Print this Page
Email this Page
Add Bookmark
Facebook
Nose Surgery in New Jersey
Dr. David Evdokimow
The nose is the most prominent part of the human face. It is a transition between the upper face (forehead and eyebrows) and the lower face, and provides balance for the mid face. The relationship of the nose to other facial features, especially the chin, is responsible for a balanced, attractive look. Even minor deviations from those facial proportions can change one's appearance. A rhinoplasty in New Jersey (nose surgery) from Dr. David Evdokimow improves nose appearance and function.
To learn more about rhinoplasty with a board-certified surgeon, you can request your consultation online or call the offices of David Evdokimow, MD, at 908-221-1136. We serve men and women from New Jersey, New York and the rest of the country.
About Rhinoplasty in New Jersey
Rhinoplasty is one of the oldest cosmetic surgical procedures and still holds its popularity today. When they say they've had a "nose job," New Jersey men and women are indicating that they have had cosmetic nose surgery. That means they've altered the size and/or shape of their nose (for example, the width of the bridge, the profile of the bridge, the shape of the tip or the nostrils). However, there are other medically-indicated nose surgeries to improve function such as septoplasty (straightening the nasal septum) or turbinectomy (reduction of the turbinates). Often, rhinoplasty is combined with septoplasty or turbinectomy to restore normal anatomic relationships, and improve function and appearance.
Patients with facial fractures (trauma) may also require nose surgery. Nasal fractures are the most common fracture of the face. The injury involves the nasal cartilages and the nasal bones. The part of the nose most commonly injured is the septum. A large percentage of septal injuries go unnoticed, explaining the high percentage of unsatisfactory results associated with treatment of nasal trauma. Septal injuries are often associated with nasal hematoma or nasal septal hematoma, a collection of blood between the lining of the septum and the septal cartilage. The injury requires immediate surgical attention.
Rhinoplasty should not be performed until the facial skeleton and facial soft tissue have fully developed. In healthy adults without craniofacial anomalies, this usually happens between the ages of 12 and 15. The reasoning for this is more than just anatomic; the maturity that comes with older age helps to ensure that the desired nasal changes are based on the patient's own feelings, rather than that influenced by others.
In rare cases, early pediatric rhinoplasty may be indicated, but usually only when they are associated with congenital anomalies and trauma. In general, procedures are more conservative for younger patients (so as not to interfere with the future growth of facial and nasal structures). These procedures are usually staged, with the final procedure been performed when facial development has been completed.
Nose surgery is a delicate and demanding procedure, one that requires special skill and experience. A margin of only millimeters can turn (what could have been) a good result into a very poor one. You can trust Dr. Evdokimow to perform your New Jersey rhinoplasty. He is certified by the American Board of Plastic Surgery. His international education at prestigious institutions includes a plastic surgery residency at Indiana University School of Medicine as well as a plastic, hand and microvascular fellowship at Beth Israel Deaconess Medical Center, a teaching hospital of Harvard Medical School.
As a part of his continuous medical education Dr. Evdokimow frequently attends conferences and seminars directed spcificaly towards nasal surgery. His significant experience with facial trauma and treatment of the most complex facial injuries and correction of congenital deformities in children helps to improve the outcome of cosmetic rhinoplasty.
Before the Procedure
Consultations before rhinoplasty are among the most comprehensive; attention-to-detail plays a paramount role throughout the process – before, during, and after surgery. The more informed the rhinoplasty New Jersey patient is, the easier it will be for Dr. Evdokimow to achieve the patient's goals. Teamwork between patient and surgeon is vitally important. The outcome of the procedure is only as good as the plan for the operation.
Most rhinoplasty patients come to their initial consultation looking to address concerns such as:
- A significant "hump" on bridge of their nose
- A crooked nose
- A thick, full, or hanging nasal tip
- Their nose is out of proportion (usually too big) to the rest of their face
- The shape and flare of the nostrils
- Difficulty breathing, in absence of cold and allergies
Medical History
It's important to discuss any history of difficulties breathing through the nose, nosebleeds, frequent sinus infections, postnasal drip, excessive snoring, frequent headaches early in the morning, excessive early morning tiredness and the feeling of lack of sleep, nasal trauma (even in early childhood), previous nasal surgeries, or any history of hypertrophic scarring or keloids (personal or in the immediate family).
