NYC Rhinoplasty (Nose Job), Septoplasty and Sinus Surgery

Written by Dr. Sam Rizk

Dr. Rizk is a double board-certified subspecialist in the nose and face - he DOES NOT perform breast augmentation or other body-related plastic surgeries. He is dually-trained to handle both functional and aesthetic components of rhinoplasty. Dr. Rizk can remove a bump, narrow nostril width, change the angle between the nose and the mouth, as well as correct injuries, birth defects, or other problems that affect breathing, such as a deviated nasal septum or a sinus condition.

Dr. Rizk is voted by his peers to Castle Connolly’s list of best New York rhinoplasty surgeons. He is international educator with an upscale practice on Park Avenue. He is regarded for his noses, which are unique, natural, and compliment a person's face. Dr Sam Rizk is a member of the Rhinoplasty Society.

Rhinoplasty Goals

Good breathing is vital for a healthy quality of life. If a patient has a significant deviated septum compromising the breathing, this can be repaired during rhinoplasty surgery. Many revision surgeries Dr. Rizk performs are done to restore collapsed areas that were resected too much in previous surgeries, not just to improve the cosmetic appearance, but also to restore breathing abilities.

Dr. Rizk employs both the advanced open (external) and closed (endonasal) surgical techniques to naturally sculpt the nose. His innovated suture reshaping techniques for cartilage sculpting rather than removal. Dr. Rizk is well known for his revision rhinoplasty method which restores the patient's ability to breathe in addition to improving nasal appearance by rebuilding previously removed cartilage or bone.

His attention to detail and focus on achieving natural looking results while using the latest surgical techniques was recognized by Tatler magazine, which featured him as one of the world's top rhinoplasty surgeons.

Cost Of Rhinoplasty in NYC

A purely cosmetic procedure is never covered by insurance. However, if a patient has difficulty breathing and is found to have a deviated nasal septum or nasal allergy resulting in enlarged turbinates may have the functional portion of the procedure covered by insurance. A sinus condition may be treated at same surgery as a rhinoplasty.

Innovations in Rhinoplasty

Dr. Rizk has performed thousands of rhinoplasty procedures, half of which are revision rhinoplasties. He is highly sought-after throughout the United States and internationally, having treated royalties, celebrities, entertainers and patients from around the globe. With each brushstroke, Dr. Rizk refines and sculpts to create a unique nose in harmony with a person's face. His unique tools and techniques allow a PRECISION OPERATION with a PAINLESS and RAPID RECOVERY.

Dr. Rizk’s Philosophy

"It’s better to focus on a few plastic surgery procedures and do them exceptionally well than to do all types of plastic procedures all over the body just mediocre - My practice is highly specialized in the nose and face only - sort of a specialist within a specialty of plastic surgery. A beautiful nose is a natural one that compliments and fits harmoniously with a patient's face. I do not believe in a universally ideal nose, only an ideal nose for a particular face. I believe the nose is one of the most artistic parts of one's face and cultural differences should be respected in changing a nose. I also do not like upturned, scooped out, or excessively pointy noses. I believe and have pioneered techniques to give you a natural nose with tiny hidden incisions and a rapid recovery. Every nose that I do is different as every face is different and a customized, individualized approach describes my techniques."

What Is Different About Dr. Rizk's Rhinoplasty Methods And Techniques?

Dr. Rizk has pioneered a three dimensional high definition rhinoplasty surgery in his New York office, which has the main advantages of precision in changing structures and less trauma with quicker recovery time. Dr. Rizk performs both endoscopic (endonasal) rhinoplasty through small intranasal incisions and open (external) rhinoplasty done through a small inconspicuous incision at the base of the nose. The 3D high definition rhinoplasty allows Dr. Rizk to see the structures very clearly before modifying them.

For instance, instead of simply filing down a bump and deciding how much to remove by looking at the nose from outside alone, which can be imprecise, Dr. Rizk inserts a high definition telescope connected to a 3d-high def camera system and looks at what the bump consists of (bone, cartilage, scar tissue and addressing and sculpting it accordingly with great precision.)

