Nasal surgery, also called rhinoplasty, enables Michigan patients of plastic surgeon Dr. Pramit Malhotra to achieve a nose that is more attractive and appealing. Rhinoplasty may also help patients who have been injured or who have breathing problems, all the while creating a more beautiful facial aesthetic.
Open vs. Closed Rhinoplasty
Open rhinoplasty allows Dr. Malhotra to create more symmetry as the entire nose becomes accessible. In a closed (endonasal) rhinoplasty, incisions are positioned inside the nostrils. The benefit of this type of rhinoplasty is that no part of the incision can be seen externally and therefore a visible scar is avoided. This type of nose surgery also causes significantly less swelling but limits visualization of the nasal cartilages and tip due to limited surgical access.
A typical nose surgery lasts from 1 to 3 hours. After anesthesia is administered, all incisions are made inside the nose, with one small incision underneath the tip of the nose. The skin of the nose is lifted so the underlying structure of the nose can be modified. Older rhinoplasty techniques do not involve lifting the nasal skin in this way, keeping much of the structure of the nose hidden during surgery. After the procedure, a small cast is placed on the nose.
Before and After Rhinoplasty Photos
*Each patient is unique and individual results may vary.
Selecting Your Rhinoplasty Surgeon
- People often say that certain surgeons always produce similar rhinoplasty results. In fact, many years ago, patients who chose a certain New York surgeon for their nose surgery were identified as having a “Goldman Nose” because it was that distinctive. Unfortunately this is often still true today, but it doesn’t have to be. Discuss exactly what you like with your surgeon, and remember that you have choices.
- Some surgeons always make scooped noses. This can look very good on some people, but make sure that fits your aesthetic sense if you choose that surgeon.
- Your surgeon should discuss breathing implications of any surgery they would perform. A nose can be reduced too much, creating a nose that looks good but doesn’t work well.
- Look at photos for the “pinched nose” look. Many surgeons remove tissue from sides of the nostril, causing a flat look from the nose-cheek junction. This is an older style of rhinoplasty, but Dr. Malhotra often sees Michigan patients with this look who want a revision to their nose job.
- Long-term results are critical. Scar contracture continues for 1 year after surgery, and if the nose has not been supported well, it can actually contract, causing a pinched look.
Benefits of a Nose Job
With cosmetic nose surgery, commonly referred to as a “rhinoplasty” or “nose job,” Michigan men and women may experience the following benefits:
- Improved nose size
- Corrected asymmetry or crookedness
- Reshaped nasal tip
- Improved facial profile
- Balanced facial appearance
Here are some insider tips about rhinoplasty from Michigan plastic surgeon and nose specialist Dr. Malhotra:
- Many surgeons consider rhinoplasty the most difficult procedure in plastic surgery. It is one of Dr. Malhotra’s specialties.
- Many plastic surgeons with an otolaryngology (ENT) background excel at this procedure. Dr. Malhotra trained in Head and Neck Surgery, with a focus on facial plastic surgery, and he is board certified in otolaryngology and plastic surgery.
- Insurance often covers rhinoplasty for correction of breathing-related issues, but not for cosmetic reasons. This means that a portion of your procedure may be covered by insurance.
- Nose surgery can put your face back into balance. Discuss your ideas of beauty with your surgeon.
- This procedure requires patience since nasal swelling can persist much longer than other procedures. Your nose will continue to improve for 6 months to 1 year.
Michigan Rhinoplasty Candidates
Each person’s nose must be analyzed for skin thickness, strength of nasal cartilage, and airway passage, and for how it complements the overall facial structure. During your consultation with Dr. Malhotra, you will discuss this as well as your cosmetic goals. Michigan Rhinoplasty patients have realistic expectations and goals about the procedure.
African American Rhinoplasty
Since each rhinoplasty surgery is different and tailored to the individual, there is no “standard” type of nose surgery that applies to African American patients seeking to make a change to the most prominent feature on their face. That said, there are certain considerations that apply to patients with an African heritage, which may not apply to other patients, as well as cosmetic concerns that are more commonly raised by African American patients.
The concerns frequently include:
- wide nostrils
- a large nasal tip
- a poorly projected tip
- a wide or low nasal bridge
Insider Tips for African American Patients
- The tip must be over-sharpened so that the sharp tip can be seen through thick nasal skin.
- The nasal tip must be de-fatted to thin the overlying skin so the changes made to the cartilage can be seen.
- The nostrils sometimes have to be narrowed by incisions along the alar rim, plus Weir excisions along the nasal sill.
The basics of rhinoplasty are common to all nasal surgery procedures, and involve the doctor carefully placing incisions that allow him to access the internal structures of the nose for shaping. Tissue may be removed or repositioned, and sutures will be used to close the incisions and hold key structures in place while they heal.
Using modern methods that have been refined through years of study and practice, Dr. Malhotra can reduce the width of the nostrils, decrease the size of a nasal tip and change it from pointing upward or downward, and can create a higher, narrower nasal bridge as desired by his patients. African American rhinoplasty is certainly not limited to these procedures, and any other changes a patient may want can be discussed.
The difference with African American rhinoplasty comes in knowing which techniques to apply as the surgery is performed, taking the entire face into account. Darker skin has a tendency to show scars in a different way from lighter skin, and its thickness can necessitate some patient-specific surgical methods designed to best camouflage any resulting lines or marks. Incisions are either made internally, where they will be hidden by the re-draped tissues once the internal rhinoplasty surgery is complete, or hidden in the creases to either side of the nostrils, where they are much less likely to be noticed—if they are seen at all.
African American patients also tend to have a more delicate nasal framework, which Dr. Malhotra takes into account as he works.
The rhinoplasty procedure will actually begin in the consultation phase, when Dr. Malhotra will meet with you to discuss your desired end result and examine your face and nose to understand the existing physical structures and develop a plan.
Remember that the ultimate goal is not to use rhinoplasty to make a patient conform to aesthetic standards applied by a different culture or ethnicity, but to fully understand each patient’s unique goals and deliver ideal results that reveal the desired changes while remaining in proportion and balance with the rest of the face and in harmony with a patient’s naturally beautiful physical features. Also, this is not to say that all African American patients have the same aesthetic goals or existing nasal structures. Every patient is unique.
I now love my nose that the Dr. 'touched up' with only an injection. It will be the one thing I do for myself yearly, right along with taking my vitamins. My mother at the age of 65 said, ‘My, how clever! I was wrong, you look complete. What could he do for me?’ The office atmosphere is downright happy and reassuring. I make the drive down to Jackson as a fun day, I go grocery shopping (food is more expensive in AA), and don’t miss the famous Front Porch ice cream parlor down the street.*
Dr. Malhotra has the education and experience necessary for helping African American patients get the facial proportions and balance they want with rhinoplasty surgery, while still maintaining and celebrating their identity and heritage. Nose surgery is one of Dr. Malhotra’s specialties, as he has focused on this notoriously challenging procedure in order to refine his techniques and offer beautiful results to all of his patients, whether African American, Caucasian, or any other ethnicity.
Learn more about rhinoplasty considerations for patients who have a non-Anglo Saxon heritage on our page devoted to “ethnic rhinoplasty.”
The recovery process depends on how extensive the rhinoplasty surgery was. Some of our Michigan patients require a small narrowing of the tip or filing of the nasal hump. These patients will wear a cast over their nose from 3 to 7 days. More extensive procedures require 7 to 9 days for recovery.