Rhinoplasty is a plastic surgery procedure of the nose that changes the external and internal shape of your nose. Of all the things that can be done to your face, the rhinoplasty procedure can have one of the biggest impacts on the beauty of your face.
Being in the center of your face, changing the appearance of your nose can have significant effects on the balance of your face. With rhinoplasty, these effects on balance and symmetry can markedly improve your facial aesthetics.
In Dr. Young’s new theory on facial beauty, the nose is one of the center pieces of the face. The eyes, nose and mouth are the major shapes within the face. The nasal tip of the nose assumes a very significant distinction: it is one of the major primary Circles of Prominence within the face. The iris and the center of the lower lip are the other primary circles within the eyes and mouth regions.
Your face will assume symmetry and be in balance based on where your primary circles lie. Balance is the distance between the iris and the middle part of the face when the eyes are equal to the distance between the horizontal level of the iris and the nasal tip, between the nasal tip and the center of the lower lip, and between the center of the lower lip and the bottom of the chin.
The most accessible way to change the balance of your face is by modifying your nose. The distance between the eyes is set. Although it can be changed through radical surgery, it is a risky procedure. To even consider changing the distance between your eyes would entail craniofacial/neurosurgical procedures. Not an attractive option. The mouth can also be changed to some degree through oral maxillofacial procedures involving cutting through your facial bones and set them in a new position. This often requires wiring the jaw shut for weeks at a time. Chin plastic surgery and reshaping is also feasible. However, with the chin being at the bottom of the face, any changes here have significant less impact compared to the rhinoplasty procedure.
After your initial phone call, we will have a consultation with you to discuss the rhinoplasty procedure and how it can be tailored for you. Through the morphing process, we will ask you what you would like to see get done.
Morphing allows us to change your picture and give you a glimpse of what your new nose can look like. The consultation is a great time to discuss your desires and preferences. We will then decide on when you would like to schedule your rhinoplasty surgery.
We will set up a preparation appointment two weeks prior to your actual surgery. This allows us to go through your morphed pictures and what you have decided to get done. We do a full assessment of your health in detail. During this two-week period, we may obtain a medical risk assessment from your primary care doctor and get extra tests done to make sure you're ready for your rhinoplasty.
On the day of your procedure, we will go through everything again to ensure your desires are being met. Our nurse and anesthesia team will prepare you for the surgery. We will give you all of our contact information in case you need to get a hold of us later. You will have an appointment six days after your surgery when we will take out your sutures and splint.
Why hide behind your nose or feel self-conscious about your appearance when you can have these same positive changes as other people have seen through a procedure. Rhinoplasty can make small but significant changes and have a major impact on your looks. Research shows the benefits of beauty are obvious from the way your parents treat you to making a difference as a world leader.
Changing your nose can be one thing that can dramatically change your looks for the better. Dr. Young discovered an award-winning theory on beauty understanding the impact of beauty in our lives. According to Dr. Young, our appreciation for beauty is connected to our desire for good things to happen in our lives.
Rhinoplasty is the most complicated procedure for a facial plastic surgeon and the reason Dr. Young spends a lot of time discussing the surgery with his patients. He wants the best results for you. There will be at least three meetings about your rhinoplasty procedure prior to surgery: the initial consultation, a pre-procedure appointment and on the day of your procedure when we will spend up to an hour going over all of the details.
Much of the time will be spent with our computer morphing program that morphs your pictures to get a sense of what you want. This is vitally important. In order to give you the best results, we need to understand all of your desires and preferences regarding the appearance of your ideal nose.
Rhinoplasty is not a magical thing but we will do everything we can to get you the results that will be as close to the morphed picture as possible. Computer morphing can be difficult, especially if your nose is significantly different from what you want in your ideal nose. Bringing in pictures of other people whose noses you like can help us make your surgery a success.
We use a program called United Imaging which morphs pictures of your nose to any form. These images help Dr. Young during the procedure. He actually brings the pictures into the procedure room and uses them to achieve the best results.
At Aesthetic Facial Plastic Surgery, we believe in quality, not quantity. We want the best results for you and we will take the time to do your rhinoplasty procedure and achieve your goal. Instead of doing up to four rhinoplasties in one day, we concentrate on just one surgery on most days.
Dr. Young has published multiple chapters in major textbooks and peer reviewed scientific journal articles on facial plastic surgery. Here, he shares some of the many topics on rhinoplasty.
Why do people use the open approach versus a closed approach? The open approach allows Dr. Young to view the structures under the skin. This incredible view of the structures lets him know what effects are being done to the nasal anatomy.