Additionally, Dr. Rizk pioneered cartilage reshaping techniques with sutures which result in less excision of cartilage to preserve a natural framework. In fact, sometimes Dr. Rizk adds cartilage in revision surgery to collapsed areas. This cartilage is usually obtained from the nasal septum or the ear (auricular cartilage.) Dr. Rizk may use this cartilage to camouflage defects, support a drooping tip, elongate an upturned nose or correct tip irregularities or asymmetries.

Who Is A Candidate For Rhinoplasty?

A subtle alteration in one's nose can greatly improve one's appearance, individuals with the following concerns may benefit from rhinoplasty:

• Teens aged to 15 years old unhappy with their nose
• Individuals with a bump, wide tip or large flaring nostrils
• Previous injury causing a crooked, misshapen nose
• Breathing or sinus problems that interfere with life
• Past rhinoplasty surgery resulting in a scooped outlook, unnatural upturn, excessively pointy tip or collapsing asymmetrical areas
• Patients seeking profile or tip changes

Patients with breathing or sinus problems can combine functional repair with an aesthetic result. Dr. Rizk’s innovative techniques employing this combined approach were published in Annals of Plastic Surgery.

Dr. Rizk may choose not to operate on prospective patients who he feels may not be good candidates for rhinoplasty.

How Long Does Rhinoplasty Take?

Revision rhinoplasty may take up to 3-4 hours depending on scar tissue, graft usage and harvesting tissue from other areas. General rhinoplasty is completed in about 2 hours. Dr. Rizk does a very meticulous operation to ensure the best results possible. To assess nuances in the shape of the nose and reduce swelling, Dr. Rizk spends time creating his surgical plan prior to the surgery with detailed diagrams to decrease operative time.

How Do I Choose A Rhinoplasty Surgeon?

Selecting a rhinoplasty surgeon may seem like a lot of work, but it’s a decision that will stick with you for a lifetime, look for a surgeon who:

• Has a dual board-certification in facial plastic surgery (by ABFPRS) and Otolaryngology-head and neck surgery (by ABO) A surgeon who is dually-trained has an extensive understanding of the inside structure of your nose as well as the outside cosmetic appearance and knows how to alter both. He is trained to deal with both functional issues such as breathing or internal abnormalities as well as the external cosmetic structure of the nose.
• Offers before and afters, to see the surgeon’s work, just as you would like to see an artist’s other works before buying one of his pieces.
• Specializes in the nose and face, and will have a better understanding of the internal support of the nose.

Natural Results

Dr. Rizk strives to design a natural angle between nose and forehead and nose and upper lip. His rhinoplasty procedure develops and compliments features of the natural nose to bring harmony to your facial profile.

Although there are certain standards for the size of the nose in relation to the face and eyes, this is a very artistic operation.

Rapid Recovery After Rhinoplasty

Dr. Rizk is one of the first NYC rhinoplasty surgeons to pioneer innovations that speed up recovery after a nose job.

• Diminished bruising and swelling: With Dr. Rizk's high definition 3D approach, blood vessels which may cause bruising are directly visualized and precisely avoided to diminish bruising and swelling.
• Natural design: Dr. Rizk performs his sculpting deeper under muscle layers of the nose which is a clean plane of operating with fewer blood vessels. Also, this results in a more natural look because the muscle layer on top of the cartilage and bone acts to soften the shape of the nose, eliminating harsh edges.
• Rapid healing: By not closing all incisions inside nose completely, which lets blood and fluid come out through gaps and not let blood and fluid collect under the skin of the nose-these incisions close on their own in first 5 days after surgery.
• Limited social downtime: Dr. Rizk uses various tissue glues and herbal supplements to result in a patient looking socially presentable in 5 days after the procedure with no pain, but just as important is the lesser degree of swelling in general which allows a better overall result. Typical recovery time is 5-7 days with minimal or no bruising and virtually no discomfort.

Revision Rhinoplasty in NYC

Noses which have had work done previously, might suffer from structural support defects resulting in a short, scooped out or overly pointy appearance and sometimes breathing difficulties. To restore structure and nasal function, Dr. Rizk harvests cartilage from septum or ear, or utilizes graft materials. The various grafts used in revision surgery by Dr. Rizk may include a spreader graft, alar batten graft, caudal septal extension graft, shield graft, tip graft or camouflage graft. Occasionally he will also use a plumping graft to soften a very acute nasolabial angle.

