Zimbler MD
Marc Zimbler, MD, FACS
Rhinoplasty / Nose Surgery - Septoplasty
990 Fifth Avenue, new york, ny 10075appointment request

Rhinoplasty / Nose Surgery - Septoplasty

Rhinoplasty is one of the most commonly performed facial plastic surgery procedures. Rhinoplasty or nasal reshaping can be performed to enhance your appearance, correct a traumatic deformity, or to improve breathing difficulties. Because the nose is the central and defining characteristic of the face, even a subtle alteration can cause dramatic improvement.

Since there is no ideal nose shape for everyone, the goal of rhinoplasty is to improve the shape of the nose so that it looks natural. Skin type, ethnic background, age, and personal preferences all play a role in the final result. Dr. Zimbler uses the latest, most innovative rhinoplasty techniques, which result in elegant, natural-looking noses without the harsh appearance of looking overdone. Nose surgery can be used to remove a nasal bump, narrow a wide tip, straighten a facial profile, and even narrow nostrils.

How do I know if rhinoplasty is right for me?

Rhinoplasty may be right for you if you want to achieve a nose that is more balanced with your facial features. Rhinoplasty can help contour the nose for a more harmonious shape that compliments your facial profile. Rhinoplasty can even help improve your breathing when combined with other medical procedures such as septoplasty for a deviated septum. For patients unhappy with rhinoplasty results from another plastic surgeon, revision rhinoplasty can correct or enhance the results of a previous nose job. If you would like rhinoplasty results without undergoing surgery, non-surgical rhinoplasty can provide quick results using dermal fillers with little to no downtime. By reducing nasal irregularities like a nasal bump, rhinoplasty can help you achieve a beautiful nose that compliments your facial features.

The rhinoplasty procedure

Rhinoplasty surgery takes place while the patient is completely sedated in an accredited surgical facility with a board certified anesthesiologist. Small incisions are made inside the nose, which allow cartilage and bone to be reshaped. A closed technique is when all incisions are made on the inside of the nose, also known as an endonasal rhinoplasty technique. While many rhinoplasties and revision rhinoplasties can be performed in this closed manner, some cases require an open rhinoplasty. An open or external rhinoplasty is defined as having similar incisions to the closed technique except 1 additional small incision is made at the base of the nose on the columella. This incision, which is only a few millimeters in length, heals extremely well and is nearly impossible to detect after rhinoplasty surgery.

Reasons for performing a closed rhinoplasty or open rhinoplasty are determined by Dr. Zimbler. There is increased maneuverability with an open rhinoplasty, as it provides Dr. Zimbler additional visibility when performing rhinoplasty. While there is no visible scarring with a closed rhinoplasty, open rhinoplasties have a higher degree of accuracy and effectiveness due to the increase in visibility. During a rhinoplasty procedure, other incisions on the outside of the nose can be performed to make the nostrils smaller. Tiny incisions hidden in the creases of the nostrils are made to narrow a wide nostril or to define an already thick nasal rim. Nasal tips can be refined and either elevated or lowered. The nasal profile is usually straightened, and the width is narrowed. Dr. Zimbler prioritizes natural-looking noses, which never appear overdone. The nasal and facial profile is a critical factor in obtaining this result.

Cartilage grafts are often used in rhinoplasty and can be obtained from either the nasal septum or the ear. These grafts are used to define and highlight points or strengthen the nose in certain regions to provide the desired cosmetic result. In most cases, there is ample septal cartilage for grafts. In some revision rhinoplasty cases, the septal cartilage may have already been removed, and ear cartilage may be required. Ear cartilage or auricular cartilage can be harvested through a tiny incision in the ear, which does not change the shape or appearance of the ear. A cartilage graft is needed when there is not enough septal cartilage in your nose to properly contour your nose. In many revision rhinoplasty surgeries, septal cartilage has already been manipulated or removed, so additional cartilage is needed from another donor site, such as the ear.

A very large portion of ear cartilage can be removed without any dramatic changes in the shape or appearance of your ear. In more dramatic cases, cartilage may need to be obtained from both ears when larger cartilage grafts are needed. In traumatic nasal deformities in large revision cases, cartilage can also be obtained from the rib cage. If rib cartilage is needed, Dr. Zimbler will discuss this in length with you prior to your rhinoplasty surgery.

If you have difficulty breathing through your nose, this can be corrected at the same time as rhinoplasty surgery. The procedure is done under anesthesia in an accredited outpatient surgical facility and takes between 2 to 3 hours. Many patients also opt to undergo additional facial plastic surgery for more beautiful, harmonious results. A chin implant or neck liposuction is often performed at the same time as rhinoplasty to balance the nose with the remainder of the face.