Dr. Evdokimow will also assess your skin type, occupation, psychiatric history, use of recreational drugs, and the use of any medications. If you take certain medications – particularly nasal sprays, decongestants and blood thinners – you may be instructed to stop using them several weeks before surgery. Your medical records should be obtained, if possible, for his review.
Physical Exam
A thorough internal and external nasal exam will be performed. Dr. Evdokimow will perform a provocative test to identify hidden problems. The nose is examined with the patient in repose (with their face relaxed) and in full smile to identify the effect of the smile on the tip of the nose. He will also assess the relationship of the nose to the lips, chin and the rest of the face. The need for chin surgery in order to achieve better facial proportions can be discussed.
It is very important to establish what part of the nose is the biggest concern for the patent and whether the concern is purely aesthetic or if there is an associated functional component. Pictures are taken and an individual treatment plan is developed. Educational materials are given to the patient and the plan is usually finalized during a follow up consultation when all of the educated patient's questions and concerns have been addressed.
On rare occasions, consultations with an allergist or sinus surgeon may be required. It may also be necessary to obtain additional studies, such as CT scans. If significant sinus disease is present, without significant nasal septal deviation, the sinus problem is addressed first.
The Procedure
Nasal surgery is usually an outpatient procedure performed in a surgery center or hospital. If combined with other procedures, an overnight stay in the hospital might be required. Depending on the extent of the procedure, rhinoplasty can be performed under general anesthesia or local anesthesia with intravenous sedation.
The surgical approach to rhinoplasty, for the sake of simplicity, can be divided as:
- Closed rhinoplasty. This approach is used for correction of minor to moderate nasal deformities. In this approach, the nasal structures are approached internally through incisions inside the nose, without any external incisions. This leaves no visible scars, unless the procedure involves narrowing the base of the nostril, which may leave very small, faint, well-hidden scars on each side of the nostril.
- Open rhinoplasty. This approach is used for correction of significant nasal deformity. A combination of internal and small external incisions is utilized. The external incision is through the lower part of the columella (the strip of vertical skin between the nasal tip and the upper lip). If properly repaired, this incision heals very well and is almost invisible in a matter of weeks. Open rhinoplasty provides visualization of all nasal structures and allows adequate treatment of a large variety of problems. As the more aggressive approach, open rhinoplasty is usually associated with longer down time.
At the end of the procedure, external and/or internal nasal splints will be placed to protect the new nose shape. The patient will be discharged home once they are completely awake and comfortable.
The rhinoplasty procedure can be combined with chin augmentation and with other facial and body cosmetic procedures such as face lift, brow lift and blepharoplasty (eyelid surgery). Dr. Evdokimow will discuss your options during your initial consultation, including fat transfer, lip enhancement and vampire facelift in NJ.
After Surgery
Generally, Dr. Evdokimow sees his New Jersey nose surgery patients in the office 6 to 7 days after surgery. After more complex procedures, patients may be seen after only 24 hours and then again in 6 to 7 days. At that time, the internal and external splints and sutures are removed. Bruising may persist for 7 to 10 days after the surgery. The majority of swelling resolves during the first week, although residual swelling may persist for several weeks. We strongly recommend abstinence from strenuous physical activities (especially contact sports) for up to 6 weeks.
Complications from rhinoplasty are possible, but relatively uncommon. Infection is possible, but very rarely occurs. Small nasal bleeds may be seen 7 to 10 days after the surgery and are usually self-contained. Asymmetries occur rarely, and may require revision in approximately 10% of rhinoplasty procedures performed. The rate of dissatisfaction with the procedure is reversely proportional to the degree of patient education prior to the procedure.
Proper recovery after your New Jersey rhinoplasty procedure is vitally important. Be sure to keep in place any splints or other supportive devices as long as directed. Also, allow your body the time it needs to rest and recover. When swelling subsides in a few weeks, you will see the change in your nose appearance, with additional subtle changes occurring for up to a year after the procedure.
Many improvements can be achieved through rhinoplasty. As one of the more experienced New Jersey cosmetic surgeons, Dr. Evdokimow will make the changes necessary to give you a more balanced facial appearance, but he will also retain your uniqueness and personal beauty. You don't need to worry that you will look unnatural or not like yourself after surgery. Instead, your natural beauty and your confidence will be enhanced. It is important to understand that not every NJ nose surgery patient can achieve the same result from rhinoplasty surgery. Good results are usually obtained, however, when the surgeon and patient have a mutual and realistic understanding of the goals and expectations from the procedure.
