A Quick Guide to Rhinoplasty
What Can Rhinoplasty Address?
Nose job surgery3 is performed to improve both the overall functionality and aesthetic appeal of a person’s nose, by altering the following characteristics:
- Size of the nose
- Width of the nasal bridge
- Profile (may address humps or depressions)
- The shape of the nasal tip, which may be too large, bulbous, droopy, or upturned
- Nasal deviation
Additionally, good breathing is vital to a person’s quality of life. If a patient has a significantly deviated septum compromising their breathing, this can be repaired during a nose job in NYC with Dr. Rizk.
Dr. Rizk is well known for his revision rhinoplasty method which restores the patient's ability to breathe. By replacing previously removed cartilage or bone, this procedure also improves the appearance of the nasal area.
Real Patient Results
26 year old female with a long nose and drooping tip shown preoperative and 6 months after surgery. Patient sent her own picture 2 years after the surgery as a followup.
23 year old female who underwent open rhinoplasty with grafts and alar base reduction. The patient has thick skin making this procedure an ethnic rhinoplasty. The nasal bridge and alar base was slimmed down to better compliment her facial features.
26 year old female shown 1 WEEK after nose surgery and septoplasty. Patient had an endoscopic rhinoplasty to shave a bump as well as tip refinement with sutures and tip graft to support the nasal tip and prevent postoperative tip drop. Patient also had a septoplasty to correct nasal obstruction. Note patient is obviously still swollen but still with swelling, can be presentable in a week after procedure.
Latino female in early 20's who underwent endonasal 3d rhinoplasty and nostril reduction. Patient had thick skin and poor tip support which was addressed during the nose surgery. Patient sent her own picture 3 years after the procedure as a followup.
32 year old female with previous history of rhinoplasty who complains of a pinched asymmetrical nasal tip and difficulty breathing. Patient has also thin skin. Patient underwent revision septorhinoplasty with cartilage grafts and fascia to nasal tip so soften its appearance. Patient is shown 1 year after revision rhinoplasty.
She is 10 days after open rhinoplasty and alar base reduction.
Female patient who had an Open Rhinoplasty. Photos shown here are 6 weeks after surgery.
17-year-old female underwent rhinoplasty to remove bump, deproject and slightly lift tip, all done through endonasal approach. Patient is shown 1 year after surgery.
Our patient 6 months after her rhinoplasty procedure. I did an open rhino to lift her drooping tip. I also removed bump to contour and create a more pleasant tip in addition with neck liposuction..
Rhinoplasty to address bump removal, droopy tip, and deprojecting nose. Patient is shown 1 year after open rhinoplasty.
Female patient who had a Primary Rhinoplasty. Photos shown here are 6 days after surgery. Bump Removal, Tip Refinement, Lifting hanging tip, narrowing bridge and tip. Patient still swollen.
55 yo patient shown 10 years after revision 4th rhinoplasty with rib bank cartilage. ( she had come back for rhinoplasty on her teenage daughters 10 years later !!)
Who Is A Candidate For Rhinoplasty?
A subtle alteration in one's nose can greatly improve their appearance. Individuals with the following concerns may benefit from rhinoplasty in NYC with Dr. Rizk:
- Teens aged 14-15 years old and up who are unhappy with their facial profile
- Individuals with a bump, wide tip, or large flaring nostrils
- Patients with a previous injury causing a crooked, misshapen nose
- Those with breathing or sinus problems that interfere with their day-to-day life
- Individuals who had a past rhinoplasty surgery resulting in a scooped outlook, unnatural upturn, excessively pointy tip, or collapsing asymmetrical areas
- Patients seeking profile or tip changes
When patients are suffering from breathing or sinus problems, functional repairs can be combined with aesthetic modifications. Dr. Rizk’s innovative techniques employing this combined approach were published in Annals of Plastic Surgery4. Dr. Rizk may choose not to operate on prospective patients who he does not believe to be good candidates for surgery.
How Long Does Rhinoplasty Take?
Typically, a nose job in New York with Dr. Rizk takes around two hours. Dr. Rizk performs a 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 before the surgery with detailed diagrams to decrease operation time.
