Primary Rhinoplasty

Dr. Dickinson, operates out of Newport Beach, Ca and he is board certified in plastic & reconstructive surgery by the American Board of Plastic Surgery. He is also a member of the American Society of Aesthetic Plastic Surgeons and the Rhinoplasty Society. Dr. Dickinson is one of the few plastic surgeons to perform both cosmetic and reconstructive rhinoplasty procedures. His experience and passionate approach draws patients from all over the country to his practice in Newport Beach, California.

The most frequent rhinoplasty request from patients is to correct a dorsal hump, bulbous or broad tip, and drooping or plunging tip. These patients typically want a smaller nose with either a straight dorsum or slightly scooped dorsum and a nasal tip that is narrower, more defined, and less droopy.

Dr. Dickinson typically corrects the deformity of the tip with an open rhinoplasty, but this can also be accomplished with a closed rhinoplasty. Dr. Dickinson utilizes both open and closed rhinoplasty techniques, deciding which method with the patient.

Another common group of patients that Dr. Dickinson treats are those with a deviated nose or nose that is not straight. These patients may have had a previous trauma or simply have a nose that has turned to one side over time. Often, these patients also have difficulty breathing, which requires an airway obstruction correction to remove part of the nasal septum that is curved and reduce the nasal turbinates. Correcting patients with a significantly deviated nose requires an open rhinoplasty.

Middle Eastern individuals are also a large subset of patients who request rhinoplasty procedures in Newport Beach. These patients have a similar nasal profile described in the first two groups above. Typically there is a dorsal hump and a large plunging tip which they want modified into a variation of a straight or scooped dorsum, and a more defined nasal tip.

Dr. Dickinson also frequently performs Asian rhinoplasties. Patients of Asian descent traditionally desire a more defined nasal dorsum or bridge and narrower nasal abase. There are several different ways to accomplish this. A dorsal graft can be inserted into the nasal dorsum, but changes to the tip are best accomplished with an open rhinoplasty and modifying the tip cartilages. The nasal base is typically narrowed and modified with nostril sill or alar base modifications.

African American patients typically desire nose jobs similar to Asian patients. There is often a desire to rotate the nasal tip downward and to reduce the amount of nostril show.

Rhinoplasty Techniques

There are two general broad types of rhinoplasty operations, open and closed.

An open rhinoplasty procedure involves an incision on the columella. This incision allows the surgeon to have great access to change the shape of the nasal tip. It also allows the operating surgeon to take apart any attachments of the nose that may be causing a deviation and correct it. The open rhinoplasty is valuable when significant changes need to be made to the nose to straighten or change the tip shape.

A closed rhinoplasty is where any changes to the shape of the nose are performed from incisions entirely on the inside of the nose. A closed rhinoplasty can be performed on almost any patient, but when significant changes are needed in relation to the tip or to straighten the nose an open rhinoplasty is more helpful.

The Rhinoplasty Consultation

The rhinoplasty consultation in Dr. Dickinson’s office takes about one hour. In the beginning of the consultation, we discuss if you have any breathing problems, or symptoms of airway obstruction. We then examine the inside of the nose with a nasal speculum and perform simple maneuvers to determine airflow. This is a relatively painless examination.

The next part of the consultation is a discussion where Dr. Dickinson wants to hear what you would like to change regarding the shape of the nose. During this part of the consultation Dr. Dickinson spends time educating patients on the different anatomical terms of the nose. Once the terms are understood, time can be spent discussing the changes and degree of changes.

It is helpful if you bring to the consultation photographs of noses you like. These can include before and after rhinoplasty photographs from other websites or noses of friends, family, or celebrities. The photos help describe the attributes of noses that you, the patient, would like your nose to look like. During the consultation you could say, “I like this feature or that feature. That nose is too upturned or upturned just right. Too wide, too narrow, or just right.”

For patients who wish to change their side profile or tip position, we use photo software to help us describe the goals of the profile that the patient would like to achieve. The photos do not guarantee and exact replica, they just facilitate discussion.

The surgery for a rhinoplasty operation is performed under general anesthesia. The patient does not see, hear or feel anything. On average, a rhinoplasty operation can take anywhere from one hour to three hours.

Rhinoplasty operations that require grafts from other parts of the body such as ear cartilage, rib cartilage, or fascia will make the operation longer. If it takes longer than three hours it simply means we are being particular to make it the best we can.

After the rhinoplasty operation, the patient will wear an external nasal splint. The external nasal splint remains in place for one week. If significant septal work has been done, there are internal nasal stents that remain in place for two days. There is no nasal packing.

After surgery patients are given a Medrol dose pack for swelling, pain medications, and antibiotics. Patients are instructed to sleep with their head elevated for about 48 hours after surgery. Patients can return to cardiovascular exercise or non-contact weight exercises after two weeks.

Revision Rhinoplasty

Dr. Dickinson performs a significant amount of Revision Rhinoplasty surgeries. The revision rhinoplasty is challenging in that an open rhinoplasty will be performed in an already operated or scarred environment. Often times grafts will be needed of fascia, cartilage, or skin and cartilage.

Revision rhinoplasty cases involve principles of reconstruction that are applied to improve the aesthetic appearance of the nose by rebuilding it. For that reason, seeking out a surgeon with extensive training and experience in plastic & reconstructive surgery is ideal in these cases.

As Seen in The LA Times

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