Rhinoplasty

Board Certified Manhattan Rhinoplasty Plastic Surgeon Douglas M. Senderoff, MD, FACS has extensive experience in performing Rhinoplasty in many types of noses. The Manhattan Plastic Surgeon realizes that sometimes a subtle change in the nasal shape can produce a dramatic improvement in facial appearance. The NYC Rhinoplasty Plastic Surgeon is committed to creating well balanced aesthetically pleasing nasal contours that fit the patient's face and appear natural. Modern techniques in rhinoplasty are focused on reshaping and providing the proper structure and proportion to the nose as opposed to just reducing the amount of bone and cartilage present as was the focus in the past. Some patients for example may require tip support in the case of a drooping nose or the addition of cartilage to increase the projection in noses that are flat and lack definition.

At the time of your complimentary consultation with board certified plastic surgeon Douglas M. Senderoff, MD, FACS he will take the time to evaluate your nose and discuss the type of result that meets your needs. The Manhattan Plastic Surgeon has the most advanced computer imaging system now available in his Park Avenue Manhattan, NYC office. Using the Vectra 3-D computer imaging system allows patients to view the simulated results of rhinoplasty surgery immediately in 360 degree views. A variety of changes to the nose can be made using the computer software so patients can understand the possible outcomes of surgical maneuvers such as increasing tip projection, reducing the bony hump, narrowing the nasal bones and improving tip definition. Today's rhinoplasty is concerned with the structural balance of the nose and for this reason patients need to be informed how the surgeon intends to approach their surgery and what type of result they can realistically expect. By performing the 3-D computer imaging and by allowing patients to review before and after photos and by spending time listening during his consultations The NYC Rhinoplasty Plastic Surgeon is effective in understanding the goals and expectations of his patients.

The rhinoplasty procedure is performed by board certified plastic surgeon Douglas M. Senderoff, MD, FACS in his fully accredited outpatient surgery facility located on Park Avenue South in Manhattan, NY. The procedure may be performed under local anesthesia with sedation or general anesthesia depending the extent of the surgery. The type of anesthesia will be discussed with you prior to your surgery. There are two main approaches to rhinoplasty which include the endonasal approach and the open approach. In the endonasal approach to rhinoplasty the incisions are made in the lining of the nostrils and as such are hidden from view. This approach is somewhat limited in that the surgeon is unable to visualize the delicate nasal structures and cannot easily shape the cartilage of the tip with this technique. The endonasal approach is best used in patients with a minor bony hump who do not require major nasal tip work. The open rhinoplasty approach involves making a fine incision in the columella which is located is located on the bridge of skin between the nostrils. This incision is joined with the internal nostril incisions to expose the bony cartilaginous framework of the nose. This exposure allows the surgeon to carefully inspect and shape the delicate nasal tip cartilage. Cartilage can be added or sculpted and the tip work can precisely be performed under direct vision. Bleeding can also be kept to a minimum. The skin of the nose is then closed with fine sutures. The nasal bones are then placed closer together to narrow the appearance of the nasal pyramid. This narrowing is achieved through the use of a small fracture of the base of the nasal bones at the maxilla. After the nasal bones are moved closer together a nasal splint is applied to the nose to keep the bones in position. This splint is usually worn for 7-10 days.

After the rhinoplasty surgery, the plastic surgeon's patients are instructed to keep their head elevated and avoid any strenuous activity. The nose may be irrigated with saline solution to wash away any clots or mucous. Nasal packing is not usually used so patients should be comfortable after surgery and need not worry about breathing through their nose. Bruising and swelling is normal after rhinoplasty. Some patients may experience bruising under the eyes for several days. The nose may ooze for a couple of days as well. Pain medication is available but most patients do well with iced compresses to the face and Arnica Montana pellets and cream. After the splint is removed the nose may still appear swollen. It may take several weeks for the swelling and bruising to subside. While the nasal profile will be evident immediately the subtle changes of the nasal tip may not be fully apparent for several months. During the months after rhinoplasty patients are encouraged to keep their postoperative visits so they can be evaluated with regard to the rate of healing and so any asymmetries can be addressed. Some patients can benefit from a small amount of cortisone injected into the nasal tip after surgery to help reduce prolonged edema.

The rhinoplasty plastic surgery procedure is one of the most rewarding operations for both patient and the Manhattan Plastic Surgeon. Prospective patients interested in Rhinoplasty are invited to schedule a complimentary rhinoplasty consultation with board certified Manhattan plastic surgeon Douglas M. Senderoff, MD, FACS, at either his Westchester or Manhattan, New York Plastic Surgery office.