Rhinoplasty

If you are dissatisfied with the appearance of your nose, you may feel self-conscious or even unattractive when you look in the mirror. Through rhinoplasty, sometimes called a nose job, San Francisco plastic surgeon Dr. Albert Chow can help your nose complement the surrounding features of your face to give your overall appearance natural symmetry and balance. He is board certified in facial plastic surgery and otolaryngology (head-neck surgery) which makes him exceptionally qualified to perform this highly complex procedure for both cosmetic and functional reasons. As a specialist in complex Asian rhinoplasty and revision rhinoplasty procedures, Dr. Chow has successfully enhanced the facial profiles of women and men from a variety of ethnic backgrounds.

If you are unhappy with the appearance of your nose or have trouble breathing and would like to explore your rhinoplasty options in San Francisco, request a consultation with Dr. Chow using his online form or call (415) 441-1888 to schedule an appointment.

Dr. Chow explains the improvements he provides through rhinoplasty. View Video Gallery

Rhinoplasty Candidates

If you are a healthy adult and want to improve the appearance of your nose, you may be a good candidate for rhinoplasty. Dr. Chow also performs this procedures for teenagers, once their facial growth is complete. Rhinoplasty may be right for you if you have one or more of the following concerns:

  • Your nose seems too large or too small for your face
  • Your nose is crooked, twisted, deviated, or off-center
  • The tip of your nose is too thick, too large (bulbous), droopy, or over- or under-projected
  • There's a bump or hump on the bridge of your nose
  • Your nose seems too wide from the front
  • Your nostrils are too narrow, too flared, asymmetrical, or misshapen

During your consultation, Dr. Chow will ask you to show him what you want to change about the appearance of your nose. He will carefully examine your nose inside and out to assess whether your needs are cosmetic, functional, or both. When appropriate, he will use software imaging to help you visualize possible results.

Nose surgery is sometimes performed in combination with other facial plastic surgery procedures including chin augmentation, eyelid surgery, or a facelift.

Functional Rhinoplasty

As a board-certified otolaryngologist, Dr. Chow has extensive knowledge of the intricate internal structures of the nose. He has specialized training and years of experience correcting a variety of functional concerns that may make you feel like you can't breathe freely. He can perform one or a combination of the following functional rhinoplasty procedures:

  • Septoplasty to treat a crooked or deviated nasal septum
  • Turbinate reduction to remove part of enlarged nasal turbinates in one or both nostrils

Septoplasty and turbinate reduction at our San Francisco practice are often covered by medical insurance because they are considered reconstructive, not cosmetic.

Reconstructive Rhinoplasty

If you have been injured and suffered trauma to your nose, reconstructive nose surgery can rebuild, repair, and reshape your nose; increase facial support; and prevent obstruction of the nasal passages. Experienced with the most extensive reconstructive procedures, Dr. Chow can safely and expertly rebuild your nose to its desired shape and proper function.

Because reconstructive rhinoplasty is performed to repair an injury or congenital defect, it is often covered by medical insurance.

Rhinoplasty Techniques

Your nose takes its shape from the bone and cartilage structure under your skin. This structure is remodeled during the nose-shaping procedure. Dr. Chow achieves the optimal nose shape for you by changing the location and amount of bone, cartilage, and soft tissue.

In appropriate situations, Dr. Chow uses endoscopy, a surgical method that inserts a flexible tube (endoscope) through small incisions or natural openings in your body. A camera attached to the end of the endoscope allows Dr. Chow to see the internal treatment area. This minimally invasive technique reduces trauma during surgery and diminishes post-operation discomfort.

He performs rhinoplasty, whether cosmetic, functional, reconstructive, or for a combination of purposes, using one of the following techniques:

  • Scarless closed rhinoplasty is performed through incisions concealed inside the nostrils, leaving no visible scarring. This technique requires exceptional surgical skill, and it is recommended for patients who need only minimal work to restore facial balance. If you are not a suitable candidate for closed rhinoplasty, Dr. Chow will discuss your alternatives with you and recommend the procedure that will best give you the results you want.
  • Open rhinoplasty involves incisions between the nostrils to separate the skin from the underlying cartilage and tissue. This approach demands the skill of a highly experienced surgeon such as Dr. Chow and is typically used for cases requiring more extensive correction and complicated surgical techniques.

