Rhinoplasty (Nose Job)

• Dr. Linkov is a double board-certified by the American Academy of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology-Head & Neck Surgery.
• He is a dual Ivy League-educated facial plastic surgeon who completed an accredited American Academy of Facial Plastic and Reconstructive Surgery fellowship.
• He has an artistic background paired with an Ivy League medical education, granting him a unique combination of skill and talent tailored for the field of facial plastic surgery.
• He is a prolific clinical researcher with over two dozen publications that have had a significant impact on the fields of Tissue Engineering, Head and Neck Cancer, and Facial Plastic Surgery.
• He is proud to be an adjunct assistant professor at New York University teaching rhinoplasty.
• He is included in the prestigious Super Doctors New York, Rising Stars™ listings and was featured on the Dr. Oz Show.

Rhinoplasty is a nose plastic surgery that alters the bone, upper lateral cartilage, and/or lower nose cartilage. Your NYC nose job specialist recommends that he perform both functional and aesthetic nose jobs at the same time.

Functional rhinoplasty

When combined, functional rhinoplasty can address several medical conditions at once, including:

• A breathing or sinus issues
• Deviated nasal septum
• Imperfections from a skin cancer cure
• Breaks that weren’t set properly

While many procedures, such as sinus surgery, can reshape your nose and improve its function, Dr. Linkov relies on advanced methods proven to be more effective. He’s received additional training in these new procedures and has performed them numerous times. When you call on a talented surgical artist like Dr. Linkov, the results are stunning, and your reshaped nose helps improve your health.

Cosmetic rhinoplasty

Patients seeking cosmetic rhinoplasty in NYC often describe a big, long nose or asymmetry as an issue that must be addressed. Issues that nose cosmetic surgery can address include:

• overly wide nostrils
• pinched or bulbous nasal tip
• pronounced bump or dip on the dorsum
• the nose is “too large” or “too long”
• tilted nose far to the left or right
• nasal asymmetry

Cosmetic rhinoplasty is one of the most common facial plastic surgery procedures performed at our facility. If you believe cosmetic nose surgery is right for you, contact Dr. Linkov, a board-certified plastic surgeon.

The best candidates for rhinoplasty in New York are non-smokers in good health. If your nose has matured or stopped growing, you can benefit from Dr. Linkov’s cosmetic nose reshaping. There is no upper age limit, but you must be medically and emotionally capable of undergoing surgery. Rhinoplasty can be performed as early as adolescence, though anyone under the age of 18 requires full parental consent.

The following are the minimum age requirements for a rhinoplasty NYC procedure:

• Girls can be as young as 15 or 16 years old;
• Boys can be as young as 17 or 18 years old;

Changing the appearance of your nose is a major decision that should not be taken lightly. You must have a strong desire for change as well as the maturity to make a wise decision.

You should not have a rhinoplasty nose job if you:

• Take blood thinners that you can’t stop taking;
• Have a medical condition prohibiting general anesthesia;
• Don’t have enough nasal cartilage;
• Have poor overlying nasal skin;
• Suffer from active vasculitis or Wegener’s disease that affects your nose;
• Have unrealistic expectations.

Rhinoplasty procedure may be beneficial if you aim at achieving one or more of the following effects:

• Change the size, shape, or angle of the nose;
• Fix issues associated with a deviated septum;
• Improve breathing function and sleep quality;
• Restore a broken or crooked nose;
• Reduce the nasal bridge or tip;
• Balance your facial features;
• Improve the appearance of the nostrils.

Dr. Linkov, one of the best New York rhinoplasty surgeons, will explain how this procedure can help you achieve your cosmetic and functional goals and will detail all aspects of the procedure during your consultation.

Prior to committing to the rhinoplasty cosmetic surgery, Dr. Linkov schedules two initial consultations, which can take up to 12 hours in total.

First Consultation

During your initial rhinoplasty consultation, you and your NYC nose job surgeon will discuss a variety of topics that may disqualify you.

Some of the factors that might potentially affect your candidacy include:

• Your health history;
• Medications you currently take;
• Any current health disorders;
• Current lifestyle habits, such as smoking and exercise routines.

Second Consultation

During your second appointment, you must explicitly outline your surgical goals. This is your chance to voice any cosmetic or functional imperfections you want to address. Dr. Linkov performs an in-depth facial evaluation, including an assessment of your nose’s six parameters to determine whether your goals are realistic.

Additionally, your doctor uses digital imaging computer software to take pictures of your nose from eight various angles. You can see what your nose might look like after surgery in a 3D simulation. You aren’t given any pre-operative simulated images before surgery to avoid strong mental fixation on a projected outcome. The computer image does not guarantee your post-surgical outcome. Rather, it serves as a guide for Dr. Linkov during surgery. Most plastic surgeons use digital imaging equipment, which is freely available. Dr. Linkov believes that the simulated result can be fully achieved or approached.

