Quality Nose Specialists in the Princeton area
The board-certified facial plastic surgery experts at the Glasgold Group specialize in rhinoplasty, revision rhinoplasty, and other related facial procedures and are proud to offer rhinoplasty in Princeton, NJ to patients who would like to achieve improved facial aesthetics and enhanced confidence.
Rhinoplasty, or nose surgery, is a popular cosmetic surgical procedure that alters and improves the shape of the nose. A disproportionately large or abnormally shaped nose draws attention away from the other facial features and negatively affects the overall aesthetics and balance of the face. Because of this, many people opt for rhinoplasty in Princeton, NJ to help address these issues.
Before & After photos
* Each patient is unique and individual results may vary.
What is Rhinoplasty?
The nose is a prominent facial feature that significantly affects the overall appearance of the face. What a rhinoplasty does is re-contour the shape of the nose to harmonize with the patient’s other facial features while addressing their specific aesthetic concerns. Some of the most common changes that patients request include:
- Reducing the size of a bump on the bridge of the nose
- Narrowing the bridge of the nose
- Narrowing the tip of the nose
- Reshaping the nasal tip
The ideal surgical result after rhinoplasty is a natural-appearing nose that complements and enhances other facial features. Rhinoplasty should also preserve or enhance nasal function while helping patients to reach their aesthetic goals.
Although cosmetic nose surgery is the most common type of rhinoplasty, there are other variations on the procedure, including:
- Functional rhinoplasty to address breathing issues like a deviated septum
- Ethnic rhinoplasty to address cosmetic concerns in non-Caucasian patients while preserving ethnic identity
- Revision rhinoplasty to correct problems caused by a previous surgery
We customize the nose to the patient’s needs and may combine different techniques to optimize results.
The ethnic rhinoplasty carries its own set of unique problems which require a significantly different approach as compared to a non-ethnic rhinoplasty. Most of these patients seek a cosmetic improvement that still respects and preserves their ethnicity.
African Americans and Asians, for example, frequently have a broader, somewhat flatter nasal structure along with generally thicker skin in the nasal area. improving tip definition and narrowing are important considerations and require the skill of a highly experienced surgeon. In some instances of New Jersey ethnic rhinoplasty we may be need to augment a flat bridge in order to produce a better nasal definition for our African American and Asian patients. Hispanics frequently have thicker skin as well, which makes refinement of the nasal tip more difficult. In general, these patients also need strong tip support requiring nasal cartilage tip grafts. A surgical technique which we developed and perfected produces especially superior results in these more challenging cases.
Rhinoplasty Consultation in Princeton
A rhinoplasty consultation in Princeton, NJ at the Glasgold Group provides patients with the opportunity to:
- express their desired goals for surgery
- set expectations for the outcome of the surgery
- understand the postoperative healing process
From the surgeon’s perspective, it is important to have a good understanding of what changes a patient hopes to achieve through surgery. We will also review any functional breathing problems the procedure can address.
We will ask patients to provide a history of prior nasal injuries or surgeries (if applicable), known medical conditions, and medication usage. Once our experts have determined candidacy and discussed the patient’s goals and expectations with them, we may use digital imaging to provide a preview of the patient’s nose postoperatively.
Prospective patients should ask questions they may have about the surgery and the results. After the consultation, patients should:
- Have a better understanding of the process
- Know what to expect before, during, and after a nose job
- Feel comfortable with their plastic surgeon(s)
- Understand the expected results
Preparing for Nose Surgery
Approximately two weeks prior to rhinoplasty surgery in Princeton, NJ, patients will have a preoperative visit and meet with a nurse or medical assistant. They will review what needs preparation for rhinoplasty and post-operative care. This visit is also an opportunity for patients to review their goals with their surgeon and ask questions.
Prior to surgery, our staff will also remind patients to avoid the use of blood-thinning medications such as Motrin, Advil, products that contain aspirin, and homeopathic medications or supplements that may have a similar effect. Your surgeon will provide a list of the items at the preoperative visit.
We tell patients to use a prescription topical antibiotic ointment just inside the nostril starting one week before surgery and continuing for one week afterward. We will also provide additional prescriptions at the preoperative visit, including pain medications and antibiotics as needed.
