Beverly Hills Rhinoplasty Surgery
Perfecting the Look and Function of Your Nose
More commonly referred to as a ‘nose job’ in Beverly Hills, nose surgery improves the appearance of the nose. Common concerns expressed by patients about their noses include a large hump, bulbous or large tip, deviation to one side, deformity from prior fractures, excessively large nostrils, ethnic nose, or a nose which simply does not match their face.
Get started right away by contacting us to discuss your procedure.
Breathing difficulties can commonly be corrected with surgery on the nasal septum (septoplasty) and reduction of the nasal turbinates, which can be overly large. Not all nose surgery is cosmetic in nature. Nasal reconstruction corrects childhood abnormalities, deformities from cancer or trauma, and represents another angle of nose surgery.
Nose surgery results do not have to be “all or none.” Think in millimeters. The bump on the nose can be gently decreased without removing it entirely, so you maintain your character. The tip can be refined and raised only millimeters until its size and shape match your needs.
Dr. Sayah also narrows or widens your nose to bring your nose into balance. The few millimeters of refinement throughout the nose together create the natural nose you request.*
To discuss your culture-specific needs or your goals for your rhinoplasty at our Beverly Hills rhinoplasty clinic, request a consultation today, and Dr. Sayah will be happy to guide you.
What About Male Rhinoplasty?
No two noses are ever alike. Dr. Sayah pays special attention to the patient’s personal preference and cultural ideals of beauty in every case. Such meticulous planning produces a proportional and natural nose that balances the entire face, particularly in ethnic rhinoplasties.*
Male rhinoplasty differs from female rhinoplasty, with a much greater emphasis on avoiding a nose too cute for the masculine face and maintaining facial angles which distinguish a male face. Occasionally a chin implant is necessary to bring the overall face into balance with the nose.
What to Expect During Rhinoplasty Surgery
Rhinoplasty procedures are performed based on your particular needs. No two noses are alike, and procedures on the nose should, therefore, be individualized, based on your nose’s appearance and the desired effect.
Alterations may be made to increase or decrease the nasal bridge, reduce the size or width of the nose, narrow the nostrils, reshape and improve the definition of your nasal tip, or change the angle between the nose and the upper lip. Dr. Sayah typically performs the procedure under local anesthesia with mild sedation. Nose surgery can indeed be performed under local anesthesia alone if you desire.
Open vs. Closed Rhinoplasty
There are two broad approaches to rhinoplasty. In “closed” rhinoplasty techniques, all of the incisions are inside the nose with no visible scars.
“Open” rhinoplasty techniques have a small incision on the vertical strip of tissue separating the nostrils (columella). Open rhinoplasties offer a more clear view of the nasal structures and may be an appropriate choice in some patients. Dr. David Sayah typically uses his “ultra-closed” techniques with half as many hidden incisions inside the nose to produce natural results.
His state-of-the-art rhinoplasty procedures modify but do not remove, important structural components of the nose, while traditional nose surgery methods remove many of the key features of the nose. Working through the open or closed rhinoplasty approaches, the nose framework of bone and cartilage is sculpted to the desired shape. Dr. Sayah may reshape or reposition the bones in your nose as necessary. He can build-up certain areas, using either nasal cartilage or bones and cartilage from other parts of your body to sculpt a well-balanced nose.
Typical cartilage donor sites are the nasal septum, the ear, or the rib. The skin and soft tissues are then re-draped over the reshaped framework. Dr. Sayah corrects large or wide nostrils by excising small wedges of skin and subcutaneous tissue at the base of the nostrils. The resulting scars are hidden in the nose’s natural creases.*
For Breathing Correction
To correct breathing problems, Dr. Sayah may perform a turbinectomy procedure. Turbinates are prominences in the nasal passage which are involved in warming and humidifying the air we breathe in. In some cases, the turbinates are enlarged and obstruct the passage of air. In such cases, a turbinectomy can open the nasal air passage and reduce the size of the turbinates. The nasal septum is a midline dividing wall within the nose that separates the right side of the nose from the left. If the septum, made of cartilage, shifts from the midline to either side it can obstruct air passage and cause the nose to deviate to one side. Such sepal deviation can result from natural, genetic or traumatic causes. A septoplasty corrects a deviated septum and its associated airway obstruction.
