Rhinoplasty

Rhinoplasty (plastic surgery of the nose, or nose job) is the most commonly performed procedure in facial plastic surgery. The name rhinoplasty is a blend of the words rhino (nose) and plasty (to mold or shape). Rhinoplasty is by far the most complex and artistic procedure in facial plastic surgery. Dr. Naficy believes that the goal of rhinoplasty should be a nose that looks attractive and natural, and is in harmony with the rest of the face without having an "operated-on" look.  Dr. Naficy specializes in rhinoplasty and performs over 10 times more rhinoplasty procedures than the average plastic surgeon.  

Rhinoplasty by Dr. Sam Naficy

Dr. Naficy's practice has been 100% devoted to rhinoplasty and facial plastic surgery for the past 18 years. This is why Seattle doctors and patients have voted Dr. Naficy one of the top plastic surgeons for the face. Patients from the entire globe seek Dr. Naficy's expertise and he has many patients flying in for surgery both nationally and internationally.

Primary Rhinoplasty Photo Gallery

This photo gallery contains representative before and after images of primary rhinoplasty procedures performed by Dr. Sam Naficy. Click on any of the thumbnails to enter the slide show. All rhinoplasty and other facial plastic surgery procedures were performed by Dr. Sam Naficy. The text accompanying the photos describes the details of the procedures performed.

rhinoplasty-gallery.jpg

Revision Rhinoplasty Photo Gallery

Here you will find a sampling of representative before and after images of revision rhinoplasty and complex secondary rhinoplasty procedures performed by Dr. Sam Naficy. Click on any of the thumbnails to enter the slide show. All revision rhinoplasty and other facial plastic surgery were performed by Dr. Sam Naficy. The text accompanying the photos describes the details of the procedures performed.

revision-rhinoplasty.jpg

What can Rhinoplasty achieve?

Many undesirable features of the nose may be improved through rhinoplasty. Noses may be made narrower, straighter, longer, or shorter. Humps may be removed and the shape, size, angle, and definition of the tip of the nose may be altered. Breathing problems, such as those caused by a deviated septum, nasal valve collapse, or enlarged turbinates may also be corrected at the same time as the cosmetic changes. The art of rhinoplasty is in obtaining the desired changes, while maintaining a natural appearance to the nose. Nasal plastic surgery may be performed for strictly cosmetic reasons (cosmetic rhinoplasty), for strictly breathing reasons (septoplasty), and more commonly for a combination of both (rhinoplasty + septoplasty). Rhinoplasty may be performed at any time after facial growth has been completed. This usually translates into age 15-16 for women and age 16-17 for men.

Bump On The Bridge

This is the one of the most common reasons for men and women seeking rhinoplasty surgery. The hump (or bump) may be made of bone, cartilage, or typically a mixture of both. In addition to the hump there may be other imperfections in the profile, such as the angle between the nose and the upper lip, which could also be corrected.

The ideal outcome in rhinoplasty is a natural-appearing nose with balance and harmony, enhancing the beauty of the eyes and lips.



Rhinoplasty by Dr. Sam Naficy

Hooked Bridge And Droopy Tip

Mostly a profile problem, certain noses have a hooked and droopy profile. Ideally, the angle between the upper lip and the nose (the nasolabial angle) should be between 90-105 in women, and between 90-95 degrees in men. When this angle is smaller than 90 degrees, it gives the appearance that the tip of the nose is drooping. The drooping of the nose tip is often accentuated with smiling.

In addition to removal of the hump, reshaping of the tip of the nose is required to produce a more desirable nasolabial angle. Good judgment and a strong artistic sense of facial balance and harmony are required to maintain a natural outcome.

Rhinoplasty by Dr. Sam Naficy

Wide Round Tip

Some noses show their undesirable features mostly from the front view. One of the more common scenarios is a nose with a tip that is too wide or too round.

Correction of a wide, round, or boxy tip requires careful reshaping and sculpting of the tip cartilages in order to reduce tip size and improve tip definition. At the same time, the surgeon must be careful to not disrupt the structural support of the nose so that the nasal passages do not become obstructed. Dr. Naficy uses modern rhinoplasty techniques which create a natural appearing tip.

Rhinoplasty by Dr. Sam Naficy

Short & Upturned Nose

At times the reason for the rhinoplasty is that the nose appears too short, upturned and somewhat unnatural in shape. Rhinoplasty can be performed to lengthen the nose. Lengthening a short nose is a challenging operation and Dr. Naficy has published a landmark article discussing the techniques for lengthening the nose.

