PLANNING

During your initial consultation with Dr. Kolker, he will thoroughly discuss your desires and expectations for rhinoplasty surgery. He will conduct a thorough examination of the inside and outside of your nose, as well as of the rest of your face. As facial harmony is the goal, a balance between the nose and other facial features is of paramount importance in rhinoplasty. With the aid of digital photography and computer imaging, together, you and Dr. Kolker will carefully plan the combination of rhinoplasty techniques that will help you to achieve your most natural and desired result. Dr. Kolker will carefully review the rhinoplasty procedure, or combination of procedures, that suit you best. Dr. Kolker will answer all questions that you might have regarding any step of the rhinoplasty process.

PROCEDURE

During your rhinoplasty procedure, small incisions are made within the nostrils that allow access to the structural framework of the nose. In rhinoplasty cases where the only requirement is a small modification of the hump or bump on the bridge of the nose, an internal approach rhinoplasty, which is a rhinoplasty with incisions placed within the nose only, can be performed. More often, when a combination of rhinoplasty refinement techniques will be required to restore balance and proportion to the nose, Dr. Kolker favors an open rhinoplasty approach (open structure rhinoplasty) to more meticulously address the very delicate anatomy of the nose. An open rhinoplasty is performed with the addition of a tiny incision between the nostrils (on the columella) in addition to the internal rhinoplasty incisions concealed within the nose. A rhinoplasty is performed with a combination of techniques tailored to your specific anatomic guidelines and individual goals; the profile of the nose can be lowered or elevated, the structure of the nose can be narrowed and sculpted by performing an osteotomy (a thin, controlled fracture), the tip may be refined by the sculpting and removal of existing cartilage, or by the addition of cartilage grafts. A droopy nose can be lifted during rhinoplasty, and a bulbous tip may be reduced. Under certain circumstances during rhinoplasty, a graft of cartilage from within the nose (such as the septum), or from another part of the body (such as the ear) may be used to improve the final shape of the nose during rhinoplasty. A splint will be placed outside and occasionally inside the nose following rhinoplasty. Dr. Kolker rarely uses packing inside the nose after rhinoplasty, although those individuals requiring more work on the internal valves or septum within the nose during rhinoplasty may require the placement of packing that is removed approximately 48 hours after your rhinoplasty. Dr. Kolker will recommend the individual rhinoplasty technique, or combination of rhinoplasty techniques, which suit you best. A rhinoplasty in New York is performed in Dr. Kolker's office-based surgical suite, accredited by the American Association for the Accreditation of Ambulatory Surgery Facilities (AAAASF). The rhinoplasty procedure takes between two and three hours, depending on the degree of refinement you require.

RECOVERY

Following rhinoplasty surgery, you will go home on the same day with a friend or family member. Mild swelling and bruising, beneath the eyes in particular, are expected after a rhinoplasty, and generally resolve after seven to ten days. The period of bruising and recovery may be slightly longer when an osteotomy is performed during your rhinoplasty. Cold compresses will be applied for comfort and to minimize swelling. Most swelling resolves within several weeks following rhinoplasty, at which time you will be very presentable, but final settling and shape will be apparent at six months to a year following rhinoplasty. Sutures placed inside the nose during rhinoplasty are all dissolvable, and any sutures beneath the nose between the nostrils (in the columella) are removed approximately five to seven days following rhinoplasty. In the rare instances when Dr. Kolker uses packing during rhinoplasty, it is removed after approximately 48 hours. Dr. Kolker suggests taking seven or eight days off work following a rhinoplasty, however many are able to return to work after five to seven days (particularly with a tip-refining rhinoplasty, or a rhinoplasty that does not involve osteotomies). Light aerobic activity (elliptical or Precor, light treadmill walking, stationary bicycle, recumbent bicycle) may be resumed as early as five to seven days following rhinoplasty, and more strenuous activity is begun at two to three weeks. Your relationship with Dr. Kolker does not end after rhinoplasty surgery; he will see you often through the first weeks and months following your rhinoplasty, and will advise you on all matters in your recovery.

RELATED PROCEDURES

Rhinoplasty is most often performed as an isolated procedure. A septoplasty, turbinectomy, or internal valve reconstruction (which are functional procedures within the nose) may be advised and performed at the time of rhinoplasty to improve pre-existing functional impairment of the nose. As rhinoplasty is geared primarily to achieve facial balance and symmetry, occasionally, a chin augmentation (chin implant) may be suggested by Dr. Kolker, and can be combined with your rhinoplasty procedure as indicated. For those individuals who desire additional plastic surgery or cosmetic surgery enhancements, your rhinoplasty may also be combined with fat transfer (autologous fat grafts), or blepharoplasty (eyelid lift).

If you would like to learn more about having a rhinoplasty in New York, and about the rhinoplasty techniques that will suit you best, we invite you to meet with Dr. Kolker for a private consultation at our office, located at Park Avenue and 70th Street, by calling 212-744-6500, or by scheduling an appointment online.