Rhinoplasty

What is a Rhinoplasty?

Rhinoplasty is a precise and technically advanced procedure that can improve both the appearance and the function of the nose. If there are features of your nose that you would like to change — or if you are having trouble breathing — the procedure can provide aesthetic enhancement and a better quality of life.

Septoplasty may be included in a rhinoplasty. The septum is the natural segment of bone and cartilage that separates the two air passages inside the nostrils. Injury or genetics can shift the septum out of place and partially limit your ability to breathe. With a septoplasty, we can correct this deviated septum and clear your breathing passages.

Dr. Jennifer Parker Porter and Dr. Jigar Sitapara, offer over 20+ years of combined experienced and expert care to patients in need of a rhinoplasty.

Why See An Open or Closed “Scarless” Rhinoplasty Expert?

Dr. Porter and Dr. Sitapara are Facial Plastic Surgeons, which means they only perform plastic surgery of the face. They have dedicated their careers to learning the intricacies of rhinoplasty, a complex procedure to change the aesthetic appearance of the nose and to improve nasal breathing. They believe in individualizing the approach based on your individual needs, rather than relying on one technique over the other. By customizing the operation to fit your goals, they are able to provide the very best results while minimizing your risk of complications.

Do You Need a Rhinoplasty Revision?

Previous rhinoplasty procedures in your medical history do not preclude you from having the procedure done again. Patients who have had an unsatisfying experience with another plastic surgeon make up about half of the rhinoplasty cases we see at Chevy Chase Facial Plastic Surgery. Most frequently, patients choose to have a revision Rhinoplasty DC because they are having trouble breathing. Our Facial Plastic Surgeons can also address cosmetic concerns related to an earlier rhinoplasty.

Revision rhinoplasty tends to be more complex than the initial procedure because of changes that the first surgery makes to the structures of the nose. Dr. Porter and Dr. Sitapara can discuss these issues during your initial consultation so that you know what to expect. Previous operative reports are helpful if available. If your nose has been injured or undergone any surgery in the past then you should inform your surgeon at the time of your consultation.

During the consultation your surgeon will determine whether the procedure will require cartilage grafts from other areas of the body. This is not necessary in all cases. A majority of revision DC Rhinoplasty procedures involve an external, or open, approach. This is to better visualize the work previously performed, but occasionally more minor refinements can be achieved with the closed “scarless” approach.

The Benefits of a Rhinoplasty from Dr. Porter or Dr. Sitapara

Washington, DC-area patients consider rhinoplasty both for their cosmetic improvement and their comfort. With this surgery, Dr. Porter and Dr. Sitapara can:

• Remove an unwanted hump or bump
• Alter a nose to be in proportion with other facial features
• Make a wide nose narrower
• Fix a flat or droopy nose
• Revise large or flaring nostrils
• Address traumatic deformities

Dr. Porter has spent over 23 years in practice with a primary surgical focus on rhinoplasty. Dr. Porter is double board certified, serves as a clinical associate professor at Georgetown University Medical Center and has lectured, contributed book chapters and journal articles on rhinoplasty to several medical texts and publications. Dr. Sitapara is a clinical assistant professor at George Washington University Medical Center and has presented his research on rhinoplasty and nasal anatomy across the United States.

View Rhinoplasty Before and After Gallery

What to Expect for Your Rhinoplasty Treatment

As responsible practitioners, the team at CCFPS wants to ensure that you get the care you need. We encourage you to start your experience by contacting our office, discussing your concerns and goals, and getting information about the type of improvement rhinoplasty can offer you. Some insurance companies will compensate patients for surgeries that address function. While CCFPS does not take insurance, we can give you the codes to use with your insurer.

The next step is an initial consultation with Dr. Porter or Dr. Sitapara, who will go over your medical history, examine your face and nose, and review digital photographs with you. Most of our patients are excited about this part of the process. Our surgeons will use sophisticated MIRROR® imaging technology to show you what you can expect from your results. As part of treatment planning, she will also aim to create a look that respects your cultural heritage and aesthetic individuality.

For revision rhinoplasty, Dr. Porter or Dr. Sitapara will determine during the consultation whether the procedure will require cartilage grafts from other areas of the body. This is not necessary in all cases. A majority of revision rhinoplasty procedures involve an external, or open, approach. This is to better visualize the work previously performed.

When you decide that you are ready to move forward, our practice will schedule your surgery. You will return to CCFPS for a preoperative visit two weeks beforehand so that we can review the surgical plan and answer any other questions you may have. Our goal is for you to enter your procedure with complete confidence and comfort in the decision.

Dr. Porter conducts her rhinoplasty procedures at the Suburban Outpatient Surgery Center in Bethesda and at Georgetown University Hospital in Washington, DC. Dr. Sitapara conducts his rhinoplasty procedures at SurgCenter of Silver Spring in downtown Silver Spring and at Suburban Outpatient Surgery Center in Bethesda. Most of our patients receive general anesthesia so that they can sleep through the entire experience.

