Rhinoplasty

Typically performed on patients who have previously undergone a rhinoplasty procedure, Dr. Furze, who is considered one of Newport Beach’s experts in nose surgery, strives to implement the changes needed to improve the patient’s nasal form, function, and confidence. He often reconstructs nose structures and addresses other surgical errors.

Rhinoplasty in Orange County, California

Surgery of the nose (rhinoplasty) is an operation frequently performed by facial plastic surgeons such as Dr. Furze. Rhinoplasty is one of the most common plastic surgeries. Dr. Furze is one of a few double board certified facial plastic surgeons in Orange County and the nose is his area of specialty. Due to his training in plastic surgery as well as in head and neck surgery, Dr. Furze is able to understand and improve the internal nasal structures as well as reshape noses externally, resulting in a nose that matches the rest of the patient’s face and is reconstructed with stable foundations to ensure a long lasting result.

These small changes can have profound impacts on both the quality of your breathing and your overall self-confidence.

The nose is one of the most prominent features of the face, which is perhaps why so many people feel unhappy or self-conscious about the appearance of their nose. There is no such thing as the “perfect” nose – each person has a unique nose shape that best suits his or her face. Dr. Furze believes in preserving some aspects of your nose after surgery, so that the new nose fits with other characteristics of your face and preserves your ethnic identity.

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Female patient before and after Rhinoplasty Orange County Before
Female patient before and after Rhinoplasty After

Female patient before and after Rhinoplasty Before
Female patient before and after Rhinoplasty After

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Reasons for a Rhinoplasty

Some of the most common complaints Dr. Furze hears from his Orange County patients are:

  • Nose is too big or too small
  • Nose is asymmetric or crooked
  • Nostrils are too large or differently sized
  • Nasal tip is too large or bulbous
  • Nasal tip droops or has a hook-like appearance
  • There is a hump or large bump that is visible from the side
  • Nose base is too wide

Rhinoplasty can correct nearly any of the above. Even a subtle change to the nose can dramatically improve the patient’s appearance by creating better facial harmony

Main Types of Rhinoplasty

While rhinoplasty is the general term used to describe a surgical reshaping of the nose, there are many other terms used to describe different types of rhinoplasty. The most common of these, other than primary rhinoplasty, include:

Refinement rhinoplasty

This term typically refers to rhinoplasty performed to refine the nasal tip. The surgery may address tip rotation or a drooping nasal tip. The term may also be used when the patient seeks a smaller, more refined nose.

Ethnic rhinoplasty

Rhinoplasty performed on a non-Caucasian patient. This type of rhinoplasty requires the skill and expertise of a surgeon who is very familiar with the nasal structure of the patient’s ethnic group so that the reshaped nose looks natural on his or her face. Dr. Furze has many Orange County patients with Hispanic, Middle Eastern, African American, and Asian heritage. He will explain his techniques when you come in for a consultation.

Reduction rhinoplasty

Used when the primary goal of the rhinoplasty is to reduce the size of the patient’s nose. A large number of patients who seek rhinoplasty with Dr. Furze are concerned about the size of their nose in proportion to their face.

Augmentation rhinoplasty

When the dimensions of the patient’s nose need to be increased to create a more balanced appearance, the surgery is described as augmentation rhinoplasty. This type of rhinoplasty is often performed after sports injuries or to address a congenital underdevelopment of the nose. Asian patients often ask for their nose bridge to be augmented.

Revision rhinoplasty

Also known as secondary rhinoplasty, this surgery is performed on a patient who has already undergone a primary rhinoplasty. The surgery may be performed because the patient is unhappy with the results of their primary rhinoplasty or because the primary rhinoplasty had a poor outcome that has resulted in a cosmetic and/or structural defect.

Reconstructive rhinoplasty

This type of rhinoplasty is performed when a nose is either partially or completely missing, which may be a result of cancer or due to trauma. This type of rhinoplasty is often performed in many stages and requires the use of grafts and skin flaps. It is one of the most complex forms of rhinoplasty and a specialty of Dr. Furze.

Ideal Candidate for Rhinoplasty

Ideal candidates for rhinoplasty are those that wish to improve the appearance of their nose, but have realistic expectations about what can be achieved through surgery. Dr. Furze does not recommend rhinoplasty to anyone who seeks perfection or who is obsessed with the idea that rhinoplasty can change their life. During your consultation, Dr. Furze will examine your nose and explain what can be realistically achieved. He wants to make sure that you will be satisfied with the results and that your expectations can be met without risking the stability of your nose.

