Introduction

Costal cartilage rhinoplasty is a popular surgical procedure for those looking to enhance the appearance or functionality of their nose. In New York City, there are several hospitals and surgeons that have earned a reputation for providing high - quality costal cartilage rhinoplasty. This article will introduce you to some of these highly recommended institutions, including Mount Sinai, the practice of Dr. Barry Weintraub, and the clinic of Dr. Cangello.

Importance of Costal Cartilage in Rhinoplasty

Costal cartilage is a valuable resource in rhinoplasty due to its unique properties. It is strong, flexible, and can provide excellent structural support for the nose. According to a study on autologous costal cartilage harvesting (Ozücer et al., 2017), costal cartilage is especially useful in cases where septum cartilage is not available or insufficient. For instance, in major nasal reconstructions, such as those required after trauma or failed previous surgeries, costal cartilage can be used to recreate a natural - looking nose with good breathing function.

In revision rhinoplasties, often too much supporting cartilage is removed in the initial surgery, resulting in a bridge that is too low, a pinched nasal tip, or an excessively upturned tip. Costal cartilage can be used to correct these issues and restore the nose's proper form and function.

Mount Sinai

Overview

Mount Sinai's division of facial plastic and reconstructive surgery is well - known for its rhinoplasty services. The nose is not only a central and defining feature of the face but also an important part of the respiratory system. The goal of rhinoplasty at Mount Sinai is to create natural, long - lasting results that improve the shape, size, and distinction of the nose while also ensuring good breathing function.

Surgeons' Qualifications

The facial plastic surgeons at Mount Sinai are double - board certified in facial plastic and reconstructive surgery and otolaryngology (ear, nose, and throat). This dual certification means they have in - depth knowledge of both nasal function and nasal and facial aesthetics. Their vast expertise allows them to create results where the new nose not only looks better but also breathes better.

Types of Rhinoplasty

Primary Rhinoplasty

This surgery is performed for the first time to address cosmetic concerns and/or nasal breathing. It can be used to 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. For example, if a previous rhinoplasty has left the nose with an unnatural shape or if there are breathing problems that were not resolved in the first surgery, revision rhinoplasty can be an option.

Techniques

Closed (Endonasal) Rhinoplasty

During this closed surgical approach, all of the incisions are made inside the nose. The advantage of this approach is the lack of an external scar and the relatively shorter duration of the operation.

Open (External) Rhinoplasty

Unlike the endonasal option, in this open approach, a small incision is added at the base of the nose to increase the surgical field of vision. This approach allows for better visualization of the nasal anatomy and more complex alterations and grafting to be performed.

Multidisciplinary Approach

Patients at Mount Sinai have the resources of a large, tertiary hospital at their disposal. For patients with specific concerns related to their nasal breathing, nasal allergies, sinus disease, or deformity after cancer treatments, the hospital works closely with Mount Sinai's widely recognized experts in the division of rhinology and sinus surgery and Mount Sinai's head and neck institute. Combined surgeries can even be performed when appropriate.

Combining Procedures

Some areas of the face are intimately related and often need to be addressed together to achieve the best outcomes. Patients who have rhinoplasty for cosmetic improvements may 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

Rhinoplasty is a common procedure among teenagers and youth. However, if a nose job is being elected for cosmetic reasons, younger patients should wait until they stop growing and their nasal bone has reached its adult size. Typically, for girls this occurs after puberty around age 15, while boys may need to wait longer until they are 17 or 18 years or older. If the surgical procedure is being performed 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

Before Surgery

Patients interested in cosmetic treatments at Mount Sinai's division of facial plastic and reconstructive surgery 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. Prior to surgery, patients are given instructions regarding medications and how to prepare for their recovery.

After Surgery

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. They are also asked to avoid strenuous activities for two weeks after surgery.

Cost

While cost is always a concern, insurance may cover surgery performed to improve breathing (i.e., 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.

Dr. Barry Weintraub

Surgeon's Background

Dr. Barry Weintraub is a board - certified plastic surgeon who was educated at the Weill - Cornell Medical Center. He is a national spokesperson for the American Board of Plastic Surgery and has more than two decades of experience. He is in his surgical prime, with mature aesthetic judgment and a keen eye for natural beauty. He performs rhinoplasty surgery at his New York City office.