The techniques that Dr. Porter and Dr. Sitapara use during your rhinoplasty will depend on your needs and goals:

• They are skilled in both “open” and “closed” rhinoplasty procedures. During your consultation, they will individualize your approach based on your goals.
• If you are having rhinoplasty for cosmetic purposes, Dr. Porter and Dr. Sitapara will revise internal and external features of the nose to create a more balanced and aesthetically pleasing appearance.
• If you are having surgery to improve problems with breathing, they will work expertly and with precision to rebuild and support the internal structure of the nose.
• Regardless of the goals of the procedure, Dr. Porter or Dr. Sitapara will use special techniques in the operating room to minimize bruising so that you can heal more quickly and comfortably.

What Determines an Ideal Candidate for a Rhinoplasty?

Rhinoplasty results vary depending on each patient’s circumstances. Once you have decided to undergo the procedure, our Facial Plastic Surgeons will assess your nose structurally and aesthetically by taking the following into account:

• Pre-existing bone and cartilage structure of your nose
• The shape of your face
• Your age
• The thickness of your skin

Dr. Porter and Dr. Sitapara use this information to construct a treatment plan to optimize your outcome. Cosmetic nose surgery should be performed on persons whose facial structure has stabilized. In most cases it is not a recommended procedure for minors, particularly if they have not completed the growth spurts that usually conclude in the mid to late teen years.

The Recovery Process

After rhinoplasty, you will spend about an hour recovering at the hospital before heading home with light nasal packing. In many cases, we will see you back at CCFPS the next day where we will remove the packing, and for the next week, you will use salt water nasal spray on a daily basis. If you have a cast and sutures, these will be removed one week after surgery.

Nine to ten days following rhinoplasty, most patients are comfortable socializing and returning to work. Eighty percent of the swelling should subside within one month, and if you have had rhinoplasty to improve your ability to breath, you should notice a difference by this point. Cosmetic patients should see the final result of their procedure after about one year: a more refined and aesthetically appealing nose that fits naturally with their other facial features.

Rhinoplasty Frequently Asked Questions

What Are the Functional Benefits of Rhinoplasty?
Rhinoplasty is about more than just cosmetic appearance. Rhinoplasty can be performed in conjunction with functional techniques. There are a number of functional benefits incorporated with rhinoplasty patients and beyond. For example, many patients have trouble breathing through their nose because of a defect in their nasal valves. These valves might have narrowed due to old age or trauma, or a person could have been born with narrower-than-usual nasal valves. Whatever the case, this limits the flow of air to the lungs, preventing the person from taking a full breath through their nose. During a rhinoplasty, Dr. Porter and Dr. Sitapara can help to open up these airways through grafting techniques and repairing cartilage in the nose.

Functional rhinoplasty can provide patients with some of the following benefits:

• Ability to breathe better, especially when working out or sleeping, as the airways are wider
• Improved well-being, as the patient may be receiving more oxygen than they are used to
• Improved appearance, as removal of cartilage can sometimes change the appearance of the nose for a sleeker, refined look

Functional rhinoplasty differs from cosmetic rhinoplasty because these functional improvements are the main goal of the treatment. Cosmetic rhinoplasty, on the other hand, is done solely to increase a person’s aesthetic appearance. In many cases, those who seek functional rhinoplasty may also see a change to the shape of their nose, as your surgeon will have to remove some cartilage to widen the airways. However unintended this benefit is, it’s still a nice bonus for patients.

What Is the Difference Between Open Rhinoplasty and Closed Rhinoplasty?
While open rhinoplasty and closed rhinoplasty are two separate approaches, in the end, they provide the same, long-lasting results for patients.

An open rhinoplasty involves making a small incision in the skin between the nostrils, called the columella. Then, your surgeon can lift the skin out of the way and visualize the underlying structure of the nose to begin the procedure. A closed rhinoplasty, on the other hand, only involves incisions inside the nose, so the patient won’t have any visible scarring. Closed rhinoplasties are appropriate for patients that want hump removal or need changes to the nasal tip.

While Dr. Porter and Dr. Sitapara will have a better view of the nose with an open rhinoplasty, the procedure can leave patients with a small scar underneath their nose. On the other hand, a closed rhinoplasty eliminates scarring but makes the procedure slightly more challenging if more drastic changes are desired.

Before deciding on whether or not an open or closed rhinoplasty is appropriate, Dr. Porter and Dr. Sitapara perform a full examination on each patient. They will ask them about their treatment goals and take a look at the current structure of their nose to decide which procedure would provide results that align closest with their expectations. In general, patients who are having moderate work done on their nasal bridge can benefit most from closed rhinoplasty, while patients who are having work done on their nasal tip (such as the removal of a malformed or bulbous tip) or other extensive reshaping are best suited for an open rhinoplasty.