Rhinoplasty can be performed on people of all ages, providing the nose has reached its full adult size. Teenagers may also be operated, depending on their development stage. Older adults can also undergo rhinoplasty if they are otherwise healthy – there is no upper age limit for rhinoplasty.

Female patient before and after Nose Surgery Before
Female patient before and after Nose Surgery After

Male patient before and after Nose Surgery Before
Male patient before and after Nose Surgery After

Click here to view all Before & After photos

How Rhinoplasty is Performed

When Dr. Furze performs rhinoplasty, he accesses the nasal structure using one of two techniques, which are referred to as open or closed rhinoplasty. During a closed rhinoplasty, he performs the entire surgery through the nostrils, without making an external incision. He uses specialized tools, such as an endoscope, to help him visualize the internal structures during surgery. During an open rhinoplasty, Dr. Furze begins by making a tiny incision across the base of the columella (the strip of skin that separates the two nostrils). He then gently separates and pulls back the nasal skin from the underlying structures to perform the surgery. Neither technique is necessarily better than the other. Dr. Furze will explain his choice of technique based upon your unique needs and the revisions being made.

Once Dr. Furze has accessed the internal structures, he begins making the planned improvements to your nose. This may include shaving down bone, removing cartilage, placing grafts, straightening the nasal septum, altering the nostrils, or any other number of revisions. Once all of the revisions are made, sutures are placed internally and externally (in the case of an open rhinoplasty) as necessary and in some cases inserts packing. The patient is then aroused from anesthesia and remains under observation until Dr. Furze has determined that he or she is well enough to return home.

Rhinoplasty Recovery Process

After the surgery, the patient should be accompanied home by a close friend or family member who should remain with the patient for at least 24 hours. The recovery from rhinoplasty is usually described as “uncomfortable”, rather than painful, due to internal swelling that occurs as a natural result of surgery. Dr. Furze provides his patients with detailed instructions for the post-operative process.

After rhinoplasty, it is important to rest at home to allow your body to recover from this demanding surgery. Most patients choose to remain at home for about 5 days, as swelling, bruising, and discomfort will peak during this time. After the first week, some people feel well enough to return to work, but others may wish to wait a few more days. After two or three weeks, the majority of swelling and bruising will have dissipated. After three or four weeks, light exercise and housework may be resumed. Throughout your recovery, you should attend regular follow up appointments with Dr. Furze so he can monitor your progress.

Rhinoplasty Anatomy – Quick Lesson

Since rhinoplasty is such a popular cosmetic surgery, many people forget that the nose is actually an important organ that must be treated with great care during surgery. Dr. Furze encourages you to learn more about the nose’s anatomy prior to surgery. During rhinoplasty, alterations may be made to several structures of the nose. The structures that are most commonly manipulated include:

Cartilage

Cartilage is a type of connective tissue that is found throughout the human body. It is softer than bone, but firmer and less flexible that muscle. There are two main cartilage structures in the nose, referred to as the upper cartilage and lower cartilage. The upper cartilage is found just below the nasal bridge, while the lower cartilage defines the nasal tip. Either or both of these may be altered during rhinoplasty. To preserve the structural integrity of the nose, the surgeon must be careful when removing cartilage from the nose. In some cases, cartilage grafts may be created to provide additional support or structure within the nose.

Bone

Nasal bones define the overall structure of the nose while protecting the internal structures from trauma that could occur during everyday activities. During rhinoplasty, the bone that defines the nasal bridge is most commonly altered, particularly in patients who complain of a high nasal bridge or humped nose.

Nostrils

Nostrils are the two openings at the base of the nose. These may be altered during rhinoplasty to reduce their size or make them more symmetrical.

Skin

Skin is less commonly altered during rhinoplasty. It is primarily a concern when a patient presents with thick nasal skin, which can be thinned out during surgery by removing some of the fatty tissue found beneath the skin.

Rhinoplasty FAQ’s

Q What is the rhinoplasty recovery process like?

There are different types of rhinoplasties and the recovery time and process is generally based on which procedure you had. However, there are certain elements which can be expected after most rhinoplasty surgeries. Below is a brief list of some of these elements:

  • You are likely to wear small cast on the nose for up to a week
  • Bruising will take about two weeks to subside
  • Most of the swelling will be gone after two weeks (see more on this in question two)
  • You will need to avoid strenuous activities for four weeks
  • Your nose will be sensitive but there won’t be any severe pain
  • You will be required to minimize sun exposure on your nose for several months

Some factors that can affect the length of the recovery period are: surgical or non-surgical procedure, location of the surgery, open or closed rhinoplasty, and your overall health. You are advised to discuss all of these with your surgeon before undergoing any procedure. Generally, my rhinoplasty patients can return to work about a week after surgery.

