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  • Before and After photo - Rhinoplasty |female, front view|

    For many people, having a rhinoplasty is the culmination of years of thought, research, and financial planning. Having come to the decision to undergo a nose job and locating a surgeon they like and trust, some nonetheless find themselves nervous and scared about undergoing cosmetic surgery. This is perfectly normal.

    Preparing yourself mentally before surgery is an important part of the rhinoplasty process. Taking steps to lower stress, boost confidence, and calm nerves can make the experience much smoother. We’ve included five tried and true pre-surgery suggestions:

     

    1. Relaxation Techniques

    Prior to having rhinoplasty, many patients feel anxious. Stress and fear may lead to sleepless nights and irritability. Finding a way to feel calm is important for both mental and physical health. Some relaxation practices my patients have successfully used include:

    • Meditation
    • Deep Breathing Exercises
    • Yoga
    • Tai Chi
    • Hypnosis
    • Massage
    • Visualization
    • Acupuncture

    Maintaining a positive mental attitude throughout the process is key to a quick recovery and ultimate satisfaction with your experience. Organize a support network of friends and family to help you in the days following your surgery. Develop a post-surgery recovery plan to ensure that you rest post procedure. Knowing that you have a safe space prepared with everything you will need will help minimize anxiety.

     

    2. Visualization

    One of the most important relaxation techniques listed above is Visualization. Visualization in this case means imagining the procedure you are about to undergo.

    To do this, find a quiet, comfortable place where you can be alone with your thoughts. Many people visualize in their bed before they sleep or after they wake up. Any place you feel comfortable is fine. Close your eyes, relax your body and do the following:

    In your mind’s eye, see yourself successfully preparing yourself for surgery both mentally and physically. Imagine the day of the surgery. See yourself feeling calm and confident. Picture the surgery itself. Watch as the surgeon completes all of the steps perfectly. Experience the recovery process unfolding without complications. See the perfect outcomes in the mirror a few weeks down the road.

    Going through these steps in your mind will help prepare you for your big day. Studies have shown that people who visualize success in this manner experience less stress and feel emotionally better the day of surgery than those who do not.

    Part of good visualization is knowing exactly what is going to happen before, during, and after surgery. This leads us to an important part of your mental preparation – education.

     

    3. Educate Yourself About the Process

    In my office, we put an emphasis on patient education. I have found that well-educated, well-prepared clients have less concerns the day of the procedure, recover faster, and are ultimately happier with their end results. Our staff will ensure that you have all the information you need about your rhinoplasty. Please do not be shy about asking questions. I am always available and happy to talk with my patients about their concerns, no matter how large or small they may be.

    I also encourage my patients to educate themselves by going on the Internet and researching rhinoplasty. As with any topic online, there are good websites on the subject, and bad. Make sure you are getting your information from reputable websites. In addition to my own website, sites you might consider referring to include aafprs.org, realself.com, entnet.org, and the National Institutes of Health’s MedlinePlus website.

     

    4. Understand What a Plastic Surgeon Can and Cannot Do

    It is important to have realistic expectations about your rhinoplasty. Studies have shown that among cosmetic surgery patients that are unhappy with the results of their procedures, the most common characteristic is that they simply had unrealistic expectations. While a rhinoplasty may certainly improve one’s appearance, it is not reasonable to expect a magical or miraculous transformation. In addition, plastic surgery cannot cure depression or other psychological conditions. Often, a successful rhinoplasty can boost one’s self-confidence, but this cannot be guaranteed for everyone.

    It is very important to me that my patients are choosing to have rhinoplasty for the right reasons. No one should undergo a procedure if they are seeking to look like someone else, or if they hope it will completely change their lives. Rhinoplasty can certainly improve one’s appearance, but it cannot fix all of life’s problems.

     

    5. Understand the Recovery Process

    The first thing to remember is that the recovery process takes time. It may take up to two years for your nose to completely reach its final form. Every patient heals differently and at her own pace.

    Your nose will be swollen following rhinoplasty, and it will take time for the swelling to go down. Most swelling will go away within two weeks. After a month it will be almost all gone, but it may take up to a year for swelling to totally disappear.