As one of a handful of surgeons who are double board-certified in both otolaryngology and facial plastic surgery, Dr. Rizk routinely performs a few revision rhinoplasty surgeries every week. When Dr. Rizk adds cartilage grafts, he usually places another graft material on top of them to soften their edges so the edges of cartilages are not palpable or visible. This helps to achieve a natural outcome. After rhinoplasty, patients enjoy beautiful aesthetic results and significant improvement in their breathing as well.

How Dr. Rizk Approaches Revision Rhinoplasty Surgery

50 percent of Dr. Rizk's rhinoplasty is revision surgery. Of the revision surgeries, 70 percent is done with the open approach and 30 percent with endonasal (closed) approach. However, Dr. Rizk finds that he can achieve a higher degree of precision and much more accurate results by using the 3-dimensional high definition telescope system for both open and closed approaches. This system, which Dr. Rizk introduced to rhinoplasty surgery, allows visualization of structures and areas difficult to see and based on density, can differentiate scar tissue versus fat versus bone or cartilage. This becomes important for changing structures or sculpting areas more accurately.

Dr. Rizk is able to achieve excellent success with revision rhinoplasty. Dr. Rizk will only operate if he feels he can achieve a significant improvement. If Dr. Rizk decides that he cannot achieve a significant improvement, he will explain to the patient why he cannot do the surgery.

Non-Surgical Nose Job

A non-surgical nose job is a media hyped term for injecting filler (Radiesse, Restylane or Juvederm) into the nose to try and camouflage a bump. This is more dangerous and painful than actually having rhinoplasty. The results aren’t permanent, lasting up to a year. Essentially, you’re making your nose larger and not addressing the tip, length or width of the nose. Fillers also create inflammation and scar tissue which can make a real nose job more difficult. These fillers can have adverse effects and can move in the nose (a central structure which is often bumped). For instance, a filler injected in a valley next to a bump to camouflage the bump can move into the bump and make it larger.

New York rhinoplasty surgeon, Dr. Rizk's nose jobs are not painful and many times, bones need not be broken (the nose is mostly cartilage - not bone) and people look socially presentable after about 5 days of healing.

The best role for fillers in the nose is to correct minor irregularities in a previously successful rhinoplasty, not as a replacement for rhinoplasty. Fillers work very well for other areas of the face because there’s more soft tissue under skin to use them deeper and augment or erase facial creases. However, there is very little soft tissue under skin of the nose to accommodate filler use, with few exceptions.

Combining Rhinoplasty With Other Procedures

Dr. Rizk may recommend a chin implant, neck liposuction, neck lift, facelift or eye lift at the same time as rhinoplasty surgery to improve the outcome and combine recovery time. Although rhinoplasty is the most common operation in patients less than 25 years old, older patients may benefit from a subtle improvement to correct an overly long nose and this may compliment a facelift or eyelift.

African American Male Rhinoplasty Patient Speaks Highly of Dr. Rizk and his Experience

Some noses have weak cartilages and are short, with thicker skin. Dr. Rizk likes to achieve tip definition and support naturally by using the patient's own cartilage grafts either from their septum or ears. He also removes fat from the thick skin to make the skin thinner, using high definition technology after creating small incisions inside the nose. Dr. Rizk finds that defatting these noses is crucial to achieving a great outcome.

Think of the skin as a covering blanket to the nose. If the blanket is thick, you will not be able to see the newly shaped underlying structure and definition. As needed, Dr. Rizk does a nostril defatting or reduction using small incisions inside the nose. He does not like to use an outside nostril scar due to the possibility of visible scars. He will sometimes add a dorsal graft to elongate a very short nose to make it look thinner. This graft is either the patient's own cartilage or a synthetic material called MEDPOR. Dr. Rizk custom sculpts the MEDPOR implant to fit your nose during ethnic rhinoplasty in NYC. Since it’s not a one size fits all option, Dr. Rizk prefers not to use silicone grafts as they can move and do not integrate well into the nose.

Asian Rhinoplasty in NYC

Most Asian noses require not only a dorsal graft but also tip grafting to achieve tip definition and projection (distance from base of nose to front portion of tip). Dr. Rizk prefers to use the patient's own cartilage from either ears or the nose septum, or MEDPOR, but never silicone. He likes to augment noses in a subtle way and reshape a nose to better match a patient's face.

