Rhinoplasty (cosmetic nasal surgery) is one of the most frequently performed cosmetic procedures. Located at the center of the face, the nose has a dramatic impact on our appearance. Rhinoplasty is the most elegant and complex operations that a facial plastic surgeon performs and produces remarkable results. Using the most advanced techniques, Dr. Steiger customizes each procedure based upon your unique anatomical features, facial structure, and desires. His goal is to create a natural appearing nose that promotes facial harmony.
In addition to its beauty, the nose is a functional organ that must allow for the unobstructed passage of air. This must be kept in mind anytime rhinoplasty is performed. Too often, reduction rhinoplasty techniques, once popular, resulted in nasal collapse and difficulty breathing. Unfortunately, this can still occur if the nose is only treated aesthetically and its functional nature is ignored.
Dr. Steiger always focuses on creating both an attractive and well functioning nose. He is an expert at both primary rhinoplasty and revision rhinoplasty surgery performed to correct cosmetic and functional nasal deficits. He believes that rhinoplasty is the ultimate fusion of form and function, art and science.
As a facial plastic surgeon, Dr. Steiger is uniquely qualified to enhance your nose. Both a fellowship trained facial plastic surgeon and board-certified otolaryngologist, Dr. Steiger is a nasal expert ; inside and out. His approach to rhinoplasty utilizes the most advanced techniques. Dr. Steiger has published numerous original research articles and chapters related to rhinoplasty and nasal surgery. He lectures on these topics to national and international audiences.
Reduction Rhinoplasty- This patient was unhappy about the "hump" on her nose. She desired a smaller, natural appearing nose, which fit her face. Dr. Steiger performed rhinoplasty in order to improve her appearance. Rather then "cut away" the hump, the nose was reduced and rebuilt using her own septal cartilage. This created an attractive, well-functioning nose, which is built to last.
Goals To surgically refine the size and shape of the nose, which improves facial balance. Rhinoplasty may also be performed to improve obstructed breathing caused by prior surgery or trauma.
The Procedure Incisions are placed within the nose, where they are not visible. In some cases, a small incision is hidden between the skin of the nostril, underneath the nose. The underlying cartilage and bone is sculpted to create the new shape. Dr. Steiger custom tailors the procedure based upon the patient's specific nasal anatomy, facial structure, and unique features. A successful rhinoplasty improves facial harmony and draws attention away from the nose.
Anesthesia Deep sedation/twilight sleep is preferred, however some patients opt for a general anesthetic.
Length of Time The amount of time varies based upon the individual nose and necessary refinements. The procedure averages between one and a half to three hours. It is performed in our state of the art, fully accredited outpatient surgical facility or at the hospital. Other procedures, such as a chin augmentation(link), may be combined with a rhinoplasty and may be recommended after a detailed consultation with Dr. Steiger.
Rhinoplasty with reduction of a nasal hump and nasal tip refinement.
After the Procedure Most patients go home comfortably after the procedure. If you prefer, professional in-home nursing care or overnight hospital suites are available upon request. Our friendly staff can assist you in coordinating these services upon request.
Recovery Most patients return to work after 1 week and are back to full activities after 10 days. However, activities which risk bumping or traumatizing the nose should be limited for four to six weeks. Bruising around the eyes may occur in some cases, and can be camouflaged . Most patients feel remarkably well immediately after the procedure, and have minimal pain which is alleviated with a mild narcotic.
The nose is made up of skin and soft tissue that is draped over an underlying nasal framework. The nasal framework is made of both bone and cartilage. Most rhinoplasties are performed by altering the nasal framework, changing its shape. The skin is then re-draped over the "new" nose and assumes that configuration.
Rhinoplasty is performed through either an endonasal (closed) approach or an external (open) approach. In the closed approach all of the incisions are made on the inside of the nose. The surgeon then manipulates the nasal framework (bone and cartilage) from within.
The open approach is performed similar to a closed rhinoplasty, however a very small incision is made on the bottom of the nose, between the skin of the nostrils (called the collumela). This tiny incision is approximately 3 millimeters in length and is not noticeable. The open approach, as the name implies, allows for better visualization and access to the nasal framework then the closed approach.