After Rhinoplasty Surgery
On the Day of Surgery
Nearly all patients return home after their rhinoplasty. You should rest on your back and avoid any pressure on your nose. Maintain your head elevated at all times with several pillows under your back. Avoid extreme bending, striking or bumping of the nose for the first month.
Begin by drinking only cold, clear liquids (Gatorade) on the day of your surgery. Slowly advance your diet to solid foods as tolerated, but avoid excessively chewy foods such as apples, dry steak, chips, or pizza. Take your medications as prescribed. Do not consume any of the prohibitive substances on the list provided to you by Dr. Sayah. Gentle oozing from the nose is normal and anticipated during the first 72 hours. Change the gauze dressing beneath your nose as necessary to absorb drainage. If uncontrollable bleeding occurs, call Dr. Sayah at once. Ice compress on your eyes will reduce swelling and soothe the eyes.
The perfect substitute for an ice compress is a bag of frozen peas. Wrap the ice pack or frozen peas in a napkin to avoid frost burn. Avoid any showers or baths on this day.
First Day after Rhinoplasty Surgery
You can enjoy a light, soft breakfast today. Continue to avoid hot liquids, including coffee or tea. Plenty of iced drinks are encouraged. You can begin to walk around on this day with assistance but avoid strenuous activities, including bending over, lifting heavy objects greater than 5 pounds for two weeks. Do not shower yet, but you can wash your face gently with cold water and mild soap. Our staff will be glad to recommend the best non-irritating brand. You can enjoy a warm sponge bath without exposing your face to water.
When washing your hair, do not allow the water to soak the splint. Avoid hot water for two days. You can gently brush your teeth, but be very gentle in the upper teeth area. If you had a concurrent chin implant, avoid the area of the lower teeth centrally. It's vital that you do not blow your nose for two weeks and avoid sun exposure for six weeks. Because your reflexes are slowed, do not drive for one week, or until 24 hours after stopping your narcotic pain medication. Our office will contact you daily to check on your progress. The nasal packing will be removed on this day.
The Second Day after Rhinoplasty Surgery
Continue to walk with assistance with the restrictions above. Applying ice packs will decrease any swelling and bruising. Follow the other instructions as above. Avoid strenuous activities, and contact sports for six weeks. Avoid bumping your nose at all times. You can shower on this day with warm water. Avoid exposing your nasal splint to water or steam for prolonged periods as it can come off your nose. You may start cleaning the front of the opening of your nose the second day after surgery. Proper cleansing and care of your nose will result in more comfort, less swelling and clearer breathing. Small amounts of dried mucus or blood can collect.
With a cotton-tipped applicator (Q-tip) and bacitracin ointment, gently cleanse just the edge of the opening and rim of your nose. The inside of the nose can be irrigated as often as desired with Ocean Spray to keep it moist and help loosen any crusts. Be very gentle and do not forcibly cleanse or pull on crusts; let them loosen themselves.
The Third Day after Rhinoplasty Surgery
Patients can switch to warm compresses on this day. Soak a small hand towel in warm water, press any excess water out of the towel and place it on your eyes and nose. You can replace the towel with another warm soaked towel once the heat has dissipated. Avoid hot water as you could burn your face. Continue walking, but adhere to your restrictions of no heavy lifting greater than 5 pounds or bending over. Sleep on your back with your head elevated.