    Immediately following surgery, your face will be puffy. You may possibly have black eyes, though I take special precautions to minimize this and other bruising. Many patients experience bouts of nausea during the day following their operation.

    Cold compresses will be used to help reduce swelling. In some instances pain medications will be dispensed to ease discomfort. Homeopathic herbal remedies like arnica montana can help you recover as well. Your head should remain elevated for a few days, and in some cases should not be moved at all. It may be several weeks before you can resume vigorous physical activity, including contact sports. You may have to sleep on your back for several weeks. You probably won’t be able to wear glasses for three weeks. Most patients are able to go back to work within ten days.

    My patients usually receive a packet of remedies to speed and aid the recovery process. This packet can include herbal supplements, vitamins, and the anti-inflammatory steroid Medrol. Other medicines designed to speed recovery may be given as well.

    To learn more about preparing for rhinoplasty, contact my office today.

    Market Watch

    Dr. Sam Rizk is featured in the Wall Street Journal’s plastic surgery article discussing revision rhinoplasty deformities. Read the full feature below:

    Dr. Sam Rizk, a plastic surgeon in New York City, says 1 out of 3 of his rhinoplasty patients have had previous nose jobs. Among the most common problems he sees are “scooped bridges,” over-restricted nostrils, and pinched tips. The number of botched nose jobs he has repaired has soared over the past three to five years as more surgeons are performing the surgery who aren’t well trained or experienced, he says. Industrywide statistics bear out his experience: Revision surgery is up 35% from 2008 to 2012, according to the American Academy of Facial Plastic and Reconstructive Surgery.

    One of the best rhinoplasty surgeons in New York, Dr. Sam Rizk is featured in a HuffPost Live Chat where he discusses revision rhinoplasty on his former patient Melissa. Melissa had two previous nose jobs. Dr. Rizk helped her fix a collapsed and short nose by building her a new bridge and tip structure using rib cartilage. Dr. Rizk also talks about how you can find the best nose job surgeon and revision rhinoplasty surgeon.

    Do you need revision rhinoplasty? Are you looking for the best revision rhinoplasty surgeon? Well, our NYC double-board certified facial plastic surgeon and rhinoplasty expert Dr. Rizk may be who you are looking for. Read more about how our internationally acclaimed doctor has proven himself to be more than just another good facial plastic surgeon in NYC.

    Before and After Photos - Rhinoplasty: 30 year old female, front view
    Before and After Photos - Rhinoplasty: 30 year old female, right side view

     

    30 yo female with history of chemical dependency who was concerned cosmetically with her open roof deformity, saddle nose deformity (cartilaginous saddle nose) and also her wide nasal bridge. Patient underwent revision rhinoplasty but since she had not septal cartilage available, banked rib cartilage and temporalis fascia was used as a graft to correct the saddle nose. By raising her nasal bridge and narrowing her nasal bones the brow-tip aesthetics have improved. Patient is shown 3 years after surgery.

    Roughly 10-15 percent of rhinoplasty patients are dissatisfied with their primary rhinoplasty nationwide and seek revision rhinoplasty, also known as secondary rhinoplasty. But is it harmful to undergo multiple revision rhinoplasties? It depends on a number of factors.

    First and foremost, it is important to note that it depends more on what was done in prior surgeries, and on factors specific to your anatomy, than it does on how many rhinoplasty procedures you have undergone. Factors that must be considered by you and your surgeon include the following:

    • Integrity of the nasal skin
    • Thickness of the skin (if you have naturally thin skin or if it’s thinner due to prior rhinoplasty procedures, the risk of undergoing additional procedures may be too high)
    • How much cartilage was removed
    • Whether you need skin grafting
    • Amount of scar tissue
    • Extent of deformities
    • Psychological condition of the patient

    Revision rhinoplasty is very technically challenging, so even one revision should not be taken lightly. For this reason, it is also imperative that you select a facial plastic surgeon specializing in revision rhinoplasty to perform any additional revisions.

    Also, it is very important that you have realistic expectations. With each successive procedure, the odds of a successful outcome diminish. The only way to know for sure is to get an evaluation from a qualified revision rhinoplasty specialist.