The Rhinoplasty Procedure
Rhinoplasty surgery with the Glasgold Group is performed at one of three locations around Princeton, NJ:
- Our accredited in-office surgical suite
- An outpatient surgery center (University Surgicenter in East Brunswick)
- Robert Wood Johnson University Hospital in New Brunswick
We will determine the location of surgery based on several factors.
The Glasgold Group can perform nasal surgery under general anesthesia or with intravenous sedation. If we perform the surgery under general anesthesia, the rhinoplasty will take place at a surgery center or hospital. We will discuss the anesthesia type at the consultation, which depends on the procedure, the patient’s preference, and the age of the patient.
We will also address functional breathing issues.
Usually, the surgery takes approximately three to four hours. We may use different techniques depending on the patient’s goals, including:
- cartilage grafting
- breaking nasal bones
- resetting the nasal bones
After we complete the surgery, patients rest in the recovery room for approximately two hours before we discharge them home. Recovery room time is shorter if we perform the surgery under intravenous sedation.
A family member or friend must accompany patients and drive them home from surgery. Patients should also plan on having someone stay with them until at least the morning following surgery.
Recovering from Rhinoplasty
Immediately After Surgery
After your rhinoplasty surgery in Princeton, the surgeon will place tape and a small metal splint on the bridge of the nose. There will also be a small gauze pad taped under the nostrils. We then provide patients with additional gauze and instructions on how to replace it. Unlike the bandage on the nose, the drip pad is changed as needed.
Patients will change the gauze less often after the first few days. Many find that, within 48 hours, drainage has reduced so much that replacement gauze is no longer needed.
The Initial Recovery Period
The first postoperative visit will be at 6-7 days after surgery. We will remove the tape, splint, and sutures. In most cases, there are just three sutures in the columella that need removal since all other sutures are dissolvable. Patients can apply make-up once the bandage is off.
Following surgery, there are varying degrees of swelling and bruising. Bruising occurs under the eyes and should mostly resolve within 7 to 10 days. The swelling usually peaks a few days after surgery and will then decrease. When patients have their dressing removed, they will appreciate the change in their profile.
At one week after surgery, it is common for the nose to look wider than expected on front view due to swelling.
Returning to Normal Activities
Most patients are comfortable returning to work or school 10 days after surgery. However, this is just an estimated time frame because of individual variations in healing time. It is important that patients inform us of any significant events they may have scheduled following surgery so we can adequately discuss their expectations for recuperation and recovery time.
Patients can return to full strenuous activity three weeks after surgery. It is important for patients to avoid tanning for the first few months as this may lead to nasal swelling. We recommend proper use of strong sunblock when spending time outdoors.
In the Months Post Surgery
After the first postoperative visit, patients return for their second visit at about one month after surgery. Patients will have experienced significant progression in the healing process. However, there will still be minor swelling in the nose. Subtle changes and decreases in the swelling will gradually occur over many months.
What Are Possible Side Effects or Risks of Nose Surgery?
While choosing the right surgeon and following all pre- and post-operative instructions reduces surgical risks, rhinoplasty carries many of the same potential risks, side effects, and complications as other surgeries. Patients should know the following risks before they move forward with the procedure:
|Bleeding||Infection||Skin/tissue necrosis||Prolonged swelling|
|Poor healing||Scarring||Numbness||Breathing issues|
|Poor aesthetic outcome||Nasal septal perforation (hole in the nasal septum)||Skin discoloration||Anesthesia complications|
Prospective patients who have any specific concerns regarding risks should bring them up during their rhinoplasty consultation in Princeton, NJ, so our surgeons can discuss and address them.
Why choose The Glasgold Group
Rhinoplasty New Jersey is a complex and custom procedure that requires a high level of skill and knowledge to perform properly. At the Glasgold Group, our surgeons have decades of experience while patients and peers alike respect them for the beautiful, natural-looking results they produce consistently. By choosing the Glasgold Group for your procedure, you can expect results of the highest caliber and the knowledge that your safety and satisfaction are top priorities.
- Dr. Robert Glasgold has an American Board of Otolaryngology – Head and Neck Surgery Certification.
- Dr. Robert Glasgold is a Fellow of the American College of Surgeons and double board certified.