The First Week after Rhinoplasty Surgery
Your splint will be removed this week. External sutures (if any) are removed at this time. Internal sutures are absorbed within 2-3 weeks. You may likely return to work and resume a more normal lifestyle after your splint is removed. Most people will not be able to discern that you have had nasal surgery.
After the splint/tape is removed, the skin over the nose may peel, similar to that which happens with a severe sunburn. No special care is needed. Vaseline or moisturizing cream may be helpful to keep the skin soft. If you wear glasses, do not rest your glasses on your nose for 6 weeks. You may suspend your glasses off your forehead with medical grade paper tape. You may be instructed to tape your nose to reduce swelling after the splint is removed. If glasses are worn, they should be taped to your forehead for a week after the splint is removed. You can switch to warm compresses on this day. Soak a small hand towel in warm water, press any excess water out of the towel and place it on your eyes and nose. You can replace the towel with another warm soaked towel once the heat has dissipated. Avoid hot water as you could burn your face. Warm compresses will help your bruising improve over the next week.
Numbness of nose skin is quite common and may continue for several weeks. Your sutures will be removed in Dr. Sayah’s Beverly Hills rhinoplasty office on this week. We will continue to contact you regularly during this week to assure you are progressing well. Again, do not blow your nose for 2-3 weeks! You may cleanse the nostrils gently with Vaseline and Q-tips after the 10th day.
From the Second to Sixth Week after Rhinoplasty Surgery
Continue to avoid sunlight on your face. Apply sunblock with a minimum of SPF 45 on a daily basis before leaving the house. We will be glad to recommend the best brands.
Six Weeks After Rhinoplasty Surgery and Beyond
You may begin more active exercise at this time. Swelling of the nose and surrounding tissue may last for a few months. Your nose will continue to mature for the next 5 to 12 months, so be patient. Numbness of the skin of the nose is quite common and may continue for several weeks.
Normal sensation usually returns within 4-6 months. Swelling of the nose and surrounding tissues may last for a few months. Subtle changes will occur in the contour of your nose for up to a year or more following surgery. Avoid sun exposure for two months following surgery. If sun exposure is unavoidable, use a minimum of SPF 45 sunscreen or zinc oxide on your nose to protect it from sunburn.
- Will I Get Black Eyes After Rhinoplasty?
- Tips for Getting a Great Nose Job
- All About Ethnic Rhinoplasty
Frequently Asked Questions
How do I select a surgeon to perform my nose surgery?
Selecting a qualified surgeon with whom you can develop excellent rapport is the most important decision you will make after choosing to have rhinoplasty. Surgeons trained in plastic and reconstructive surgery and board certified by the American Board of Plastic Surgery are the most completely trained specialists performing nose surgery. They not only perform cosmetic nasal surgery, but they routinely reconstruct nasal deformities resulting from cancer, trauma, or infections. Dr. David Sayah completed his training in general surgery followed by his specialty in plastic and reconstructive surgery. He is a Diplomate of the American Board of Plastic Surgery and an Ambassador of the American Society of Plastic Surgeons. With an excellent staff, we are confident you will find the care you receive at our office unmatched.
How do I decide what nose shape best matches my face?
During your consult, Dr. Sayah will review your areas of concern and offer suggestions on improving your nose to your specifications. He recommends reviewing photos of models to select your favorite nose features and learn about other nose possibilities. With these photos in mind, your personal images can be morphed on a computer screen under your guidance to show you an approximation of what you will look like with your future new nose.
How do I make sure that nose surgery will look natural?
Excellent communication and rapport between patient and surgeon are of utmost importance in achieving the natural nose you desire. You are encouraged to return to our office as many times as necessary until you feel you have decided on the nose you envision for yourself. Remember that small changes throughout the nose lead to effective but natural results.
How long until I see final results?