Those needing a revision nose job can expect the procedure to take between three to four hours, depending on scar tissue, graft usage, and harvesting tissue from other areas.
What Does Rhinoplasty Recovery Look Like?
Dr. Rizk is one of the first New York rhinoplasty surgeons to pioneer innovations that speed up recovery after a nose job. His surgical techniques allow for:
Dr. Rizk sculpts the nose deep under the muscle layers, resulting in fewer blood vessels and a cleaner operating plane. Since the muscle layer sits on top of the cartilage and bone, it softens the shape and eliminates its sharp edges, resulting in a more natural appearance.
By not closing all incisions completely, blood and fluid come out through gaps without collecting under the nasal skin. These incisions close on their own within five days of surgery.
Dr. Rizk uses various tissue glues and herbal supplements that allow patients to look socially presentable sooner. This, combined with the reduced swelling and bruising allows for a more comfortable healing journey and better overall results.
Dr Rizk In The Media
Tatler Magazine - Top Rhinoplasty Surgeon in NYC/New York
Dr. Rizk featured in Town & Country Magazine as one of the masters of the subtle lift and tweak that will turn back time
How Much Does Rhinoplasty Cost in NYC?
The cost of rhinoplasty in New York depends on the surgeon and the location of the clinic. Dr. Rizk works closely with patients to ensure that expectations are met. During each patient’s initial consultation, he provides them with the exact cost of their surgery.
A purely cosmetic procedure is never covered by insurance. However, instances, where part of the procedure may be covered by insurance, include:
- If a patient has difficulty breathing
- A deviated nasal septum
- Nasal allergies resulting in enlarged turbinates
In some cases, Dr. Rizk can also treat sinus conditions during nose surgery.
Dr. Rizk’s Unique Approach to Nose Surgery
Dr. Rizk has pioneered a three-dimensional high-definition rhinoplasty surgery in his New York office. This allows him extreme precision in changing structures, while also reducing trauma and recovery time for patients.
He is highly sought-after throughout the United States and internationally, having treated members of royal families, 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. The tools and techniques he uses allow for a precise operation with a virtually painless, rapid recovery.
Dr. Rizk performs both endoscopic (endonasal) and open (external) rhinoplasty through small inconspicuous incisions at the base of the nose. With a 3D high-definition nose job, Dr. Rizk can clearly see the structures before modifying them.
To determine how much to remove from a bump, Dr. Rizk uses a 3D high-definition camera rather than just filing it down. Then he addresses and sculpts it accordingly. Additionally, Dr. Rizk pioneered cartilage reshaping techniques with sutures that result in less excision of cartilage to preserve a natural framework. Furthermore, Dr. Rizk often 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
- Correct tip irregularities or asymmetries
Dr. Rizk strives to design a natural angle between the nose and forehead as well as the nose and upper lip. His 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.Book an Appointment
Dr. Rizk believes:
"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, badly. 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 don’t like upturned, scooped out, or excessively pointy noses.
I 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."
The Difference Between Rhinoplasty and Revision Rhinoplasty
Noses that 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 the septum or ear.
He also 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. When Dr. Rizk adds cartilage grafts, he usually places another graft material on top of them so the edges of the cartilage are not palpable or visible. This helps to achieve a natural outcome.
As one of a handful of surgeons who are double board-certified in both otolaryngology and facial plastic surgery, Dr. Rizk routinely performs multiple revision rhinoplasty surgeries every week. Of the revision surgeries, seventy percent are performed with an open approach and thirty percent with an endonasal (closed) approach. However, Dr. Rizk finds that he can achieve a higher degree of precision and much more accurate results by using the three-dimensional high-definition telescope system for both open and closed approaches.
Open or Closed Rhinoplasty?
Open rhinoplasty is also referred to as external rhinoplasty, and involves altering the skin, bone, and/or cartilage to achieve the patient’s desired look. An incision is made in the inside of each nostril and through the skin between the nostrils. This allows the surgeon to ‘open’ the nose to reach its internal structure and make the necessary changes.
