Question: I had a nose job that did not turn out the way I expected. I am quite anxious about getting it repaired. Are you able to add tissue to the nose? My nose was made too short for my face.

Answer: Yes, we can definitely add to an overly short nose so that we can lengthen it or increase its projection. This typically involves placement of cartilage grafts. The cartilage typically comes from the nasal septum, which is the wall in the middle of the nose, but if this has already been used and there is no more extra cartilage left then I typically go to the ear to obtain cartilage for grafting. Ultimately, a consultation with an experienced rhinoplasty surgeon is definitely an absolute necessity for you due to the fact that revision rhinoplasty is much more complicated than primary rhinoplasty and you need a well experienced surgeon so that you end up getting the result that you desire.

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Question: If you get a non-surgical nose job with fillers and do not like the results can it be undone?

Answer: It depends on what type of filler was used as to whether or not the non-surgical nose job can be undone. If a hyaluronic acid-type filler such as Juvederm or Restylane is used then you can definitely undo this non-surgical nose job by infiltrating the area with some hyaluronidase. This is an enzyme that breaks down the hyaluronic acid and within 24 hours the nose will retain the shape prior to the injection. If you were treated with Radiesse or ArteFill or silicone, these unfortunately cannot be reversed and the ArteFill and silicone can be permanent problems, whereas the Radiesse can last for 1 to 2 years. This is one of the many reasons that I am not a big fan of non-surgical nose jobs in general, but if we are going to perform a non-surgical nose job I always recommend patients have injections with the hyaluronic acid-type fillers.

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Question: I have a typically flat Asian nose and I am wondering if there are any limitations to how high you can raise the nose and how this is achieved?

Answer: Yes, there are certainly limitations in how high we can raise the nose simply due to tension that is created as we lift the soft tissue up. I typically perform Asian rhinoplasty through an external approach which involves a small incision in the tissue between the nostrils and the soft tissue of the nose is then elevated and I typically place an alloplastic dorsal implant, which is a Gore-Tex coated silicone implant that is customized for each individual’s anatomy. This raises the height of the bridge of the nose and then I modify the tip with various cartilage grafts that are harvested from the inside of the nose itself. This adds important structural integrity to the cartilage of the nasal tip and also can aid in improving the nasal height and shape. The combination of these maneuvers can greatly improve the typically flat Asian nose.

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Question: I am African-American and I would like to undergo rhinoplasty, my nostrils flare too much and the tip is too bulbus in appearance. I really am not sure what I want my nose to look like however. Do you have pictures to choose from or a computer program that will show my face with different noses?

Answer: I do perform computer generated imaging for my rhinoplasty patients and this is how I like to try to show the patient what the nose would look like after surgery. I do not tend to show the patient different noses since, for the most part, each individual’s nose can only be reshaped in a certain way and ultimately there is a best nose for each individual. I would recommend that you seek out an experienced rhinoplasty surgeon so that you end up with the result that you desire.

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Question: I am African-American and interested in getting a nose job. I do not want a “cookie cutter” nose that would be given to someone who is Caucasian. How do you avoid this?

Answer: Well first of all, I never perform what you describe as a “cookie cutter” nose job since I feel very strongly that nasal surgery needs to be highly customized for each individual’s anatomy. With that said, because we are starting with an African-American nose, my desire is certainly not to try to create any sort of Caucasian nose but it is to reshape your specific nose into a more refined and appropriate shape that better fits in harmony with the remainder of your facial features. This is one of the reasons that I like to perform computer generated imaging so that I can show a patient the expected outcome and make sure that they approve of this. I then customize the actual surgical procedure so that we can end up creating the appearance of the nose that we formed on the computer. Ultimately, I would recommend that you seek out a very experienced rhinoplasty surgeon to assure that you end up getting the result that you desire.

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