Once your splint is removed at one week after surgery, most people will not be able to detect that you’ve had nose surgery. At 8 weeks after surgery, your close friends will not see any further signs of a rhinoplasty, though you still feel swollen. At 6 months after surgery, you will not feel any more swelling, but the minimal residual swelling continues to decrease slowly over the next six months. The swelling at your nasal tip will be the last detail on your nose to settle. Your final result will show itself only at one year after surgery which is far longer than other surgeries.
Will nose surgery improve my breathing?
Aesthetic nose surgery alone does not change breathing. Internal nose surgery on the nasal septum (septoplasty) and turbinates (turbinectomy) opens the breathing passage. During your consultation, Dr. Sayah thoroughly examines your nose including the internal components of your nose to diagnose any abnormalities such as septal deviation of enlargement of your turbinates. He will then suggest appropriate treatment options for your breathing problem.
Does my health insurance pay for nose surgery?
Health insurance companies typically do not cover aesthetic nose surgery. They do, however, cover nasal surgery for breathing difficulties and reconstructive nasal surgery.
How old do I have to be to have rhinoplasty?
The nose continues to develop until mid-teens with most of the development occurring in the first 14 years of life. However, patients have to be mature enough to want nose surgery for the “right reasons,” have realistic expectations, and understand facts associated with the procedure. For that reason, Dr. Sayah typically does not perform rhinoplasty on anyone younger than 16 years old. Nose surgery for developmental problems or breathing difficulty can be performed at younger ages based on the severity of the problem.
Is there a maximum age for rhinoplasty?
There is no age limit to rhinoplasty. As long as you are in good overall health and obtain a health clearance from your primary care physician, you can have nose surgery.
What type of anesthesia is recommended for nose surgery?
Dr. Sayah prefers mild sedation along with local anesthesia for nose surgery. With this type of anesthesia, you will not feel, hear, or remember any part of your surgical procedure. Minor to moderate complexity rhinoplasty procedures can be performed using local anesthesia alone if you prefer. More complex nose surgery is safer with mild sedation.
Will I have bruising or black eyes after my rhinoplasty?
Dr. Sayah uses special techniques to minimize any bruising after nose surgery. Mild bruising and black eyes typically occur after more complex nose surgeries which involve fracture of the nasal bones. The risk for bruising can be minimized by avoiding aspirin, non-steroidal anti-inflammatories such as Ibuprofen (Advil, Motrin), or herbal supplements which can thin your blood prior to surgery. Please adhere to your pre and post-operative instructions to minimize the chance of bruising.
Can I wear glasses after rhinoplasty?
Glasses are the perfect disguise while the splint is on your nose. After your splint is removed one week after surgery, you may not wear your glasses until 6 to 8 weeks after surgery.
When can I return to work after nose surgery?
Most patients return to work one week after surgery as long as they are able to avoid heavy lifting or the head down position. Those wishing to resume an active lifestyle or work life need to wait until 2 to 4 weeks after surgery. Essentially it is important to avoid the possibility of trauma to your new nose while minimizing the chance of increased swelling. Dr. Sayah will guide you through the recovery process during your regular follow-up visits.
I'm disappointed with my prior rhinoplasty. What can be done?
Dr. Sayah specializes in revision nose surgery. Based on the type of problem, you must wait 6 months to one year after your last surgery prior to undertaking revision rhinoplasty. Options for correcting your nose surgery results include revising the structural components of your nose by refining the existing components of your nose, adding cartilage grafts to improve contour and breathing difficulties, or revising scars at the nose. You are encouraged to schedule a consultation with Dr. Sayah if you have any concerns with your prior rhinoplasty.
How Is ethnic rhinoplasty different from standard rhinoplasty?
Ethnic rhinoplasty can be divided in 2 categories: ethnic patients who want a less ethnic nose, or ethnic patients who want refinement in the appearance of their noses while maintaining their ethnicity. Any standard nose surgery must give consideration to your ethnicity and your desire to maintain or minimize your ethnic appearance. Dr. Sayah will discuss minimal changes in your nose to achieve natural results and maintaining balance with your other features.
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