In a closed rhinoplasty, the only scars are on the inside of the nose and they are not visible. It is generally also a quicker procedure, although in some cases, more work may be needed if drastic results are required by the patient. Dr. Rizk can help you choose the best option between open vs closed rhinoplasty based on your individual needs and aesthetic goals.
Do I need my nose broken during rhinoplasty?
Not necessarily; in about sixty percent of procedures, Dr. Rizk does not break the nose. As most of it is cartilage, breaking the nose is not always necessary to narrow the bridge.
How does the nose age?
Dr. Rizk often does a minor rhinoplasty with a facelift or an eyelift to refine or rejuvenate a person’s appearance. As we age, the skin in and around our nose becomes thicker, causing the nose to “drop”, which is why rhinoplasty in New York with Dr. Rizk can be beneficial.
As the nose "drops," the tip's attachment to the dorsum (or top of the nose) weakens and starts falling, giving the appearance that one is developing a bump. This bump is usually a "relative" bump, meaning that it is relative to the lower tip.
Upon lifting the tip to a more youthful position, the bump disappears. Whether done alone or in conjunction with other facial rejuvenation procedures, a soft nose job can be performed without touching the nasal bones and heals very quickly. Dr. Rizk may also refine the tip during a light lift.
How does male rhinoplasty differ?
Men have thicker skin and stronger bones, therefore, the aesthetics of the male nose are different. Male rhinoplasty has to address the thick skin to achieve excellent results. In addition, removing the bump or lifting the tip has to be done very conservatively so that it does not look feminized. Dr. Rizk performs thirty percent of rhinoplasty on men.
What is a deviated septum?
A deviated septum is when the nasal septum (or wall between your nostrils that separates your right and left nasal cavities) is severely shifted to one side or "crooked," making one nasal cavity larger than the other.
How does a deviated septum disturb your life?
A deviated septum can cause many side effects, including breathing problems. This is the result of a blockage of one or both nostrils, nasal congestion, frequent nosebleeds, or recurrent sinus infections. Sinus infections can also be due to excessive drainage from the front or back of the nose into the throat (post-nasal drip), and headaches.
When do you know if you are ready for rhinoplasty?
If you are unhappy with the shape of your nose from birth, an injury, or a result of aging, you may be a candidate for nose surgery.
Can nose surgery look natural if you have a wide nose and want to make it narrower?
Absolutely. In some noses, particularly in ethnic rhinoplasty patients, the base is wider than it should be. A nostril reduction can help.
Can someone with a small or upturned nose undergo surgery to enlarge it?
A small or upturned nose can be corrected with rhinoplasty and may be the result of a previous nose job that the patient now wants to correct. Dr. Rizk pioneered cartilage-reshaping techniques with sutures that help lessen the removal of cartilage and preserve natural nose structures.
In the event one nostril looks much different than the other, can you use rhinoplasty to make the size and shape of both nostrils the same?
Yes, asymmetries in nostril size, shape, thickness, or horizontal placement on the face can be corrected. Dr. Rizk will use cartilage grafts, fat removal, or fat addition. For example, in a nostril that has a collapsed shape, Dr. Rizk will correct this and produce a natural curve in the nostril with fat injection or a cartilage graft. A nostril reduction or correction in shape or size can also be done in combination with rhinoplasty. In this instance, surgery to the nostrils does not prolong the recovery process from rhinoplasty.
What are the challenges with working with patients with thinner skin?
Every rhinoplasty is different. Dr. Rizk has worked with many patients with thin nasal skin. Northern Europeans typically have thin nasal skin. Similarly to thick nasal skin, thin skin has its advantages and disadvantages in rhinoplasty. Thin skin patients are less likely to experience swelling, swelling tends to subside more quickly, and incisions are less likely to leave scars.
Written Patient Testimonials
Dr. Rizk and his staff were absolutely incredible! They made me feel so comfortable throughout this entire process and I am so grateful for everyone (especially Dr. Rizk) for helping me look the best version of myself. My nose looks natural and perfect and I am in love with the results!!! If you are on the fence, I definitely encourage you to come to this office because Dr. Rizk gave me the confidence and grace to present myself to the world!
