Based on the experience of performing hundreds of rhinoplasties every year, Dr. Kosins has made Newport Beach the center of excellence for primary rhinoplasty surgery. As a Board Certified Plastic Surgeon, I remain absolutely passionate about the operation as it changes peoples’ lives by giving them greater self-esteem and making them more attractive. Most rhinoplasties or Newport Beach “nose jobs” are done to make the nose look better and for the patient to feel better about his/her appearance. The majority of our cases are adolescent girls and women who feel that their profile has a bump, their tip lacks definition, and the nose is too big or too wide. Essentially, they want a smaller, cuter, more feminine nose without any sign of surgery. However, our practice also is 25% male, 50% non-Caucasian (ethnic), and 40% revision rhinoplasty.
A primary rhinoplasty refers to a patient that has never had an operation on his/her nose. When we sit down with you at your initial consultation, we will ask a lot of questions about your ethnic background, wishes, and the 3 things that you don’t like or would want changed about your nose. Below are a few of the common issues that our patients bring up:
- My nose looks masculine
- I have breathing problems
- My nose is too long
- I have a hump or bump on my nose
- My nose is asymmetrical
- My nostrils are different shapes
- My nose does not fit my face
After understanding your history and performing a detailed physical exam, we can begin to have an intelligent discussion about what you want your nose to look like after surgery. After taking your thoughts into account, we will discuss the plan to achieve your ideal results. Oftentimes, we will take photos and use them as a teaching tool. We are analytical specialists, and we assume that you want to know the details of what we see and how we plan on doing your specific surgery. Also, you can feel confident that you have a realistic view of what your nose will look like after it is healed. Two weeks prior to surgery, we will meet again for your pre-operative visit to go over all the details again and to instruct you on all the pre- and post-operative instruction to assure a successful operation. Lastly, the final details of your operation will be confirmed and we can answer any questions that you may have.
To understand primary rhinoplasty involves having a very detailed plan before stepping foot in the operating room. Also, a rhinoplasty specialist must consider the function of the nose when performing any maneuvers during surgery. The surgery is certainly not successful if you have a “surgical look” or cannot breathe after the operation. In many rhinoplasties, the nose is made smaller and therefore it must be made stronger. Just like reducing the size of a building, the structure must be solidified to prevent collapse. Even though your nose will become more refined, it will be stronger in every way and your breathing should improve. A misunderstanding of these basic concepts is why we perform many revision rhinoplasties in our practice.
Open vs Closed Rhinoplasty
Each Newport Beach nose job is done differently depending on what the needs are of each individual patient. I perform both open and closed rhinoplasty, which refers to the approach of the operation by the surgeon. In an open rhinoplasty, a small incision is made on the pillar in between the nostrils (the columella) and this allows for good exposure of the tip cartilages. The incision is very small and after a few months is usually completely healed. Closed rhinoplasty involves doing the surgery with all incisions on the inside of the nose meaning no external incisions are used. During the initial consultation, we will discuss how your rhinoplasty will be done at The Rhinoplasty Center.
Male rhinoplasty is often a much different operation than a female rhinoplasty. Men have a different soft tissue envelope (skin), different goals, and a higher likelihood of having trauma. Most men are looking for a gentle refinement of their nose, and issues with breathing are more common. More than half of our male patients have had some sort of nasal trauma over the course of their lifetime before coming to The Rhinoplasty Center. Dr. Kosins himself has broken his nose twice playing baseball and surfing!
Like all other patients who come for nose jobs in Newport Beach, goals and objectives are discussed. We are very interested in what you want to change about your nose, and we take photographs to use as a teaching tool. Your physical examination will be both internal and external, with a keen eye for both the aesthetic and functional objectives. We will watch you breathe at rest and on forced inspiration (taking a big breath through your nose). This is all very important to understand how any aesthetic changes will alter the function of the nose.
A large portion of my rhinoplasty training and initial experience was at the Long Beach Veteran’s Hospital. At this institution I took care of a large number of male patients who needed nasal surgery. Overall, it is very important that your rhinoplasty specialist be very comfortable with male rhinoplasty. The worst thing that can happen to a man is to have his nose overly feminized by a rhinoplasty operation. At your consultation, I will show you lots of before/after photographs to detail the surgery and to understand your aesthetic goals.
What To Expect After Your Rhinoplasty
All rhinoplasties at The Rhinoplasty Center in Newport Beach are done under general anesthesia in an outpatient setting (surgery center). After your surgery, you will be sent home with a splint on your nose and a drip pad underneath your nostrils. While this is not a very painful operation, swelling in the middle of your face can be uncomfortable so pain medication is prescribed. We recommend that patients sleep upright for the first 3 days and ice intermittently around the eyes and cheeks.
Your first post-operative visit will be 6 days after surgery when we will take off your cast and remove any sutures. You will be instructed how to tape your nose at night to decrease swelling. We recommend being very mellow and avoiding heavy activity for the first 2 weeks to avoid swelling and issues with bleeding. The nose then heals in 2 phases. Phase 1 is swelling and that resolves over the course of the first month although most patients go back to work after 1 week. Phase 2 is the remodeling process of the nose, which takes up to a year especially to see the full definition of the nasal tip. In males and those with thick/oily skin this process can take even longer. Be patient and have confidence — the definition will continue to improve over time.