“I will do a rhinoplasty, a nose job on this lady who is asleep now. She has a big bump on her nose, it is a wide nose, a wide tip, droopy, so we are going to take the bump off, thin out the nose, thin out the nasal tip, and bring it up a little, and she will be very happy.”
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About Closed Rhinoplasty
“So what I am going to do is it is a closed rhinoplasty. By that I mean I am not going to make any external cuts, not going to create any scars on the outside of the nose to make it look like Michael Jackson. It is all going to be done by getting the exposure to do all the work internally – inside the nose, then close that with dissolvable stitches so there is no packing the nose afterward.
The patients have very little to no swelling. They have a little cast on the nose, but after a few hours when the anesthesia wears off, they can go out of the surgery and do whatever they want, it is fine. They can go to work, they just have a cast on the nose.”
The Procedure
“What I have done so far is I have exposed the bottom in the midline nasal septum, which is in the middle, separating the left side and right side. I got the corner end of the cartilage here and the upper part of the cartilage here. And now I want to get exposure of the bone up here by peeling off the periosteum and lifting up all the soft tissue from the bone itself.
So I elevated the periosteum fibrous tissue of the nasal bones and, yes, all this chin from the bone itself and the hump is also the bone right up here, and cartilage. The hump is part cartilage and part bone and you will see when I take it out.
Right now, I am going to work on the lower third of the nose. The lower part of the nose being cartilage. This is what makes the nose, the lower third of the nose. This is a nasal valve actually, it is cartilage that helps the airflow in the nose, and this does not have the same structure as the nose itself. If you take this out completely, you will have a deformity but also a collapsible nose. So what I am doing here is taking out a little trim, it narrows the nasal tip itself.
So you can see what I have done already. Compared to the right side, the left side is much narrower, thinner, and less prominent, so I would do the other side, all right?
I am going to cut the cartilage hump and this will majorly change her nose okay. So now we are going to take down this hump she has. I did the boning of the cartilage hump – this is where it was right here. I have brought the tip up, I took out the bump, and I thinned out the lower part of the nose. I am going to thin out more when I bring the nasal bones together, and for that, we will break the nose.
See, it is already so much improved! Isn’t it? You look at it, how nice it looks.”
The Results
“Now just smoothing the surface, the top surface out. It is a little swollen, but look how nice it looks. I hoped to give her a very natural-looking, non-surgical look because I am tired of seeing people running around Beverly Hills with these noses that look like they are ten percent of what they had. They look so fake and are turned up and ridiculous.
I try to give her a nose that looks like it belongs to the face, and I think there is a very strong nose with good dorsal, and most people are going to look at it and not know really what she had done but know that she looks better, and that is my philosophy. She has a strong bridge of the nose, it is not taken down to be a nothing bridge, and she has a much narrower tip but still, it is a good tip that fits her face, and the tip is elevated, it is not droopy like it was before. So she is done! That is good.”
