Rhinoplasty


 RhinoplastyIt’s all about the nose. The nose is the most central and prominent feature on the face and significantly contributes to an individual’s facial harmony and balance. When a nose is out of proportion with the rest of the face, nose surgery can be a great way to create a nose that compliments the patient’s other facial features.

Rhinoplasty, or nose surgery, is one of the most common plastic surgery procedures. Generally, patients want nose surgery to improve the appearance and proportion of their nose and enhance facial harmony. Surgery of the nose is also performed to correct impaired breathing or structural abnormalities.

Why choose Dr. Kulbersh for your rhinoplasty?

Rhinoplasty is one of the most rewarding and challenging procedures in facial aesthetic surgery.  As an experienced rhinoplasty doctor, Dr. Kulbersh has dedicated his entire career on the study of the nose and face.  Toward this end, he chose to do five years of training in facial and neck surgery before undertaking an additional one and a half years of training with the best facial plastic surgeons in Beverly Hills, California.  During this time, he studied under top rhinoplasty surgeons who have performed the rhinoplasties of Ashley Simpson, Jennifer Aniston, and many other celebrities.  This focus and training provides Dr. Kulbersh’s  patients with the highest level of skill and expertise for their rhinoplasty.

before after rhinoplasty and fillers1 RhinoplastyRhinoplasty Philosophy at Carolina Facial Plastics

When you think of a beautiful face, what makes the face beautiful?  Commonly, we find people to be attractive when they have stunning eyes, strong bone structure, clear skin, and a beautiful smile.

Why is it uncommon to refer to the nose as beautiful?  Dr. Kulbersh believes elegant noses are the ones not recognized.  During a rhinoplasty, nose specialist Dr. Kulbersh will take all necessary means to create a beautiful and proportionate nose by making small changes that will enhance one’s entire facial appearance.  With this philosophy, the nose should be shaped so that people focus most on the natural features of the face.  Dr. Kulbersh’s definition of the most successful nose jobs are those in which the patient receives more compliments about their eyes, smile, or skin.

What are the different types of rhinoplasty?

columnellar incision 300x193 RhinoplastyAs no two noses are alike, Dr. Kulbersh’s insight into both the aesthetics and the function of the nose allow him to provide each patient with results that are specific to their facial structure. There are several different types of patients who require nose surgery, and each type requires a different surgical strategy.

Primary Rhinoplasty is the first surgery a patient undergoes. This is usually a cosmetic procedure to improve the appearance of the nose.

Revision Rhinoplasty is second (or third) nose surgery that may be needed to fix the results of a previous nose job. Patients generally need revision rhinoplasty when they are either unhappy with the aesthetic results from their first nose job or wish to fix any breathing problems incurred by the original surgery.

A revision rhinoplasty typically can be done one year after the primary rhinoplasty procedure. Your revision rhinoplasty consultation with Dr. Kulbersh will be very thorough so that he can appropriately examine your nose and determine the cause of the unsatisfactory results.  More information about Revision Rhinoplasty.

Ethnic Rhinoplasty requires special techniques in order to preserve the patient’s ethnic identity. Dr. Kulbersh has a thorough knowledge of many ethnicities’ characteristic facial anatomy and aesthetics and is able to improve the appearance of their noses without compromising their cultural identity.  More information about Ethnic Rhinoplasty.

  • African American rhinoplasty takes a great deal of surgical skill and a detailed understanding of facial aesthetics in order to achieve facial harmony. The majority of Dr. Kulbersh’s African American patients are looking to direct attention away from the nose by decreasing the width, resulting in a better “fit” for their face.  After surgery, patients will have a new nose that improves their facial harmony yet still preserves their ethnic identity. More information about African American Rhinoplasty.

Kulbersh NonSurgicalRhinoplasty1 large 300x203 RhinoplastyNon-Surgical Rhinoplasty is often a great option for patients who are unhappy with a small area of the nose. In many cases. patients who need to even out the shape of their nose or just need one area to be plumped up can benefit from filler injections.  Dr. Kulbersh prefers to use dermal fillers, such as Restylane or Perlane. With these techniques, Dr. Kulbersh can instantly improve the shape of the nose by filling in depressions, smoothing out sharp angles or changing the angle of the tip of the nose. The goal of a non-surgical rhinoplasty is the same as rhinoplasty surgery: to make the nose appear more symmetrical and in harmony with the rest of the face.