In the closed approach, the incisions are located inside the nose and the nostrils are hidden from view. The closed approach is favored by some people because the incision is made on the inside. However, the closed approach limits the view on the structures. At our Seattle Bellevue office, we prefer and mostly perform the open approach.
Approximately 30 percent of Dr. Young's surgeries are devoted to rhinoplasty. We specialize in the face and neck. We do almost as many revision procedures than first time rhinoplasties. We also offer revision rhinoplasties and have plenty of experience with this hard procedure.
Rhinoplasty is one of the most performed cosmetic procedures for people of all ages because the nose is the most prominent feature on a person’s face. Disproportion in the size and shape of the nose can distract from an otherwise attractive face. Your desires and facial structure are important criteria in deciding how your new nose should look.
Dr. Young has performed over 5,000 cosmetic and reconstructive procedures, including nose reshaping to provide balance and symmetry to his patients. He has trained with some of the most prominent plastic surgeons in the country. With his internationally acclaimed understanding of facial aesthetics, Dr. Young has a very unique perspective on how nose reshaping can enhance your natural beauty and bring your nose into an ideal relationship with the rest of your face.
We had an Asian female client from Washington come in for an Asian rhinoplasty. She was in her 20’s and wanted her nose to be smaller and more refined. She said her tip was big and wanted it smaller and prettier.
The Asian woman also felt that her nostrils were too wide as well. Dr. Young agreed with her assessment. He felt her nose could benefit from more ultimate symmetry. While examining her nose, he found that her upper bridge and the middle part of her nose needed to have some widening to match a smaller tip.
The goal: to slightly widen the upper part of the bridge and middle part of her nose to match the future smaller tip. During the procedure, Dr. Young strove to have the same width from the area in between her eyes down to the tip of the nose. The width we wanted to achieve needed to be equal to the width of the colored part of her eye. This is based on our findings on facial beauty, Dr. Young's theory on beauty.
The results were successful in creating more symmetry of her nose. In the after images, from the bridge of her nose through the middle part of her nose and down to the tip has maintained the same width and the aesthetics of her nose has markedly increased.
“My goal was to find a method to bring back a person’s natural youthfulness without the operated, unnatural look and that is why I have my patients bring in photos of them when they were age 5 to 30. My YoungVitalizer helps restore natural and youthful contours they haven’t seen in years.”
—Dr. Philip Young, Seattle Facial Plastic Surgeon
During your recovery period, you are going to feel groggy and sedated. There may some bleeding from your nose. We will show you how to take care of your mustache dressing, including changing it as needed depending on how much you bleed.
We will also suggest you start to use the Afrin spray as soon as you get home. It will help slow down the bleeding and keep your nose more open. We highly suggest using the spray for a max of five days. If you continue to use the spray, you can get a condition called Rhinitis Medicamentosa, in which your nose gets stuffy all the time. We also suggest you irrigating your nose soon after your surgery. You can use the Neil Med kit or other nasal irrigation kits that you can buy at the drugstore.
You can make your own nasal irrigation with one quart of distilled water, 1-3 teaspoons of salt (the less preservatives the better, try pickling salt) and 1 teaspoon of baking soda. You can use the blue bulbs from the drugstore to irrigate your nose.
You will feel discomfort in the first few days. Dr. Young can prescribe pain medication for the discomfort. You may consider taking the medication regularly in small doses at first as it takes up to five pills to feel relief. Please follow the directions on the bottle given to you and do not take more than what is prescribed to you.
We usually want you to start taking 1/2-3 tablets of the pain medication every four hours. Percocet is what we usually prescribe to our patients. The pain medication will not be as effective the first few hours until it kicks in. We want you to keep your pain level in the 3-4 out of 10 ranges (with 10 being the worst pain).
We also want you to start taking your antibiotics usually every six hours. It is possible for the antibiotics and pain medication to give you nausea. We suggest that you take the nausea medications a half hour before each pain and antibiotic dose. Ondansetron is what we usually prescribe. Always read the instructions on your medication bottle.
Try to sleep with your head elevated to keep the bleeding to a minimum, especially for the first 48 hours. You will likely heal better if you can do this for the first two weeks.
Icing should be done for 15 minutes every hour for a couple of days.
You should clean your incisions two to four times a day for the first week. It is very important to do this in the first few days. We usually recommend constantly cleaning your incisions with 1/3 vinegar and 2/3 distilled water. For best results, clean it every hour for the first few days. The frequency is best for cleaning, not a forceful rubbing of the nostrils and incisions. The mixture of vinegar and water moistens the crusting and allow the cleaning and removal of the crusting. The liquid breaks down the crusting more gently than forceful rubbing. We recommend cleaning the incision at the bottom of the nose and inside the nostrils about 1/2 inches inside the nostril. The spray will also help cleaning the nose. Crusting promotes bacterial growth, infection and causes the incision to break down. It is important to get rid of the crusting.
