The Un-Nose Job
Natural results and quicker recovery with closed rhinoplasty
Why Closed Rhinoplasty?
There are two basic types of rhinoplasty: open and closed. During an open rhinoplasty, an external incision is made in the columella (the area between the nostrils), whereas during a closed rhinoplasty all incisions are made through the nostrils, inside the nose.
Dr. Tobias performs only closed procedures which have many advantages over open surgeries, including:
No visible scarring
Very little pain
Less postoperative bruising and swelling
Shorter recovery period
A rhinoplasty usually takes about 2 hours, but may run up to an hour longer in certain complicated cases.
The rhinoplasty procedure is a complicated and delicate one for the doctor, but an easy one for the patient. The surgery takes place in a full-service hospital to provide the utmost safety and comfort. First, the patient is put under general anesthesia by a highly trained anesthesiologist. Because Dr. Tobias only performs closed surgeries, there will be no incision made in the columella (the area between the nostrils). Instead, the entire operation will take place through the natural opening of the nostrils. Once the incisions are made, the skin covering the nasal bones and cartilage is gently lifted to allow Dr. Tobias access in order to reshape the nose. He is almost always able to use existing cartilage during the surgery, though depending on the individual case, tissue may be removed or added before skin is redraped over the nose.
Once the rhinoplasty has been completed, the inner nose will be stitched closed, without packing, and externally splinted or casted. The patient, who has slept soundly throughout the surgery, will soon be moved to the recovery room where he or she will be monitored until fully awake.
Opening the Door to Closed Rhinoplasty
When Dr. Tobias first went into the field of rhinoplasty, patients who had “nose jobs” had a marked tendency to have noses similar to one another. It was easy to see who had had nasal surgery and who had not. Efforts to veer away from “cookie cutter noses” at the time necessitated open surgery, resulting in visible scars, increased swelling and bruising, and a longer recovery.
When Dr. Tobias entered the field, all of this changed. With his surgical skill and creative talent, he developed a type of rhinoplasty in which results were individually perfected. Not only was he able to craft naturally beautiful noses; he was able to do so with closed surgeries, something no other surgeon had managed. As a result, Dr. Tobias’ patients healed quickly, with only minimal swelling, and without any visible scars.
How Closed Rhinoplasty is Performed
1. Before Rhinoplasty Surgery
This young woman wanted a thinner stronger bridge and profile. In addition, her tip was too round and large. She wanted more definition and shape to this part of her nose.The solution involved inserting a small implant into the bridge. In addition, the tip was refined by incorporating a natural cartilage graft under the skin.
2. Rebuilding the Nose
Strengthening the bridge. Implant inserted under the skin of the bridge through her nostril in order to thin and define her bridge.
3. Rebuilding the Nose
Sharpening the tip. The red structure represents a cartilage graft inserted into the tip of the nose to shape it. The blue image represents the patients original cartilage
4. After Surgery
The Bridge of Nose Is Now Thin And Well Defined. The Tip Is Small and Feminine. These photos were taken over one year after rhinoplasty. It takes this amount of time for most, if not all of the subtle swelling to disappear. We see a natural, attractive, and feminine outcome. It should be noted that the final shape and size of the nose can differ significantly for each individual patient. The results seen in this particular patient can not necessarily be duplicated exactly in someone else’s nose.
5. After Surgery Tip
Refined tip and reduced nostril size after closed rhinoplasty surgery.
The Art of Rhinoplasty
Rhinoplasty, colloquially referred to as “a nose job,” is a surgical procedure designed to create facial harmony by proportioning and shaping the nose so that it is in balance with the other features. The surgery can also be performed to correct structural defects in the nose that interfere with breathing, eating, or sleeping.
Seeking Symmetry and Balance: Aesthetic Reasons for Rhinoplasty
There are many aesthetic reasons that people desire to have rhinoplasty procedures. Rarely is the decision made lightly. For most patients, contemplating any surgery requires serious thought and research. For those who take steps to have their noses remolded, the rewards far outweigh any reservations.
For some, their noses have always felt like somewhat inappropriate appendages. For others, their noses have developed, as they have grown, in seeming disproportion to their face. It is often in adolescence, when the nose has changed from its childhood dimensions, that patients begin to feel self-conscious about its appearance. In some cases, however, due to financial concerns or parental constraints, it is not until patients are adults, with their own money and their own decision-making capabilities, that they opt for the self-improvement they have previously been denied.
It is not only the size of the nose that makes individuals consider rhinoplasty. The following nasal characteristics, which may be disturbing to patients, can also be altered with surgical procedures:
Width of the bridge of the nose
Size and position of the nostrils
Excessive flaring or pinching of nostrils
Visible bumps or depressions that affect the profile
Nasal tip that is enlarged, bulbous, upturned, hooked or drooping
Nose that appears abnormally crooked, off center, or asymmetrical
Nose that appears to angle too much or too little relative to the upper lip
While noses can give the face a distinctive look, there are situations in which they draw attention away from lovely eyes, a facial expression, or even from meaningful spoken words. These are the situations in which patients seek relief from cosmetic discomfort.
Love Your Nose. Love Yourself.
Self-esteem is important. Changing something about yourself, such as improving the appearance of your nose, can make a tremendous difference in your self-assessment, your sense of comfort inside your own skin, and your self-confidence. Just as the nose, the central feature of the face, can distract from the beauty of your eyes, hair, or even the resonance and meaning of your words, when properly shaped, the nose can help you redefine, even reinvent, yourself as the person you have always felt meant to be. Putting yourself in Dr. Tobias’ capable hands for what may seem to be only an external alteration can be the key to positive inner changes, a means toward a new awareness of your worth as a person. Nothing makes Dr. Tobias happier than the recognition that his delicate work has helped to increase his patient’s joy and quality of life.
It is important that you recognize, as Dr. Tobias does, that your nose is, and will remain, one of a kind. In keeping with his belief in embracing diversity and individuality, he will be improving and refining your nasal contours, not creating some model of perfection that doesn’t synchronize with your other features. When you have realistic expectations of what the hands of this extraordinarily talented surgeon can accomplish, you will be surely be delighted with the results.
A pretty smile, an imperfect profile. This young woman, tired of having her nose draw negative attention, decides to have a rhinoplasty with the very best surgeon she can find: Dr. Geoffrey Tobias.
The beauty beneath emerges. A few weeks later, after successful nose surgery she is delighted with her image in the mirror and her image in other people’s eyes.