fully enough, Dr. Fialkov will use cartilage suturing and grafting techniques that require the utmost precision to increase tip projection. In the Asian nose, this often requires enhancing the definition of the nasal tip. This can be done with cartilage reduction, grafting and sometimes soft tissue reduction as well. Dr Fialkov then uses special suture techniques in order to fold the cartilage into a more defined and refined shape.
Asian patients often have weaker nasal tip cartilage which may require reinforcement with extra cartilage to achieve definition and projection. This extra cartilage can be taken from either a hidden crease behind the ear or from the septum (the tissue that separates the nostril air passages) to create supporting structures that enhance definition and projection of the tip.
Many Asian patients have low, broad nasal bridges. In order to achieve better definition and refinement of the nose, the bridge may be narrowed and augmented with graft. This must be undertaken with caution in order to maintain the ethnic character of the nose, while refining it aesthetically.
The extent to which the nostrils should be narrowed is heavily influenced by the ethnic background of the patient. In general, Dr Fialkov applies advanced rhinoplasty surgical techniques in order to project the nasal tip which in turn also narrows the nostrils without adversely affecting their curvature or creating visible scars that can both leave the nose looking unnatural.
While no two noses are the same, there are key nasal and facial features shared within ethnic groups that can help provide a procedural guideline. Effective rhinoplasty results should fulfill patient expectations but also preserve a natural appearance.
African-American nose characteristics
The noses of African Americans share a number of characteristics. In general, patients from this group form thicker scars and have thicker skin with weaker cartilages and shorter nasal bones when compared to Caucasians. It is important to balance aesthetic refinement of the ethnic nose with the preservation of features that allow for a natural non-artificial appearance.
African-American patients often seek rhinoplasty in order to address concerns of a wide flat nasal bridge, a broad nasal tip that lacks definition and projection, wide nostrils and, as with all rhinoplasty patients, breathing problems.
The most common concern expressed by African American rhinoplasty patients is overly wide nostrils (nasal ala). Older forms of rhinoplasty attempted to correct this issue by excising nostril skin, but to achieve a more natural improvement, the entire nostril is reshaped instead. This avoids scars and creates a more natural looking curve than what was possible through skin excision.
Wide nose bridge
Patients with an overly wide or low nasal bridge (nasal dorsum) may require narrowing of the bones or augmentation of the bridge with cartilage graft taken from the patient’s ear or septum.
Wide nasal tip
An overly wide nasal tip can be modified by narrowing and reshaping the cartilage found in the lower third of the nose. In some cases, Dr. Fialkov must remove cartilage from another area of the face and use this tissue as a graft that supports and better defines the tip of the nose.
Dr. Fialkov thus achieves overall refinement of the nose in African-American patients by modifying both the internal structures and soft tissue of the nose. The end result of this ethnic rhinoplasty is a better defined, natural looking nose that preserves the ethnicity of the patient, and is properly supported by a stronger internal framework.
Are you a candidate?
If you would like to improve your facial contour and self-esteem with a nose job, it is important that you examine why you’d like to do so and have realistic expectations of surgery. Express your goals and reasons to Dr. Fialkov during your consultation so he can have a better understanding of your expectations from surgery. That way, you’ll be happier with your results.
Every surgical operation can lead to complications. These include infection, excessive bleeding, deep vein thrombosis (the development of a blood clot, typically in a leg vein), blood accumulation underneath the skin (hematoma), and unexpected reactions to anaesthesia. Risks that are specific to rhinoplasty include poor wound healing/infection, nose asymmetry, the rupture of small surface vessels on the nose, skin discolouration and contour irregularities, persistent pain, and swelling. Patients may also develop changes in skin sensation (like numbness), spontaneous suture surfacing that can become visible and require removal, and unfavourable scarring.
More serious complications include alterations to the nasal airways that make breathing difficult. In rare cases, it is possible for a hole in the nasal septum (the tissue separating the nasal passages) to develop. This issue can be extremely difficult or, in some instances, impossible to correct through further surgical treatment. Pulmonary and cardiac problems can also result from operations that take a long time to complete. These issues may lead to the formation of venous system blood clots or an increase in the number of clots already present in an individual’s body. In some cases, patients may require additional surgery in order to correct aesthetic or health complications resulting from the rhinoplasty procedure.
Deciding whether or not to undergo the procedure is a completely personal decision, based on balancing the potential complications with achievable aesthetic benefits. Your surgeon will discuss these risks with you in full detail before scheduling your surgery. During the consultation, your surgeon will be able to assess how an individual’s unique circumstances (health, facial features, expectations, etc.) can affect the success of the surgery. Using this knowledge, each patient must then decide whether or not they are comfortable with the level of risk that applies to them.
You’ll be advised not to take vitamin E, any aspirin-based medications, and garlic or fish oil tablets for two weeks before surgery. The use of both tobacco and alcohol before surgery should also be avoided because these can compromise your recovery. You should not smoke or drink in the three weeks leading up to surgery. A full list of instructions will be provided to you.
