Introduction
Nostril position adjustment surgery, often a part of rhinoplasty, is a highly sought - after procedure in New York City. The nose is a central and defining feature of the face, and even minor adjustments to the nostril position can significantly enhance a person's facial aesthetics and sometimes improve nasal function. In this article, we will explore several hospitals and surgeons in New York City that come highly recommended by those who have undergone nostril position adjustment surgery.
Mount Sinai Hospital
Overview of Rhinoplasty at Mount Sinai
Mount Sinai Hospital offers a comprehensive rhinoplasty program. The nose is not only crucial for facial aesthetics but also plays a vital role in the respiratory system and the sense of smell. At Mount Sinai’s division of facial plastic and reconstructive surgery, the goal is to create natural, long - lasting results that improve the shape, size, and distinction of the nose.
The facial plastic surgeons at Mount Sinai are double - board - certified in facial plastic and reconstructive surgery and otolaryngology (ear, nose, and throat). Their expertise in nasal function and aesthetics ensures that patients not only get a better - looking nose but also one that breathes better.
Types of Rhinoplasty Procedures
Primary Rhinoplasty
This surgery is performed for the first time to address cosmetic concerns and/or nasal breathing. It can change the size and shape of the nose, modify the bridge of the nose, increase or decrease the size of the nostril openings, balance the facial features, improve nasal breathing for patients with chronic sinus problems or anatomical problems, and reconstruct previously injured or disfigured noses from accidents or nasal disease.
Revision Rhinoplasty
This procedure is carried out to address concerns or deformities resulting from prior nose surgeries. Whether it's a result of an improperly performed initial surgery or new issues that have arisen over time, Mount Sinai's surgeons are well - equipped to handle revision cases.
Open and Closed Rhinoplasty Techniques
Closed (Endonasal) Rhinoplasty
During this approach, all incisions are made inside the nose. The main advantage is the lack of an external scar and a relatively shorter operation time. It is a good option for patients who have less complex nasal issues or those who prefer a more minimally invasive approach.
Open (External) Rhinoplasty
In this open approach, a small incision is added at the base of the nose to increase the surgical field of vision. This allows for better visualization of the nasal anatomy and enables more complex alterations and grafting to be performed. It is often used for more extensive nasal reconstructions or when precise adjustments to the nostril position are required.
Multidisciplinary Approach and Additional Considerations
Patients at Mount Sinai have access to a large, tertiary hospital with a wide range of specialists. For patients with specific concerns related to their nasal breathing, nasal allergies, sinus disease, or deformity after cancer treatments, the hospital works closely with experts in the division of rhinology and sinus surgery and the head and neck institute. In some cases, combined surgeries can be performed.
Some patients who have rhinoplasty for cosmetic improvements may also benefit from cheek or chin implants to improve facial balance. Whenever possible, the cosmetic surgeons at Mount Sinai combine procedures to reduce recovery time and lower operating costs.
Adolescent rhinoplasty is also an option at Mount Sinai. However, if the surgery is for cosmetic reasons, younger patients should wait until they stop growing and their nasal bone has reached its adult size. Typically, girls can consider it after puberty around age 15, while boys may need to wait until they are 17 or 18 years or older. If the surgery is to correct a breathing problem or repair the bone after an injury, it can be performed before the patient is fully grown.
Before and After Surgery Care
Patients interested in cosmetic treatments start with an extensive consultation to identify areas of concern and review their goals. The surgeons then develop an individualized treatment plan.
Rhinoplasty surgery is usually performed in an outpatient setting under general anesthesia or with a combination of local anesthesia and sedation. Before surgery, patients are given instructions regarding medications and how to prepare for their recovery. After surgery, patients are usually given a short course of antibiotics and mild pain medication as some mild discomfort may persist for the first few days.
The majority of swelling subsides within the first two weeks, although it may take up to a year for all the swelling to fully fade. Patients should expect to return to work or school within one to two weeks after surgery and are asked to avoid strenuous activities for two weeks after surgery.
The cost of rhinoplasty can be a concern. Insurance may cover surgery performed to improve breathing (e.g., deviated septum), but it does not cover surgery that is done for cosmetic reasons. Mount Sinai provides patients with expected costs prior to any intervention.
NYU Langone Health
Surgery for Deviated Septum
NYU Langone Health specializes in surgeries related to a deviated septum. A deviated septum can make breathing through the nose difficult or impossible, and if medication doesn't provide symptomatic relief, their specialists can perform surgery to straighten the septum.
The otolaryngologists, who specialize in head and neck surgery, and plastic and reconstructive surgeons at NYU Langone use minimally invasive techniques and perform surgery in an outpatient setting, allowing patients to return home on the same day.