Rhinoplasty by Dr. Sam Naficy

Crooked Nose

A crooked, asymmetric, or deviated nose can throw the entire face off balance. The cause of a crooked nose may be the cartilage of the septum, the external cartilages of the nose, or underlying asymmetry of the face as a whole. Deviation of the septum, if severe, can push the lower half of the nose off center. Noses that have been fractured (broken) can also be crooked, as a result of the displaced nasal bones that healed in a crooked position.

Rhinoplasty by Dr. Sam Naficy

Correction of a crooked nose is technically challenging, often requiring manipulation of both the cartilage and bone of the nose, as well as the septum. With a crooked nose, there is often nasal obstruction caused by a deviated septum. Simultaneous straightening of the septum will also help improve the nasal obstruction.

Rhinoplasty by Dr. Sam Naficy

Revision Rhinoplasty

Dr. Naficy specializes in corrective surgery (revision rhinoplasty) for situations where the outcome from an initial rhinoplasty surgery was less than ideal. There are a number of reasons why patients seek a secondary rhinoplasty procedure. In certain situations, the initial procedure may have not fully corrected the undesirable features of the nose. In other situations, the initial rhinoplasty may have actually resulted in certain undesirable features. Some of the more common causes for revision rhinoplasty include a residual hump, irregularity or asymmetry of the bridge, tip asymmetry, tip pinching and collapse, too much nostril show (caused by alar retraction and/or hanging columella), or tip deformities (bossae).

Dr. Naficy specializes in complex revision rhinoplasty procedures and has an international clientele. In revision rhinoplasty, often a very small change, in the proper location, can make a big difference in the overall look of the nose.

Revision rhinoplasty by Dr. Sam Naficy

Revision rhinoplasty typically requires a careful balance of removing and adding (grafting) cartilage to the nose to obtain the desired outcome. In many instances the cartilage needed for grafting can be obtained from the nose itself, usually from the septum. When septal cartilage is not present or previously used, cartilage may be harvested from the back of the ear or from the rib.  For more information on revision rhinoplasty please visit our revision rhinoplasty page.

Revision rhinoplasty by Dr. Sam Naficy

Rhinoplasty in Men

Male rhinoplasty has shares similarities with female rhinoplasty in some aspects but has some key differences. In male rhinoplasty, strength and symmetry of the nose are typically the most important. The male nose should not be made too small or too upturned as this may feminize the face.

Rhinoplasty by Dr. Sam Naficy

What Type of Anesthesia is Used?

We use IV sedation anesthesia, which is a safe and effective method of anesthesia for facial plastic surgery. IV sedation anesthesia is extremely safe compared to the standard general anesthesia techniques used today. The main advantages of IV sedation anesthesia are: (i) it does not require putting a breathing tube in the throat, (ii) it does not require a breathing machine, (iii) the recovery is much faster, (iv) there is much less "hang-over" from anesthesia, (v) and there is much less nausea. All these elements translate into greater comfort and safety. Dr. Naficy has used this technique of anesthesia in several thousand plastic surgery procedures without any anesthetic complications.

During IV sedation anesthesia a small flexible IV (intravenous) needle is placed into one of the veins of the back of the hand. Through this IV line, relaxing medication is given to make you fall sleep. The amount of medication given is adjusted to the specific needs of each person. After you are sleeping, some numbing medicine is also placed in the skin to numb the area that is being operated on. The beauty of IV sedation anesthesia is that during the procedure you are unaware of anything going on and cannot hear anything, yet you are still breathing on your own.

When the procedure is finished, the relaxing medication is discontinued and you begin to wake up. Because the medications used in IV sedation anesthesia clear the system rather quickly, most of our patients are able to go home in less than 30 minutes after the procedure is completed.

Anesthesia guidelines [21kb PDF]

What is the recovery like?

A tape dressing will cover the nose for one week. With modern techniques employed by Dr. Naficy, no packing is required inside the nose. There may be some discoloration and swelling around the eyes which will typically improve over 5-7 days. One week is usually enough time for returning to work and social activities.

Post-operative care instructions [18kb PDF]

I am interested! What do I do next?

If you are considering this procedure we encourage you to schedule a consultation with Dr. Naficy. There is a great variety in nose shapes and features and each procedure must be custom tailored for the patient to get the best possible result. During this visit Dr. Naficy will listen to your concerns and discuss your options. He will tell you whether you are a suitable candidate for this procedure and inform you of the potential risks of the procedure. Your breathing passages will also be evaluated and it will be determined whether you are eligible for insurance coverage of a portion of the procedure. Rhinoplasty costs will be also discussed at that visit.

AAFPRS Logo
RealSelf Top Doctors Logo
Best of Western Washington Logo
FACS Logo