Q How long does the swelling last after a rhinoplasty procedure?

Majority of the swelling after a rhinoplasty will fade away within one week and even more so the following week. That means you will be able to go out in public without people noticing that you underwent a surgical procedure on the nose. However, the rest of the swelling will take up to a year to completely disappear. If your rhinoplasty involved lessening the “hump” or the central protrusion on the bridge of the nose, then this is one of those areas where swelling may remain for few months. Always remember that it can take up to a full year for the final results of a rhinoplasty to show, so do not consider the minor swellings as a sign of unsuccessful surgery. If you are concerned of the results of your rhinoplasty even after a year, schedule an appointment with your facial plastic surgeon.

Q When should I stop drinking alcohol prior to surgery?

The goal of every surgeon is to ensure their patients receive a safe surgery and that they recover well afterwards. That is why it is highly recommended that one stops consuming alcohol at least one week prior to the surgery and, if possible, up to two weeks. Drinking alcohol can lead to complications such as excessive bleeding or liver problems which makes it crucial to stop the consumption early.

Q Can a non-surgical rhinoplasty make my nose smaller?

In short, non-surgical rhinoplasty cannot reduce the size of the nose. Non-surgical procedures mainly use nasal fillers, such as Juvederm XC or Restylane, and these injectables do not have the qualities of reducing the nose size. At most, non-surgical procedures can help in aspects such as refining the symmetry of the nose or to fill depressed areas to make the nose appear more even with other features of the face.

Q How soon after a rhinoplasty can I fly?

As we all know, there are air pressure changes during takeoff and landing when flying and this can cause some complications to a rhinoplasty patient. It is recommended that one avoid flying for about one week to ten days after a rhinoplasty surgery to lessen the chances of excess swelling, bleeding, or infection of the nose. Moreover, staying in the same area where your surgery was performed during this time will also allow immediate access to your surgeon in case something goes wrong post-surgery. If you are planning on vacationing after your rhinoplasty, be sure to schedule your rhinoplasty at least a month ahead. If you are a patient from out-of-town, I recommend staying in a hotel for 2 weeks until your surgeon considers it safe for you to fly.

Load More Questions

Q How old do I have to be to get a rhinoplasty?

Typically, rhinoplasty is safe for anyone who has passed their mid to late teen years. If someone is younger than that, the surgery can pose risks because some features of the nose may still be developing and the body may not have matured completely. Usually, for girls, maturation occurs earlier than boys. Females usually mature around 16 – 18 and males around 18 – 19 years old. Regardless, for teenagers, we advise their parents to be fully involved with the decision making process.

Q Will a rhinoplasty affect my voice or sense of smell?

It is common for rhinoplasty patients to experience temporary reduction in their sense of smell or even a temporary loss of the ability to smell. Since the nose is swollen and nasal congestion is present, this occurrence is completely normal. The voice can also be affected post-surgery for a short period of time for the same reasons. Your sense of smell and voice will return to normal within 2-3 weeks post-surgery, once swelling has subsided. Chances of changes in your voice and smell are very small, but still possible.

Q Do “nose reshaping” devices and instruments actually work?

Certain devices available on the market recently claim to reshape the nose from outside. Not only is this medically impossible, but it is unlikely that these devices and instruments can deliver any results. Thus, it is best to avoid them as they can prove to be dangerous. Remember, rhinoplasty is a complex surgical procedure and should only be performed by an experienced board-certified plastic surgeon. Any shortcuts and/or quick fixes should be completely avoided.

Q Can I only reduce the size of my nose tip?

Reducing the size of the nose tip is definitely possible. In fact, tip refinement is a common rhinoplasty procedure. Generally, this procedure involves reduction of the lower cartilage of the nasal tip. Open rhinoplasty is usually the best approach in which the surgeon trims the shape of the tip, alters the projection, decreases the size, or raises or lowers the tip among other things. Nose tip refinement is a beautifully subtle change in the nose that can create a drastic difference in appearance.

Q How should I sleep after my rhinoplasty?

The best method of sleeping after a rhinoplasty is to keep your head above the chest. This is proven to decrease the swelling on the nose. Sleeping on your back with your head elevated with also decrease the risk of hitting your fragile nose. I recommend placing two or more pillows under the head. Wedge pillows can also be purchased online which will give you a similar position. At most, you will only have to sleep like this for one to two weeks.

