Rhinoplasty, otherwise known as a nose-job, is one of the most common procedures that I perform. I consider it one of the most satisfying and artistic procedures in plastic surgery. It is performed by only the best plastic surgeons in the world. In fact, many of the plastic surgeons in Loudoun don’t even perform nose surgery as part of their medical practices. The nose is central to the character and beauty of the face. The art is trying to match the concept of the perfect nose with the desires of the patient’s personal view of aesthetics and the patient’s ethnic anatomy and views.
Is Rhinoplasty Right For Me? Am I A Good Candidate for a Nose Job?
There are many reasons why patients might choose to have a nose job procedure. The reasons, however, are unique to each individual. Some of the reasons are more intellectually based while some are more emotionally based. Whatever the reason, you can be sure that Dr. Chang will freely discuss them with you.
- Large noses can be made smaller
- Small noses can be made larger
- Button noses can be made more elegant and refined
- Crooked noses can be made straight
- Nasal humps can be flattened
- Flat noses can be given more volume
Patients need to be older than 18 years of age. Patients with very minor issues could be candidates for a nonsurgical rhinoplasty. All women over 45 require an EKG and standard blood work.
Some Reasons Why Patients Choose a Rhinoplasty Procedure
- Large noses can be made smaller
- Small noses can be made larger
- Button noses can be made more elegant
- Crooked noses can be made straight
- Bulbous noses can be smaller and more refined
- Nasal humps can be flattened
The most common complaints include a nasal hump and a large or bulbous nasal tip. But the number of personal complaints I hear are infinite. The nasal bones might be too wide or too narrow. The nostrils might be too flared. The nose might be too long. Some noses even hook. So in order to address all of these issues, the surgeon must not only have a good aesthetic eye, but must have my significant experience in treating a multitude of nasal types.
I perform, depending on your problem, three general types of rhinoplasty procedures. Minor deformities including flat nasal bones or wide nasal tips can be treated with a nonsurgical rhinoplasty. This is a procedure that I pioneered as early as 2001 where I use nasal fillers like juvederm or voluma to build up and tweak the nose without the need for surgery. The majority of patients will either need an open rhinoplasty or a closed rhinoplasty.
In general, if your complaint is mostly about the nasal bones, a nasal hump, or a slightly widened nose, I perform a closed rhinoplasty. In a closed rhinoplasty, there are no external incisions. An incision is made on the inside of the nose through which instruments are used to rasp down the nasal hump or break the nasal bones to either widen a narrow nose or make more narrow a wide nasal bone. If part of your complain is a wide, large, or bulbous nasal tip cartilage, you will benefit most from an open rhinoplasty. In this procedure, there is a small incision placed at the base of the columella. This incision is extended inside the nose to lift and expose the nasal tip cartilage which is then manipulated and fashioned in a cosmetic way.
The procedure is performed at the surgery center and will take about 2 hours depending on what you need. It is an outpatient procedure. Most patients will wear a nasal cast / splint for 1 week. They will usually return to work in 1 week. It will often take up to 6 months to a year to settle completely.
Dr. Phillip Chang is a Board Certified Plastic Surgeon. His office is in Leesburg, Virginia. Dr. Chang specializes in surgical and nonsurgical cosmetic enhancements including breast augmentation, facelifts, tummy tucks, and other face and body improvements.
Choosing between an open Rhinoplasty and a closed Rhinoplasty
Open Rhinoplasty is a newer, more advanced technique. The main benefit is it allows a better visualization of your relevant anatomy including the bones, cartilage, and soft tissues. This better visualization allows a more precise adjustment of the structures including trimming of the nasal tip cartilage, adding grafts where needed and manipulating the bone to provide for a better result.
The open Rhinoplasty technique uses a small, barely perceptible, incision on the columella (the tissue between the nostrils) that extend to invisible incisions inside the nose. This allowsme to lift the tissue and see all the structures I need in order for me to give you a beautiful looking nose.
Closed Rhinoplasty is an older technique that is for the most part a blind technique. The main benefit is there are no visible external scars. The scars are inside the nostril. There is no visualization of the nasal structures. The procedure is completely performed by feel and experience.
