Nora,
The answer is it would depend. I have done fat grafting for a nose on one occasion and it worked quite well, but it was a generalized depression from an injury and not a rhinoplasty defect. We would just have to look at your concerns and decide whether fat grafting would be an option. I have also used Restylane for post rhinoplasty defects. It works quite well, and while you do have to repeat the treatment it lasts about a year. Let us know if we can help you further.
Ed Buckingham
Jolie,
You can achieve natural results with either an endonasal or an open approach to rhinoplasty. The different approaches both work, but each should be used in the appropriate circumstances for that patient and according to the surgeon’s preference. There are surgeons who perform almost all of their procedures one way or the other. I prefer to use the endonasal approach in simple noses that require only a hump reduction with perhaps a little tip narrowing and in a nose that could also be made a little smaller, deprojected, and/or rotated a little. If a nose has significant asymmetry, needs more tip work, or needs to be projected or de-rotated then I prefer the open approach. I am also very careful to not over narrow the middle part of the nose which can happen in an endonasal rhinoplasty. If my patients have any narrowness to their nose pre-operatively and need a hump taken down, the narrowness will likely get worse and so I place what is known as spreader grafts. This will not only lead to a more natural result, but will also prevent functional and cosmetic problems years down the road.
Sorry for the long answer, but rhinoplasty is a very complicated operation and requires a little more thought than just a yes or no answer. Good luck with your decision.
Ed Buckingham
Mary,
Thanks for your question regarding rhinoplasty. It is absolutely possible to only address the bump on your nose. When you come in for your consultation, the first item we address is what concerns you about your nose. If your only concern is the bump, ie you love your overall size, tip etc. then we can easily address only the bump. On occasion you need to perform something called spreader grafting to be sure the the nose is not overly narrowed when the bump is removed, but this is not difficult and will not change your nose in any way other than to be sure that it looks natural and functions well.
Please review our before and after gallery. There are many different noses on the site and each one has been altered to meet the patients wishes. We do not try to make all of our nosed match one another, but rather to make alterations specific to each patient’s desires. We look forward to meeting you.
Ed Buckingham
Paige,
Thanks for your question regarding revision rhinoplasty. We perform about 75 rhinoplasties per year and about 150-200 nasal reconstructive cases per year. Of the 75 rhinoplasties about 15-20% are revision cases. So while I haven’t actually worked the numbers, over the years we have plenty of experience. I received my initial training in rhinoplasty in my residency in Galveston, TX where we had an excellent experience with rhinoplasty. I then performed a facial plastic surgery fellowship with Edwin Williams, M.D. in Albany,NY. Dr. Williams trained with one of the most world famous rhinoplasty surgeons to date, Gene Tardy in Chicago. I sought to obtain a fellowship with Dr. Williams because of the strong exposure to rhinoplasty. We performed several hundred nasal cases that year. Since the end of my fellowship I have continued to refine my techniques and participate in constant education in rhinoplasty. Rhinoplasty is my favorite procedure and I strive to achieve excellent results on every case. Our website has many rhinoplasty cases, both primary and revision. Please take time to look through them and please give us a call anytime.
Ed Buckingham
Jerry,
We do use fillers for the nose on occasion, but you have to have a specific deformity for them to work. If your hump is small and you have a low point superior or inferior to the hump then you can use filler to build up the nose around the hump and camouflage the hump. If the hump is large or the areas surrounding the hump are not deficient however then this is not possible. There is not a permanent filler I would recommend for the nose. Especially if you are considering rhinoplasty. The temporary fillers last at least 12 months in the nose however, are easy to do in the right person and are relatively low cost.
Ed Buckingham