Q Can smoking affect my rhinoplasty results?

Yes, smoking can certainly affect rhinoplasty results. Smoking is harmful, as we all know, but smoking shortly before or after the surgery can complicate the recovery process. Smoking can restrict the blood flow to the nasal region, cause breathing issues, produce poor healing, and increase the likelihood of having an infection among various other problems. So, it is best to stop smoking at least two weeks before and after the surgery.

Q Can I wear my glasses after my rhinoplasty procedure?

It is best to avoid wearing glasses after a rhinoplasty and this is especially true if the surgery involved parts of the nasal bridge as this is the place where glasses rest. A sensitive and swollen nose is not an ideal environment to put pressure on because it can cause indentation in that area. An alternative to wearing glasses is obviously wearing contact lenses. However, if that’s not possible, then one can also use transparent tape to attach the glasses to the forehead. Relieving your nose from any pressure is key to a speedy recovery.

Q Can I blow my nose after a rhinoplasty procedure?

Blowing nose should be avoided for at least one week after the surgery as it can aggravate the already sensitive nose. After one week, one may blow their nose but without applying excessive pressure or pulling and tugging the nose. The main problem with blowing the nose is that it can cause bleeding at the early stages of the recovery period. Maintaining your health before and after rhinoplasty can prevent the need to blow your nose all together. If I keep your splints in your nose for any reason over the one week mark, you do not want to blow you nose till the silicon splints are removed from your nose.

Q Will a rhinoplasty change my smile?

Because of temporary stiffness which is caused by swelling or numbness after a rhinoplasty surgery, the upper lip can be a bit difficult to move. However, this is quite normal and a temporary side effect of the procedure. In most cases, normal functions of the upper lips and the nerves in the surrounding areas return within few weeks. However, depending on how the surgery was performed it can take longer (up to a few months) for the stiffness to subside.

Q Can I combine a rhinoplasty with another nose procedure?

Rhinoplasty can be combined with another nose procedure. For example, surgery of the septum and the nose being performed together to get a more appealing overall look. Moreover, it is very common for individuals to combine rhinoplasty with other facial cosmetic procedures such as chin augmentation.

Q Will my insurance policy cover my rhinoplasty?

No, rhinoplasty is classified as cosmetic surgery that is performed for solely cosmetic reasons.

Nasal or sinus surgery may be covered if it is being performed to address trauma or a congenital defect, or is required to reconstruct the nose after skin cancer is removed. In addition, insurance policies may cover the medically necessary portion of your surgery, if you have certain medical conditions, such as a deviated septum, which are being addressed at the same time as your rhinoplasty. Please see Dr. Furze today for a head and neck exam to see if you qualify for medically necessary surgery with your rhinoplasty.

Q How old must I be to undergo rhinoplasty?

Minimum age to undergo rhinoplasty is 14 to 16 years of age as your nose must have finished growing before the surgery can be performed. In females, this is usually around 14 or 15, while in males it is typically between 15 and 16. In addition, you must be emotionally mature enough to handle the demands of surgery and the recovery process.

Q How much will my rhinoplasty cost?

The cost of your rhinoplasty will depend upon many factors, such as the complexity of the rhinoplasty and whether or not it is revision rhinoplasty. Outpatient surgery center and anesthesia fees must also be factored into the cost of a rhinoplasty procedure. The outpatient surgery center and anesthesiology fees are priced according the amount of time needed to perform the rhinoplasty. If you are considering rhinoplasty, please call our office and speak to our Practice Administrator, Hana M. Ayoub, MHA, who will be able to answer all of your questions. She will also give you a quote in office after she takes into consideration the the type of rhinoplasty recommended, as well as the total amount of time that Dr. Furze will need to perform your rhinoplasty. Don’t shop for a nose surgery – choose excellence to avoid having to do revision surgery at an older age. As one of the most experienced nasal surgeons in Orange County, Dr. Furze has completed thousands of nasal and sinus procedures.

What Our Patients are Saying

“I am a rhinoplasty surgery patient and it took me 9 years to finally choose a surgeon to trust with my nose”

Dr. Alexis is a pleasant young doctor who is knowledgeable and willing to take the time to answer your questions and cover all your concerns so that you feel good when you leave his office. I definitely recommend him if ever need his services.

Dr. Furze is easy to communicate with, and is meeting all my post op needs. Of course this is after a successful surgery that I fully understood and was scheduled on my terms as immediate as was needed.

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