This procedure is in my mind only useful for treating minor problems of the nasal dorsum such as a small nasal hump. Treatment of the nasal tip requires more delicate techniques and more precision than a blind procedure.
Common Rhinoplasty Questions
How do you treat a nasal hump?
Treating a nasal hump or a bulbous nasal tip are two of the most common problems treated. Although some patients want only the nasal hump addressed, it is usually part of a more extensive plan such as treating the nasal tip. For this reason, it is usually performed through an open Rhinoplasty technique.
The nasal hump is made of bone toward the top and cartilage toward the nasal tip. The bone portion is reduced using a diamond tipped surgical rasp. The cartilage portion is removed with a refined scalpel under direct visualization. The goal is usually to make at least a straight top if not a very slight scoop (for women).
For patients who only want the nasal hump addressed without anything else, the procedure can be performed using a closed Rhinoplasty technique. Dr. Chang has offices in Loudoun and Fairfax Virginia.
How do you treat a bulbous nasal tip?
Treating a bulbous nasal tip or a nasal hump are two of the most common problems treated. A bulbous nasal tip is usually formed be nasal tip cartilage that is too wide and thick. Treating usually involves narrowing the nasal tip cartilage as well as joining the left and right sides which are usually too wide apart. Some patients will benefit from bending of the cartilage and many patients will benefit from the addition of cartilage grafts to soften the appearance of the nasal tip.
An open Rhinoplasty technique is usually used because of the technical need for precise adjustments of the nasal tip. Patients having only a nasal tip adjustment can be treated in the office operating room under oral sedation and local anesthesia. Patients often combine a bulbous nasal tip procedure with treating other areas of the nose such as a nasal hump or narrowing the width of the nasal bones.
How do you treat wide nasal bones?
Wide nasal bones are treated by a closed technique using osteotomies. The nose is broken in a controlled fashion along its base by the cheek from bottom to top and then pushed inward. An external nasal splint is then placed for 1 week.
How do you treat large nostrils?
Wide nostrils are treated by a procedure call Wier Excisions. A small triangle of extra skin around the nostrils is removed and re-sutured bringing nostril in.
How do you treat a hanging columella?
The columella is the skin-cartilage bridge that separates your two nostrils. This bridge sticks out in some patients. The hanging columella is treated by removal of the extra skin and cartilage through hidden internal incisions.
What is a One Hour Rhinoplasty (Nonsurgical Rhinoplasty)?
The one hour Rhinoplasty is a technique that I helped develop over 8 years ago. Using different fillers, minor imperfections of the nose can be addressed in what I would call a lunch-time procedure. Results are immediate with no down-time. There are many fillers now available but I in general use Juvederm. Juvederm lasts for about 6 to 9 months. The procedure takes about 30 minutes with next to no pain.
Do I need a septoplasty?
Septoplasty is performed if the nasal septum, the cartilage between the two nostrils is curved. Curvature of the nasal septum can lead to breathing problems and sometimes causes curvature of the nose. The procedure is performed by placing internal incisions. The curved portion of the septal cartilage is removed and internal splints are placed.
Why Choose Dr. Chang for Rhinoplasty?
Dr. Chang is a Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery and has trained at some of the premier centers of plastic surgery in the United States including a Plastic and Reconstructive Surgery Fellowship in Rochester, New York and a Cosmetic Surgery Fellowship in Beverly Hills and Newport Beach.
Dr. Chang is the owner and medical director of the Aesthetica Cosmetic Surgery and Laser Center as well as Radiance Salon and Medispas with offices in Loudoun ( Leesburg and Ashburn ) as well as Fairfax ( Reston ) Virginia.
Dr. Chang is trained in the latest techniques of performing Rhinoplasty procedures including Open Rhinoplasty, Closed Rhinoplasty, and Nonsurgical Rhinoplasty procedures. Dr. Chang was one of the first plastic surgeons to perform the Nonsurgical Rhinoplasty Procedures according. He has subsequently performed hundreds of these procedures and teaches other physicians to perform the procedure.