Deviated septum, breathing problems, and sinus surgery

Many patients who request rhinoplasty surgery often complain of nasal obstruction, breathing difficulty, snoring, or sinus conditions. These conditions are, for the most part, unsuccessfully treated with medications and antibiotics. In this case, correcting these issues at the time of surgery is ideal. It requires only 1 surgical operation and recovery time. Nasal breathing difficulties are most commonly caused by a deviated septum. The nasal septum is the cartilage structure that separates one nostril from the other. This deviation can be congenital, worsen with age, or be the result of a nasal injury or fracture. Septoplasty is the procedure in which portions of twisted septal cartilage and bone are removed to improve the nasal passage and increase air flow.

Turbinate reduction surgery

Often with septal deviations, turbinate hypertrophy is possible. The nasal turbinates are the humidifiers of the nose and swell to moisten air. This swelling is cyclical and can often be worse at night, explaining why many patients have difficulty breathing in their sleep and, in some cases, suffer from snoring. Turbinate surgery is typically performed in conjunction with septoplasty and rhinoplasty surgery to improve nasal breathing. Dramatic turbinate procedures, which often remove the inferior turbinate, have been abandoned over the past few years because they have caused even more nasal problems. Dr. Zimbler performs limited turbinate reduction surgery, which often involves leaving the turbinate intact but shrinking the tissues with lasers or ultrasound therapy.

Sinusitis

Sinus infections or sinusitis is different than nasal airway breathing problems. Sinusitis is an infection of the nasal sinuses which can cause nasal swelling, breathing difficulties, and blockage. Sinusitis is often treated with antibiotics. In many cases, patients require multiple treatments of antibiotics without any resolution of their symptoms. In these cases of recurrent sinusitis, a CT scan can determine if you would benefit from sinus surgery. Sinus surgery is performed with small nasal instruments and an endoscopic probe inside the nose. Septoplasty surgery is often performed in conjunction with rhinoplasty surgery. If Dr. Zimbler suspects you may have recurrent sinusitis, he will examine your nose with an endoscope in the office to make sure you do not have an active nasal infection or nasal polyps. A CT scan is often required to determine the extent of a sinus disease before any surgery is performed.

See the results of your rhinoplasty with nose surgery simulation imaging

Computer imaging is an excellent way for facial plastic surgeons to show the patient how they anticipates the outcome of the surgery. Computer imaging is an opportunity for both the patient and surgeon to see exactly what the possible results will look like. This session will help stimulate dialogue between you and Dr. Zimbler so that there are no surprises before, during, or after rhinoplasty surgery. Patients may require changes that may not be obtainable because of anatomy or skin thickness. These imaging sessions are a way to describe to the patient what constitutes a realistic aesthetic outcome during cosmetic rhinoplasty surgery. Medical imaging is also very helpful in revision rhinoplasty cases or secondary rhinoplasty where changes may be very dramatic or very subtle.

Rhinoplasty recovery time

The average healing time following rhinoplasty surgery is approximately 1 week, but some patients may experience a quicker or slower recuperation process. A splint is applied to the nose after a rhinoplasty procedure and remains in place for 1 week. Swelling and bruising under the eyes is to be expected; these symptoms do not last long and usually resolve within 1 week. Ice packs should be applied the first few days after rhinoplasty surgery to minimize discomfort and to promote proper healing. Light exercise can be started 2 weeks after surgery. Nasal swelling decreases dramatically the first few weeks after surgery, and you will experience continuing results in the months following your rhinoplasty surgery.

What to expect following rhinoplasty surgery

Certain physical changes should be expected following rhinoplasty. Some individuals experience all of the following changes, and others experience only some. The degree to which each person is affected varies with each patient. Most patients experience some swelling and mild bruising around the eyes. Blood-tinged nasal discharge is not unusual for the first few days following your rhinoplasty surgery. Breathing may be difficult for the first 2-3 weeks after rhinoplasty, while numbness or stiffness of the nose may take longer to resolve.

After your splint is removed, your nose will be swollen and may need to be retaped for several more days. Nasal swelling resolves slowly over time, but most of the swelling resolves within the first few weeks. You will notice continuing rhinoplasty results and a reduction in swelling in the months following your rhinoplasty procedure. We advise you to avoid physical exertion, extreme physical activity, heavy lifting, or any strenuous actions for 1-2 weeks after rhinoplasty surgery. It is also important that you rest often during the days following your rhinoplasty surgery.

If any questions arise or you are concerned about something you consider significant, please do not hesitate to communicate with us. We advise that you please keep your head elevated for 48 hours after rhinoplasty surgery. Make sure you try to sleep on your back with the support of several pillows. Cold ice packs to the eyelid region can help further diminish swelling. Change the dressing under your nose routinely until the drainage stops. If you have packing in your nose, please do not disturb it. The packing will be removed in our office after your rhinoplasty procedure.