Rhinoplasty for breathing problems will remove nasal obstructions so that the patient can breath easier. There are several different contributing factors to breathing issues, so after a thorough examination Dr. Kulbersh will determine the cause of your breathing difficulties and recommend the appropriate surgery. More information about Rhinoplasty for Breathing Problems.

Who is a candidate for rhinoplasty?

The best candidates for rhinoplasty are people who are looking for improvement, not perfection, in the way they look.  These patients should be physically healthy and psychologically stable.Rhinoplasty 3 300x187 Rhinoplasty

There are many indications that you may be a good candidate for nose surgery. Whether you are considering a rhinoplasty or nasal shaping surgery for functional or aesthetic reasons, the most important consideration is your motivation for undergoing the surgery.  Cosmetic rhinoplasty can enhance your appearance and your self-confidence. Before you decide to have surgery, think carefully and make sure your expectations regarding the procedure are realistic.

The nose is the centerpiece of the face and its shape can profoundly affect one’s overall appearance. Patients may have aesthetic concerns about their nose including:

  • A nose that is too big for the face
  • A nasal “hump”
  • Long nose
  • Crooked nose
  • Fat or poorly defined tip
  • Wide nose
  • Asymmetric nose
  • Too masculine nose on a female face
  • Collapsing or shrinking nose from previous surgery
  • Upward turned or pig nose

Alternatively, some consider a rhinoplasty to maintain the four main functions of the nose: breathing, smelling, filtering air, and humidifying air.  Of the four functions, a rhinoplasty can only improve the function of breathing.  Depending on the cause of the nasal obstruction there may be better medical treatments or other more appropriate procedures. More information on Rhinoplasty For Breathing Problems.

Rhinoplasty Before & After

For more nose job before and after pictures, visit the photo gallery.

Rhinoplasty Before After 300x203 Rhinoplasty Rhinoplasty Rhinoplasty

frontal view fillers rhinoplasty1 RhinoplastyRhinoplasty Fillers before after Rhinoplasty

 

 

What are the different rhinoplasty techniques?

The two surgical approaches to rhinoplasty are open and closed. The technique that Dr. Kulbersh will use depends on the level of complexity the surgery requires and the areas of the nose that need to be addressed.

Open Rhinoplasty involves peeling back the nasal skin to expose the underlying support of the nose. The incisions are generally made between the nostrils and in the nose.  These incisions heal beautifully.  This technique is preferred when visualization of the nasal support system is required to achieve aesthetic and functional goals.

Closed or Endonasal Rhinoplasty requires Dr. Kulbersh to perform the surgery from the inside of the nose. The advantage of this technique is that the small scar is eliminated and the swelling my resolve faster.  The reason this procedure is not appropriate for every situation is a decreased field of vision for Dr. Kulbersh during the rhinoplasty.

Dr. Kulbersh uses both approaches with rhinoplasty procedures in Charlotte.  In patients that will require minimal changes to the nose, he will generally choose a closed rhinoplasty. For patients who need surgery for an asymmetrical nose, revision rhinoplasty, or require significant refinement of the nasal tip, he prefers the open rhinoplasty technique.

Dr. Kulbersh will explain how each technique would be applied to your nose to help you decide which is the best rhinoplasty approach for you.

Rhinoplasty Frequently Asked Questions

 

Q: What is rhinoplasty?

Rhinoplasty is surgery to correct the shape or function of the nose. Rhinoplasty surgery is commonly referred to as a nose job.

 

Q: What should I expect during my rhinoplasty consultation?

During your consultation with Dr. Kulbersh, you will spend a significant amount of time discussing personal goals for your nose job rhinoplasty surgery. Dr. Kulbersh will ask you questions about your lifestyle and health history to make sure you are a good candidate for nose surgery. Additionally, he will evaluate your current health, examine your face and discuss surgery options. Finally, he will answer all of your questions and address all of your concerns about the surgery and your likely outcomes.

 

Q: How long will it take for swelling to go away after rhinoplasty?