Rhinoplasty – What Should I Expect?
A wide range of aesthetic goals can be met at our cosmetic surgery practice. Our Facial Plastic Surgeons are some of the area’s best in cosmetic nose surgery, and can alter the size of your nose, change the shape of the tip or the bridge, adjust the width of the nostrils, or alter the angle of the nose in relation to the upper lip. Rhinoplasty can remove a hump and improve nasal disproportion. In addition to achieving cosmetic improvements, the procedure can also be employed to correct problems resulting from nose injuries and can help relieve certain breathing difficulties.

How Is a Cosmetic Nose Surgery Procedure Performed?
There are two basic methods for performing cosmetic nose surgery, the open method and the closed method. At our Maryland-based Rhinoplasty Centre, Dr. Jennifer Parker Porter and Dr. Jigar Sitapara have extensive experience with both methods. During an open rhinoplasty procedure your surgeon will make a small incision along the columella. The columella is the strip of tissue that separates the nostrils. An open rhinoplasty tends to leave a tiny scar, but the scar is hardly visible because it is strategically placed in an area that is usually in shadow. If a closed rhinoplasty procedure is performed then the sites of incision will all be internal, rather than external.

Our surgeons prefer to use the closed technique for the majority of their procedures, reserving the open technique for patients undergoing revision rhinoplasty, patients increasing their tip definition, or patients correcting an overall structural problem such as a crooked nose. The closed rhinoplasty procedure works best for patients with thin to medium skin thickness, while the open procedure is often the more suitable option for patients with increased skin thickness. There are benefits associated with both methods and a comprehensive consultation is the only way to be certain about which method would be most appropriate for your specific rhinoplasty needs. Visit us to see a collection of rhinoplasty before and after pictures.

How Does the Computer Mirror® Imaging System Work?
The computer is able to transform a photograph of your face into an image of what you might look like following rhinoplasty. During your cosmetic surgery consultation, this photographic image can be manipulated based on your aesthetic preferences and any suggestions that Dr. Jennifer Parker Porter or Dr. Jigar Sitapara may have in accordance with their extensive experience as rhinoplasty surgeons. The computer imaging system is a communication tool that allows you to more clearly express the desires you have for your nose’s ultimate appearance. In turn it enables your surgeon to show you exactly what is possible using the most recent advances in rhinoplasty surgical techniques and technology so that you can enjoy more realistic expectations for the outcome of the procedure.

How Long Is the Recovery Period Following a Rhinoplasty Procedure?
Recovery time from cosmetic nose surgery can vary. Our rhinoplasty experts usually recommend that a patient reserve seven to 10 days for their initial recovery. The cast and stitches, if any are present, are removed approximately one week after surgery. Sometimes patients are fitted with a nose splint to stabilize the septum, the wall dividing the nasal passages. If present, this is also removed after about a week. Bruising is common following the procedure. Shortly after any postoperative dressings have been removed, many patients feel strong enough to resume light activities, such as having dinner with friends, driving, or going to the movies. Remember, however, that a complete recovery after cosmetic nose surgery will take time and patience. The final results of your cosmetic surgery will not be apparent for up to a year after rhinoplasty is performed. You should avoid strenuous activities for at least four weeks and avoid excessive direct sun exposure to help ensure a smooth recovery. Complications associated with the procedure are rare and usually minor. The risk of complications can be greatly reduced by adherence to our detailed post-operative care instructions.

How does Rhinoplasty differ for patients from different ethnic backgrounds?
Our surgeons have written several book chapters on this topic and, through the years, have treated many patients from a variety of ethnicities. Whether it is African American Rhinoplasty, Asian Rhinoplasty, or Rhinoplasty in patients of Latino descent, each patient is approached on an individual basis. Frequently our surgeons find that the external approach is the preferred surgical approach because of the thickness of the skin and the desire for increased definition of the tip. The external approach allows for further contouring that will become apparent as the nose heals. Additionally, the healing time to reach the final result in the “ethnic” rhinoplasty patient is usually on the order of one and a half years. Although there are obvious changes early on, this extra time is the time to refinement. Visit the best clinic for plastic surgery in Bethesda, MD. We’ll be happy to share our rhinoplasty before and after collection of satisfied procedures.

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With rhinoplasty, Dr. Porter and Dr. Sitapara produce natural-looking results that are in harmony with each patient’s features. They carefully consider the functional aspect of procedures to improve or maintain proper breathing. Outcomes reflect the patient’s personal aesthetic vision, based on our doctor’s skill and on the collaborative and extensive consultation that makes up treatment.

Talk with an experienced Facial Plastic Surgeon about your options with rhinoplasty. Schedule a consultation online with CCFPS or by calling us at (301) 618-0733.