Rhinoplasty New York City
Choosing a Rhinoplasty
In every interaction with the world our face takes center stage. Much of what defines facial appearance is the nasal structure. For many dissatisfaction with their nose starts at a young age and can negatively affect esteem. As a top rhinoplasty surgeon in the country, Dr. Cangello specializes in rhinoplasty and excels in creating natural noses – the kind his patients say “I should have been born with”. He understands how cosmetic rhinoplasty can be life changing and works to surgically reshape the nose to fit harmoniously with the rest of the face. Through his expertise and artistic vision he will skillfully alter your nose in a way that ultimately enhances your underlying features.
A rhinoplasty (more commonly known as a “nose job”) is a surgical procedure that will reshape your nose for medical or cosmetic reasons. Rhinoplasty for medical reasons will improve the function of your nose so that you can breathe more easily. A cosmetic rhinoplasty will improve the appearance of your nose so that you feel more attractive.
Some of our patients require a functional (for medical purposes) rhinoplasty and use the required surgery to also improve the aesthetics of their nose. Regardless of the motivation, Dr. Cangello’s goal is to surgically enhance your nose in a manner that is functional, proportional to your face and aesthetically pleasing. A rhinoplasty can increase or decrease the size of your nose. It can also change the shape of your nose, straighten the bridge of your nose, reshape the tip, or change the size of your nostrils.
Am I a good candidate for a rhinoplasty?
You are a good candidate for a rhinoplasty if you are in good health, live in New York City (or are willing to travel), and are motivated to follow your pre-operative and post-operative instructions.
It is also important that you have reasonable expectations for your rhinoplasty. While rhinoplasty can make your nose more visually appealing, the changes are often subtle. It is important to understand that the best results are achieved when your nose is shaped to best suits your features – rather than trying to achieve the look of someone else, such as a celebrity or any other individual.
Teens are good candidates once they have completed their growth spurts. Dr. Cangello generally waits until teens are about 16-years-old, but this will be decided during the consultation. In New York, parental approval is required for anyone younger than 19 who is undergoing a rhinoplasty.
The Consultation: Creating Your Plastic Surgery Plan
Your rhinoplasty journey begins with a consultation with Dr. David Cangello in our New York City office. Dr. Cangello will discuss your medical history and the results that you would like to achieve from your rhinoplasty. For your surgery to proceed safely, you need to be honest about your allergies, medications, personal habits, and previous surgical procedures. You will also need to inform Dr.Cangello if you’ve sustained any injuries to your face, as well as any medical problems you have related to your nose.
Dr. Cangello will ask about your goals for the rhinoplasty, including whether it is for medical and/or aesthetic reasons. Dr. Cangello will ask for you to describe the parts of your nose you do not like and the look you hope to achieve from surgery.
Next, Dr. Cangello will conduct a physical examination. He will examine the external and internal structure of your nose and nasal passages.
Following the physical examination, Dr. Cangello will recommend a surgical plan that will help you achieve an aesthetically pleasing, functional nose. At this time he will also answer your questions and explain how to prepare for your rhinoplasty.
Patients often ask if we have to “break their nose” during a rhinoplasty. This procedure (called an “osteotomy”) means that a bone is cut. An osteotomy may be required based on the anatomy of your nasal bones and the degree of reshaping that you desire. If an osteotomy is required, Dr. Cangello will explain the process as part of his surgical plan.
Preparing For Your Rhinoplasty
Dr. Cangello is committed to achieving the best results possible. During your initial consultation, he will create a pre-operative plan for you to follow. This plan is designed for your unique needs, to make sure that you have the best outcome possible. Your pre-op plan may include changes in diet and other habits that impact your health. For example, you will be asked to reduce your exposure to the sun and to stop smoking.
Dr. Cangello will also give you instructions for the days before your surgery. These include stopping certain medications and supplements. You will also be told not to eat on the day of your surgery. A pre-op plan will be carefully created for you, and may include changes in diet and other habits that impact your health. You will be asked to fast the night prior to surgery, and may be asked not to take certain medications, refrain from common activities, or stop certain habits.
Where will the surgery be performed?
Your rhinoplasty surgery will be performed at Dr. Cangello’s New York City office. He has a fully accredited (AAASF) state-of-the-art operating room on-site. You are encouraged to ask for a tour of the operating facility when you come in for your consultation. Alternatively, if you have a preference for having your surgery in a hospital setting, Dr. Cangello can perform the surgery at Manhattan Eye Ear and Throat Hospital (MEETH).
Types of Anesthesia
Rhinoplasties generally take one and a half to two hours. They can be performed using either general anesthesia or using local anesthesia with intravenous sedation. In either case, you will not feel any pain or remember the surgery.
Rhinoplasty Surgery Techniques
The exact technique and incision sites are based on many factors. These include the anatomy and structure of your nose, your personal goals, the existing function of your nose, and whether you are having any additional procedures done at the same time. Dr. Cangello will discuss this plan with you prior to surgery.
There are two types of approaches to nasal surgery. With the “closed” approach to rhinoplasty surgery all of the incisions are made inside your nose and there is no visible scar left on the nose. If an “open surgery” is required, a small incision will be made on the vertical strip of tissue between your lip and your nostrils (referred to as the columella). The advantage to this approach is that the the skin envelope is able to be fully retracted, uncovering all of the nasal architecture for the surgeon to view and more easily manipulate. When the columellar incision is made very precisely and meticulously closed at the end of surgery it ultimately ends up being invisible.
