Nose Surgery Techniques


The nose is the forward most feature on your face. Your nose may also be the part of your face that you spend the most effort into making appear less noticeable. Sometimes concealers, contouring products and finishing powders aren’t sufficient to push your nose into the background so that other assets like your eyes and lips can shine. People like yourself often seek the help of a plastic surgeon to correct obvious nasal defects such as humps, crookedness, asymmetry, and tip deformities.

Corrective nasal surgery, also known as rhinoplasty, is one of the most common procedures we perform at Premier Image Cosmetic & Laser Surgery. Our nasal surgery candidates come to us for a variety of reasons. Your initial rhinoplasty consultation will include a careful discussion of your specific needs and goals. After a thorough assessment of your nasal structures, you and your doctor will discuss outcome goals and review achievable expectations. This consultation will help your doctor determine the best surgical method to achieve your desired outcome. Several surgical methods will be considered. Sometimes a combination of these rhinoplasty approaches may be necessary for the doctor to achieve your desired outcome.

Open Rhinoplasty

Open rhinoplasty may the method your surgeon chooses should your rhinoplasty goals require a substantial correction. Open rhinoplasty begins with a small incision in the columella, the narrow skin located between the tip of your nose and your upper lip. Once the skin is lifted away, the surgeon can fully visualize and access the internal structures that will be altered during your surgery. After the structures are modified, the skin will be re-draped or “shrink wrapped” over the modified nasal structures and sutured close. The nose is then taped to lend protection and support during healing. A customized splint is sculpted a to fit your new nose and fitted over the tape to provide additional protection and support of the nose during the recovery period. Sometimes gauze packing is inserted into the nostrils after surgery to assist with healing. Tape, splints and packing will be removed by your physician during your post-operative follow up visit.

Some nasal swelling and bruising under the eyes may occur after a revision rhinoplasty. A discrete, z-shaped scar will form on your columella. Most people recover quickly from open rhinoplasty and return to most of their normal life activities within a week or two.

Closed Rhinoplasty

A closed rhinoplasty hides the surgical incisions inside the nose and leaves no visible scars. The soft tissue of the nose is lifted slightly upward, making the nasal structures accessible to your surgeon. The techniques your surgeon uses on the internal structures of the nose are similar to those used during an open rhinoplasty. Because closed rhinoplasties usually cause less swelling and bruising, recovery time is nearly always minimal.

Augmentation Rhinoplasty

Sometimes meeting your rhinoplasty goals requires your surgeon to use materials to fill hollows or improve the appearance of nasal deformities such as humps. Sometimes augmentation materials are employed to correct functional abnormalities. Augmentation can also provide additional reinforcement to the nasal cartilage. Common augmentation materials include silicon implants, Gore-Tex surgical mesh or patient-derived cartilage implants. Augmentation can take place during either open or closed rhinoplasty procedures.

Filler Rhinoplasty

Filler rhinoplasty is a a non-surgical outpatient procedure. No incisions are made during filler rhinoplasty. Injectable fillers such as Juvederm and Restylane are locally injected to correct minor imperfections in the nose. Changes made during filler rhinoplasty are not permanent. Recovery time is minimal. In rare incidences, minor scarring and blood vessel obstruction have occurred. Over time, the filler absorbs back into the skin, making repeat procedures necessary to maintain the cosmetic goal.

Revision Rhinoplasty

Sometimes patients come to us seeking to improve or repair the results of a previous rhinoplasty. Revision rhinoplasty is always a subsequent surgery. This procedure is often performed to address functional problems created by the primary surgery. Revision surgery can also seek to improve or “touch up” the cosmetic changes made during a previous surgery. Sometimes successful revision rhinoplasty requires the surgeon to address both functional and cosmetic deficiencies. Successful revision rhinoplasty requires more advanced surgical skills and experience than any other type of rhinoplasty.

Rhinoplasty is one of the most common cosmetic surgeries, but it is also considered one of the most challenging facial cosmetic procedures to successfully perform. Dr. Louis DeJoseph, M.D. leads the team at Premier Image Cosmetic & Laser Surgery. He is triple board certified in facial plastic surgery, reconstructive surgery & laser surgery. He has performed numerous rhinoplasty in Atlanta, GA and is often heralded as one of the county’s most gifted facial plastic surgeons. His reputation for excellence has made him the surgeon that many other doctors refer their clients to. Many physicians have even chosen Dr. DeJoseph to perform their personal rhinoplasty surgeries. Dr. DeJoseph’s work is a testament to his skill. Most of his patients come to him through referrals from his former patients. You can learn more about Dr. DeJoseph here:


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