I was recently asked about a "quick fix" rhinoplasty on the plastic surgery patient chat line RealSelf.com. This is another case of "if it sounds too good to be true....then it usually isn't". The question involved a quick fix to narrow the bottom part of the nose. Rhinoplasty has been described as the most difficult of all facial plastic surgical procedures by the greatest plastic surgeons in the world. Sculpting the nose to blend in with the other surrounding facial features is the goal. A beautiful nose "gets out of the way" of attractive eyes, cheeks, jaw line, and mouth. Narrowing the base of the nose can be one step in a rhinoplasty, very rarely the only step. When one area of the nose is altered, the rest of nose is usually sculpted to fit the change. The most essential aspect of rhinoplasty is the proper diagnosis of what is causing the perceived problem. Once the diagnosis is made, then a properly qualified rhinoplastic surgeon can carry out the necessary maneuvers to accomplish the desired results. It is essential to choose your rhinoplasty surgeon most carefully. Everyone's nose is different, and surgeon’s skills and aesthetic senses of beauty differ. Take your time and make sure that you and your surgeon are "on the same page" with regard to your expectations and the surgeons ability to meet those expectations. By all means avoid the "quick fix". The first rhinoplasty operation is your best chance at getting the excellent result that you desire. Revision rhinoplasty is more difficult because of what has been removed as well as scar tissue.

In the early years of rhinoplasty, having a nose that looked operated on was somewhat of a status symbol, so much so that a few surgeons had characteristic noses that they created consistently on their patients. In New York City there was the "Diamond" nose, and in Los Angeles the "Parkes" nose. Today, the goal of any good cosmetic surgery is a natural look. Recently in my practice I have come to realize that there are thousands of people who have a minor bump, hump, or tip disproportion that has bothered them for a long time, but feared having it repaired because they did not want the rest of their nose and appearance changed. They didn't want to end up with the Dr. "you fill in the name" nose job. Now those slight nasal "offending parties" can be corrected with a subtle rhinoplasty. The procedure is quicker and easier for the patient as the nasal bones are not broken, the nasal septum (center divider of the nose) is not operated upon, and there is no packing placed into the nose. There is no to minimal bruising, swelling, or pain. Nasal breathing can be improved at the same time. The downtime is only 4 to 5 days, and full normal activities can be resumed in 14 days. Patients need no longer fear that their entire look will change. Call our office to find out if that little thing that bothers you about your nose can be taken care of with the subtle, finesse rhinoplasty.

There is no recipe for an excellent rhinoplasty. Everyone is different. A beautiful nose gets out of the way of the eyes and mouth. The nose then "fits" the face. Choose your surgeon most carefully. They should have experience, they should be Board Certified in plastic surgery, facial plastic surgery, or otolaryngology (ENT), but most importantly they must have an artist's aesthetic sense.

Christina Ricci stars in the recently released motion picture, Penelope. In the "fairy tale" film, she is born with a pig's nose (as well as pig's ears) because of a witch's curse. The curse can only be reversed if she is accepted and loved by someone of her same "blue blood" society. Penelope's nose is short, turned up with a "ski slope", has enormous nostril show, a retracted columella, is very wide at it's base, and has many horizontal deep lines across the dorsum. Repairing her nose would require an open rhinoplasty. Cartilage grafts would be needed to lengthen and support her tip. Nostril reduction and lower nasal cartilage narrowing along with the injection of fillers along her dorsum would likely improve the porcine appearance. In the movie, Penelope finally accepts and loves herself for what she is (not a bad idea for all of us), and it is she that reverses the curse, giving herself a "normal" nose. In real life, the best way to avoid a "pig's" nose deformity after a rhinoplasty is to choose your surgeon most carefully before the first operation. It always amazes me that many patients will spend more time picking out the color of their new car than they will spend on choosing their nasal surgeon. Carefully look at many before and after pictures. Ask to speak with, and preferably see patients whom the surgeon has operated upon. Otherwise, you may end up like Penelope with a "pig's" nose, and be forced to select your revision surgeon more carefully.

Ashley Tisdale, a young teen star from the popular High School Musical, unveiled her new nose a few weeks ago in New York City during a holiday performance. According to reports she had difficulty breathing through her nose, visited another Ashely's (Simpson) surgeon, and underwent the procedure to correct her breathing. "Oh, by the way, while you're in there, can you straighten out my nose and take off that bump from when my nose was broken?" "Hope that she didn't Jennifer Grey her career with that nosejob" is what I've heard from some Hollywood agents and actresses. The key to any facial plastic surgery is that it should look natural, nearly undetectable. Some ethnic and celebrity noses have the potential to change the entire look of the face when they undergo rhinoplasty. After a rhinoplasty, it should not be necessary for the patient to have to greet friends, family, and aquaintances with " Hi, I'm (fill in the name of the nose job patient)". I empathize with Ashley and her surgeon( a world class rhinoplastic surgeon) as they are being scrutinized under the world media magnifying glass. It takes about 6-12 months for the nose to settle as it heals. Hopefully her burgeoning career will not be affected and she will be able to breath well through her newly reconstructed nose.