The Modern Rhinoplasty - Nose Job

Rhinoplasty for the New Century – The Nose Job is no longer the Plastic Look of Old
By Peter Cheski, MD, FRCS, FAACS, FASCBS
The Rhinoplasty, or “Nose Job” is an operation that is centuries old, yet continues to evolve and improve with every decade. Nasal surgery today is dramatically improved from even ten or twenty years ago.
The primary change is the change in cosmetic surgery in general, in that surgery must be considered in harmony with all of the other features of the body, personal desires, adjunctive treatments, and underlying functional or medically necessary procedures.
Just as correction of hernias or C-Sections scars should be addressed when a tummy tuck is performed, evaluation and correction of such disorders as nasal obstruction, mouth breathing, snoring, sleep apnea, sinus disease, allergies, post-nasal drip, and allergies should be performed.
Also, the nose should be considered in harmony with the entire face and with the desires of the patient. It was not more than a few decades ago that every patient would receive the same nose job. This led to a nose that might be ideal for some, but look fake, plastic, or even ridiculous on a different face with a different facial profile, sex, and ethnicity. We have all seen examples of this. The Rhinoplasty of today should take into consideration the patient’s pre-existing facial structure, sex, ethnicity, and most importantly the patient’s desires.
The modern rhinoplasty should address both functional and cosmetic issues at the same time. It is one of my favorite operations to perform for many reasons; it can significantly improve someone’s appearance and self confidence, as well as their breathing and sleeping; I have had the surgery myself and am very happy that I have; and I am uniquely trained for this procedure as I have completed a full residency in Otolaryngology – Head and Neck Surgery as well as an accredited post-residency Fellowship in Cosmetic Surgery and Facial Cosmetic Surgery. I have passed board certification, re-certification, and equivalent examinations( in Canada, The Royal College of Surgeons>, in fields such as Otolaryngology, Head and Neck Surgery, Facial Plastic and Reconstructive Surgery, and Cosmetic Surgery. Over the last 17 years I have performed thousands and thousands of nasal surgeries and it continues to be one of my favorite, if not my most favorite, operation.
Health Insurance may cover some of the improvements in nasal and sinus function, but of course will not cover cosmetic improvements. I try to improve both nasal function and cosmetics at the same time to avoid 2 surgeries, 2 anesthesias, and 2 recoveries.
For the surgery itself, I try to individualize it to every patient. Often pictures or pre-operative imaging is used to most fully understand the patient’s pre operative desires.
Some doctors use external incisions on the nose on a routine basis. This leaves scars on the nose that are permanent. I almost always avoid external scars on the nose. All of the surgery is done from inside the nose and closed with dissolvable sutures, leaving no external scars on the skin of the nose or the face. Also, I almost never use packing in the nose. The packing is extremely uncomfortable and claustrophobic. By avoiding packing, nasal surgery has very minimal pain and a much faster recovery. When I had my nose done, I had the surgery on a Friday, by Saturday I was out shopping, was back to work on Monday, and in the Gym on Tuesday. I only took one pain pill on the night of the surgery and nothing after that. As you can see from the statistics below, Rhinoplasty continues to be on the rise.

New survey indicates more than 17 million
cosmetic procedures performed last year in U.S.
Procedures by AACS members increased 8 percent since 2008
CHICAGO (March 9, 2010) – A procedural survey conducted by the American Academy
of Cosmetic Surgery says more than 17 million cosmetic surgery procedures were
performed in the United States in 2009.
The total number of procedures from this first-time study far surpasses any number that
has previously been reported in the U.S. This is the first nationwide survey of its kind
done by the AACS. In addition to the annual polling of its own members, the AACS also
surveyed random physicians across the country to find out who is performing cosmetic
surgery procedures.
The total number of procedures performed by AACS members has increased by eight
percent since 2008.
Among AACS member practices, the biggest increase in invasive procedures in the last
five years are in blepharoplasty (eyelid lift), abdominoplasty (tummy tuck) and
rhinoplasty (nose). For less-invasive procedures, the biggest increase over that five-year
period is in laser resurfacing, chemical peels and fillers.
For AACS members, rhinoplasty surgeries had a 74 percent increase. Facelifts were also up this year, from by a 44 percent spike.