Your rhinoplasty recovery should take a week. We typically remove the outside splint and sutures on the sixth day. It is important to clean your nostrils, irrigate the inside of your nose and frequently clean the incisions on the outside. Cleaning your nose is important to remove the crusting and prevent bacteria from accumulating. Through effective cleaning, you decrease your risk of infection and scarring. In a scientific study, researchers found that 20% of your deeper healing beneath the skin occurs after two weeks. Your most noticeable healing should be within the first week. You will continually heal for up to two years but will see major improvement along the way. At six weeks, you should see about 60% healing. At six months, you should be 80% healed.
Breathing through your nose will be difficult for the first two weeks due to the natural swelling. It gets better by the end of the first week. We can discuss employing steroids to help you with the overall swelling.
The most challenging time of recovery is the first week. During this time, you will have a nasal cast splint on your nose. This splint helps protect your nose and control the swelling.
You may notice the cast gets looser after five days. It means the swelling in your nose is decreasing. The bruising is often not too pronounced thanks to our use of small instruments to shape your nose and nasal bones. It cuts down on the trauma of the tissues around your nose so less bleeding and bruising. Everybody is different and you may have a propensity to bleed.
It may be hard to breathe the first couple of days due to internal swelling. You will have swelling a week after your surgery after the splint comes off. This mild swelling can take a few more weeks to decrease but it will be less noticeable. Your ultimate results can take from six months to a year. During this time, subtle changes will take place. People have complained of headaches because of the central location of the nose. If the headaches persist, visit your doctor.
Bleeding is not unusual for the first couple of days. If you bleed aggressively, pay a visit to your doctor. Icing and irrigating with cold solution helps keep the bleeding down. The Afrin sprays can also help with decreasing bleeding and to breathe easier. Frequent cleaning during the first week aids your recovery and can be a factor in preventing infections.
A rhinoplasty adjusting your nostrils can range from $2500-$5000. Working on your nasal tip is a bit more complicated and ranges from $4000-$6000. A full rhinoplasty depends on what you want done and can range from $6000-$12000. A revision or redo rhinoplasty is more than $12000 depending on what you need done.
Many non-Caucasian people need to increase the height of the tip and bridge to get the desired effect in your nose. The artificial or alloplastic option, include silicone, Gore-Tex, and medpor for the bridge. Silicone is likely placed 70-90% of the time.
Silicone does not have tissue in growth and can be encased in bone. Gore-Tex does not have tissue in growth as well but sometimes the tissue encases this implant fairly well. Medpor has pores that allow the tissue to grow into the implant which allows it to function like your own tissue. The drawback with medpor is any infection can be hard to get rid of.
For natural augmentation, we can use septal or ear cartilage. You can also use rib cartilage but it is a last resort for our practice. We can create a full bridge using one of your ears by wrapping little pieces of your ear cartilage with the tough tissue that covers your muscles. Specifically, we use your fascia (muscle covering) from your temporalis muscle, which is next to your temples and behind your hairline. This technique, sometimes called the Turkish delight, has worked very well for us. This temporalis fascia ear cartilage graft is used when you need 3-6 mm of augmentation. For less augmentation, we can use ear cartilage by itself (shaped, crushed or minced) or septal cartilage. For anything larger than 6-7 mm of augmentation, we may need a rib cartilage.
When we do revisions, we often have a difficult time finding our own incisions. The most noticeable area should be under the nose between the nostrils. The rest of the incisions are located inside the nostrils. We specialize in scar revisions and how to reduce the risk of scarring and how to treat the worse types of scarring. Frequent cleaning early during your recovery will help the incision heal with less scarring.
Narrowing the nasal bridge can entail taking wedges of bone at the most anterior portion and closing the gap. If the root of your bridge is wide, it may mean cutting through the bone near your cheek bone to allow the nasal bones to become more medialized and narrow. Each area requires a different approach in narrowing the anterior part of the bridge or the posterior portion next to the face.
Based on previous wound healing studies, you get 20% of your wound strength two weeks after an incision, 60% after six weeks and 80%-90% after six months. You can slowly start to exercise after two weeks. We suggest using 20% of your effort from your normal exercise routine.
For example, if you squat with 100 pounds, you should start with 20 pounds and increase the weight each week. Sexual activity should be avoided for the first two weeks. We also suggest no blood thinners for two weeks unless you have complications. Smoking and drinking should also be avoided for the first two weeks after your procedure.
