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  • Dr. Sam Rizk notices a significant increase of men in their 20s and 30s getting rhinoplasty, chin implants, and chin contouring procedures at his NY Facial Plastic Surgery Center. The trend of men interested in cosmetic enhancements are due to the pressure of needing to look youthful in order to compete in their respective fields and the constant stigma to look good, says Dr. Rizk.

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    Alar batten grafts are grafts used to strengthen the nasal airways in order to prevent alar retraction or to treat nasal valve collapse. They can also be used to treat a “pinched” nasal appearance. “Alar” refers to the nasal ala while “batten” is a nautical term that means to stiffen.

    In cases of nasal valve collapse, alar batten grafts are used when the nasal sidewall is collapsed, causing narrowing of the nasal valve that may lead to breathing problems.

    Alar batten grafts are placed in pockets just above the lower lateral cartilages. They may be made of costal, septal or conchal cartilage. Conchal is the least sturdy of these and is therefore not the best option for some patients.

    In certain cases alar batten grafts may be combined with septoplasty or septorhinoplasty.

    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.

    Dr. Sam Rizk comments on Duchess of Cambridge Catherine Elizabeth “Kate” Middleton’s nose. Dr. Rizk says “Kate is a natural beauty. Her nose has a good shape, looks like she was born with it, has no visible irregularities (even in tabloid close ups) and no hump or asymmetries,” and “It is not too large, too small, or too chiseled, and most importantly, it suits her face and complements her other features.”

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    PRIME: International Journal of Aesthetic and Anti-Ageing Medicine


    In this guest editorial of PRIME magazine, Dr. Sam Rizk discusses the ever expanding global landscape of cosmetic medicine, aesthetic surgery and consumer demands.

    If you are considering rhinoplasty, it is very important that you choose a facial plastic surgeon (not a general plastic surgeon) who specializes in rhinoplasty. Dr. Rizk is focused exclusively on the face and neck, with a particular interest in nose surgeries.

    Your best bet when selecting a surgeon is to narrow your choices to surgeons who are dual board certified in facial plastic surgery and otolaryngology-head and neck surgery. These surgeons have extensive knowledge of the internal structures of your nose, as well as its external cosmetic appearance, and they are trained to surgically alter both. They are also trained to address functional issues like breathing.

    Following medical school, facial plastic surgeons receive residency training in general surgery or otolaryngology-head and neck surgery, followed by rigorous training in facial plastic procedures. They usually receive board certification in one of these areas before seeking certification by the American Board of Facial Plastic and Reconstructive Surgery. To achieve the latter they must possess medical licensure and submit a documented record of experience that includes surgical reports for at least 100 facial plastic procedures.

    While general plastic surgeons also possess advanced surgical skills, they typically divide their time between breast/body procedures and facial procedures, and they may lack an in-depth knowledge of the nose’s internal support structures. For these reasons, it is best to select a board-certified facial plastic surgeon to perform your rhinoplasty procedure.

    A non-surgical nose job and rhinoplasty are vastly different procedures. A non-surgical nose job is a relatively simple, non-invasive procedure with temporary results; in contrast, rhinoplasty is one of the most complex, invasive plastic surgery procedures and has permanent results.

    Non-surgical nose procedures may be used to address issues such as a bump on the nose or nasal tip problems. These procedures involve the use of injections or neurotoxins. Injectables such as Restylane, Juvederm and Radiesse can add volume and smooth bumps, while neurotoxins like Botox and Dysport are used to lift the nasal tip.

    Non-surgical nose job treatments cannot reduce the size of the nose, change its inherent structure, reduce a large tip, narrow a wide nose or help with breathing difficulties. In other words, these treatments are not a replacement for rhinoplasty.

    That being said, a non-surgical nose job may be the right choice for you if you want a temporary change in appearance. These procedures only last up to six months. They are often a good option if you want to look great for a party or wedding. They are also a useful way to test out the results before deciding to have the far more complicated rhinoplasty procedure.

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