    More often than not, patients requiring secondary rhinoplasty or revision rhinoplasty have had too much cartilage removed during their primary procedure. An area of the nasal structure may collapse if too much of the area is resected. For example, the saddle of the nose may collapse, resulting in a “scoop” look and possibly leading to breathing difficulty. The internal or external nasal valve is another area that can collapse if cartilage is removed improperly, or if too much cartilage is removed.

    Unfortunately, many secondary rhinoplasty or revision rhinoplasty patients have already undergone a few rhinoplasty procedures before reaching out to New York City Facial Plastic Surgeon, Sam Rizk, MD, FACS. Many of these patients have cartilage depletion or a lack of cartilage in their nose.

    Dr. Rizk is known for a revision method that both rebuilds cartilage or bone and restores proper breathing. He may use auricular (ear) cartilage, nasal septum cartilage, irradiated rib cartilage, or alloplastic biocompatible implants, depending on the nature of the problem as well as the patient’s unique needs.

    For internal and external nasal valve collapse, Dr. Rizk may use spreader and nasal batton grafts. Saddle nose deformities may be repaired using dorsal grafts and/or spreaders. The grafts are harvested and then shaped to create the proper size, thickness, shape and dimension, and occasionally depending on the size and number of cartilages needed to be grafted, an open rhinoplasty approach may be needed. Dr. Rizk uses the endonasal approach to create a precise pocket to accommodate the graft. This approach is minimally invasive and results in less scar tissue formation, as well as better healing.

    For more information, contact Dr. Rizk.

    If you are unsatisfied with the results of your primary rhinoplasty surgery (the original procedure), what you need to look for this time is a nose specialist. This is very important because revision rhinoplasty is a complex procedure – perhaps the most complex of all cosmetic procedures. But how do you determine who is and isn’t a rhinoplasty specialist?

    A good way to narrow your search is to focus on board-certified facial plastic surgeons. Though general plastic surgeons are also qualified to perform rhinoplasty, they rarely specialize in procedures of the face. As a general rule, facial plastic surgeons perform more rhinoplasty procedures on a monthly and yearly basis than general plastic surgeons do. The American Board of Facial Plastic and Reconstructive Surgery (AAFPRS) has strict requirements that surgeons must meet to acquire and maintain certification.

    Note that not all facial plastic surgeons specialize in rhinoplasty. So, to further winnow down your list, focus on surgeons who perform a large number of rhinoplasty procedures. Your surgeon should have experience using advanced grafting techniques with different types of cartilage (ear cartilage, irradiated rib cartilage, etc.). In addition to having experience with revision rhinoplasty, he or she should also have extensive experience performing rhinoplasty on different types of noses, including different ethnicities and shapes.

    Ask your surgeon to see pictures of rhinoplasty patients. This is important because you and your surgeon may not share the same sense of aesthetics. Ask to see examples that are similar to your situation. Also ask to see some that are different, as different nasal characteristics look good on different faces. Some surgeons have a signature look; this isn’t a good thing, because everyone’s face is different.

    A good tool for determining if you and your surgeon are on the same page is 3D imaging. This technology can help you understand if your prospective surgeon understands what you’re looking to achieve in your secondary surgery.

    Also make sure to read testimonials from other patients, and ask to speak with patients who have undergone revision rhinoplasty with your surgeon.

    In the end, trust your gut. If you have a bad feeling about a particular surgeon, don’t be afraid to walk away.

    Generally, Double Board Certified, New York City Facial Plastic Surgeon, Sam Rizk, MD, FACS, advises patients to wait at least a year following their primary rhinoplasty procedure before undergoing revision rhinoplasty (secondary rhinoplasty).

    Although some problems, such as displaced cartilage or bone, can be addressed as soon as a few months after the original rhinoplasty procedure, most cannot. This is because it takes a year or more for the scar tissue that develops to soften, and because the skin and soft tissue that surround the structural components of the nose remain swollen for a year or longer. Most facial plastic surgeons agree that some residual swelling lasts even longer. Until swelling has fully subsided, your surgeon will be unable to determine the right course of action. You yourself might decide that you don’t need revision once the swelling is gone.

    Of course, as with any cosmetic procedure, the amount of time you need to wait before having revision rhinoplasty depends on the specifics of your situation. It also depends on what you are trying to achieve. There is no one-size-fits-all answer to this question.

