The Rhinoplasty Procedure by New York City’s Dr. Kassir

Rhinoplasty can reshape, reduce or augment the nose, remove a hump, narrow nostril width, change the angle between the nose and the mouth, or correct injury, birth defects, or other problems that affect breathing, such as those due to a deviated septum.
Dr. Ramtin Kassir also specializes in ethnic rhinoplasty, a great option for people of different ethnicities and backgrounds who are looking for a subtle change to their nose.
Here’s what you need to know now about rhinoplasty.

Rhinoplasty Defined

Rhinoplasty is a surgical procedure designed to reshape the nose. Sometimes referred to as a “nose job”, it can be performed to correct a structural deformity (such as a bump or hook), to improve your appearance by making subtle changes to nose size and shape, or to correct a functional problem (such as difficulty breathing due to a deviated septum).
The septum is the wall between the two nostrils. Composed of cartilage and bone, it divides the nasal cavity into halves. The ideal nasal septum is straight, separating the left and right sides of the nose into passageways of equal size. In contrast, a deviated septum occurs when the septum is shifted away from the midline. In severe cases, a deviated septum may cause difficulty breathing through the nose.

Are You a Candidate for Rhinoplasty?

Dr. Kassir will give you a list of instructions before you undergo rhinoplasty. In general, there is no eating or drinking after midnight on the evening before.

If you smoke, you should quit in advance of your nose surgery. Dr. Kassir will provide tools to help you quit. In addition to all the other negative health effects associated with smoking, it severely compromises blood flow to the skin. This means there is less oxygen to aid in wound healing, and necrosis (death) of skin can occur. Drinking alcohol during the week before rhinoplasty is also discouraged, as alcohol can also impair the healing process.
Dr. Kassir will also discuss discontinuing certain medications in the days or weeks leading up to your rhinoplasty. For example, non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin can increase the risk of bleeding. While considered natural, certain vitamins and herbal preparations such as Vitamin E, gingko biloba, omega-3 fatty acids and green tea can also increase the risk of bleeding. Never stop taking any medications without first discussing it with your doctor.

Dr. Kassir may prescribe homeopathic therapies before your rhinoplasty, such as arnica (an herb that can minimize bruising), or prescription steroids before rhinoplasty to decrease the initial swelling.

Key Rhinoplasty Statistics

In 2009 there were 138,258 rhinoplasty operations performed in the United States, according to statistics compiled by the American Society for Aesthetic Plastic Surgery.
Rhinoplasty is one of the top five cosmetic plastic surgery procedures performed each year.

The Procedure’s Specifics

Most rhinoplasties are performed on an outpatient basis in a hospital or our surgical suite. Exactly how long the procedure takes depends on the type of rhinoplasty that is performed. For example, a primary rhinoplasty normally requires one to three hours in surgery, while a revision rhinoplasty can take much longer. A filler rhinoplasty can take just 15 minutes.


Dr. Kassir will likely recommend local anesthesia with some sedation or general anesthesia for your primary rhinoplasty. A secondary rhinoplasty may involve general anesthesia due to the complexity of the procedure. A filler rhinoplasty requires just local anesthesia.

The Incision

Surgery on the nose is performed either using a closed procedure (where incisions are hidden inside the nose), or an open procedure (where an incision is made across the columella). Dr. Kassir then raises the soft tissues that cover the nose through these incisions. This provides access to reshape the structure of the nose.

The Reshaping

Dr. Kassir can reduce or augment nasal structures with cartilage grafted from other areas of your body. These pieces of cartilage can come from the septum or occasionally from the ear or the rib cartilage. If the septum was deviated, this should straighten it. In addition, any projections inside the nose will be reduced to improve breathing.

Closing the Incision

Once the underlying structure of the nose is sculpted, the nasal skin and tissue are redraped and the incisions closed. A cast or splint may also be applied.

Recovering from Rhinoplasty

You will probably be excited, if not anxious, to see your new nose, but patience is key after rhinoplasty. Complete results are not immediate and can take up to one year to be fully evident.

You may be unable to breathe through your nose for the first 24 hours due to swelling or nasal packing (if used). There may be some discomfort, which can typically be controlled with pain medicine. Most people who undergo rhinoplasty can stop pain medication after 48 hours. Some people may have an upset stomach after the surgery; anti-nausea medication may be helpful.

You may experience limited bleeding during the first few days. Dr. Kassir may also tell you to apply a cold compress to your nose to reduce swelling and to elevate your head for the first 24 hours. It is important to avoid any trauma to the nose during the first week after surgery. Blowing your nose is not permitted after rhinoplasty. This can be tough, as you may feel stuffy. Decongestants may help.

On about day seven, the cast or splint is removed. Your nose will still be swollen, but after two weeks much of the swelling will have decreased. At this point, all nasal packing, splints and other post-surgical dressings should be removed. A splint may be placed over the outer part of your nose to protect your nose as well as help it hold its new shape during the healing process.

By one month after surgery, approximately 85 percent of the swelling will have gone down. The remaining swelling may take up to one year to subside. For this reason, you should wait at least one year before undergoing revision rhinoplasty.

To schedule your rhinoplasty procedure with Dr. Kassir call 212.288.3000 today