Cosmetic Rhinoplasty in Syracuse & Rochester, NY

We will ask you to specify what features of the nose you would like to improve. Dr. Kim will carefully examine both the inside and outside of the nose. He will then explain the underlying structural causes for the appearance of your nose, and how he will correct those problems from the surgeon’s perspective.

Key features of the nose that are unique to each patient: skin and soft tissue envelope; shape, symmetry, and strength of the tip cartilage (lower 1/3); width and height of nasal bone including the hump and location of keystone area (upper 1/3); the middle vault area comprising of internal nasal valve (middle 1/3); and the inside of the nose including the septum and turbinates.

We will discuss what approach of rhinoplasty is recommended: open rhinoplasty with external incision, or endonasal rhinoplasty with internal incision; and what technique will be expected based on the physical exam and goal of the surgery.

Traditionally, cosmetic rhinoplasty focuses on reductive technique – shaving or cutting the tip cartilage to refine or reshape the tip of the nose. Through the experience of past plastic surgeons we now know that the traditional reductive rhinoplasty can sometimes result in unpredictable and undesirable long term outcomes.

Modern principles in cosmetic rhinoplasty consist of reinforcing the supportive structure of the nasal tip. Every change made to the nasal tip will destabilize the tip support mechanism to some degree, and therefore must be countered with a reinforcing supportive maneuver. Furthermore, preservation rhinoplasty philosophy preaches minimizing removal of tissue to reduce disturbance of integrity of each nasal structure and contracture resulting in delayed adverse outcome.

Shape and strength of the nasal cartilage, thickness of the skin and soft tissue will dictate which techniques – suture technique, reshaping of the cartilage, or addition of cartilage grafts – are necessary to achieve the desired outcome which will stand the test of time. This approach will also help prevent unforeseen complications of rhinoplasty – functional problems of the nose.

Finally, we will take photos of the patient and digitally morphed photos will be provided to simulate the desired outcome from rhinoplasty. While this is an imperfect simulation, it is a helpful tool for the patient and the surgeon.

There is an on-call physician during off-hours, and surgical patients will also have access to the surgeon’s personal cell phone for any specific surgery-related questions/concerns.

Week 1: Patients should expect some swelling and bruising. Patients may experience some discomfort during the first 2-3 days after the surgery. There will be some numbness at the time of the nose which will resolve over time. While some bruising under the eyes is possible, many patients may not have significant bruising under the eyes. Most patients plan to take 1 week off from school or work. External splint and sutures will be removed on day 7 after the surgery. In rare cases when necessary, Dr. Kim may also use an internal nasal splint which will be removed at day 7.

Week 2: No exercise for two weeks after the surgery, and no glasses or contact sports for 6 weeks. Patients should continue to apply ointment at the external incision site for 2 weeks, then start using a silicone sheet for 1 month. Continue with saline spray to keep the inside of the nose moist as often as possible.

Week 4+: Some patients with a thick skin-soft tissue envelope and post op edema may need a steroid injection as determined by Dr. Kim during post op visits. During this time, cartilage will feel very hard and sometimes it may feel like the nose is pulling to one side. This is not usual as the different structures of the nose may contract/pull toward different directions (like a 4-way tug-of-war), and massage or exercise may be helpful to redirect and mold as the nose heals.

6 months - 1 year: Swelling will continue to improve, cartilage will continue to soften as the nose begins to look and feel more organic and natural. Typically we expect the final outcome will take 1 year from surgery, it is not uncommon for the nose to take more time after the surgery.