Patient references are available.
Why Do Doctors and Surgeons Send Dr. Chang Their Most Difficult Cases?
Before Dr. Chang established his office in Leesburg, Virginia, he completed a rigorous plastic and reconstructive fellowship in Rochester, New York which included correcting nasal deformities from other bad nose job, and nasal deformities that either occurred naturally or after trauma or cancer resections.
After leaving the University of Rochester, Dr. Chang completed a cosmetic surgery fellowship in Beverly Hills and Newport Beach California. Dr. Chang now treats patients from around Virginia and around the United States that are unhappy with their previous nose jobs. Sometimes, these patients require a revision rhinoplasty, but sometimes they need a nonsurgical rhinoplasty.
What is the Consultation Procedure Like?
Your consultation will begin with a personal consultation with Dr. Chang, where you will discuss:
- Why you feel that a Rhinoplasty procedure would be good for you and what do you not like about your nose
- What I think a Rhinoplasty can do for you
- Digital imaging is available to most patients
- Do you have breathing issues?
- Which Rhinoplasty technique is most suitable to your needs
- Do you have to have the nose broken?
- Where is the surgery performed?
- What is the recovery like?
- When can you return to work?
Where is the surgery performed
All procedures are performed at either Countryside Ambulatory Surgery Center, INOVA Loudoun Hospital, or INOVA Fair Oaks Hospital. All facilities are Accredited facilities and are overseen by Anesthesiologists (not just a nurse anesthetist). No procedures are performed in the office setting.
What is the recovery like?
- Patients will recover at home or at the Lansdowne Resort for out of town patients
- Most patients will need strong pain medicine for 2-3 days
- Light exercise may resume in 2 weeks
- More strenuous exercise may resume in 3-4 weeks
Final shape, settling, and size takes up to 6-12 months to resolve. There will be subtle swelling of the nose that subsides over time. Your complete and final result may not be realized for weeks or even months, but you will see improvement within one week. Results can be immediate and dramatic if the nose was very large or if a large bump was removed, but usually the changes are not dramatic. A slight bump or oversized tip can be improved without attracting a great deal of attention. Friends and family my say that they don’t see a major difference, but that’s okay.
- The first postoperative visit is a day or two after your procedure.
- Sutures are removed in 4 to 7 days
- Bruising around the eyes sometimes occurs, but it is usually gone in about a week. Keeping your head elevated and applying a cold compress to your eyes will also help reduce any swelling and bruising.
Most people return to work within a week after nasal surgery, using makeup if there is any residual bruising. Your surgery should improve your appearance without drawing attention to itself. Remember, the idea is not to create a new nose, but rather to improve the one that you have. And, remember, unlike some procedures that offer only temporary improvements, surgery of the nose lasts forever. You’ll look better and feel better for the rest of your life.
What Other Types of Nasal Surgery Does Dr. Chang Perform?
- Open Rhinoplasty
- Closed Rhinoplasty
- Nonsurgical Rhinoplasty ( one hour Rhinoplasty )
- Revision Rhinoplasty ( secondary Rhinoplasty )
- Reconstructive Rhinoplasty ( trauma or cancer reconstruction )
Dr. Phillip Chang is a board certified plastic surgeon. His office is in Leesburg, Virginia. Complimentary consultations are offered at Aesthetica Cosmetic Surgery and Laser Center as well as Radiance Salon and Medispa. Dr. Chang sees patients from Virginia, Maryland, and DC. Areas including Winchester, Frederick, Leesburg, Ashburn, Chantilly, Sterling, Middleburg, Fairfax, Reston, and Vienna.
Facial aging is not one dimensional. There are many components to facial aging. The mini facelift is therefore often combined with additional procedures. These include using facial fillers or fat transfers to add volume to a face that is beginning to lose its facial volume, improving the appearance of aging and sun-affected skin through a variety of laser skin procedures, upper eyelid surgery to treat excessive eyelid skin, and lower eyelid surgery to treat excessive lower eyelid skin or fat bulging.