Rhinoplasty Procedure

Hi, folks, I'm Dr. Shervin Naderi. I'm a board certified facial plastic surgeon and I'm a rhinoplasty specialist. As many of you do know, almost 100% of my surgical practice is focus only exclusively to rhinoplasty, essentially nose job surgery. It's the weekend, I'm in the office sending patients before and after pictures to them by email. And I thought I'd make a quick little video about rhinoplasty procedure. Essentially, rhinoplasty procedure is an operation where the skin is elevated either closed or open. Doesn't make a difference. In both surgeries, the skin is elevated off the cartilage and bone that makes up the shape of the nose. And then changes are made to the cartilage and bone, and then skin is laid back down. The only difference between open and closed is an extremely tiny, tiny incision on that little bridge of skin that separates the two nostrils. That's it. The rest of the surgery essentially is the same thing. The skin has to come off of the cartilage and bone. A plastic surgeon or facial plastic surgeon makes changes to the cartilage and bone, and then the skin is taped back down, and over time, it adheres back down. Swelling goes down, scar tissue goes down, and you start seeing the changes to the nose. Now, a rhinoplasty procedure is complicated. The nose is complicated. It's a hollow structure. It's made of very thin, flimsy pieces of cartilage and bone. And after rhinoplasty, the scar tissue that develops on everybody underneath their skin starts shrink, wrapping and contracting. And over time, this can change how things heal. Edges of cartilage, edges of bone have to heal. So not a single plastic surgeon can guarantee that a nose will be 100% smooth, 100% symmetrical. That's just impossible. And if somebody's saying that to you, I would raise an eyebrow. But what a specialist can tell you, what a good rhinoplasty surgeon can tell you, is that you're going to be able to get a better nose. If the surgeon doesn't have the confidence to give you a better nose, if you don't have a good plan, a good feel, I would suggest seeing several other surgeons until you come up with one that has a plan for you. This is a surgery that is planned beforehand. When I walk into a room to see a patient, as soon as I look at them, I've already done the surgery. My mind and my eyes, then when I examine them, when I feel their skin, feel their cartilage, feel their bone. I've done the surgery a second time. And then when I take pictures and do computer imaging, I've thought about the surgery yet again the night before surgery. And finally, when I'm in the or in the operating room doing the surgery, that's when actual fine tuning of the plans are made. For example, if I'm planning on doing certain maneuvers and I feel that during surgery their cartilage is behaving a little bit differently, obviously I'm going to make adjustments, and you have to have a surgeon that has a huge bag of tricks, bag of tools, many, many different techniques. Every nose is going to be different. Even the right and the left side of the nose is treated sometimes differently because perfect symmetry in the human face and body is very rare to almost unfound. So what has to happen is your surgeon has to have a lot of different skills to be able to deal with different noses. But essentially the surgery is the same in everybody. The cartilage, the bone, if needed, is changed. How that's done is going to be different in everybody. And like I said, in the left and the right side of nose, that's different as well. So you want to have a skillful surgeon, but a very honest surgeon, somebody that can tell you what can, but more importantly, what can't happen. There's limitations to what can be done. You can't have somebody else's nose. I've done multiple sisters in the same family, mothers and daughters. I've done multiple family members where the noses are completely different. So you have to be able to adjust your technique, have a variety of techniques, and be able to give every single patient that you offer rhinoplasty the confidence that you can give them a better nose. It may not be a perfect nose, but it's going to be a much better nose. And if a surgeon can't tell you that, much better not to have surgery. There's plenty of patients that I see, and what they want is just not possible or not realistic. And I just talk them out of surgery or I tell them that I can't give them what they want. I much rather have a happy patient than to do a surgery for the sake of doing surgery.