Structural (or incisional) rhinoplasty refers to the modification of the nose by changing the shape and position of the nasal tip cartilage. This process leaves the skeletal framework of the nose strong and relatively intact, helping to make treatment safer, predictable, and more accurate. If any tissue is removed, particularly when fixing an oversized nasal bridge, hump or bulbous tip, it can also be referred to as excisional rhinoplasty. The excisional technique involves the removal (or excision) of some of the cartilage and other tissue found in the nostril and/or tip of the nose during the reshaping process. By removing this cartilage and tissue, the contours of the nose are enhanced. However, experienced rhinoplasty surgeons like Dr. Fialkov limit the amount of tissue that is cut out, removed, and discarded in order to preserve the skeletal support structure of the nose during the remodelling process. Serious aesthetic and medical complications may not become fully apparent for months, years, or decades when too much tissue is removed, but have commonly been found to develop over time.
When too much tissue is taken away, the remaining nasal cartilage will often buckle due to skin shrinkage and/or begin migrating upward as the scar tissue contracts. This can happen immediately or gradually. Other problems include retracted nostrils, overly prominent nostrils, and a pinched or artificial looking outcome. The end result is a deformed nose that may require further treatment to correct.
Open vs closed rhinoplasty
In the past, the rhinoplasty procedure was generally limited to reducing the size of certain structures of the nose through excision only. This was performed by creating an excision, for the most part, through a closed or “blind” approach. The surgeon was not able to directly see the structures and tissues that they were modifying, which increased the risk of an undesirable outcome.
The open approach septorhinoplasty allows for direct visualization of each structure of the complex nasal anatomy. This allows your surgeon to make more predictable changes under direct vision, such as the following:
- increasing size where needed
- changing shape or contour by means of grafting or suturing techniques
- reducing the size of structures
The open approach allows for greater precision and in turn greater predictability of outcome. It allows your surgeon to perform a more structural rhinoplasty, whereas a closed rhinoplasty is often limited to excision. Excision may still be part of an open rhinoplasty if any part of the nose needs to be reduced in size. Being able to properly view the operating site makes it possible for cartilage grafts to be accurately placed, immobilized with sutures and hidden from view, ready to heal into a strong, beautiful looking nose.
Following your surgery
You may experience a degree of swelling, soreness, and stiffness that typically develops in the area beneath the eyes. The tip of the nose may be numb or stiff for several months as well. Tissue swelling can make breathing through the nose impossible, but this issue usually resolves itself as the body heals. You may also experience minor nose bleeds for one or two days following surgery.
Each of these side effects is usually temporary and can be expected to subside with time.
These are some things that you can do to help with your recovery:
Brushing your teeth shifts your mouth in a way that causes both the upper lip and nose to move. Because of this, you must be very careful when brushing your teeth during recovery. Avoid aggressive movements and be sure to slow down if you can feel your nose moving while brushing.
It’s extremely important that you avoid the use of both tobacco and alcohol after surgery since these substances inhibit the recovery process. You should not smoke or drink in for three weeks.
The body needs time to recover after surgery. You should do your best to relax while your body heals. This involves avoiding any strenuous movement—including aggressive exercises—for at least six weeks. Sports that may lead to nose injury (like volleyball, baseball, or basketball) should be ceased for longer. Speak to your surgeon to find out when you can start playing sports again.
Swimming affects the nose and can interfere with the recovery process. Diving and other movements through the water will shift the nose’s position before it’s resilient enough to handle this. Exposure to chlorine can also lead to a stinging sensation. For all of these reasons, it’s recommended that you avoid swimming for six weeks from the time of surgery.
Putting on or taking off clothing items like t-shirts and pullover sweaters can bump or tug on the nose while it’s healing. You should wear buttoned shirts or zip-ups to prevent this.
The skin of the nose is very sensitive during recovery and should be protected with sunscreen. It’s also a good idea to limit the amount of time you spend in direct sunlight while the nose heals. Excessive exposure to UV rays can lead to permanent skin discolouration.
The nose becomes very sensitive after treatment. It swells for much longer than many other parts of the body (its healing process isn’t fully complete for as long as a year) and should be treated extremely carefully. Common actions like nose blowing cannot be performed for at least two weeks.
Since glasses put weight on the nose it’s best to avoid wearing them while healing. If contact lenses aren’t an option anyone who requires prescription glasses should use a nasal splint that is taped onto the nose before wearing them. This splint will help absorb the weight of the glasses and reduce the risk of permanent nasal bone damage.
Chewing tough food causes the nose to move just as much as aggressive tooth brushing. Any meal that involves a lot of chewing should be avoided until the nose has had a chance to properly heal.
Dr. Fialkov will be able to augment your nose in a way that both looks fantastic and is able to withstand the test of time. You’ll enjoy long-lasting results.
A special note on nonsurgical nose jobs
There are some medical professionals who perform filler injections to enhance the nose contour. Known as nonsurgical nose jobs, this is very risky. Unlike other areas that are treated with injectable fillers, nasal injections carry a particular high risk due to the arteries located near your eyes, and can lead to blindness. Since this is the only anatomical location which carries such a high risk, this is the one type of injection we do not perform. Edelstein Cosmetic is focused on your safety above all else. We won’t risk your health, or your pocketbook, if there is a better, and more permanent alternative to giving you the look you want.
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