Types of Rhinoplasty

Functional Rhinoplasty

This type of rhinoplasty focuses on correcting breathing problems such as nasoseptal deviation, turbinate hypertrophy, and middle - vault collapse. These are mechanical obstructions to one's breathing, and this category is usually insurance - reimbursable. Functional rhinoplasty can also be done at the same time as cosmetic changes.

Aesthetic Rhinoplasty

Aesthetic rhinoplasty aims to correct aesthetic problems such as a hump or bump of the nose, a bulbous or ill - defined tip, a plunging tip that becomes pronounced upon smiling, a too - wide or too - flat bridge, nostrils that are too big, small, or wide, or a nose with too much or too little projection. It can be performed either in a closed manner (no external incisions) or in an open fashion (small incisions at the nasal base for more complex problems).

Consultation Process

When considering rhinoplasty, patients should wait until after their growth spurt (usually over 13 years of age) and should make the decision for themselves, not due to pressure from others. During the consultation, Dr. Weintraub will help patients better understand their own issues. When choosing Dr. Weintraub for rhinoplasty, patients should check for his board certification by the American Board of Plastic Surgery, ensure that he attends a major hospital in the community and is in good standing, confirm his fine reputation among other medical professionals, and speak to his patients who have undergone similar procedures. A good plastic surgeon, like Dr. Weintraub, listens to the patient's specific needs and desires.

Procedure Details

Dr. Weintraub prefers his rhinoplasty patients to be in a comfortable state of twilight sleep, where the patient is unarousable and is awakened only after the procedure is over. He insists on the most sterile conditions in his New York City operating room, with board - certified anesthesiologists and state - of - the - art monitoring equipment commensurate with the highest hospital standards. He performs the surgery himself with precision and care, and all wounds are sewn in multiple layers by his own hand.

Best Candidates

The best candidates for rhinoplasty surgery with Dr. Weintraub are well - balanced, in good general health, and possess realistic expectations. They should be highly motivated to make the change, have the ability to pause their daily responsibilities (work, family, school, etc.) to undergo the procedure, and have the financial wherewithal to afford an elective cosmetic surgery. For patients living out of town or overseas, he advises a two - night post - operative stay and has relationships with hotels to provide special reduced rates. A private nurse can also be provided.

Preparation and Aftercare

Preparation

Once patients decide to undergo rhinoplasty with Dr. Weintraub, they need to provide medical clearance from their family physician. They will be given instructions on how to prepare for surgery and prescriptions to be filled in advance.

Aftercare

There will always be a short period of minimal swelling and sometimes bruising after a rhinoplasty surgery. Patients must carefully follow all instructions provided by Dr. Weintraub to achieve the best results possible. Mild pain medication, a broad - spectrum antibiotic, and medication to reduce swelling are started immediately following surgery. He applies a carefully fashioned heat - sensitive splint to hold all delicate structures in place and uses more modern inflatable splints to support the interior of the nose instead of uncomfortable and outdated nasal packing. Two to three days of bed rest is advised. Approximately five days after surgery, he will remove the heat - sensitive splint and may remove or change the flesh - coloured tape on the nose. After this time, daily showering is recommended, and he will advise on when patients can return to their normal lifestyle and exercise routine.

Dr. David Cangello

Surgeon's Expertise

Dr. David Cangello is a board - certified plastic surgeon who is highly regarded for his rhinoplasty work in New York City. He is a pioneer in the field and is one of only a few surgeons in the United States to offer preservation rhinoplasty. He combines well - honed surgical precision with an innate sense of artistry, allowing him to produce rhinoplasty results that perfectly complement the unique and beautiful face of every patient. He is a member of the rhinoplasty society, has authored numerous articles in medical journals, and has been named to Castle Connolly's list of America's top doctors and listed as a “super doctor” in the New York Times. He is also frequently featured in major media for his expertise in plastic surgery.