You should start your antibiotic prescription the evening of rhinoplasty surgery and take the medication until completed. Prescription pain medication may not always be required. Tylenol® may be substituted when appropriate. If you have a cast on your nose, please do not disturb it. Your cast will be removed at our office 1 week following your rhinoplasty procedure. Please keep your rhinoplasty cast dry until you return to our office. If you have sutures on the undersurface of your nose, gently clean the suture line 3 times a day. This is done with hydrogen peroxide on a clean Q-tip to remove any excess crusting of the skin. After cleansing, apply a thin layer of a topical antibiotic ointment over the suture. Do not blow your nose until instructed. If you need to sneeze, open your mouth so that the sneeze does not travel through your healing nostrils. Do not rest eye glasses or sunglasses on your nose during your rhinoplasty recovery.

Revision rhinoplasty

Revision rhinoplasty is typically required when patients have had nose surgery years ago when surgical techniques were not as advanced as they are today. Revision rhinoplasty is sometimes required if the cosmetic portion of the procedure compromised the functional portion causing a breathing problem. Revision rhinoplasty is also needed if scarring occurred or if the recuperation period did not progress well. Rhinoplasty surgery is a very challenging facial procedure that may require revisions if performed by a less skilled plastic surgeon. One of the most respected and sought-after facial plastic surgeons in NYC, Dr. Zimbler has gained highly specialized training and dual board certification in both facial plastic surgery and otolaryngology. Dr. Zimbler has become an expert in revision rhinoplasty in New York.

Some patients who need revision rhinoplasty may have lost trust in the procedure or not understand how revision rhinoplasty can correct the mistakes of a previous rhinoplasty. Dr. Zimbler and his staff are well-trained rhinoplasty experts who can help you with problems such as this. Dr. Zimbler uses medical imaging to extensively plan for revision rhinoplasty. Dr. Zimbler will create an effective rhinoplasty surgery plan that will provide natural-looking improvements. Patient-oriented, Dr. Zimbler will work with you as long as you need to provide the most pleasing rhinoplasty results.

After meeting with our rhinoplasty surgeon, it will be clear to any patient how caring and detail-oriented Dr. Zimbler is. Secondary rhinoplasty surgery requires more time to heal than primary rhinoplasty surgery, so final results may not be visible for a few months following your rhinoplasty procedure. Cartilage grafts from the septum, ear, or rib may be required in secondary surgery, making this procedure a complex operation that needs to be handled carefully by a skillful facial plastic surgeon like Dr. Zimbler.

Revision rhinoplasty can help treat:

In many cases, revision rhinoplasty surgery is required because too much septal cartilage was removed and the nose looks overly done or turned up. Dr. Zimbler will review with you in detail his approach and surgical plan on how to deal with each of these particular issues. Although significant improvement should be expected, patients undergoing revision surgery should realize that outcomes vary from patient to patient. Revision rhinoplasty can significantly improve the effect of a previous rhinoplasty, but realistic goals are a prerequisite to revision rhinoplasty.

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Revision Rhinoplasty

Non-surgical rhinoplasty

The non-surgical nose job or 15-minute nose job is an in-office procedure in which nasal shape can be improved with simple injections rather than extensive surgery. A non-surgical nose job is performed in the office with minimal discomfort and simple topical numbing cream. Various FDA approved dermal fillers are used to contour the nasal profile and tip. Through precise injections, nasal bumps and irregularities are easily camouflaged. Some dermal fillers are made from calcium hydroxylapatite crystals, similar to the material found in teeth and bone, so it is an ideal substance to place in the nose along the nasal bridge. The results typically last 8-12 months, but a non-surgical nose job only takes a few minutes with minimal downtime and only mild discomfort. Bruising and swelling can occur but typically resolve within a few days.

For patients who are considering rhinoplasty surgery, this is a great way to see what is possible before actually undergoing rhinoplasty surgery. For those not interested in rhinoplasty surgery, a non-surgical nose job can help you avoid going under the scalpel. Non-surgical nose jobs are also ideal for patients who have undergone a previous rhinoplasty and were unhappy with the results. By simply injecting contour irregularities, results can be obtained without undergoing extensive revision rhinoplasty surgery.

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Non-surgical Rhinoplasty

Rhinoplasty / nose surgery before & after

Nose Job Before And After Rhinoplasty Before And After

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before & afters

Frequently asked questions

  1. What will happen during my consultation for rhinoplasty?

    Dr. Zimbler will extensively review your medical history and then perform a detailed examination of both the inside and outside of your nose. The history and nasal exam will give Dr. Zimbler an idea of what will be required during your rhinoplasty procedure and to make sure no prior trauma, infections, or surgeries will affect the ultimate outcome of your surgery. Dr. Zimbler will then discuss the procedure in detail along with how the procedure is performed, where he performs rhinoplasty surgery, and what rhinoplasty recovery will be like. A discussion of risks and benefits is also critical to making any type of informed decision before agreeing to undergo rhinoplasty surgery.
  2. Can I have an idea what my nose will look like after surgery?

