San Diego Rhinoplasty Specialist

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Rhinoplasty (Nose Surgery) Information

Nasal Plastic Surgery (Rhinoplasty) or "nose job" involves changing the bone and cartilage framework of the nose in order to improve its outside appearance. Patients often seek this type of surgery due to concern that their nose is out of harmony with the rest of their face. The nose may be excessively large (or small), crooked, or may contain an unwanted hump or other deformity. Generally speaking, an attractive nose is one that draws attention to the person's eyes, rather than to the nose itself.
Our practice specializes in various aspects of rhinoplasty and Dr. David commonly performs 15 or more rhinoplasties per month. You are invited to visit our ethnic rhinoplasty and revision rhinoplasty pages.
Rhinoplasty is a delicate operation, and requires careful planning and meticulous technique. The end result, however, can be extremely gratifying for both patient and surgeon.
Examples of Nasal Surgery

It is important to remember that rhinoplasty surgery is part art and part science. The artistic part involves the surgeon listening to his or her patient's desires for improvement, and then meshing these desires with his own aesthetic standards and skill to obtain the best possible result. The goal is to create an attractive, aesthetic nose that is in balance with the face, but will also be natural-looking. The science of rhinoplasty involves creating a nose that will withstand the test of time and maintain its structural integrity, as well as its functionality as an organ of respiration.
The Rhinoplasty Consultation
At your consultation, you will meet our patient care coordinator Amy, who will strive to make your visit as enjoyable and informative as possible. Photos will be taken for medical record purposes, and you will then meet with Dr. David for an in-depth examination and discussion.
Computer imaging is a very useful tool we use in our San Diego office to enhance patient understanding and to set realistic goals. Using the computer, we are able to show our rhinoplasty patients what they may look like after surgery, and this generally leads to greater satisfaction with the results. Please note: all before/after pictures in this website are actual and unretouched patient photos.
Occasionally, patients may benefit from adjunctive procedures such as chin implant or cervical (neck) liposuction to further enhance the profile:

In planning your rhinoplasty, it is important to take into consideration the need for any functional surgery to correct blocked breathing passages in the nose. This may relate to a deviated nasal septum, hypertrophy of the nasal turbinates, or inward motion of nasal sidewalls with respiration (nasal valve collapse). If such a problem exists, this portion of the rhinoplasty may be covered by your insurance.

In many cases the rhinoplasty can be performed with no external incisions. If the nose requires advanced tip sculpting, or reconstruction of the middle third of the nose, you may be a candidate for "Open Rhinoplasty." The open approach involves making a short incision along the bottom part of the nose which allows direct visualization of the nasal components. This open rhinoplasty incision generally heals with an imperceptible scar which is of no concern to the patient. An experienced facial plastic surgeon is equally comfortable with an "open" or "endonasal" approach, and Dr. David will choose whichever approach best suits your nose.
The rhinoplasty procedure may take from one to three hours, and is usually performed on an outpatient basis at our fully staffed, AAAASF certified surgical facility. Most of our San Diego rhinoplasty patients will go home that afternoon, however some who travel a distance prefer to stay overnight in the nearby Radisson hotel. Anesthesia for facial plastic surgery is usually a general anesthesia or IV sedation, depending on patient preference and length of the procedure.

Upon awakening from surgery, your nose will be covered with a firm external splint, which functions to hold the nasal bones in place and to protect the nose. The splint will remain in place for one week. While pain is normally quite minimal, all patients receive pain medication, as well as a brief course of antibiotics and medication to reduce swelling. Breathing is generally stuffy the first night, but the next day you will return to our San Diego office for a brief post-op visit and a small bit of gauze is removed from the nostrils. You should then be able to breathe comfortably.
Many patients are able to return to work or school after two to three days, however most prefer to take a week of vacation around the time of surgery. While you should expect some post-surgery swelling and occasional bruising after rhinoplasty, your nose will be very presentable at one week. Post-operative swelling or edema will largely resolve over the first month, however you may notice subtle changes for up to 3 months and occasionally up to one year after surgery.