Rhinoplasty

Rhinoplasty Boca Raton | South Florida Nose Job

 

Rhinoplasty (cosmetic nasal surgery), also referred to as a “nose job,”  is one of the most frequently performed cosmetic procedures. Located at the center of the face, the nose has a dramatic impact on our appearance. Rhinoplasty is the most elegant and complex operations that a facial plastic surgeon performs and produces remarkable results. Using the most advanced techniques, Dr. Steiger customizes each rhinoplasty procedure based upon your unique anatomical features, facial structure, and desires. His goal is to create a natural appearing nose that promotes facial harmony in order to give you the best rhinoplasty results possible. Dr. Steiger performs  rhinoplasty procedures at his state of the art medical and surgical facility in Boca Raton. Dr Steiger is a world renowned South Florida Rhinoplasty expert. He has performed thousands of Rhinoplasty surgeries using the most advanced techniques and technologies in order to achieve the best possible long term rhinoplasty results.

 

In addition to its beauty, the nose is a functional organ that must allow for the unobstructed passage of air. This must be kept in mind anytime rhinoplasty surgery is performed. Too often, reduction rhinoplasty techniques, once popular, resulted in nasal collapse and difficulty breathing. Unfortunately, this can still occur if the nose is only treated aesthetically and its functional nature is ignored. As a rhinoplasty specialist, Dr. Steiger performs the most advanced rhinoplasty techniques to maintain and/or restore your nasal passages. This can assure you of the best rhinoplasty surgery results possible.

 

Dr. Steiger always focuses on creating both an attractive and well functioning nose. He is an expert at both primary rhinoplasty and revision rhinoplasty surgery, in Boca Raton, performed to correct cosmetic and functional nasal deficits. He believes that rhinoplasty is the ultimate fusion of form and function, art and science.

 

As a facial plastic surgeon, Dr. Steiger is uniquely qualified to enhance your nose. Dr. Steiger is one of South Florida’s most experienced rhinoplasty surgeons. Both a fellowship trained facial plastic surgeon and board-certified otolaryngologist, Dr. Steiger is a nasal expert ; inside and out. His approach to rhinoplasty utilizes the most advanced techniques in order to ensure that you obtain the best rhinoplasty results. Dr. Steiger has published numerous original research articles and chapters related to rhinoplasty and nasal surgery. He lectures on these topics to national and international audiences.

 

 

Goal

To surgically refine the size and shape of the nose, which improves facial balance. Rhinoplasty may also be performed to improve obstructed breathing caused by prior surgery or trauma.

The Procedure

Incisions are placed within the nose, where they are not visible. In some cases, a small incision is hidden between the skin of the nostril, underneath the nose. The underlying cartilage and bone is sculpted to create the new shape. Dr. Steiger custom tailors the procedure based upon the patient’s specific nasal anatomy, facial structure, and unique features. A successful rhinoplasty improves facial harmony and draws attention away from the nose.

Anesthesia

Deep sedation/twilight sleep is preferred, however some patients opt for a general anesthetic.

Length Of Time

The amount of time varies based upon the individual nose and necessary refinements. The procedure averages between one and a half to three hours. It is performed in our state of the art, fully accredited outpatient surgical facility or at the hospital. Other procedures, such as a chin augmentation, may be combined with a rhinoplasty and may be recommended after a detailed consultation with Dr. Steiger.

After Procedure

Most patients go home comfortably after the procedure. If you prefer, professional in-home nursing care or an overnight hospital suites are available upon request. Our friendly staff can assist you in coordinating these services upon request.

Recovery

Most patients return to work after 1 week and are back to full activities after 10 days. However, activities which risk bumping or traumatizing the nose should be limited for four to six weeks. Bruising around the eyes may occur in some cases, and can be camouflaged . Most patients feel remarkably well immediately after the procedure, and have minimal pain which is alleviated with a mild narcotic. Dr. Steiger does NOT pack the nose after rhinoplasty which markedly helps minimize swelling and discomfort in the rhinoplasty recovery process.

 

How is rhinoplasty performed?

The nasal structure is composed of both bone and cartilage. This nasal structure is covered by the skin and soft tissues of the nose.  The majority of rhinoplasty surgeries are performed by changing the shape and position of the underlying nasal bones and cartilage. The skin then re-drapes over the “new” nasal structure, giving the nose it’s new shape and appearance.