Whichever approach will produce the best result!
Dr. Steiger utilizes both approaches in his practice. Since every nose is different, the approach is individualized to the patient. Each approach has its benefits. This will be determined after a thorough consultation, evaluating your unique nasal anatomy and desired result.
Dr. Steiger's philosophy is centered around achieving natural appearing results. He believes in creating facial harmony. It is not only important to create an attractive nose, but to create one that is proportional and fitting to the face it belongs to. Rhinoplasty has evolved significantly over the past decade. Dr. Steiger uses the most advanced and proven rhinoplasty techniques to achieve this goal.
We have digital imaging software in our office, which can be utilized during the consultation as a communication tool. It is very important for Dr. Steiger to understand what his patients desire and this is a great way to make sure that everyone is on the same page. A picture is worth a thousand words.
Rhinoplasty After Nasal Trauma- This patient had a history of significant trauma to his nose which has caused saddling and shortening of his nose. Dr. Steiger performed rhinoplasty correcting these deformities, straightening the nose and improving his breathing. Dr. Steiger recreated a strong nasal bridge, which fits this patient's male gender and facial appearance.
Most procedures are performed in our fully accredited outpatient surgery center. There we have the latest equipment to provide state of the art care. We maintain the strictest safety standards as recommend by JCAHO. A board certified anesthesiologist will provide your care.
I prefer to perform rhinoplasty under a deep sedation (twilight sleep). This way you sleep comfortably through the procedure, but do not have the side effects commonly seen from the heavy doses of medication needed for general anesthesia.
There are generally three levels of anesthesia: local anesthesia, sedative anesthesia, and general anesthesia.
Local anesthesia- The nose is numbed with a local anesthetic and the procedure is performed pain-free while you are awake. You can speak and are aware of what is happening.
Sedative anesthesia- The nose is numbed with a local anesthetic and you are given an IV medication to make you sleep. You are breathing on your own, but are sleeping through the procedure and are not aware of what is happening.
General Anesthesia- The nose is numbed with a local anesthetic, you are given medications that make you sleep, and a tube is placed in your wind pipe to support your breathing. Heavier doses of medication are given then in the sedative technique.
This patient requested to have the "hook" of her nose reduced. Dr. Steiger performed a reduction rhionoplasty to balance the appearance of the nose. At the same time he re-enforced the "new" nose with cartialge from her own septum, to ensure a lasting result.
Yes. Patients feel remarkably well after surgery and have little to no pain. Any pain or discomfort is relieved with a mild analgesic.
No! In Dr. Steiger's opinion there is hardly ever a good reason to pack the nose. Nasal packing leads to discomfort after rhinoplasty, so he avoids this.
Most patients go back to work in 1 week, and back to full activities in 10 days. However, activities which risk bumping or traumatizing the nose should be avoided for 6 weeks.
Yes. Rhinoplasty comprises a significant portion of Dr. Steiger's practice. As a plastic surgeon dedicated to the face, he is experienced in the most advanced rhinoplasty techniques. He writes about these techniques and presents on them at national conferences.
If you have problems breathing, insurance often covers the functional aspect of septorhinoplasty. Most insurances do not cover the cosmetic portion of the procedure. Our office will help you get preauthorization from your insurance company, if necessary, for the functional portion of the procedure.
Yes. During the consultation, we can review before and after photographs of patients who have kindly given us permission to do so.
If you desire, our office will put you in touch with patients who have undergone the procedure and voluntarily agreed to speak with you.
Most patient do not complain of significant pain after rhinoplasty surgery. Since Dr. Steiger does not pack the nose, this significantly reduces or eliminates pain and discomfort. In order to better understand this, please visit our rhinoplasty video journey. Here you will be able to visualize the patient experience at various stages of the procedure- before and after surgery.
This is called revision rhinoplasty, an area that Dr. Steiger has particular expertise in as well. Please visit our revision rhinoplasty page.