Is it really necessary to have a consultation in person?
I will never operate on any patient unless I have previously met with them in consultation. Any surgeon that would do so is suspect.

Will my insurance company need to contact you before my rhinoplasty procedure?
If the procedure is for functional improvement and medically necessary to correct a problem, then insurance can be applied. We often work with insurance companies in these instances and they usually will require that we pre authorize the case with them beforehand.

Are there any visible bumps or indents if grafts are used to correct a nose that is too narrow?
Whenever a graft is used in rhinoplasty there exists the potential for visible or palpable irregularities, usually at the edges. This is especially true for grafts on the nasal dorsum because the skin is thinner in this area. I do my best to thin the grafts, soften them and bevel the edges and sometimes I may use other techniques, such as covering a graft with soft tissue, to make it blend in. If such issues exist then a some fine tuning may be necessary to correct it.

Is there a difference between a broken nose and a nasal bump or are they the same thing?
A bump on the nose may be the result of trauma or just because the nose is shaped that way. There are some subtle differences in treatment of these two entities but they should both be amenable to correction.

I'm interested in both chin augmentation and rhinoplasty. Can you perform them both?
I often perform chin augmentation at the same time as rhinoplasty.  Often times it is necessary to use a chin implant in order to correctly balance the way a nose looks on the face. Sometimes, by using a chin implant I can leave a stronger nose than I otherwise would be able to if I didn't. Chin implants are extremely powerful in achieving facial harmony and they are relatively easy to perform, low risk, and can always be removed if the patient doesn't like them.

I'd like to have my nose fixed because it hangs too low. Will I have a visible scar after rhinoplasty?
NO

I have a narrow nose. What do you do during rhinoplasty to make it wider?
To widen a narrow nose there are several things that I do including lowering the profile, rotating the tip, placing spreader grafts, out-fracturing the nasal bones, and using onlay grafts. Which of these I do depends on the specific nose I am working on.

I have a nose that sticks out too far. How do you correct this during rhinoplasty?
A nose that sticks out too far is overprojected and there are number of ways to bring it in closer to the face. When the tip is deprojected I must also bring down the profile to compensate and keep the nose balanced.

have a nose that's too short and I want it to look normal. Can you fix this?
Lengthening a short nose is very difficult but can be done by using a patient's own cartilage to elongate it or by creating the illusion of length with various maneuvers. It is more difficult to lengthen a nose that was shortened as a result of prior surgery than one that is just like that naturally.

What do you do during surgery to make an overly wide nose more narrow?
To narrow a nose I often fracture the nasal bones and bring them in. I also will occasionally narrow the middle part of the nose by removing some of the nasal septum or upper lateral cartilages. The tip cartilages can be narrowed by removing cartilage or by using sutures to change their shape and the base of the nostrils can be narrowed by removing some soft tissue. Occasionally I find it necessary to build up the height of the nasal dorsum to make the nose look narrower.

My nose is overprojected and my nostrils are too long. How do you correct this during rhinoplasty?
When an overprojected nasal tip is deprojected the nostrils will automatically change orientation. There are a number of ways to deproject a nasal tip and this can be done equally well via an endonasal (closed) or open technique.

The end of my nose points upward. How do you correct this during surgery?
If the end of your nose points upward then it can be re-oriented to point forward by using sutures to change it's shape or grafts to elongate it. Sometimes removing some septum or membrane can also accomplish the same goal as well.

Can my pug nose be fixed with rhinoplasty?
Pug noses can be fixed by using various techniques that strengthen and elongate the nose as well as those that increase nasal tip projection. This is a common problem and should respond well to advanced rhinoplasty techniques.

Can you explain the difference between primary rhinoplasty and revision rhinoplasty?
A revision rhinoplasty is a secondary operation that serves to improve upon or correct problems that still remain after prior rhinoplasty. I have done many revision rhinoplasty operations on patients that have had 5 or 6 prior nasal surgeries. I find revisions more technically difficult to do but also more rewarding for myself and the patient.

When it comes to rhinoplasty for children, are there any special considerations to take into account?
Children that have yet to fully mature may be adversely affected by a rhinoplasty because their faces have yet to become fully developed and may continue to change. In this scenario the rhinoplasty yields a result that may initially look good but that doesn't look good as the jaw bone grows or other facial features change. Additionally, the nasal septum serves as a secondary growth center for the midface and it may be impacted by surgery, interfering with midfacial development (although the recent science on this suggests it may not be som important).

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