 

how rhinoplasty is done

The nose is made up of bone (yellow) and cartilage (blue). This is covered by skin and soft tissue (light red). Rhinoplasty is performed by changing the shape of the bone and the cartilage. The skin takes the shape of the newly shaped structure.

 

Where are the Rhinoplasty incisions?

There are two possible approaches that can be utilized when performing rhinoplasty surgery. These are called the endonasal (closed) approach or an external (open) approach. The type of rhinoplasty approach used will depend upon the preference of your surgeon along with the necessary changes that need to be made to your nose.  There is not right or wrong approach, the best approach is the one that gives you the best possible rhinoplasty results.

  1. External Rhinoplasty- This is also often referred to as an open approach.  The open rhinoplasty is performed through a very small incision on the bottom of the nose, between the skin of the nostrils (called the collumela). This tiny incision is hidden within the shadow of the collumela, is approximately 3 millimeters in length and is not noticeable. The open approach, as the name implies, allows for better visualization and access to the nasal framework then the closed approach.
    Open-Rhinoplasty-Incisions

    This is a before and after photo of a patient’s healing open rhinoplasty incisions, 3 months after surgery.  Notice that the incision is almost completely healed and is not noticeable.

     

    south florida rhinoplasty

    This is a patient one month after open rhinoplasty. This photo shows the open rhinoplasty incision healing. It is barely noticeable one month after surgery.

     

  2. Endonasal Rhinoplasty- This is also often referred to as a closed Rhinoplasty.  In the closed approach, there is no small incision along the collumela, instead, additional incisions are made inside of your nose in order to access the nasal structure from within the nose. The rhinoplasty surgeon will then make changes to the bones and cartilages of the nose from within.

 

Can a rhinoplasty look natural?

Absolutely! Dr. Steiger employs the most advanced rhinoplasty techniques and technologies in order to achieve the best and most natural rhinoplasty results. He believes in creating facial harmony and balance. It is not only important to create an attractive nose, but to create one that is proportional and fitting to the face it belongs to. Rhinoplasty has evolved significantly over the past decade. Dr. Steiger uses the most advanced and proven rhinoplasty techniques to achieve this goal. View some of our rhinoplasty before and after photos to see some of the amazing results that can be achieved. The picture below is a patient who is 4 years after her Rhioplasty surgery. This shows how natural the results can be and the long lasting nature of Dr Steiger’s Rhinoplasty techniques.

 

south florida rhinoplasty

4 years after Rhinoplasty Surgery. Her results are natural looking and long lasting. She also breaths better through her nose than before surgery.

 

florida rhinoplasty

4 years after Rhinoplasty. She has long lasting, natural and beautiful results.

What is open structure Rhinoplasty?

Open structure rhinoplasty is a method of performing rhinoplasty surgery which is based on the concept of building a structurally sound nose that is built to last.  In the older reductive endonasal rhinoplasty techniques, cartilage and bone were cut out off of the nose and the nasal tip. Scar tissue then filled the areas when it healed. The nasal structures were weakened and the support structures of the nose did not work as well.  In certain cases this could eventually lead to noses that look unnatural and created collapse. The noses lacked adequate support and relied on camouflaging grafts to make it appear supported.

Open structure rhinoplasty utilizes the concept of building a structurally sound nose that is as strong or stronger than the original nose. In open structure rhinoplasty, the natural strength and structure of the nose is either maintained or rebuilt.  The support cartilage of the nose is either reinforced or rebuilt to make the nose better supported. This leads to better and more reliable long-term rhinoplasty results.  The open structure rhinoplasty techniques usually require an open rhinoplasty approach for the surgeon to perform the fine detail modifications necessary to achieve the end goal. Dr. Steiger utilized open structure rhinoplasty techniques in order to achieve his goal of the best and most reliable possible rhinoplasty results.

 

What are cartilage grafts?

Cartilage grafts are portions of cartilage that are carved/sculpted and placed into the nose to either sculpt, contour, support, or strengthen the nose.  There are many different types of grafts that can be utilized by the rhinoplasty surgeon in order to achieve the goals of surgery. Grafts can be used in all techniques of rhinoplasty surgery (open and closed). While many Rhinoplasty surgeons use cartilage grafts to give contour to the nose, Dr Steiger mainly uses them, if necessary, to give structural support. He always prefers to first use the natural structure of the nose to achieve the most natural and organic rhinoplasty results. He rarely will use any added cartilage grafts to give shape to the nose because he believes that your natural cartilage shape ages better and looks more natural. This makes a big difference in achieving the best possible Rhinoplasty results.