After the incisions are made, Dr. Cangello will carefully separate the nasal skin from the bone and cartilage. He will then sculpt the bone and cartilage in the manner outlined during your consultation. Most frequently, the procedure involves reduction of a nasal hump and alteration of the lower cartilages of the nose in order to better define the nasal tip. Often osteotomies (fracture of the nasal bones) needs to be performed to narrow the dorsum of the nose, particularly after reduction of a large nasal hump. The skin envelope is then repositioned back to cover the nose, revealing the altered shape. Sutures (stitches) are placed to close the incisions and may dissolve on their own or need to be removed after one week.
To make sure that your nose maintains its new shape, a splint may be applied to the outside of your nose. Your nostrils may also be packed with cotton or soft splints.
The Recovery Process
After the surgery, your face will feel puffy and achy. You may also have some drainage of blood and mucus from your nostrils. Dr. Cangello will prescribe pain medication to keep you comfortable.
Bruising, numbness and/or swelling around your eyes are very common after a rhinoplasty. Dr. Cangello may advise you to use cold compresses and to keep your head elevated when you are lying down. Bruising will be worst on the second or third day and be much better within two weeks. Nasal packing and splints are usually removed after the first week. Most patients feel well enough to return to work or school after one week.
Dr. Cangello will give you specific instructions on what to avoid following your rhinoplasty. You may be advised to avoid strenuous physical activities, not blow or rub your nose, and not to rest eyeglasses on your nose. You will also need to avoid rubbing your face. Slight swelling can last for up to six months.
Please call our New York City office at 212-644-4416 to set up a consultation about how a rhinoplasty can improve the function and/or appearance of your nose.
What is the difference between “open” and “closed” rhinoplasty?The difference between a “closed” vs. an “open” rhinoplasty is that with a closed rhinoplasty, all of the incisions are made inside the nose. However, with an open approach, incisions are also made inside the nose, but there is one very tiny incision across the skin between the nostrils, called the columella. If the incision is made and closed meticulously at the end of the surgery, the scar is literally imperceptible. It can not be seen. Many surgeons, including Dr. Cangello feel that access to the structures of the nose that need to be modified is made simpler and can be performed under more direct visualization, through an open approach. Hence, Dr. Cangello prefers the open approach and uses the closed approach only in rare instances.
Is it possible to have a rhinoplasty without having that unnatural or “operated” look?It is absolutely possible to have a natural looking rhinoplasty. However, this is really dependent upon the artistry of the surgeon and his/her ability to visualize and construct what is a “natural” looking nose for your face. If done properly, the nose will not look operated on at all.
Can you improve the breathing through my nose?Rhinoplasty is both for aesthetic and functional purposes. So breathing can be made better with rhinoplasty surgery. There are many reasons for why patients may have difficulty breathing. Some of the structural problems that make it difficult to breathe include but are not limited to: deviated septum, collapsing nostrils on inspiration, enlarged turbinates, collapsed internal valve(s) of the nose. These can all be corrected with rhinoplasty surgery.
Will I have bruising after surgery?You may or may not have bruising after surgery. Usually bruising occurs as a result of intentionally fracturing the nasal bones in order to reposition them. When they are fractured, the process may cause some bruising in the soft tissues around the lower eyelids. Sometimes patients do not bruise at all though. There is no way to predict who will or will not bruise. However, if you do bruise, it is usually completely gone in 10-14 days and it can easily be covered up with make up in female patients.
Will I have visible scars?You will not have visible scars with this procedure. Even through the open approach, the incision heals so beautifully when done correctly that it is imperceptible over time.
Are there any age restrictions for undergoing rhinoplasty?Rhinoplasty should not be performed until the facial skeletal growth is complete. This is usually at age 18.
In order to fix a nose that is too long is it necessary to remove tissue?It is necessary to remove tissue to fix a nose that is too long. Part of the septum is removed in order to shorten a nose that is too long. There is NO skin removal however. The skin contracts on its own to conform to the new nasal skeleton below.
Is it true that swelling can disguise the end result of surgery? How long does this last?Swelling in rhinoplasty surgery can last for one to two years. That is not to say your nose will not look good until that time. The results of your surgery will be noticeable the minute the cast is removed at 7 days. However, the nose will look a little puffier, and not as well defined as it will ultimately look as time progresses. Usually by one month the nose looks quite good, but at three to six months it looks very good. Beyond six months, while swelling will still continue to diminish, it is minimal and therefore improvement in the appearance of the nose continues, but very subtly.
Do you have some before and after examples?Some before and after photos are available in our photo gallery. However, due to our concern for patient privacy we limit the amount of photos posted on the website. If you would like to see more before and after photos we are happy to show you more during your consultation in our office.
“Dr. Cangello is an amazing surgeon! Let me start off by saying he is genuinely one of the nicest people I’ve ever met. I had a septorhinoplasty performed by him last week. The results are amazing! My nose was broken when I was younger and it really affected my self confidence growing up. Now, I finally have the straight gorgeous nose I yearned for. Dr. Cangello is definitely one of the best plastic surgeons out there right now. I highly recommend him.”
“Dr. Cangello was great from the first consultation all the way through my post op appointments. He has a great bedside manner and answered all of my questions and concerns and made me feel very confident and comfortable about the surgery. I am pleased with the results of my surgery and I would definitely recommend Dr. Cangello to anyone considering rhinoplasty. PS the staff was also fantastic!”