Dr. Chow also offers advanced methods for post-surgical pain management that enable patients not to feel pain for the first 3 to 4 days after surgery.

Rhinoplasty Recovery Guide

First 24 hours:
Avoid stress and rest. While sleeping, elevate the head to discourage swelling. Usually patients experience little pain over the first 3 to 5 days due to long-acting local anesthesia. Use a nasal drip pad as needed.

Days 1 to 3:
Breathing is congested. Swelling and bruising peak.

Days 5 to 7:
Nasal splints, casts, and stitches will be removed. Makeup may be applied to conceal any bruising. Use splint at night for further protection.

First Week:
Keep your head elevated at all times. Avoid aspirin, Motrin, blood thinners, and alcohol, which may increase swelling.

Days 7 to 10:
Bruising under the eyes has faded. Most patients are ready to return to non-strenuous jobs and school.

First 2 weeks:
Avoid blowing your nose.

Weeks 2 to 4:
Swelling diminishes significantly. Breathing is improved.

3+ weeks:
Avoid any activities that may elevate your blood pressure, such as vigorous exercise, lifting, or straining.

4 to 6 weeks:
Keep eyeglasses and sunglasses off the bridge of your nose. Avoid contact sports or running as this will cause aching and discomfort.

1 year:
Protect your nose from exposure to the sun and cold as much as possible until normal sensation returns because the skin is sensitive to sun damage.

Rhinoplasty Specialties

Dr. Chow has specialized expertise in the following highly complex types of rhinoplasty:

  • Revision Rhinoplasty: Some patients may not be happy with the results of a previous nose job — maybe the surgeon performed poor work, or perhaps the patient was given misguided expectations. Revision rhinoplasty, also known as secondary rhinoplasty, corrects these problems. Revision rhinoplasty surgery can address aesthetic issues or correct breathing difficulties that may stem from surgical errors. Highly skilled in complex revision surgery techniques, Dr. Chow can successfully fix a collapsed nose, correct asymmetry of the nasal tip, and remove a nasal implant. The complex nature of the procedure requires precise technique to carefully restore the appearance and/or function of your nose.
  • Asian Rhinoplasty: Some patients of Asian descent are unhappy with certain ethnic features of their nose, such as a flat bridge or wide nostrils; in these cases, Dr. Chow can correct these perceived aesthetic flaws without compromising the patient's ethnic identity. With thorough knowledge of all aspects of this procedure, Dr. Chow provides patients with the most up-to-date resources about the costs, benefits and risks of Asian rhinoplasty.

Frequently Asked Questions

How Much Does Rhinoplasty Cost?

The cost for a rhinoplasty procedure at our San Francisco practice depends on several factors, including the complexity of the procedure, surgical technique, and anesthesia. You will receive a personalized quote during your consultation.

With rhinoplasty, it is especially important to "get it right the first time." Revision procedures are very complex - and they are typically more expensive than primary procedures. Accordingly, while cost is a necessary consideration, your priority should be to choose a highly trained and experienced rhinoplasty surgeon such as Dr. Chow.

Is Rhinoplasty Covered by Insurance?

For the most part, insurance companies will not cover the cost of cosmetic surgery procedures. However, if you are considering rhinoplasty for functional repairs–for example, to improve breathing that is hampered by a deformity within the nose–then surgical costs are more likely to be covered. If your procedure is performed for both cosmetic and functional reasons, you should expect to pay a portion of the costs.

How does a plastic surgeon change the appearance of the nose through rhinoplasty?

Rhinoplasty surgeons typically change the underlying cartilage and bone structures and sometimes the surface skin to improve the appearance and functionality of the nose. Dr. Chow is a plastic surgeon with ears, nose, and throat (ENT) training, so he performs surgery using conservation techniques that minimize damage to normal structures, decrease the potential for future collateral damage, and reduce diminished functionality.

How long does the rhinoplasty operation take?

Typically, nose surgery takes about 2 to 3 hours depending on the complexity of the case. Because Dr. Chow is meticulous and conserves and preserves the structures with the goal of achieving results with a natural "born that way" look, he can take anywhere from the usual 2 to 3 hours up to 4 to 6 hours, depending on the patient's goals and desires.

Will rhinoplasty affect nasal allergies?

The impact of rhinoplasty surgery on allergies is minimal. However, it may help breathing when passages are opened. We often recommend that our patients get treated for allergies and make necessary lifestyle modifications before surgery.