- Dr. Mark Glasgold is a Fellow of the American College of Surgeons and double board certified.
- Dr. Mark Glasgold is a co-director of the Facial Plastic Surgery Fellowship Program of AAFPRS.
- Dr. Mark Glasgold has an American Board of Facial Plastic & Reconstructive Surgery Certification.
- Dr. Mark Glasgold has an American Board of Otolaryngology-Head and Neck Surgery Certification.
Frequently Asked Questions
Imaging software helps you and your surgeon visualize the goals of your rhinoplasty surgery. In our offices in Princeton, NJ, we use the Canfield mirror imaging program and 3-D Vectra program. With these imaging devices, we attempt to show a result that is realistic and appropriate for you.
It is important to note that imaging does not provide the actual exact result. Instead, it represents a planned goal and helps patients get a sense of what their new nose will look like. Pre-operative imaging helps align the goals of both the patient and the surgeon.
We can perform rhinoplasty through either an open or closed (endonasal) approach. In our practice, we perform almost all surgeries through the open technique. An open approach combines the use of incisions inside the nostrils with an additional small incision that hides in the columella (the skin between the nostril openings).
The advantage of the open technique is that it provides better visualization of the underlying nasal structure with the ability to more effectively and precisely re-contour the nose. The scar in the columella typically fades well over time and becomes difficult to see.
Reshaping the upper portion of the nose (aka the bridge or dorsum) involves alterations in the bone and cartilage. When reducing a bump, we can shave the bone and cartilage components down. When needed, we can elevate the dorsum with the use of cartilage grafts or implants. Reshaping the nasal tip requires alterations of the cartilaginous structural components responsible for the external appearance of the tip.
Depending on the desired changes in the nasal tip, we can alter the tip cartilages by removing excess cartilage responsible for a wide-appearing tip. Suturing the existing cartilage to change its shape and adding cartilage to strengthen areas that are weak creates a more defined nasal tip shape.
The addition of cartilage in the nose, cartilage grafting, is an important tool for reshaping the nasal tip. The open technique allows precise placement and suture stabilization of these grafts.
The preferred source of cartilage for the grafts is the nasal septum; this involves removing a non-structural component of the septum and creating the grafts from it. We can use auricular (ear) or costal (rib) cartilage when there is an inadequate source of septal cartilage (usually because of patients having prior septoplasty and/or rhinoplasty surgery).
Yes. Because the basic nasal structure is frequently misaligned so that you are not just altering the size or shape of the nose you are dealing with the asymmetries which sometimes can be significant.
Augmentation of the nasal dorsum is almost routinely performed in Asian noses. Asian patients generally complain that they do not have much of a bridge and request this. Dorsal augmentation can be accomplished with a variety of materials. Cartilage can be taken from the nasal septum or the ear or donor cartilage may be used if these areas are not sufficient. In addition, gortex is an excellent means of dorsal augmentation. It has a very natural feel, adapts readily to the contour of the nose and does not move. I’ve used this frequently with great success. Having just come back from Vietnam, where I performed five rhinoplasties during a pro bono Face to Face program, in each case, I had to augment the dorsum. The common means of dorsal augmentation in Asian countries is a pre-formed Silastic implant. This has a higher incidence of problems than gortex or cartilage. In addition, when building up the dorsum, we frequently have to project the nasal tip in order to balance the increased height of the rest of the nose. This is always done with cartilage grafts, generally taken from the septum.
Natural implants would generally be considered those taken from the patient’s own material. We frequently use grafts in rhinoplasty taken from the patient’s septum or ear. Rib cartilage can also be used and this can be taken either from the patient or from a donor.
The tip of the nose is the lower one-third. There are cases in which the upper two-thirds are acceptable and don’t require any change. In these cases the surgeon can focus on the tip of the nose and re-contour it. Usually this involves narrowing, improving definition and rotation of the nose.
The most common age related change is due to lack of support of the nasal tip. With aging and loss of some skin elasticity the tip can appear to droop giving the nose a longer appearance. This also can accentuate a small protrusion of the nasal bones that was not apparent before. This certainly can be fixed. We have written extensively on the fact that the drooping nose can be one of the most aging facial features in a mature woman.
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