Procedures for Deviated Septum
Septoplasty
This procedure centers the septum, creating two nasal passages that are the same size. A surgeon uses small surgical instruments to make an incision in the tissue lining the septum, then straightens or repositions the deviated section of the septum to maximize airflow through the nasal passages. If the septum is damaged in addition to being out of place, doctors may remove small pieces of cartilage or bone.
Septorhinoplasty
If an injury such as a fracture is the cause of a nasal obstruction, or if surgery to reposition the septum changes the appearance of the nose, NYU Langone's specialists work with facial reconstructive plastic surgeons to perform septorhinoplasty. During this procedure, surgeons eliminate the nasal obstruction and use cosmetic techniques that ensure that the nose looks natural. They correct the position of the septum and address any other structural problems, such as widening a narrow area inside the nose between the septum and the bridge of the nose to help with breathing. Surgeons may also remove cartilage from the septum and place it in other areas to improve breathing or alter the shape of the nose.
Submucosal Resection
In submucosal resection, a surgeon removes small sections of the septum, the turbinates, or both to open the nasal passages. The surgeon accesses the septum or turbinates through the nostrils and makes a small incision in the layer of soft tissue lining the nasal passage. This allows surgeons to remove portions of the underlying bone structure without disturbing the outer layer of tissue, which is important for keeping the nasal passages hydrated. Surgeons may use a laser or a microdebrider to reduce the size of turbinates.
Turbinate Outfracture
In addition to a submucosal resection or laser procedure, surgeons may also permanently reposition the turbinates to provide more space in the nasal passages. This permanent repositioning, called outfracture, involves breaking the thin bones of the turbinates in order to reposition them.
Dr. Philip Miller's Practice
Crooked Nose Correction
Dr. Philip Miller is a double - board - certified facial plastic surgeon known for his work in crooked nose correction. A crooked nose can affect both the function of the nose and its appearance, and rhinoplasty is the only permanent solution to fixing it.
Dr. Miller offers options in rhinoplasty for crooked nose patients in Manhattan, New York, and New Orleans, Louisiana. He will customize the surgery to the patient's precise needs and goals to ensure natural and beautiful results while optimizing function.
Types of Crooked Nose Rhinoplasty
Cosmetic Rhinoplasty
This type of rhinoplasty only alters the appearance of the nose. It can reduce nose size or length, remove bumps or humps, or reshape the tip or nostrils.
Functional Rhinoplasty
Functional rhinoplasty not only corrects the appearance of the nose but also addresses any breathing problems associated with the crooked nose. It alters the position or shape of bone, cartilage, and skin to realign the nasal bridge and improve functionality.
Techniques and Patient Experience
Dr. Miller uses a variety of techniques during crooked nose surgery to ensure the most natural results for his patients. His thorough understanding of facial anatomy provides a superior aesthetic outcome while preserving or improving functionality. He incorporates his proprietary Natra Look process during all of his consultations, which creates a comfortable environment where patients can freely discuss their concerns and goals.
Like any surgery, there may be some side effects after having a crooked nose fixed through surgery, such as bleeding, infection, reactions to anesthesia, and scarring. However, when working with an experienced and double - board - certified surgeon like Dr. Miller, patients are likely to enjoy a smoother recovery process and fewer risks associated with their procedure.
The cost of a crooked nose rhinoplasty in New York can range from $10,000 to $20,000, depending on the complexity of the procedure. Relying on a double - board - certified facial plastic surgeon like Dr. Miller can make this a one - time investment with no revision surgeries necessary due to excellent aesthetic and functional results.
Dr. Khosh's Practice (for Droopy Tip)
Droopy Tip Correction
A common complaint in nose shape is the ptotic nasal tip, also referred to as a hooked nose or droopy tip. This feature is noticeable both from the front and side view of the face, and it can become more pronounced when the person smiles. Dr. Khosh, a renowned New York facial plastic surgeon and rhinoplasty surgeon, is uniquely qualified to correct droopy tips.
Solutions for Droopy Tip
Non - Surgical Options
For mild nose tip droop, dermal fillers like Restylane and Juvederm can be used to reduce the angle of the droop and soften the nose appearance. However, non - surgical options are usually ineffective for moderate to severe nose tip droops and are therefore not recommended for nose reshaping in such cases.
Surgical Options
For mild nose tip droop, a closed rhinoplasty procedure can be performed with incisions placed inside the nostrils. This may include shortening the septum, placement of a columellar strut (a cartilage graft that helps support the nasal tip), and performing a cephalic trim (removing the upper edge of the nose tip cartilage). For moderate to severe nose tip droop, depending on the severity of the droop, either the closed (inside the nostril) or the open (through the columella) rhinoplasty approach is used. During the surgery, the nasal tip cartilages may be elevated and suspended from the septum cartilage, a columellar strut may be placed, and a cephalic trim may be performed.