Types of Rhinoplasty

Open vs. Closed Rhinoplasty

Dr. Cangello prefers the open approach to rhinoplasty. In a closed rhinoplasty, all incisions are made inside the nose. In an open rhinoplasty, in addition to internal incisions, a tiny incision is made across the skin between the nostrils. The open approach allows for a “component separation of the nose,” where the seven separate structural components of the nose can be exposed, modified, and repositioned in the most proportionate and balanced way. Although the incision is external, the resulting scar will be imperceptible. The closed approach may not separate all the components as effectively, which can lead to disproportionate and unbalanced results.

Preservation Rhinoplasty

Dr. Cangello is among a handful of plastic surgeons in the country to offer preservation rhinoplasty. This technique preserves as much of the patient's natural bone structure, cartilage, and tissue as possible while reducing bumps and humps. The results are refined and natural - looking, with the potential for a quicker recovery than with traditional rhinoplasty.

Ethnic Rhinoplasty

Dr. Cangello is sensitive to the cosmetic surgical needs of patients of different ethnicities, including African - American, Middle Eastern, Asian, and Latin American descent, as well as Persian patients. Ethnic rhinoplasty can achieve goals such as making a flat nose more elevated and refined, enhancing the structure of a small - looking nose, improving the balance of the nose with the chin and other facial features, reducing the width of the nasal bridge and nostrils, and reducing the length of the nose. Specialized techniques like cartilage grafting or nasal implants may be required, and Dr. Cangello has extensive experience in this area.

Non - Surgical Nose Jobs

For patients who prefer a less - invasive option, Dr. Cangello offers non - surgical nose jobs. This procedure involves the use of dermal fillers to treat minor cosmetic irregularities such as dorsal bumps or drooping nasal tips. It is a quick, in - office process that requires virtually no downtime or recovery.

Patient Candidacy

Ideal candidates for rhinoplasty with Dr. Cangello are men and women who are in good health but are unhappy with the appearance of their nose. They may have cosmetic imperfections after an injury, breathing problems due to a congenital defect of the nose, or dissatisfaction with the size or shape of the nose. Teens should wait until their nasal bones are fully developed. Dr. Cangello will determine the patient's candidacy at the consultation and will discuss the surgical plan based on the patient's anatomy, goals, and preferences.

Procedure and Recovery

Procedure

Dr. Cangello's choice of technique and incision sites are based on multiple factors such as the patient's nasal anatomy, goals, function, and whether additional procedures are being performed. After making the incisions, he carefully separates the nasal skin from the bone and cartilage, sculpts the bone and cartilage as planned, and then drapes the skin back onto the nose. He closes the incisions with sutures that dissolve on their own or that he removes within a week. A splint is applied to maintain the new shape, and soft splints may be placed inside the nose if septoplasty is performed. The surgery usually takes around two hours to complete, depending on the extent of treatment.

Recovery

After surgery, patients may experience puffy and achy faces, drainage of blood and mucus from the nostrils, and congestion. Dr. Cangello will prescribe pain medication if needed. Patients are advised to avoid strenuous physical activities, blowing their nose, rubbing their face, and resting eyeglasses on their nose. Bruising, numbness, and swelling around the eyes are common but can be reduced with cold compresses and by keeping the head elevated. Bruising usually peaks on the second or third day and significantly improves within two weeks. Dr. Cangello will remove the splint after the first week, and most patients can return to work or school at this time. Some slight swelling may persist for up to six months.

Conclusion

In New York City, there are several excellent options for those considering costal cartilage rhinoplasty. Mount Sinai offers a comprehensive approach with its double - board - certified surgeons, multidisciplinary resources, and a range of rhinoplasty techniques. Dr. Barry Weintraub brings his extensive experience and attention to detail to the table, providing personalized care from consultation to recovery. Dr. David Cangello stands out with his innovative techniques such as preservation rhinoplasty and his ability to handle ethnic rhinoplasty cases. Each of these options has its own strengths, and patients should carefully consider their own needs, goals, and the surgeon's expertise when making a decision.

If you are interested in learning more about costal cartilage rhinoplasty in New York City, we encourage you to schedule a consultation with one of these recommended surgeons. Explore their websites, read patient testimonials, and gather as much information as possible to make an informed and confident decision about your rhinoplasty journey.