    It is important to note that while primary rhinoplasty is considered a very complex procedure, secondary rhinoplasty is even more complicated – perhaps the most complicated of all cosmetic surgeries – so it is extremely important that you enlist the services of a highly qualified, experienced rhinoplasty specialist such as Dr. Rizk. If a surgeon advises you to have revision rhinoplasty too early, the results may be disastrous. Some of the most serious complications associated with nose surgery can occur as a result of a prior revision surgery that was performed too soon. Performing surgery too soon can also lead to poor healing.

    In sum, if you recently underwent primary rhinoplasty, patience is important. Contact Dr. Rizk for a thorough evaluation.

    Rhinoplasty Before & After

    July 30th, 2012

    Before Photos - Rhinoplasty: 30 yo female, front view After Photos - Rhinoplasty: 30 yo female, front view
    Before After
    Before Photos - Rhinoplasty: 30 year old female, right side view After Photos - Rhinoplasty: 30 year old female, right side view
    30 year old female who underwent previous rhinoplasty who presented to Dr. Rizk for secondary septoplasty and rhinoplasty with an inverted v deformity, collapse of her external nasal valves, a nasal hump, and a hanging columella, and pinched nasal tip. Patient had trouble breathing as well. Patient is shown 1 year after revision rhinoplasty and septoplasty with grafts to correct the collapsed middle nasal vault and external nasal valves.
    Before Photos |Rhinoplasty| 25 yo female, front view After Photos |Rhinoplasty| 25 yo female, front view
    Before After
    Before Photos |Rhinoplasty| 25 year old female, right side view After Photos |Rhinoplasty| 25 year old female, right side view
    25 yo with history of previous rhinoplasty and is unhappy with scooped, short nose, with nostrils showing too much and a rotated up tip. Patient underwent revision rhinoplasty with Dr. Rizk using banked irradiated rib cartilage for grafts and Alloderm to soften the edges of the grafts. Dr. Rizk does not like to use the patient’s own rib due to scarring, risks to lung and danger to patient. Banked rib cartilage works excellent and has been used for many years in patients who are collapsed and need significant nose support. Patient is shown postoperatively at 1 year.
    Before Photos - Rhinoplasty - 29 yo female ethnic rhinoplasty patient, front view After Photos - Rhinoplasty - 29 yo female ethnic rhinoplasty patient, front view
    Before After
    Before Photos - Rhinoplasty - 29 yo female ethnic rhinoplasty patient, right side view After Photos - Rhinoplasty - 29 yo female ethnic rhinoplasty patient, right side view
    29 yo female ethnic rhinoplasty patient with thick skin who had previous rhinoplasty who requests improvement in symmetry, breathing and definition. Patient underwent revision rhinoplasty with multiple cartilage grafts into tip and middle nasal vault to correct her breathing and cosmetic appearance. Patient is shown one year after revision rhinoplasty.
    Before Photos - Rhinoplasty - 26 yo female who underwent previous rhinoplasty, front view After Photos - Rhinoplasty - 26 yo female who underwent previous rhinoplasty, front view
    Before After
    Before Photos - Rhinoplasty - 26 yo female who underwent previous rhinoplasty, left side view After Photos - Rhinoplasty - 26 yo female who underwent previous rhinoplasty, left side view
    26 yo female who underwent previous rhinoplasty who wanted further improvement in shape of her nose. She was unhappy with the boxy tip which was also overprojected as well has her bony bump (slight). She underwent secondary rhinoplasty with correction of the boxy tip as well as deprojection of the nasal tip (bringing it closer to her face) and reduction of the bony bump. Patient is shown 1 year after surgery.


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    Rhinoplasty Before & After

    March 16th, 2011

    Before Photos - Rhinoplasty - 54 yo female, front view After Photos - Rhinoplasty -  54 yo female, front view
    Before After
    Before Photos - Rhinoplasty -  54 yo female, right side view After Photos - Rhinoplasty -  54 yo female, right side view
    54 yo female with history of severe nasal trauma to nasal bridge/nasal reconstruction. Patient has a severe saddle nose, overprojected nasal tip, deviated nasal septum, and multiple collapsed areas in external nasal valve region. Patient underwent rhinoplasty, septoplasty, as well as medpor implant placement on nasal bridge. Patient had septal cartilage grafts to external nasal valve and nasal tip as well. Patient shown 4 weeks postoperatively. Patient was given options of rib versus medpor for the nasal bridge and chose the medpor instead after the advantages and disadvantages of each were given.


