Posts Tagged ‘nose job’

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Kate Middleton Responsible For The Newest Cosmetic Craze: The Royal Rhinoplasty!

Wednesday, March 20th, 2013

Revision Rhinoplasty Kate Middleton Responsible For The Newest Cosmetic Craze: The Royal Rhinoplasty!Kate Middleton, the Duchess of Cambridge and wife of Prince William, has been long known for her keen fashion sense that has sparked trends worldwide. However, her style isn’t the only thing gaining attention—now more than ever, American women are seeking what has been dubbed the “Royal Rhinoplasty,” and are getting cosmetic surgery to achieve a nose described as the perfect size and shape.

As a rhinoplasty surgeon in Charlotte, I believe that it’s important for my patients to understand exactly why Kate’s nose is garnering so much attention. Kate has a very feminine nose, meaning the bridge swoops very slightly and the tip does not fall or droop when she smiles or speaks. Kate’s nose is also very symmetrical and in balance with the rest of her facial features. One of the lesser-known facts about the nose is that it must in harmony with the eyes, cheeks, mouth, and chin..

Undergoing A Rhinoplasty In Charlotte

I commonly get asked to model a nose after a celebrity or someone who the patient believes is beautiful.   While this can give me insight on the result the patient would like to achieve, I remind them that it is important to remember that each nose and face shape is unique.  During a rhinoplasty, the nose has to be shaped to fit the individuals face.  A beautiful nose on one person, may not be a beautiful nose on another.   As a board certified head and neck surgeon with  a fellowship facial plastics, I believe that the most important aspect of performing any rhinoplasty is to strive for a result that makes the nose appear to blend in with the face.

During your initial consultation at Carolina Facial Plastics, I’ll listen to your concerns to develop a treatment plan completely unique to your face and goals.  I believe that a rhinoplasty is a surgery of millimeters.  Doing a variety of millimeter changes on the nose together can create a nose that looks natural on your face, but does not change the character of the nose.  Depending on what you’d like done, I will decide on either a closed, open, or non-surgical rhinoplasty approach to accomplish your goals.

Contact Carolina Facial Plastics Today

If you’re considering undergoing a rhinoplasty but aren’t sure about how to obtain the results you’re looking for, I encourage you to contact my medical practice in Charlotte today to schedule your initial consultation by calling (704) 323-5090. During this time, I’ll be able to address your needs and goals while coming up with a tailored treatment plan unique to you and your nose. As an expert facial plastic surgeon in Charlotte, I know that achieving subtle and natural results is always the best way to provide my clients with a pleasing nasal structure.

For more information about the royal rhinoplasty, or to schedule your consultation with me today, please contact my office.

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How Do I Treat Patients Undergoing a Rhinoplasty in Charlotte with Thin Skin?

Thursday, May 24th, 2012

There are two steps that must occur for a successful aesthetic outcome in patients with thin skin after a rhinoplasty in Charlotte. The nose is supported by an underlying framework composed of bone and cartilage. During rhinoplasty, this framework is changed and then the skin over the nose has to heal back onto the framework. It shrinks and wraps itself on the foundation over one year. During this time, the nose becomes more defined and elegant.

The cartilage and Bony foundation of the nose Charlotte Rhinoplasty Specialist How Do I Treat Patients Undergoing a Rhinoplasty in Charlotte with Thin Skin?

The cartilage and bony foundation of the nose. The skin will eventually shrink wrap back onto the foundation.

The thickness of the skin plays a key role in the ultimate outcome. Thick skin will not shrink and wrap as well. This will limit the definition possible in the nose. On the other end of the spectrum, in patients with very thin, it skin shrinks and wraps on the framework very well. This creates a risk that a minor irregularity under the skin may become noticeable over time. To prevent an issue that will sometimes appear months to years after the surgery, I will use a thin sheet of natural tissue from the body called temporalis fascia, to lie underneath the thin skin of the nose. This will slightly thicken the skin and help prevent the appearance of a minor irregularity.

Temporalis fascia is tissue that overlies the temporalis muscle located in the temple region. The incision to get the fascia is very small and is placed in the hair to hide it.

Temporalis Muscle 300x263 How Do I Treat Patients Undergoing a Rhinoplasty in Charlotte with Thin Skin?

Tissue that covers the temporalis muscle is harvested to be placed in the nose, slightly thickening the skin.

As a rhinoplasty specialist in Charlotte, I will take every step possible to ensure that my patients have the best chance to create a nose that will last a lifetime.

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Cosmetic Plastic Surgeon Hires Punk-Rock Band to Promote Rhinoplasty…and May Get into Trouble

Friday, March 16th, 2012

A cosmetic plastic surgeon in Miami is currently under investigation for hiring a band to write a song encouraging a Jewish teen with a large nose to have a nose job. The doctor offered a free rhinoplasty, free airfare, and free lodging to whomever made the video and received the most hits on YouTube.

The Groggers, a Jewish punk-rock band, took the plastic surgeon’s offer.  They wrote a song and created a music video which encourages a nose job on a young adult.  In return, the doctor performed a rhinoplasty on the lead singer.

These decisions have caught the eye of the media, as well as the American Society of Plastic Surgeons.  The doctor in question is currently under investigation by the Society for Unethical Behavior as a result of these actions.

Rhinoplasty is a surgical procedure and should be taken seriously.  Patients considering the surgery should consider all of the benefits and risks.  As a rhinoplasty specialist in Charlotte, I spend time with all of my patients to help them make an educated decision.