Dr. Andrew Jacono's Practice
General Information on Rhinoplasty
Dr. Andrew Jacono is a world - renowned rhinoplasty specialist. A rhinoplasty is a surgical procedure that improves the shape, width, and length of the nose. Dr. Jacono prefers to give his patients natural results that are subtle and aesthetically balanced. He uses digital morphing technology to work with each patient individually and deliver their desired outcomes.
Types of Rhinoplasty Approaches
Open Rhinoplasty
The open approach is considered to be a more invasive surgery. It is better suited to those with larger noses, severely asymmetrical or crooked nasal bridges and nasal tips. During this procedure, an incision is made across the columella, and then the nose's skin is lifted off the underlying bone and cartilage.
Closed Rhinoplasty
The closed approach is better suited to patients with smaller, more symmetrical noses. Typically, “closed” rhinoplasties reshape the tip of the nose, shorten the nose's length, and shave down the dorsal humps. All incisions are hidden within the nostrils, allowing for a more discreet procedure.
Unique Techniques and Recovery
Dr. Jacono has patented a quick recovery rhinoplasty™ technique that minimizes the visibility of incision lines, does not require the nose to be broken, and reshapes cartilage rather than cuts it away. He also specializes in revision rhinoplasty, using the patient's own cartilage and bone to reshape the nose.
After surgery, patients' noses will swell. Patients who have undergone an open rhinoplasty can expect most of their swelling to resolve within 4 weeks, while those who have had a closed rhinoplasty can expect the majority of their swelling to resolve within 2 - 3 weeks. During the first week of recovery, patients may feel congested from internal nasal swelling, and a cast will be on the nose. They should avoid physical activity and get as much rest as possible. By the third and fourth weeks, patients should be able to return to normal activities but should avoid bumping their noses.
Dr. David Cangello's Practice (for Bulbous Tip)
Bulbous Tip Rhinoplasty
The term bulbous nasal tip is used to describe a nose tip that is excessively round, bulging, and/or heavy in appearance. Dr. David Cangello, a board - certified plastic surgeon in New York City, is highly experienced in performing rhinoplasty with specialized techniques to correct a bulbous nasal tip.
Importance of Proper Nasal Tip Surgery
Oftentimes, the lower third of the nose, which includes the tip complex, is not properly addressed during rhinoplasty, resulting in an unnatural appearance. An obviously augmented or “done” look can occur when the surgeon straightens the dorsum but leaves the tip and lower third of the nose with fullness in the supratip area. This can lead to a pinched - looking tip, an excessively large infratip lobule, or a columella that hangs or droops well below the nostril rim on profile view. Dr. Cangello takes a comprehensive approach in every nasal tip surgery he performs.
Dr. Cangello's Approach
Dr. Cangello utilizes state - of - the - art rhinoplasty techniques, such as an endonasal approach (a minimally - invasive “closed” method), to refine a bulbous nasal tip without compromising the patient's underlying nasal structure. He reconfigures the tip cartilages and adds strategically placed dissolvable sutures to produce a structured yet natural - looking nasal tip.
For patients with dense or thicker than usual nasal skin, he may determine that debulking of the fibrous fatty tissue around the nasal tip is necessary for a beautiful aesthetic and optimal functional result. Sometimes a septal extension graft may also be used. The lower lateral cartilages, which form the tip of the nose, are sutured to the septal extension graft, creating a “tent pole” type structure that helps to create tip definition.
When determining his surgical approach, Dr. Cangello uses the concept of aesthetic nasal polygons, which allows for a mathematical analysis of the underlying nasal structures. This helps him understand how shadows and light influence the appearance of the nose and enables him to rearrange or reconstruct the nasal structures in a symmetrical and aesthetically pleasing way.
Conclusion
In New York City, there are several top - notch hospitals and surgeons that are highly recommended by those who have experienced nostril position adjustment surgery. Mount Sinai Hospital offers a comprehensive approach to rhinoplasty with a team of double - board - certified surgeons and a multidisciplinary approach. NYU Langone Health is well - known for its surgeries related to deviated septum using minimally invasive techniques. Dr. Philip Miller specializes in crooked nose correction, while Dr. Khosh is an expert in droopy tip correction. Dr. Andrew Jacono offers both open and closed rhinoplasty with unique recovery - friendly techniques, and Dr. David Cangello is renowned for his work on bulbous tip rhinoplasty.
If you are considering nostril position adjustment surgery, it is essential to do your research, schedule consultations with these experts, and discuss your goals and concerns. By choosing the right hospital and surgeon, you can achieve the desired results and enhance your facial aesthetics and nasal function. Don't hesitate to take the next step towards the nose you've always wanted. Reach out to these professionals and start your journey today!