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    Before Photos - Rhinoplasty - 24 yo female who underwent revision rhinoplasty, front view After Photos - Rhinoplasty -  24 yo female who underwent revision rhinoplasty, front view
    Before After
    Before Photos - Rhinoplasty -  24 yo female who underwent revision rhinoplasty, left side view After Photos - Rhinoplasty - 24 yo female who underwent revision rhinoplasty, left side view
    24 yo female who underwent revision rhinoplasty with Dr. Sam Rizk using banked rib cartilage and temporalis fascia to correct an overshortened, scooped nose with multiple areas of collapse secondary to previous rhinoplasties. Patient is shown 1 year following revision rhinoplasty with Dr. Rizk. The short nose is one of the most difficult deformities to correct.

    Watch this patient’s testimonial video

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    Before Photos - Revision Rhinoplasty - 45 year old male with previous rhinoplasty, front view After Photos - Revision Rhinoplasty - 45 year old male with previous rhinoplasty, front view
    Before After
    Before Photos - Revision Rhinoplasty - 45 year old male with previous rhinoplasty, left side view After Photos - Revision Rhinoplasty - 45 year old male with previous rhinoplasty, left side view
    45 year old male with previous rhinoplasty who presents for revision or secondary rhinoplasty. Patient has inverted v deformity, pollybeak deformity, a drooping nasal tip and a deviated septum to the right side. Patient is shown 6 months after revision rhinoplasty with septal cartilage grafts to correct the tip and middle vault of the nose.


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    Before Photos - Rhinoplasty - 45 year old female who had a previous rhinoplasty , front view After Photos - Rhinoplasty - 45 year old female who had a previous rhinoplasty , front view
    Before After
    Before Photos  - Rhinoplasty - 45 year old female who had a previous rhinoplasty , left side view After Photos - Rhinoplasty - 45 year old female who had a previous rhinoplasty , left side view
    45 year old female who had a previous rhinoplasty and presented for secondary rhinoplasty. Patient wanted a straighter nose and to make her nose longer. Preoperative profile photos show a very short nose and hanging columella. Preoperative front views shows a deviated nose and a collapse of the right upper lateral cartilage and a bone on the right that is not in properly. Patient underwent revision rhinoplasty (endonasal) with osteotomy on right bone and spreader graft on right cartilage collapse and multiple tip grafts to elongate the nose. Patient is shown 6 years after secondary rhinoplasty.


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    Before Photos - Rhinoplasty - 25yo female with a severe rhinoplasty, front view After Photos - Rhinoplasty - 25yo female with a severe rhinoplasty, front view
    Before After
    Before Photos  - Rhinoplasty - 25yo female with a severe rhinoplasty, right side view After Photos - Rhinoplasty - 25yo female with a severe rhinoplasty, right side view
    25yo female with a severe rhinoplasty deformity from a previous rhinoplasty with both a floating bone open roof problem as well as tip bulbosity. Patient actually has attachment of bone into thin skin in dorsum. Patient is shown 5 months after revision rhinoplasty.


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    Before Photos - Revision Rhinoplasty - 25 year old female complains about her tip as too boxy, front view After Photos - Revision Rhinoplasty - 25 year old female complains about her tip as too boxy, front view
    Before After
    25 year old female complains about her tip as too boxy. Patient has separation of her lower tip cartilages and a saddle above her tip. This was corrected with cartilage grafts obtained from patient’s septum and suture techniques were used to make tip cartilages narrower. Patient’s deformities had resulted from a previous rhinoplasty and patient underwent secondary rhinoplasty with Dr Rizk to correct these deformities.

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    Plastic surgery does not always go the way it should. Unfortunately, very often the outcomes of plastic surgery do not meet the expectations of many patients. With revision rhinoplasty, sometimes a surgical mistake or poor healing can result in a bad outcome requiring revision rhinoplasty.