Very often, Dr. Rizk receives patients who were operated in Asian countries and who have silicone in their noses which moved or they feel it is too large for their faces. He usually removes the silicone implants and replaces them with the patient's own cartilage or a smaller MEDPOR implant on the dorsum. For the tip however, he prefers to use only the patient's own cartilage. Sometimes he will also do a nostril (alar) reduction on these patients to achieve balance and nasal-facial harmony.

Septoplasty Sinus Surgery

Septoplasty is a form of functional rhinoplasty done to correct a deviated septum, putting an end to frustrating symptoms once and for all. As an award-winning septoplasty surgeon in NYC, Dr. Sam Rizk has performed countless deviated septum procedures to help patients restore their nasal function. After septoplasty, patients generally experience a great deal of relief and improvement in the conditions below:

• Sleep apnea
• Sinus issues
• Allergies
• Snoring
• Vertigo

These conditions can seriously interfere with one’s daily quality of life. Septoplasty surgery with NYC surgeon Dr. Rizk offers relief from these aggravating conditions. Some patients have found great improvement in their sense of smell and taste after septoplasty surgery.

What is a septoplasty?

Septoplasty is one of the most common procedures Dr. Rizk performs to improve breathing.. This can be done with the septoplasty procedure alone or with the septoplasty and rhinoplasty procedures together. Dr. Rizk will determine if your turbinates are significantly enlarged and would benefit from a reduction.

What nasal conditions lead to difficulty breathing and how can it be corrected?

A deviated nasal septum (parting wall between right and left nasal chambers) can result in difficult breathing and is treated with a septoplasty surgery. Allergies can also result in enlargement of the nasal tissue called turbinates and various procedures can be performed to reduce the size of the turbinates. Treatment can be done as an isolated procedure or can be combined with sinus surgery or rhinoplasty surgery.

How is sinusitis treated?

Additionally, there may be polyps or other nasal conditions which may be discovered on nasal exam which can result in difficulty breathing. Dr. Rizk performs a thorough intranasal exam to evaluate these conditions. A CT scan may be recommended if Dr. Rizk suspects polyps or if you have a sinus condition which is not getting better with medical therapy. The first line of treatment is antihistamines and nasal steroid sprays to shrink the nasal tissue. Allergy testing may also be recommended. If your condition is persistent and not improving, endoscopic sinus surgery is performed to drain the sinuses, and turbinate reduction and/or septoplasty may be recommended.

Accommodating International Rhinoplasty Patients

International patients usually need to stay in New York for one week after Rhinoplasty. An office concierge will arrange all accommodations. Patients have the option of using nurses after surgery at their hotels and we can provide those nurses. Many times patients are able to return to their countries just one week after their procedure.

Your NYC Rhinoplasty Consultation

Your consultation with Dr. Rizk will entail a thorough examination of the internal and external structure of the nose and how it relates to the face. Photographs will be taken and reviewed with the patient with possible computer imaging performed. A review of what to expect before, during and after the rhinoplasty will be discussed as well and an offer to call other patients who have had rhinoplasty with Dr. Rizk who wish to share their experiences will be made. All questions you have should be written and brought in during your consultation to with Dr. Rizk. Schedule your rhinoplasty or revision rhinoplasty consultation today.

Medical Articles

Rizk, Samieh S., and David Rosenberg. Algorithm for Analysis and Correction on Nasal Tip Deformities in Revision Rhinoplasty.

Romo T 3rd1, Rizk SS, Suh GD. Mucous cyst formation after rhinoplasty. Arch Facial Plast Surg. 1999 Jul-Sep;1(3):208-11.

Rizk SS1, Edelstein DR, Matarasso A. Concurrent functional endoscopic sinus surgery and rhinoplasty. Ann Plast Surg. 1997 Apr;38(4):323-9.

Rizk SS1, Kraus DH, Gerresheim G, Mudan S. Aggressive combination treatment for invasive fungal sinusitis in immunocompromised patients. Ear Nose Throat J. 2000 Apr;79(4):278-80, 282, 284-5.

Rizk, Samieh S., and David Rosenberg. A 21st Century Approach to Rhinoplasty: Marriage of Form and Function. Kraus O, Orlikoff R, Rizk S, Rosenberg D. Arytenoid adduction as an adjunct to type I thyroplasty for unilateral vocal cord. Paralysis Head & Neck, 1999; 21(1):52-59.

