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Why Rhinoplasty?

Your nose plays an important role in communicating your overall attractiveness and the character of your face. It also reflects your genetics and past trauma. By virtue of its location, the nose is very important to facial aesthetics. Dr. Shermak’s goal in rhinoplasty is to create better balance between the nose and face.

Some patients only need small changes while others desire more dramatic changes. Few people are born with a perfectly shaped nose that is optimally balanced with the rest of their facial features. Individuals desire to smooth a hump, straighten a crooked shape, refine a full tip, thin the width, repair flaring nostrils, and correct breathing problems relating to a deviated septum or collapse.

Even if what we perceive as an abnormality is relatively small, it can weigh heavily on our self-confidence. If you do not like the way your nose fits your face, the lack of confidence in your appearance can take a heavy toll on your life.

Rhinoplasty may be one of the most exacting and personally satisfying procedures that exists in cosmetic plastic surgery. Rhinoplasty incisions are hidden under or inside the nose. You can gain improved confidence with natural, customized results where your family and friends may not even notice that you had surgery. They will know you look great, but not be able to put their finger on why! This is the hallmark of a well-executed, natural approach to nasal shaping.

Who is a good candidate for rhinoplasty?

Rhinoplasty is performed on teenagers and adults who are unhappy with the appearance of their nose, who have suffered traumatic injury to their nose, or who have functional breathing problems. Dr. Shermak will review your history and presentation, and discuss ways she can help.

Dr. Shermak is an expert in assessing the ratios and proportions of what constitutes the ideal nose for each individual patient.

Dr. Shermak understands there is a significant relationship between how a nose looks and how it functions. A deviated or crooked nose will not be aesthetically pleasing, but may also indicate that the nasal airways are compromised. Correcting these problems can dramatically improve both the look and function of the nose.

Men vs. women

Men have different expectations than women when describing their perfect nose, so communication is important when developing the surgical plan. It is critical to maintain a masculine aesthetic while making the changes the patient desires. Usually the changes are intentionally more modest in men. Improving their appearance and function without feminizing the outcome takes a nuanced approach.

Injectable rhinoplasty

There is a small patient population who are seeking very subtle changes and are not convinced they want surgery. Using temporary fillers will simulate the changes they can expect with surgery to a certain degree. As the product slowly dissipates over perhaps a year, the patient can determine if a more permanent correction would make them happy. It’s a low risk way to “try on” a result, but the vast majority of rhinoplasty patients would not be candidates.

Are all rhinoplasty operations performed the same way?

Every rhinoplasty performed by Dr. Shermak is tailored to the patient. There are many, many techniques, so selecting the right one is a big part of the consultation process. Dr. Shermak is knowledgeable in a variety of approaches and will choose the method that will achieve the most attractive and functional outcomes.

Details of the procedure

Dr. Shermak performs rhinoplasty surgery under general anesthesia. Surgery is performed at our outpatient medical facility, and patients go home after surgery is done. Surgery typically takes 1-3 hours depending on the extent of the rhinoplasty procedure performed.

Dr. Shermak prefers the open versus the closed approach for her rhinoplasty procedures. The difference is a small incision on the columella (bridge between the nostrils) that is inconspicuous when healed. This approach provides ultimate control and visibility.

Dr. Shermak believes the risks are too great to practice “blind maneuvers” and leave the result to chance. Without benefit of full vision, you can inadvertently disrupt bone, cartilage and soft tissue attachments. Being a procedure involving millimeters, control is essential to feel confident everything humanly possible was accomplished.

Dr. Shermak is not only technically superb, she is a visionary as well. Every dimension and proportion is planned ahead of time. It is not the same surgery for every patient. Every alteration influences another structure, so a precise operative plan is essential.

So you’ve had rhinoplasty before and you need improvement?

Revision rhinoplasty can be a much more difficult operation for both the surgeon and patient. It is no longer a virgin nose. Essential tissue may have been destroyed, and restructuring may require grafts from other parts of the body. This underscores the benefit of getting it right the first time.

Can septal deviation be treated during rhinoplasty?

Absolutely! Many people have a deviated septum that leads to a decrease in airflow through the nose. Sometimes people are born with this, while others suffer from secondary trauma. Septal deviation may be visible from the outside with asymmetry seen through a worm’s eye view up the nostrils, or may be visualized only by looking inside the nose during an exam.

The septoplasty work will help provide some cartilage for other aspects that enhance the rhinoplasty procedure, providing contour, symmetry, and support across the top of the nose, in the nasal tip or in the columella. The septal work may also help reduce the cost of the cosmetic work when the surgeries are performed at the same time.

What is the recovery like for rhinoplasty?

Rhinoplasty surgery is performed on an outpatient basis. Tapes and a splint are placed across the back of the nose, and there may be packing or stents in the nostrils. You may experience temporary swelling, numbness, discomfort, and bruising that respond well to head elevation, ice packs, saline spray and Arnica Montana herbal supplementation.

Most clients resume non-strenuous activities and return to work within a week. Depending on the rhinoplasty surgery performed, swelling may take one month to a year to completely resolve. And while there may be swelling, cosmetic improvement will be visible from the moment the dressings are removed.

Are there ways to reduce bruising after rhinoplasty?

Gentle surgical technique, ice, and avoidance of blood thinners are the best ways. Some patients may take Arnica Montana, Bromelein, pineapple extract or other homeopathic remedies just prior to and after surgery, which may help.

Rhinoplasty recovery tips

Prior to surgery, minimize blood thinning medications (ibuprofen and vitamin E, for example) and start oral Arnica 2 days prior to surgery to reduce postoperative swelling and bruising. A daily multivitamin improves health and healing.

Postoperatively, ice packs help reduce swelling and bruising. The best ice pack is frozen vegetables in a baggie. Nasal saline spray keeps the nostrils moist. Nasal congestion medications like Sudafed improve postoperative comfort as well. Sleep with your head elevated above the level of your heart, propped up on pillows. A recliner may be a good initial place to sleep. Avoid wearing glasses with heavy frames for at least 2-3 weeks. Take a break from workouts for 2-3 weeks, as a rise in blood pressure will be uncomfortable.

Is rhinoplasty safe?

The procedure as a whole is safe from a medical standpoint, as long as the patient is cleared as an optimal candidate by her/his primary care physician and plastic surgeon.

How much does a rhinoplasty cost?

Since no two noses are alike, prices reflect the complexity of the procedure to be performed. If there is a functional component to the procedure such as nasal airway obstruction, that portion may be covered by insurance.

Next steps? Schedule a Consultation

There are varied skill levels even among board certified plastic surgeons. Not all are created equal, because not everyone gets the same type of training in rhinoplasty, nor do they have the same level of experience. Rhinoplasty demands a complete understanding of nasal aesthetics and function. Interview the doctor carefully to be sure you are a good match in terms of aesthetic sensibilities and artistic vision.

We invite you to call Dr. Shermak’s plastic surgery office in Lutherville at 410-324-6592 to schedule your personal, complimentary consultation today.

1304 Bellona Ave, Lutherville-Timonium, MD 21093

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