Words cannot express how tremendously grateful and impressed I am for his services. The process was painless and he produced beautiful results that I’m so happy with. Dr. Rizk is extremely precise, patient and detail orientated. He narrowed my nose 1mm at a time! I’m already looking forward to my next small tweek with him.
Fixed my nose that was extremely crooked from a car accident. Also did my brother's nose which case out beautifully
Popular Nose Treatments
In terms of nose surgery, Dr. Rizk does not believe in one-size-fits-all. During ethnic rhinoplasty surgery, he creates a more appealing nose while maintaining your identity with precision and extra attention to detail. When it comes to dealing with patients from different cultural backgrounds, his technique is more refined. He sees patients from diverse cultures in his Manhattan practice, including Asian, Middle Eastern and African American. Regardless of how your nose appears prior to surgery, Dr. Rizk spends a lot of time learning about your own personal goals concerning beauty and rhinoplasty.
In addition to maintaining balance with cultural aspects, his aim is to develop and refine a nose that beautifully fits the face. The characteristics of ethnic noses are thick skin and weak tip cartilages (according to Dr. Sam Rizk), although there is a wide spectrum of differences between these noses.
Dr. Rizk can perform rhinoplasty on teens to address many issues. He can straighten noses, enlarge or reduce nostrils, remove a hump or bump, open nasal passages, or reduce or increase nose size.
He takes extra care to ensure that the nose is fully developed before performing a nose job. One indication he uses to determine this is the growth of the feet. He will not perform nose surgery on a teen until the teen’s foot is fully matured; this occurs around age 14 in girls and 15 in boys.
Because rhinoplasty is an invasive procedure that involves certain risks, teens must have their parents' or guardians' consent before undergoing the procedure. Dr. Rizk also ensures that prospective teen nose surgery patients are seeking surgery for the right reasons. If a parent or other party is driving the teen's decision to undergo nose surgery, he will not consent to it.
Additionally, Dr. Rizk takes the time to ensure that a teen is mature enough to handle the risks of a nose job. Dr. Rizk often asks teens to consult a psychologist or psychiatrist before deciding whether to proceed.
In a secondary nose job, the tissue inside the nose has changed and may not tolerate extensive dissection, thinning procedures, or multiple incisions. Thin skin and extensive scarring may be present in some noses. During revision surgery, the skin is less pliable, so it is more difficult to expand or contract.
To overcome the scar tissue, the surgeon must use specialized techniques to alter the structure of the nose. Dr. Rizk uses suture and cartilage graft techniques to create a greater tension than the scar tissue and skin envelope. This results in greater resistance to change the structure of the nose.
Septoplasty is one of the most common procedures Dr. Rizk performs to improve patients’ breathing. He achieves this with a simple septoplasty procedure or by combining septoplasty and nose job.
During your initial consultation, Dr. Rizk will determine if your turbinates are significantly enlarged and would benefit from a reduction.
What is a Non-Surgical Nose Job?
A non-surgical nose job is a media-hyped term for injecting filler (Radiesse, Restylane, or Juvéderm) into the nose to try and camouflage a bump. This is more dangerous and painful than having a rhinoplasty. The results are not permanent, lasting up to a year. The procedure enlarges the nose and does not alter its length, width, or tip.
Fillers create inflammation and scar tissue that can make future rhinoplasty more difficult. Fillers can move in the nose (a central structure often bumped) and have adverse effects. Fillers injected into a valley next to a bump can eventually move into the bump and make it larger.
In most cases, Dr. Rizk's rhinoplasties are not painful and no bones need to be broken because the nose is mostly cartilage. Five days after healing, people are socially presentable.
