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Primary Rhinoplasty

Rhinoplasty and aesthetic procedures of the face are my most favorite surgeries to perform and I have spent over a decade learning, improving, and specializing my practice of rhinoplasty surgery and aesthetic surgery of the face.  I operate in Newport Beach, CA and I am board certified in plastic & reconstructive surgery by the American Board of Plastic Surgery. I am member of the American Society of Aesthetic Plastic Surgeons and the Rhinoplasty Society. I perform both cosmetic rhinoplasty and reconstructive rhinoplasty/airway procedures in the Newport Beach Surgery center as well as at Hoag Hospital in Newport Beach, CA. Rhinoplasty and aesthetic surgery of the face are my passion and I hope you find this website helpful and informative to you. Please call the office to make a consultation at 949-612-8632 so we can develop a personalized plan to improve the appearance of your nose and improve the quality of your breathing. These changes can also potentially improve the quality of your life.

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. These changes can be corrected with an open or closed rhinoplasty. I perform both open and closed rhinoplasty techniques depending on your anatomy, your goals, and what the structure of your nose will allow. There are pros and cons of each approach as well as limitations.

Another common group of patients that I treat in my practice are those patients who have a deviated nose or nose that is not straight. Typically, these patients have a nasal airway obstruction that needs to be corrected. These patients may have had a previous trauma, previous rhinoplasty, or simply have a nose that has turned to one side over time. Correcting breathing in these patients requires relieving the airway obstruction and is accomplished with removing part of the nasal septum that is curved, reducing the nasal turbinate, or providing support to the nose to prevent collapse. Often, correcting patients with a significantly deviated nose requires an open rhinoplasty. Depending upon previous operations, cartilage grafts from the ear or rib may be needed to provide structure to the nose.

The photo gallery below may help you find a nose, appearance, or change that you are seeking. I do not have a one size fits all approach to rhinoplasty and trying to understand what it is that you wish to accomplish with your rhinoplasty is of paramount importance. The blog section of this web page will help you understand different rhinoplasty terminology and can hopefully help us have a more effective consultation and communication. Please call the office to schedule a consultation-the phone number is 949-612-8632. My office staff is extremely friendly, polite, and knowledgeable. They enjoy answering your questions and I enjoy speaking about rhinoplasty, so there is no question too simple and there is no question that you should be embarrassed about. I look forward to meeting with you and helping you accomplish your goals. 

 

Rhinoplasty is a common procedure. There are many different types of patients who come to our office for consultation regarding their nose. 

Middle Eastern individuals are 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. It is important to bring in photographs of noses that you like or do not like. This helps me understand what your goals are so I can get it right. Some patients want subtle changes and other patients want more significant changes to their nose. 

We also have a large group of Asian patients who present to our office requesting a rhinoplasty. Patients of Asian descent traditionally desire a more defined nasal dorsum or bridge and narrower nasal base. 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 rhinoplasty similar to Asian patients. There is often a desire to rotate the nasal tip downward and to reduce the amount of nostril show. The rhinoplasty in this population of patients also focuses on narrowing the nasal bridge with osteotomies and narrowing the nasal base.

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 our 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 I would like to hear what you would like to change regarding the shape of the nose. During this part of the consultation, I spend 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 my website or 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 Vectra 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. We use the Vectra camera to take a photograph of your face. The photograph is then integrated into software, and we morph the image together to get an idea of which changes you would like to accomplish to your nose. The Vectra software is very helpful in defining your goals and which surgical maneuvers we will perform on your nose.

After the Vectra photographs, we take a standard set of photographs as well as an OVIO 360-degree photograph. The OVIO 360-degree photograph allows me to study your nose from all angles. 

 

 

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The surgery for a rhinoplasty operation is performed under general anesthesia. You will 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, you 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.

Nasal Cancer & Nasal/Facial Trauma

OPERATION MEND

The principles used for nasal reconstruction and airway reconstruction are also used for cosmetic rhinoplasty procedures.

Dr. Dickinson performs airway reconstruction, nasal reconstruction and aesthetic rhinoplasty procedures in Newport Beach, California.

As Seen in The LA Times

Revision Rhinoplasty FAQs

I had my nose broken in a car accident a few years ago. Since then I can't breathe correctly out of my nose. I snore at night. I use nasal sprays, and my allergies are worse. Is it possible to have this fixed with a rhinoplasty reconstructive surgery?

My friend had an airway surgery and they needed to take cartilage from somewhere else on his body. Will this need to be done in my nose job?

Can you also improve the appearance of my nose while you help me breathe better?

What's the overall process to have a rhinoplasty surgery at your Newport Beach facility?

Take Me To the Rhinoplasty Blogs