Zimm A.J., Rizk S.S. (2013) Restoring the Drooping Tip and Hanging Columella in Revision Rhinoplasty. In: Shiffman M., Di Giuseppe A. (eds) Advanced Aesthetic Rhinoplasty. Springer, Berlin, Heidelberg

NEW! Click here to read medical articles by Dr. Rizk, covering different conditions, techniques and technologies used in rhinoplasty.

• Analysis and Correction on Nasal Tip Deformities in Rhinoplasty
• Concurrent Functional Endoscopic Surgery and Rhinoplasty
• Mucous Cyst Formation After Rhinoplasty
• Endoscopic Sinus Surgery, Scarless Rhinoplasty by Dr. Rizk in Annals of Plastic Surgery
• Sinusitis/ENT Journal
• A 21st CENTURY APPROACH TO RHINOPLASTY: A Marriage of Form and Function

What problems can rhinoplasty correct/fix?

Rhinoplasty (nose surgery) can fix a variety of problems. It can reshape the nose, make it larger or smaller, change the angle of its tip and/or render it in better proportion with other facial features. Nose surgery can also fix structural problems that may be affecting a person’s breathing or causing congestion, such as nasal valve collapse.

Dr. Rizk may change any of the following during rhinoplasty surgery:

• Size of nose
• Width of the nasal bridge
• Profile of the nose (may address humps or depressions)
• Shape of the nasal tip, which may be too large, bulbous, droopy or upturned
• Asymmetry
• Nasal deviation

He can also address issues stemming from previous nose surgeries, such as over-resection or nasal collapse.

For more information on what rhinoplasty can correct or fix, schedule an appointment with Dr. Rizk today.

Other Links

• Nasal Tip Rhinoplasty
• Male Rhinoplasty Photo Gallery
• Female Rhinoplasty Photo Gallery
• Visit Dr. Rizk's Blog to See His Philosophy & View More Patient Photos
• 3D Rhinoplasty - Latest Advances Article by Dr. Rizk in Plastic Surgery Practice Magazine
• Tatler Magazine - Top Rhinoplasty Surgeon in NYC/New York
• Dr. Rizk Featured on Tatler's Beauty & Cosmetic Surgery Guide - Voted Top or Best Rhinoplasty Surgeon Worldwide
• ABC Nightline's Lead Story- Interviewing Dr. Sam Rizk and his patient about teen rhinoplasty
• Dr. Sam Rizk's Interview on the Today Show (NBC) with Mat Laeur on Teenage Rhinoplasty/Plastic Surgery
• Dr. Rizk discusses about Teenage Rhinoplasty on NBC's Today Show
• "Correcting the Drooping Tip and Hanging Columella in Revision Rhinoplasty" Chapter in Rhinoplasty Medical Textbook
• Alar Base Reduction
• Can a Nose Implant / surgery affect my voice?
• Fat loss under eye following rhinoplasty
• Finesse Rhinoplasty FAQs
• How to reduce swelling after rhinoplasty
• Life after rhinoplasty
• Non-Surgical Nose Job
• Post-rhinoplasty concerns
• Rapid Recovery Rhinoplasty FAQs
• Spreader Grafts In Rhinoplasty
• Tip Refinement Rhinoplasty FAQs
• Treatment of nasal obstruction from nasal valve collapse
• What to expect after rhinoplasty
• How To Avoid Bruising & Swelling After A Rhinoplasty
• 5 Tips for Teen Rhinoplasty New York Patients
• Analysis and Correction on Nasal Tip Deformities in Rhinoplasty
• Augmentation Rhinoplasty
• Concurrent Functional Endoscopic Surgery and Rhinoplasty
• Endoscopic Sinus Surgery, Scarless Rhinoplasty by Dr. Rizk in Annals of Plastic Surgery
• Mucous Cyst Formation After Rhinoplasty
• Nasal Tip Cartilage Sculpturing Principles
• Nasal Tip Support Mechanisms
• Revision Rhinoplasty Information
• Sinusitis/ENT Journal
• Sculpturing of the Nasal Tip and Nasal Tip Surgery
• USA Rhinoplasty Surgeon
• Ethnic Rhinoplasty

Last Modified On: 6/7/2019