Sometimes a rhinoplasty can transform your face. Dr. Young wrote about the balance in the face based on the iris, nasal tip and center of the lower lip. Based on where your nasal tip is located, you can markedly affect the balance of your face. The nasal tip is the easiest thing you can position in the face, one of the most basic levels of beauty. Having an ideal nose is very important to the whole beauty of your face.
Dr. Young has received advanced training in rhinoplasty, including training at the University of Southern California's head and neck surgery department. Among his teachers were Dr. Paul Nassif (featured on The Real Housewives of Beverly Hills), Dr. Mark Berman (2011 president of the American Academy of Cosmetic Surgery) and Dr. Francis Palmer (Beverly Hills plastic surgeon).
Dr. Young also received fellowship training in facial plastic and reconstructive surgery under Dr. Frederick Stucker. Fellowship training is an extra year of training in the arts of plastic surgery in the face and neck area. Dr. Stucker is a former president of the American Academy of Facial Plastic and Reconstructive Surgery and one of the founding members of Face to Face, the humanitarian arm of this academy. Dr. Stucker is considered one of the grand masters in facial plastic and reconstructive surgery.
When you want to consider a rhinoplasty surgeon, you want a surgeon who understands beauty and the basic foundation to achieve the best results. Dr. Young discovered a breakthrough theory on facial beauty, called the Circles of Prominence. Through his studies, Dr. Young felt compelled to find better answers to facial beauty and discovered fascinating ideas on facial beauty that has allowed him to get the very best results and set him apart from other surgeons. Dr. Young continuously refines his expertise in the face, neck, and especially nose.
Dr. Young believes each case is unique and listening to his patients is very important to his success. He spends more time with each patient through the course of their treatment. When you decide on a procedure, you will attend a preparation appointment to ensure your thoughts match your desires for a procedure.
It’s about what you want, not what we want. You’ll go through our computer imaging process and see potential outcomes by morphing your photos. We will go over your health history and ensure you are healthy enough for the procedure. We also discuss all the risks and benefits and preparation for the surgery.
Dr. Young takes his time to get the best results. Rhinoplasty is known as the most difficult plastic surgery procedure. Dr. Young takes more time to do his surgeries than other plastic surgeons because he wants to make sure that you end up with the best results possible.
This requires checking, rechecking and fine tuning your rhinoplasty results. Over 95% of the time, your rhinoplasty will be the only one scheduled that day. Dr. Young schedules his procedure in such a way that there are no distractions while he is in surgery allowing him to take his time and do his very best work. He is not known to be the fastest surgeon in the world. Dr. Young prides himself on the results, not the time it takes him to perform the procedure.
Dr. Young prefers doing his procedures by making a tiny incision at the base of the nose between the nostrils. This exposes all of the elements of the nose in an open fashion. Dr. Young feels that this allows him the ability to accurately determine what needs to be done and how to carry out those specific maneuvers. He pays extra attention in closing this incision.
Rhinoplasty has changed from using old techniques (cutting the cartilage of the nasal tip, cross hatching and tip grafts) to non-destructive techniques with the use of sutures. Dr. Young constantly improves his technique and routinely does research to further his knowledge on the procedures. He believes in non-destructive techniques and an open approach.
It is recommended that you start slowly after two weeks. At two weeks, you should do 20% of your normal effort and increase to 60% after six weeks and 80% after six months. The same principle applies for weightlifting: lift 20% of your normal weight after two weeks, etc. Follow the 20, 60, 80 rules for other activities such as running and yoga.
It depends on how healthy you are before your surgery. Being in good physical shape will help recover quicker. If you smoke, stop smoking two weeks before the surgery and wait two weeks after it. The same goes for drinking and drugs. Avoiding blood thinners is very important. Icing 15 minutes every hour for the first week helps with the swelling. Cleaning your incisions effectively means no crusts which prevents infections and promotes the healing of your incisions. Sleeping elevated can decrease the swelling.
Cleaning Your Incisions
Food and Liquids
“I just wanted to leave a note and say that my procedure with Dr. Young approximately 6 years ago took years off my face. He did an excellent job and I am still enjoying the results. It was very much worth the downtime. I look exactly like myself, just younger. Thanks, again!”
“He gave me my confidence back that I thought I would never get back. I can now look in the mirror and actually love what I see and not have to deal with pitted scars in my face. If you or anyone you know who thinks they have to just live with these scars, don't!”
“My procedure went great and I left the office with no concerns and all of my questions answered. I have never felt so good about myself and my appearance. I have you to thank for that Dr. Young. My new nose is perfect, I cannot thank you enough for this new look on life.”
If you have any questions or concerns, please call our office at 877-808-9244 or set up an appointment immediately.