    Dr. Sam Rizk is a double board certified top facial plastic surgeon in New York who does revision rhinoplasty. In one of the cases shown on the FOX National News segment about Plastic Surgery Nightmares, Dr. Rizk helps correct multiple areas of the patient’s nose, damaged by previous plastic surgeries. After the reconstructive operation, the patient’s nose looks straighter, more defined, and has improved breathing capability.

    YouTube Preview Image
    Before Photos - Revision Rhinoplasty - 25 year old female who underwent rhinoplasty 8 years ago, front view After Photos - Revision Rhinoplasty - 25 year old female who underwent rhinoplasty 8 years ago, front view
    Before After
    Before Photos  - Revision Rhinoplasty - 25 year old female who underwent rhinoplasty 8 years ago, right side view After Photos - Revision Rhinoplasty - 25 year old female who underwent rhinoplasty 8 years ago, right side view
    25 year old female who underwent rhinoplasty 8 years ago and was very dissatisfied with her nose. Her preoperative pictures shows the typical stigma associated with an overreduced rhinoplasty. Preoperative pictures shows the following deformities from the profile: Scooped out saddled cartilage bridge and a bony bump, overprojected tip with a hanging columella, pointy tip on the right. Preoperative picture from the front view shows the following deformities: open roof deformity near the bony top part of nose, inverted v deformity in the cartilage part of nose, pointy tip on right, and hanging columella. Postoperative pictures are shown after rhinoplasty with the use of septal cartilage graft. Additionally, patient could not breathe preoperatively secondary to a deviated septum and could breathe after that was fixed at the same time.


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    Before Photos - Rhinoplasty - 31 yo old male Indian doctor, front view After Photos - Rhinoplasty - 31 yo old male Indian doctor, front view
    Before After
    Before Photos  - Rhinoplasty - 31 yo old male Indian doctor, right side view After Photos - Rhinoplasty - 31 yo old male Indian doctor, right side view
    31 yo old male Indian doctor who underwent previous rhinoplasty in Beverly Hills who is dissatisfied with his lack of definition and his scooped feminized nose. Patient is shown only 1 week after revision rhinoplasty with multiple sculpted grafts in his tip and bridge to masculinize his nose and successfully define it despite having very thick skin with underlying scar tissue. Additionally, the nostrils were asymmetric and were adjusted. Patient is still swollen as he is shown only 1 week after surgery.


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    Before Photos - Rhinoplasty - 19 year old male, front view After Photos - Rhinoplasty - 19 year old male, front view
    Before After
    Before Photos - Rhinoplasty - 19 year old male, left side view After Photos - Rhinoplasty - 19 year old male, left side view
    19 year old male with history of previous nasal injury and previous rhinoplasty complains of a crooked nose and a nasal bump as well as difficulty breathing. Patient is shown 1 week after endonasal septorhinoplasty with spreader and camouflage cartilage grafts on the left side to correct collapse in the cartilaginous middle part of the nose. Patient is noted to have minimal bruising after cast removal.


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    Rhinoplasty Before & After Photos

    November 30th, 2009

    Before Photos: - Rhinoplasty - 48 year old female, front view After Photos: - Rhinoplasty - 48 year old female, front view
    Before After
    48 year old female with previous history of rhinoplasty unhappy with her front view irregularities and areas of collapse (worse on right side) and inability to breathe. Patient shown after revision rhinoplasty using septal and auricular cartilage grafts to correct multiple areas of deformities and collapses. Both spreader and alar batton grafts were needed as well as dorsal onlay grafts. Graft edges were smoothed using Dr. Rizk’s new graft sculpting technology. Only front pictures are shown as there was mainly front changes only.


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    Rhinoplasty Before & After Photos

    November 12th, 2009

    Before Photos: - Rhinoplasty - 27 year old Asian female, front view After Photos: - Rhinoplasty - 27 year old Asian female, front view
    Before After
    Before Photos: - Rhinoplasty - 27 year old Asian female, right side view After Photos: - Rhinoplasty - 27 year old Asian female, right side view
    27 year old Asian female who had a previous rhinoplasty with silicone implant which became infected and extruded through her tip and also became crooked. Patient underwent revision rhinoplasty with Dr. Rizk to remove silicone implant and Dr. Rizk used cartilage from inside her nose to lengthen her nose and define her tip.


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