Rhinoplasty

If you are considering changing something about your nose, you are not alone. A rhinoplasty, also known as a “nose job”, is one of the plastic surgery procedures most commonly performed in the United States. Rhinoplasty normally ranks third after liposuction and breast augmentation.

Where to start

If you are considering a rhinoplasty, it is important that you carefully determine what changes you would like to see in your nose.  In order to evaluate your own nose, you have to see it within the whole picture, i.e. your face. This is because your eyes and your nose are the central point of attention when someone looks directly at you. After that, the gaze quickly turns towards the mouth, the cheeks, forehead and finally your face as a whole.  A rhinoplasty surgeon is trained to evaluate the nose on its own, as well as its proportions within the face.

Determine what you would like to change about your nose

Take a look at yourself in front of the mirror or take a picture of your full face.  Start by seeing and palpating your nose at its root, from the top of the nasal bridge.  You will feel the hard nasal bones which surgeons refer to as the nasal pyramid because they are actually hollow.  During a rhinoplasty, the nasal bony pyramid can be made narrower at its base. Also the top can be modified in every dimension; it can be made more narrow or wide, increased in height, or the opposite, reduced by rasping a bony dorsal bump.  Continue palpating your nose and you will feel a step-off where the nose becomes more flexible and movable.  This is all cartilage, all the way down to the nasal tip but it does not extend to the nostrils on the sides.  Again, during a rhinoplasty in the nasal tip can be modified in every dimension.  The tip can be made less bulbous, less boxy and better defined.  If you have already had a rhinoplasty, sometimes the opposite has to be done and the tip has to be widened because it has been overly narrowed (this is called a pinched-tip deformity).  If you see a picture of your face in the side view, imagine what your nose would look like if the tip was pushed upward, or rotated downward. Also determine whether the entire nose sticks out too much or too little. Below you will find before and after pictures of patients who underwent rhinoplasty. Make sure to read the picture comments as each patient’s requests are different and unique.

Rhinoplasty Case #1


This 17 year old patient is shown before and after open rhinoplasty. She requested narrowing of nasal bridge and refinement of nasal tip with slight upward rotation. This change brought her better facial harmony with a more feminine nasal profile.

Rhinoplasty Case #2


40 year old patient is shown before and after open rhinoplasty. He desired improvement of nasal tip and requested refinement. During evaluation it was noted he also had slight asymmetry between his nares. The post-op views show the nasal tip has been refined and is no longer bulbous while improving his asymmetries. On side view, the nasal tip was turned upwards modestly while leaving a masculine nasal profile.

Rhinoplasty Case #3


19 year old patient is shown before and after open rhinoplasty. She requested reduction of large dorsal hump and over-projection without much change in her front view. The patient liked her nose in front pictures so the tip was only modified enough to achieve harmony in her nasal profile with a more feminine silhouette.

Rhinoplasty Case #4


This 24 year old patient is shown before and after open rhinoplasty. He requested improvement nasal profile with reduction of dorsal hump, refinement of nasal tip with upward rotation. The post-op views show the nasal bridge has been narrowed and the nasal tip refined. On side view, the nasal tip was turned upwards modestly while leaving a masculine nasal profile.

Rhinoplasty Case #5


23 year old patient is shown before and after open rhinoplasty. She requested refinement of her nasal tip with upward rotation. The post-op views also show narrowing of the nasal bridge, improvement of dorsal hump and her nasal length is slightly shortened. This operation gave her better facial harmony with a more feminine nose.

Rhinoplasty Case #6


41 year old patient is shown before and after open rhinoplasty. He had a history of multiple traumatic blows to the nose and it was deviated. He requested improvement of the deviation as well as slight dorsal hump reduction and softening of the nasal tip.

What to expect during a Rhinoplasty consultation

During your consultation for a rhinoplasty, you will initially meet with a medical assistant who will review the paperwork you fill out containing a full medical history. This is important information that will be used to determine whether you are a good operative candidate. Next, you will be able to discuss your observations and goals with Dr. Cocco, who will in turn give you an honest opinion and help you understand your options. This initial meeting should treated as a two-way interview. It is just as important that you agree and understand the recommendations given to you, as Dr. Cocco must feel she understands your expectations and is confident she can help you achieve your goals. Once a full understanding between doctor and patient is reached, a proposal will be generated and the decision to proceed with surgery will be made jointly.

What to expect after setting a surgery date

Details of the surgical process, such as pre/post surgery instructions, informed consent, surgery center requirements and financial obligations will be fully discussed days to weeks before surgery. As a patient, we want you to feel positive about your upcoming surgery, including being comfortable with your surgeon and confident of your decision to move forward.

Rest assured, the aftercare will be personally directed by Dr. Cocco. There will be a series of postoperative appointments scheduled for the following year and it is important that you follow all instructions for optimal healing. The nose is one of the few areas in the human body that can take months to fully heal. Even though the results will be immediately appreciated, it takes time for all swelling to subside and the process of scaring to fully mature. We are happy to walk you through the process and look forward to meeting you in consultation.

To find out if you are a candidate for this procedure, contact our office to make an appointment to be evaluated in person and given a professional opinion.

Dr. Cocco | Jennyfer Cocco, MD

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