The best surgical approach depends on the preferences of you and Dr. Linkov. Both methods are acceptable to your doctor. Unless you require a more complex nose reconstruction, he guides you through the process of selecting the best one for your specific case. The following are the differences between the two procedures:

Closed rhinoplasty

It is called an endonasal approach and this technique:

• Involves no visible incisions. Dr. Linkov makes the incisions inside your nose.
• Limits what your surgeon can see, which is why this technique has become less popular.
• May allow your surgeon to better judge the outcome during the surgery because the nasal skin remains in place.
• Often causes nasal tip swelling if the tip is manipulated.

Open rhinoplasty

It uses an external approach, with a small incision made at the mid-columella, close to the base of your nose, with a few internal incisions. This technique:

• Allows for more complex reconstruction.
• Provides greater visibility for your surgeon.
• May leave more swelling after surgery.
• Has a rare risk of poor scarring at the external incision site.

Once you’ve decided to undergo nose surgery, Dr. Linkov gives you the following preparation instructions:

• Avoid blood-thinning drugs and supplements such as aspirin, ibuprofen, naproxen, vitamin E, garlic, ginger, ginseng, St. John’s wort, ginkgo, and black cohosh.
• Stop smoking at least two weeks before surgery, as tobacco products decrease blood flow to your skin, slowing the healing of your surgical site.
• Discontinue all nasal sprays two weeks before surgery, except for saline.
• Pick up the prescribed medications you’ll need after surgery, such as an antibiotic and pain medication.
• Arrange for someone to accompany you home and stay with you for at least the first night.

On the day of your nose job surgery, you:

• Cannot eat or drink six hours before the procedure.
• Change into a surgical gown.
• Take a pregnancy test if you’re a woman of child-bearing age.
• May spend about an hour for the intake process.

Dr. Linkov completely reshapes your nose while you are under twilight or general anesthesia. Simpler procedures, such as a nostril reduction or reduction rhinoplasty, can be performed with only local anesthesia. Anesthesia ensures that your comfort is maximized, movement is restricted, and airways are protected. Rhinoplasty nose reduction typically takes two to four hours. You spend another hour in recovery.

What is reduction rhinoplasty?

Reduction rhinoplasty is a cosmetic procedure that involves reducing the size of the nose. There are two types of nose reduction surgery:

• The surgery that focuses on reducing the overall size of your nose;
• The surgery that focuses on particular parts of the nose, such as the nasal tip or a dorsal hump.

The major steps of the surgery include:

• Exposing the underlying structures. Your surgeon makes certain incisions to safely expose the necessary septal cartilage and bone without disrupting the blood flow or damaging these underlying structures.
• Sourcing cartilage as a building material. Grafting materials used in a nose job can be obtained from one of four sources:
  • Autografts, from somewhere else on your body;
  • Homografts, from another compatible human donor;
  • Xenografts, from another species;
  • Alloplasts, from a synthetic source.
• The cartilage building material typically comes from your own nose, ear, or rib. In general, using your own body tissues lowers infection rates and makes the cartilage graft more stable.
• Grafting. Dr. Linkov expertly carves and places the necessary grafts into your nose’s inner structure to suit your needs.
• Manipulating the bones. Your doctor makes controlled cuts in the nasal bones and parts of the cheekbones that allow him to reset the structures. The cuts help straighten your nose, providing a solid and aligned foundation for your new nose.
• Closing up. After your surgeon has made all of the necessary changes to the bone and cartilage, the skin and soft tissue envelope is redraped over your nose and sutured closed. Dr. Linkov uses a combination of dissolvable and non-dissolvable sutures.

The length of your recovery depends on the extent of your nose job procedure. Following your surgery, you will go through a short-term healing phase before entering the long-term healing phase. A multitude of personal factors influences how much time you spend in each phase.

The short-term healing phase lasts from a few days to a few weeks after your NYC rhinoplasty procedure. More complicated surgeries necessitate two to three weeks of recovery while the swelling and bruising subside. Common, anticipated conditions occur in the short-term phase, all of which normally resolve within a couple of days or over the first few weeks.

Depending on the peculiarities of your case, you might experience the following side effects:

• Bruising;
• Redness;
• Swelling;
• Bleeding;
• Nasal obstruction;
• Some pain.

To ensure the best result, you should take several precautions during the short-term healing phase, such as:

• Apply an antibiotic ointment and scar gel on your external incision;
• Keep the external cast dry;
• Sneeze with your mouth open to avoid excessive force in your nose;
• Use a nasal saline spray five times a day, starting 48 hours after surgery;
• Don’t blow your nose for the first week;
• Avoid vigorous exercise for at least one week after surgery;
• Avoid participating in contact sports for at least six weeks;
• Attend a follow-up appointment as directed to remove the sutures, splint, and cast.

The long-term healing phase starts several weeks to months after your rhinoplasty NYC surgery. The length of time you spend in this phase depends on your health and the extent of your surgery.

You must follow your surgeon’s instructions during this period to maintain the results of your surgery. In general, you can expect:

• Final results about one year after your surgery;
• Your doctor to schedule follow-up appointments to monitor your progress;
• To have to wait for the longest to see swelling on the tip of your nose improve;
• Steroid injections to be used if needed to control the swelling.

Aging can also have an impact on your long-term rhinoplasty results. As you become older, the tip of your nose weakens, creating a droopy appearance. Dr. Linkov conducts tip rhinoplasty to permanently secure the tip and limit its ability to droop.

