Rhinoplasty

While Rhinoplasty is a very popular cosmetic surgery, not everyone is a candidate for Rhinoplasty. The most important part of the process in deciding your candidacy is your complimentary pre-consultation with a Patient Care Manager. They will discuss your Rhinoplasty goals and offer a photo review to determine if this surgery is the right option for you. After this pre-consultation is complete, and you and your Patient Care Manager have decided that Rhinoplasty could be right for you, they will then book an in-person (or virtual) consultation with Dr. Buonassisi. To determine if you are a candidate for Rhinoplasty, our Patient Care Managers are available to help discuss the surgery in more detail and conduct a photo review. You can contact them on (604) 733-1669 or complete our booking form online to request a call back.

While there are a number of different techniques when it comes to Rhinoplasty, when reshaping or changing the nose, the work is primarily done to the cartilage and bone that form the structure of your nose. Dr. Buonassisi performs both open and closed Rhinoplasty, ensuring that any scarring is minimal to imperceptible. Open Rhinoplasty is performed at the base of the nose, where a small incision is made across the columella – the area between your nostrils. After the incision is made, the skin is very gently raised to expose nasal bones and cartilage so that the required changes can be made. The incision is then strategically sealed using sutures to ensure that any scarring is minimal, and disguised in natural creases of the nose. Unlike open Rhinoplasty, closed Rhinoplasty is less-commonly performed by Dr. Buonassisi, and is a surgery performed inside the nose, through small incisions in the nostrils. This is where Dr. Buonassisi will carefully and skilfully craft the bone and cartilage to achieve the desired result. Which technique is used, and how Dr. Buonassisi will perform the surgery (open or closed) is dependant on a number of unique factors, and will be discussed in detail upon your consultation with him. Whichever method is used will be chosen because it will be the ideal way to achieve your goals.

For people who want a rhinoplasty, it is tempting to want to focus strictly on how the nose will look after surgery. Your motivation should be to find a surgeon who has extensive experience with the nose both functionally and cosmetically. Many rhinoplasties will require that changes be made to the septum (the wall of cartilage that separates the two nasal airways) which can affect your breathing. In addition to improving the cosmetic look of your nose, you also want your nose to function as well or even better than before surgery.

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ULTRASONIC RHINOPLASTY (PIEZO RHINOPLASTY):

Ultrasonic rhinoplasty (also known as ultrasound rhinoplasty or piezoelectric rhinoplasty; piezo rhinoplasty for short) is a modern surgical technique used to reshape and refine the nose by utilizing ultrasonic energy. Unlike traditional methods that involve manual tools, ultrasonic rhinoplasty employs a specialized Piezotome® device that emits high-frequency sound waves to precisely sculpt the nasal bones and tissues. The ultrasonic energy effectively softens and cuts through bone or cartilage without injuring the surrounding soft tissues, allowing for more enhanced precision and more controlled reshaping.

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PRESERVATION RHINOPLASTY:

Preservation rhinoplasty is a subtle, modern approach to modifying the aesthetic appearance of the nose. The primary goal of preservation rhinoplasty is to retain as much of the patient’s original bone and cartilage as possible while improving the general appearance of the nose. The technique is used exclusively for modifying the nasal bridge, while traditional techniques are still required for tip modifications. In the right patient, however, it is a phenomenal technique that can give excellent results. Preservation rhinoplasty is very complex and it’s just one of the tools that a skilled rhinoplasty surgeon will have in their tool kit.

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HUMP REDUCTION RHINOPLASTY:

Resizing the bump on the bridge of the nose is one of the most common reasons that people pursue Rhinoplasty. As the name suggests, this surgery works by reducing and resizing the dorsal hump of your nose, to soften and balance the nose.

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TIP REFINEMENT & ROTATION RHINOPLASTY:

This term refers to a collection of surgical techniques that target the tip of the nose. From tilting the tip up, to narrowing a larger tip; tip refinement is often combined with other Rhinoplasty procedures, such as hump reduction or correcting a crooked nose, for the most striking, natural-looking results.

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ALAR BASE REDUCTION:

Alar base reduction refers to reducing the width of the alar, or base, of the nose. It is often, but not always, combined with augmentation Rhinoplasty. A small incision is placed at the base of each nostril, and a wedge of tissue is excised so that the nose appears smaller and more narrow.

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AUGMENTATION RHINOPLASTY:

Another procedure that is often combined with other Rhinoplasty techniques, augmentation involves increasing the height of the bridge of the nose. Limitations do exist with what can be done and expectations are set very early on.

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FACIAL FEMINIZATION RHINOPLASTY (NOSE FEMINIZATION):

Rhinoplasty for facial feminization aims to reshape the nose to create a more feminine appearance and is one of the most common feminization surgeries for transgender women. The complex procedure typically involves a combination of techniques such as reducing the width of the nose, narrowing the bridge, refining the tip, and lifting up the angle between the nose and upper lip while ensuring functionality is retained. Through careful incisions and sculpting of the nasal structures particularly with the aid of technologies like the piezo rhinoplasty device, facial feminization rhinoplasty can help soften masculine features and achieve a more harmonious, feminine balance in the face.

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Very common questions that people ask are “how long is the downtime?” or “how long is the healing process?”. Most patients are then surprised by the answer, as recovery from rhinoplasty is easier than they expect. Most patients will take 1-2 weeks off work or school, and are able to work or study from home in the early days of recovery. Your cast is removed 1 week after surgery, but be prepared to still see bruising and swelling on cast removal day – the exciting part though is that you will get the first glimpse of your new nose. During the second week, you can expect most of the bruising to dissipate, but it always varies from patient to patient. It is also important to keep in mind that it will take a year for everything to heal and set for you to see your final result. All of this and more (including an overview of what to expect day-by-day after surgery) are covered in your free pre-consultation discussion with a Patient Care Manager.

You may have a dissolvable stitch poking out. This is not dangerous but can be irritating. Internal rhinoplasty stitches are often used inside your nose during surgery. They dissolve roughly 10 days later – but sometimes not uniformly – meaning one might hang around a little longer and start to irritate you. You could notice a stitch up to 6 months after surgery. No, your surgeon did not forget that stitch in there by accident. If your stitch is bugging you, please call your surgeon’s office and let them know. They should schedule you an appointment to have the suture trimmed. In the meantime, please do not pick or tug at it, as this may irritate you nose or cause an infection.

Experienced rhinoplasty surgeons will often over rotate the tip on purpose since they plan for it to fall to it’s intended position in the post operative healing period. They expect that swelling will make it look higher than it will actually be once healed. This planned over rotation should last about 3 – 4 weeks, or a little longer in some patients. So, if you are early on in your recovery period, please don’t be concerned. This is one of the side effects of swelling that will resolve itself over time.