    At Dr. Zimbler’s Manhattan office, we specialize in rhinoplasty computer imaging. Our specifically designed software will give you the most realistic image of what your nose will look like after surgery. 
  3. Can my deviated septum or sinus condition be corrected at the same time as a rhinoplasty?

    The simple answer is yes. Many rhinoplasty surgeries go hand in hand with functional nasal surgery, and it is not uncommon for Dr. Zimbler to perform his procedure in conjunction with one of his ear, nose, and throat colleagues. In some cases, septoplasty is also performed during a rhinoplasty for results that are both cosmetic and functional.
  4. Do I need to have general anesthesia for rhinoplasty?

    While many patients are scared of having anesthesia, rhinoplasty surgery can only be performed properly when both the patient and surgeon are comfortable. Most patients do not want to be conscious during rhinoplasty surgery, and we make sure the appropriate amount of sedation is given to each individual patient. Typically, rhinoplasty surgery is performed with a laryngeal mask airway (LMA) under deep sedation anesthesia for maximum comfort.
  5. Can my previous rhinoplasty be corrected?

    Revision rhinoplasty allows facial plastic surgeons to correct results from previous rhinoplasties. Dr. Zimbler’s combined training in facial plastic surgery and ear, nose, and throat medicine makes him one of only a handful of surgeons who are experts in treating complex revision nasal cases. Dr. Zimbler can help correct any results with revision rhinoplasty that you are not happy with from a previous rhinoplasty procedure.
  6. Will insurance pay for any part of my surgery?

    The cosmetic portion of surgery is never covered by insurance. However, if you have a functional breathing problem that will be addressed at the same time as the cosmetic portion, insurance will typically cover that portion of the surgeon’s fee along with the overhead of the operating room and anesthesiologist. 
  7. Do I need to have my nose broken during rhinoplasty?

    In many cases, Dr. Zimbler will not need to break your nose or the nasal bones during surgery. Often, these structures can be shaved or carved so that breaking them is not necessary. In some cases, however, this may be required, but it will depend on your nose and what particular outcome or goal you wish to achieve. Dr. Zimbler will discuss with you your options and the various aspects of your procedure at length before any final decisions are made.
  8. Can rhinoplasty improve my breathing?

    Rhinoplasty can improve breathing difficulties in certain cases. If you combine rhinoplasty with septoplasty to fix a deviated septum, your breathing can be improved. Rhinoplasty can also help treat pinched or crooked noses. A pinched or crooked nose can inhibit breathing, so when these are addressed during rhinoplasty, the functionality of your nose and breathing can be improved.

Why choose Dr. Zimbler for rhinoplasty surgery

Limiting his practice to facial surgery only, Dr. Zimbler is a true expert in facial plastic surgery. Because his practice is devoted to only cosmetic facial surgery, Dr. Zimbler has more experience and skill with the nose than many other plastic surgeons who perform surgery over the entire body. Rhinoplasty is one of the most complex and challenging of all plastic surgery procedures and requires years of expertise and training to be performed well. Dr. Zimbler’s unique surgical background makes him an expert in rhinoplasty surgery, as well as other facial plastic surgeries. Dr. Zimbler’s attention to detail and focus on natural-looking noses make him a top rhinoplasty surgeon in New York. With extensive training in plastic surgery and ear, nose, and throat medicine, Dr. Zimbler is a leading rhinoplasty surgeon. Choosing the correct facial plastic surgeon for your rhinoplasty procedure is one of the most important steps. Your rhinoplasty surgeon should be board certified, experienced at performing rhinoplasty surgery, and have a unique understanding of facial anatomy, which are all standards that Dr. Zimbler meets.

Dr. Zimbler is a facial plastic and reconstructive surgeon with particular expertise in rhinoplasty surgery and revision rhinoplasty surgery. Dr. Zimbler teaches current residents and medical students that are training to become future surgeons. Double board certified in both facial plastic surgery (AMFPRS) and otolaryngology – head & neck surgery (ABOHNS), Dr. Zimbler trained in diseases of the ears, nose, and throat before performing facial plastic surgery. Having been named a Super Doctor by The New York Times Magazine and a Top Doctor by New York Magazine, Dr. Zimbler has been lauded as one of the best rhinoplasty surgeons in the NYC area.

How to get started with rhinoplasty / nose surgery?

Marc S. Zimbler, MD and his staff will be happy to discuss rhinoplasty / nose surgery with you. Please call for a private consultation or schedule an appointment online at our office.

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