 

What is preservation rhinoplasty?

Preservation rhinoplasty is a philosophy within Rhinoplasty where as much of the nose’s natural structures as possible is preserved during Rhinoplasty surgery. This includes the natural ligaments, cartilages and bones of the nose.  The goal is to achieve the most natural/organic appearing results that will withstand the test of time.

PreservationRhinoplasty (PR) encompasses a variety of different techniques that are all aimed to preserve as much of the natural structure of the nose as possible. One common method of the preservation rhinoplasty surgery is called dorsal preservation.  The dorsum is the bridge of the nose, and is a combination of complex connections between bones and cartilages.  In this rhinoplasty technique, the nasal hump is reduced from the deeper structures of the nose.  Rather than cut off a hump, the structures underneath the hump are reduced, bringing the hump down. This is sometimes called push down Rhinoplasty. This preserves the natural structure of the nasal dorsum and prevents the need to rebuild it with cartilage grafts.

There are several preservation rhinoplasty techniques and the best preservation rhinoplasty technique is chosen based upon the type of nose you have. Not all patients are candidates for preserving all the structures of the nose, but the utility of preservation rhinoplasty is very powerful when performed in certain indications. Dr. Steiger’s philosophy is based upon preserving the structures of the nose that can be preserved while obtaining the best and most natural possible rhinoplasty surgery results.

Which rhinoplasty approach do you use?

Dr. Steiger will use whichever approach will get you the best rhinoplasty result! The most important factor is not the approach, but the rhinoplasty results. Dr. Steiger believes that every nose is different and there should never be a “one size fits all” approach to rhinoplasty surgery.  Utilizing preservation rhinoplasty alone, open structure rhinoplasty, or Dr. Steiger’s unique combination of the “best of” these techniques, Dr. Steiger will help you achieve the best rhinoplasty results possible. His philosophy is based upon creating a beautiful and structurally sound nose using the most advanced rhinoplasty techniques.

Depending on your nose and the desired changes that are necessary to achieve the best rhinoplasty results, Dr. Steiger will customize the procedure to your nose.  The goal is for you to get the best possible rhinoplasty results using either the open or closed rhinoplasty approaches. Achieving the best possible end rhinoplasty result is what matters most.

Can you show me how my nose will look if I have a rhinoplasty?

During your rhinoplasty consultation, Dr. Steiger will take a picture of your nose and will discuss the potential results with you. This is called rhinoplasty digital imaging. We have digital imaging software that will allow you to see how your nose can look after surgery.  Dr. Steiger believes that digital imaging is a very important part of the rhinoplasty consultation.  The imaging software is an excellent for of communication tool for Dr. Steiger to discuss with his patients what he feels would both suite their face the best and what is possible with rhinoplasty surgery.  This allows you to best understand your possible rhinoplasty results.

 

rhinoplasty computer imaging

This is an example of rhinoplasty computer imaging. The photo on the left is her before photo, the center photo is the computer imaging, and the photo on the right is her photo one year after rhinoplasty surgery.

What is ultrasonic rhinoplasty?

Ultrasonic rhinoplasty is one of the newest advancements in rhinoplasty surgery. Ultrasonic rhinoplasty also known as piezosurgery,  utilizes a powered instrument called a piezotome in order to sculpt, shave or cut the bones of the nose. The piezotome machine uses ultrasound energy to take away or cut bone without damaging any surrounding structures. Technically the ultrasonic rhinoplasty method gives excellent control over re-shaping the bone part of the nose during a rhinoplasty surgery.  We can perform rhinoplasty without technically breaking the bones uses piezosurgery.

Dr Steiger performs ultrasonic rhinoplasty with the piezotome in patients when it will benefit them.  We have the latest and most advanced piezotome unit in our fully accredited surgical facility where we perform all of our Rhinoplasty surgeries.

Where will my rhinoplasty surgery be performed?

The Steiger Facial Plastic Surgery Center is a state of the art medical facility with a fully accredited surgical suite. As a premier South Florida rhinoplasty center,  safety is our #1 concern.  Our operating room has the latest rhinoplasty equipment and maintains the strictest standards for safety as recommended by the AAAASF. A board certified anesthesiologist will provide your anesthesia and will accompany you throughout the procedure.