This is one of the first questions Dr. Kulbersh typically receives from his patients.  Everyone heals differently, but a good rule is that 60-70% of the swelling will be gone after 3 weeks and the remaining will continue to resolve over 1 year.  Typically, swelling may be worse in the open approach or in patients that have the nasal bones broken during the procedure.

 

Q: How long does it take to see the final results of a nose job?

The nose heals slowly, but after a month one should be able to get a good estimate on the final result.  The final result is best appreciated about one year after surgery.

 

Q: How much recovery time is needed after rhinoplasty in North Carolina?

Recovery from rhinoplasty surgery generally lasts between 1-2 weeks. The patient will have to wear a splint on the nose, which will be removed after a week. Most patients are able to return to work or their daily activities, within moderation, 7-10 days after the surgery.

 

Q: Will rhinoplasty surgery help me breathe better?

Yes. Rhinoplasty surgery can improve your breathing. Dr. Kulbersh can use techniques to open the airway and ensure that you are able to breath through your nose more easily.

 

Q: What is the optimal age for teenage rhinoplasty?

Age is a consideration during rhinoplasty. A rhinoplasty should not be performed on a nose that is still growing. In young women, Dr. Kulbersh will operate once the patient is either 14 or 15 and has started menstruation (a sign of slowing growth).  Young men will continue to grow past the age of 14, so the youngest candidates Dr. Kulbersh will operate on are 15-17 years old, depending on circumstances.  Dr. Kulbersh also strongly considers the teenagers’ social and emotional motivations for a rhinoplasty.  He wants to make sure that the patient fully understands the procedure and has the proper motivation.

 

Q: What are some of the new techniques Dr. Kulbersh learned in Beverly Hills?

While Dr. Kulbersh cannot share all of his many secrets online, in Beverly Hills the high profile patients cannot afford to have long downtimes after a rhinoplasty.  He has learned many small “tricks of the trade” that he believes decreases bruising and swelling after a rhinoplasty procedure.  Additionally, Dr. Kulbersh utilizes a new product known as PDS plate to help straighten a crooked septum and make grafts during a nose job.

 

Q:  Does the nose grow with age?

 

Q: How much does rhinoplasty cost?

The cost of a nose job is unique to each patient. The price of rhinoplasty surgery varies based the type of correction required by the patient. During your consultation with Dr. Kulbersh you will discuss your nose job price in detail.

 

At Carolina Facial Plastics we do everything possible to ensure your safety.

During the initial intake prior to surgery, we run appropriate tests to ensure your safety and health.

Several tests are required at different times from two weeks to two months before surgery. We know this requires dedication and patience, but we believe that these tests are essential. If the tests reveal anything unusual, we work with the patient and their primary care doctor to see if we can solve the problem, or we postpone the surgery until proper treatment can be completed.

Basic tests consist of lab work to check for anemia, bleeding disorders and electrolyte levels, as well as medical clearances to determine the physical health of the patient. If the patient is going to be in surgery for more than four hours, we also require an EKG.

Pre-operative tests and medical clearances include:

  • An electrocardiogram, which is done if the patient is over 50 years of age or if the patient will be in surgery for more than four hours. Also known as an EKG or ECG, an electrocardiogram is done to measure the electrical signals that control the rhythm of your heart. An EKG tests for any irregularities in your heartbeat, as well as evidence of past heart attacks or conditions. Additional testing may be required if irregularities are detected during this test.
  • A complete blood count test, which measures thirteen blood levels in the body. This blood test can reveal blood deficiencies or disorders that could affect your safety during the procedure and recovery. These may include anemia or other blood disorders. These tests also check your electrolyte levels and platelet levels. Inadequate platelet levels can lead to an increase in bruising and bleeding. Low hemoglobin levels can slow the healing process, while low levels of white bloods cells can lead to increased infection after surgery.
  • A chest x-ray, which may be recommended if the patient is a smoker or smoked in the past, has any chest or lung issues in their medical history, or are over 50 years old.
  • A cardiology clearance with a stress treadmill test, which may be recommended if the patient is over 50 years of age, has a personal history of heart disease, or has heart disease in their family history.

At Carolina Facial Plastics it is our priority to make sure that it is safe for each patient to undergo surgery.

To schedule a rhinoplasty consultation with Dr. Kulbersh, call us at (704) 323-5090 today!

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