Cosmetic improvements are never covered by insurance, but breathing problems, which are medical reasons for a nose job, may be. Insurance companies are becoming less likely to cover a rhinoplasty nose job. You may have to wait three months before getting a decision from your insurance company. Plastic surgeons’ appeals are often necessary to secure coverage.

Photos often need to be sent to insurance providers in order to justify the need for a functional nose job. Many New York rhinoplasty surgeons, including Dr. Linkov, are strictly out-of-network. That means your policy must contain out-of-network benefits in order for your insurance company to compensate you for nose surgery. Regardless, facial cosmetic surgeon fees are often required in advance of surgery.

The cost of a nose job surgery in NYC is a combination of several factors, including a surgeon’s fee, facility fee, and anesthesia fee. These are sometimes reported as a combined fee in certain offices. In other cases, these are broken down into their components. In New York, the current range for rhinoplasty is between $5000 to $25000, plus the additional fees for the operating room and anesthesia.

Revision rhinoplasty surgery costs are typically 20% to 30% higher for the surgeon’s fee.

The cost of a nose job will vary by:

• Location;
• Experience of the surgeon;
• Demand for the surgeon;
• The anticipated complexity of the surgery.

As an alternative to surgical rhinoplasty, some patients opt for liquid rhinoplasty, also known as nonsurgical rhinoplasty, which involves injecting dermal fillers (such as Restylane) into specific areas of the nose to achieve cosmetic changes. These nonsurgical nose job outcomes are temporary and limited in what can be achieved.

No, not exactly. Rhinoplasty and septoplasty can all be performed separately. The most common scenario is that they are performed together because the septum is the most common source of cartilage for a nose job and often has to be addressed for cosmetic and functional concerns. Septorhinoplasty is a treatment that combines the two procedures.

The literature-reported satisfaction rates after rhinoplasty surgery are in the 80-90% range. The rates are lower in men compared to women. These findings highlight the difficulty of nose job surgery and the importance of finding the best plastic surgeon who performs many of these surgeries every year.

Some plastic surgeons, including Dr. Linkov, use computer renderings of what the nose might look like after surgery to help guide patient decision-making. The most crucial thing is that both the doctor and the patient agree on the aesthetic goals. Please remember that the computer image is not a guarantee of what will follow after surgery, but rather a framework for the surgeon to work with during the procedure.

Rhinoplasty is the technical term for a nose job. A nose job is a blanket term for any surgery involving the nose, but it is most commonly used to indicate a rhinoplasty or septorhinoplasty. The term “nose job” does not encompass the whole range of nose surgeries. Nasal reconstruction, for example, can be done after the skin cancer has been removed, and septoplasty surgery can be done separately to address a deviated septum without involving any other nasal structures. Rhinoplasty specifically describes nose plastic surgery that alters the bone, upper lateral cartilages, and/or lower cartilages of the nose.

You should be able to return to work a little more than a week after surgery. However, there may still be some swelling and reddish incisions.

Dr. Linkov will use an external splint to keep your cartilage and bone in place while they heal. The splint will help minimize swelling and protect your nose’s new shape. Internal splints may be used by your doctor to offer support within the nose and to stabilize the reshaped septum after septoplasty. Internal and external splints are usually left in place for one week following surgery.

Dissolvable stitches are often used internally to keep the lining in place during healing and may take many weeks to completely break down. Non-dissolvable sutures are commonly used on the outside of the nose and should be removed within 5 to 7 days after treatment.

Bruising is common following surgery and can last anywhere from two to three weeks. Most swelling in the nasal tissues will usually subside within two months. However, depending on your procedure’s complexity, it can persist for a year or even longer, typically in the tip of the nose. We use delicate surgical techniques and Arnica Montana to decrease the extent and the intensity of swelling and accelerate postoperative healing.

Rhinoplasty makes your nose’s blood vessels extremely sensitive, and exercising too soon after surgery can result in bruising, nose bleeds, and other postoperative complications. Hence, you should avoid any exercise other than light to brisk walking for at least one week following your surgery. Within three to four weeks of the treatment, you can gradually resume gentle, non-contact exercises.

Yes. Dr. Linkov has a profound understanding of nasal structure as well as the exceptional surgical technique required for secondary rhinoplasty. If you’ve failed to achieve a satisfactory result with a previous surgeon, Dr. Linkov can develop a customized plan based on your anatomy, medical history, and the results of a primary procedure to produce the remarkable and natural outcomes he’s always been known for.

There are various anatomical differences between men and women. Men tend to favor more prominent nasal structures, such as a strongly defined straight angle nose (an approximate angle of 90 to 95 degrees between the nose and upper lip). Women, on the other hand, prefer a much more subtle and softer appearance with a slightly upturned nasal tip (95 degrees or more angle between the nose and upper lip) and a slight dorsal hump. When combined with thinner skin, these characteristics of the female nose result in sharper, more delicate nasal features. Eventually, rhinoplasty is a procedure tailored to an individual patient, and regardless of what characteristics are regarded as “normal” for each gender, the procedure should be customized to your exact needs and goals.