What kind of anesthesia will I receive?

Dr. Steiger performs the majority of his rhinoplasty surgery under a deep sedation (twilight sleep) anesthesia. Dr Steiger has performed thousands of surgeries with this type of anesthesia and believes that our patients have a much easier recovery with this type of anesthesia over a general anesthesia with a tube. This IV sedation type of anesthesia will have you completely sleeping throughout your rhinoplasty procedure, but does not have the side effects commonly seen from the heavy doses of medication needed for general anesthesia with a breathing tube.  Rhinoplasty anesthesia at the Steiger Facial Plastic Surgery center is administered by a board certified anesthesiologist.

There are generally three levels of anesthesia: local anesthesia, sedative anesthesia, and general anesthesia.

 

Local anesthesia- The nose is numbed with a local anesthetic and the procedure is performed pain-free while you are awake. You can speak and are aware of what is happening.

 

Sedative anesthesia- The nose is numbed with a local anesthetic and you are given an IV medication to make you sleep. You are breathing on your own, but are sleeping through the procedure and are not aware of what is happening. This is the type of anesthetic that you will most likely have during your rhinoplasty surgery with Dr. Steiger.

 

General Anesthesia- The nose is numbed with a local anesthetic, you are given medications that make you sleep, and a tube is placed in your wind pipe to support your breathing. Heavier doses of medication are given then in the sedative technique.

 

Who will administer anesthesia for my rhinoplasty?

Our fully accredited surgical facility is staffed by board certified anesthesiologists.  Our anesthesiologists are very experienced and accomplished doctors that provide the safest and best possible care.  The anesthesiologist will accompany you throughout your entire procedure and ensure your comfort and safety.

Will I go home after my rhinoplasty surgery?

Yes. Patients feel remarkably well after surgery and have little to no pain. Any pain or discomfort is relieved with a mild analgesic.

Does Dr. Steiger pack the nose after rhinoplasty?

No! In Dr. Steiger’s opinion there is hardly ever a good reason to pack the nose. Nasal packing leads to unnecessary discomfort and swelling after rhinoplasty. We do not pack the nose and this is one of the many reasons that our patients are very comfortable immediately after surgery.

Will I have much pain after my rhinoplasty ?

Most patient do not complain of significant pain after rhinoplasty surgery. Since Dr. Steiger does not pack the nose, this significantly reduces or eliminates pain and discomfort. In order to better understand this, please visit our rhinoplasty video journey. Here you will be able to visualize the patient experience at various stages of the procedure- before and after surgery.

When can I go back to work/school?

Most patients go back to work in 1 week, and back to most activities in 10 days. However, activities which risk bumping or traumatizing the nose should be avoided for 6 weeks.

Do you perform this surgery often?

Yes. Dr. Steiger is a Rhinoplasty expert who has performed thousands of rhinoplasty and nasal surgeries. He performs over 300 rhinoplasty surgeries a year and has done thousands.  We have patients who come from all over South Florida (including Miami, Ft. Lauderdale and Palm Beach), the United States, and around the world to have rhinoplasty performed by Dr. Steiger. Many patients chose Dr. Steiger for his natural style of rhinoplasty and ability to consistently deliver the best rhinoplasty results possible.

 

Can I see rhinoplasty photos patients that you have treated?

Please visit our before and after rhinoplasty photos  to see a selection of  rhinoplasty result photos.  We have a much more extensive collection of before and sfter rhinoplasty photos in our office. We will show you this during your consultation. Every before and after rhinoplasty photo is of one of Dr. Steiger’s patients. We have hundreds more photos to show in the office of patients who have kindly given us permission to do so.

If you desire, our office will put you in touch with patients who have undergone the procedure and voluntarily agreed to speak with you.

 

I have had prior rhinoplasty but not happy with the result, can you help me?

This is called revision rhinoplasty, an area that Dr. Steiger also specializes in.  You can visit our revision rhinoplasty page to learn more about this procedure and it’s possibilities.

Dr. Jacob D Steiger MD is the Best South Florida Rhinoplasty specialist board certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology- Head & Neck Surgery. He practices Advanced Rhinoplasty Surgery in Boca Raton, Florida. We help Rhinoplasty patients from Miami, Palm Beach, Ft. Lauderdale,  all over the US and from around the world. 

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