The best use for fillers in the nose is to correct minor irregularities in a successful nose job, not to replace it. In other parts of the face where there is more soft tissue under the skin, fillers work well to augment or erase facial wrinkles. However, there is very little soft tissue under the skin of the nose to accommodate filler use, with few exceptions.
|Non-Surgical Nose Job||Surgical Nose Job|
|Technique||Radiesse, Restylane, or Juvederm is injected into the nose||Surgical incisions paired with rapid recovery and scar concealment|
|Treatment Time||15 minutes||A few hours|
|Pros||Quick results||Addresses the tip, length, and width of the nose, can correct breathing|
|Cons||Dangerous, painful, make the nose larger, doesn’t address all concerns||Longer recovery time|
|Side Effects||Swelling, botched fillers, filler migration, overfilled appearance, scarring||Bruising, swelling|
|Permanence||One year||A lifetime|
Combining Rhinoplasty With Other Procedures
Dr. Rizk may recommend a chin implant, neck liposuction, neck lift, facelift, or eye lift with rhinoplasty to improve the outcome and combine recovery time. A nose job in New York is a common operation in patients under 25 years; however, older patients can have a subtle correction to an overly long nose, and this can complement a facelift or eyelift.
Are There Any Risks To Rhinoplasty Surgery?
As with any surgical procedure, rhinoplasty comes with its own set of risks.
- Difficulty breathing
- Feeling unsatisfied with your nose's appearance
- Skin discoloration
- The possibility of a revision nose surgery
While these are legitimate risks, Dr. Rizk is a highly trained and experienced facial plastic surgeon who takes every precaution when undertaking any surgical procedure. Moreover, he works closely with each individual patient to ensure that he understands their goals in order to provide them with the results they have been dreaming of.
Choosing A Rhinoplasty Surgeon In NYC
Selecting a NYC nose job surgeon may seem like a lot of work. However, it is a decision that will stick with you for a lifetime. As a result, patients should look for a surgeon who is:
- Double board-certified in facial plastic surgery (by ABFPRS) and otolaryngology-head and neck surgery (by ABO).
- Highly trained and has an extensive understanding of how to enhance the internal and external nasal structures.
- Trained to deal with both functional issues such as breathing or internal abnormalities as well as the external cosmetic structure of the nose.
- Experienced and has a selection of before and after images so that you can see their work, just as you would like to see an artist’s portfolio before buying one of their pieces.
- A facial plastic surgeon ensures they have a better understanding of the internal support of the nose.
Voted by his peers, Dr. Rizk is on Castle Connolly’s list of best New York rhinoplasty surgeons. He is an international educator with an upscale practice on Park Avenue and is highly regarded for his nose surgeries which are unique, natural, and individually designed to complement a person's face. He is also a member of the Rhinoplasty Society.
His attention to detail and focus on achieving natural-looking results while using the latest surgical techniques were recognized by Tatler Magazine, which featured him as one of the world's top nose job surgeons.
Accommodating International Patients for Rhinoplasty in NYC
International patients usually need to stay in New York for one week after rhinoplasty. An office concierge will arrange all accommodations. We can also provide you with a private nurse to care for you at your hotel.
Typically, out-of-town patients can return home just one week after the procedure. Learn more about booking your appointment from abroad by visiting our international patient page.
After rhinoplasty in New York with Dr. Rizk, patients enjoy beautiful results and significant improvement in their breathing as well.
1 American Society of Plastic Surgeons. Rhinoplasty. Available: https://www.plasticsurgery.org/news/plastic-surgery-statistics.
2 MedEsthetics. Sam Rizk, MD: Blending Art and Science. Available: https://www.medestheticsmag.com/business/article/21146126/sam-rizk-md-blending-art-and-science.
3 Harvard Health Blog. David A. Shaye, MD, MPH. Thinking about rhinoplasty? Available: https://www.health.harvard.edu/blog/thinking-about-rhinoplasty-2019030616112.
4 S S Rizk, D R Edelstein, A Matarasso. Concurrent functional endoscopic sinus surgery and rhinoplasty. Available: https://pubmed.ncbi.nlm.nih.gov/9111889/.
5 Mansour Khorasani, Pejman Janbaz, corresponding author and Farshid Rayati. Maxillofacial reconstruction with Medpor porous polyethylene implant: a case series study. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024064/.
By Dr. Sam S. Rizk, M.D., FACS.
Dr. Rizk is a double board-certified facial plastic surgeon who specializes in rhinoplasty surgery and a recognized expert on the latest advances in facial plastic surgery techniques. He performs a range of facial plastic surgeries at his New York practice.