Next read:  New study show keliods rare during facial plastic surgery.

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Does Your Nose Grow with Age?

Thursday, March 8th, 2012

I’m sure you have heard the saying that your nose and ears continue to grow as you age. Let’s take a look at the facts.

How does the nose change with age?

Different areas of the nose change in different ways.  The nose is supported by an underlying bony cartilaginous framework.  The top part of the nose is supported by bone while the lower part near the nostrils is supported by cartilage.

nose with bones and carilages Does Your Nose Grow with Age?

A youthful appearing nose:

ideal nasal profile1 Does Your Nose Grow with Age?

Overtime, the cartilage becomes weaker and this causes the tip of the nose to droop, otherwise known as tip ptosis.  The bony part of the nose becomes weaker, but it does not move.

The skin of the nose actually becomes thinner, but the sebacous component of the skin increases.  The increase in the sebaceous skin makes the skin heavier and more vascular, which will cause the nasal tip to droop.

The bone that supports the nose from below, the maxilla, begins to reabsorb and shrink. This loss of support also contributes to tip ptosis.

Does the nose grow with age?

The answer to the question is both yes and no.  As one ages the nose does not grow, but it changes in shape, which often makes the nose appear larger.

As the support of the nasal tip weakens and the nose begins to fall, the nose appears longer from the side or profile view.  Additionally, it will make an existing nasal hump appear larger or cause a small hump to appear as the tip falls.

ideal nasal profile aging changes Does Your Nose Grow with Age?

The arrow pointing down shows the direction of movement of the nasal tip as we age.  The red line shows the outline of the anticipated appearance of the nose after the tip falls.  This illustrates how the nose is longer from the side view and appears to grow as we age.

Watch a video of me explaining the descent of tip of the nose with age.

How do these changes affect a rhinoplasty, also known as a nose job?

As a Charlotte nose job specialist, these changes are critical to understand.  A nose job performed on a patient that has a falling nasal tip secondary to the aging process is a very different operation than a young female seeking nasal refinement.    Generally speaking, a young patient with a large nose and hump will need the nose to be made smaller. An adult with a drooping tip which causes the nose to appear larger will need the tip lifted first to restore a youthful and refined appearance.  If additional changes are warranted, they can also be accomplished during surgery.  If the surgery were to be performed identically in both types of patients, the patient with the fallen tip could end up with a nose too small for their face.  As a Charlotte nose job specialist, I understand the anatomical changes of the nose as it ages and will tailor the operation to achieve the desired results.

Next read Major league baseball player gets nose job.

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Kicked Out of Parliament for a Nose Job?

Monday, March 5th, 2012

The Arab Spring…There are multiple revolutions occurring in many of the Middle Eastern countries.  One of the more unusual stories just came out of Egypt, one of the countries currently undergoing a revolution.  A member of the conservative Islamic party (I will not try to spell his name) claimed that he was beaten during a robbery and underwent surgery from the injuries.   It appears his claim was a lie to cover-up his real operation, which was a traditional nose job. He was dismissed from Parliament for these actions.

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Increase in African American Rhinoplasty

Saturday, February 25th, 2012

When African Americans seek facial aesthetic plastic surgery, they overwhelmingly choose to undergo a rhinoplasty, also known as a nose job, 88% of the time.  Check out many more interesting facts about African American rhinoplasty in the link below!

http://www.aafprs.org/media/stats_polls/m_stats.html

Jonathan Kulbersh is a specialist in ethnic rhinoplasty.  He trained in Beverly Hills with one of the most noted ethnic nose job specialists in the world, Dr. Paul Nassif.  Dr. Kulbersh now transfers these skills and techniques to his patients in Charlotte and Columbia.

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Nasal Implants and Why I Choose Not to Use Them

Thursday, February 23rd, 2012

Today, I had to do an unfortunate revision nose job that I believe could have been prevented.   Some nose jobs, also referred to as rhinoplasties, require that the profile or bridge of the nose be built up in order to help the nose fit the face.  This is commonly the case in ethnic nose jobs including African American and Asian patients.  There are natural procedures and implants that can be done to build the nasal profile.

Natural options include using your body’s own cartilage and tissue.  Depending on the patient, the cartilage can be taken from the nose, ear, or even rib.  In most cases, I always try to use the nose cartilage if there is a large amount in the body.  I will only use the ear or rib as a back-up.  Tissue can be taken from a hidden area either in the scalp or near the rib.

Some cosmetic surgeons use implants made of silicone or Gore-Tex in the nose.  These implants have been used safely in other areas of the body including the breast and chin.  They can be carved to give a nice shape to the nose.

Back to the question at hand: Why don’t I use nasal implants?

The nose has very unique qualities, and I do not believe that an implant is a good option for the nose.  The nose skin is very thin compared to other areas of the body.  There is a risk that the pressure of the implant on the thin skin can cause the implant to injure the skin.

When compared to natural tissue, an implant has a much higher rate of infection.  If the implant gets infected, it is also harder to treat than natural tissue.  An infected implant can actually cause the skin of the nose to die and the nasal implant may then be exposed.  These increased risks of an implant in the nose are the main reason I use the natural cartilage of the body to build the profile of the nose.

Today’s unfortunate case was a revision rhinoplasty of a Hispanic patient that had a silicone nasal implant placed in the nose. I had to remove the implant to clear the infection.  The patient will be on antibiotics for weeks.  This will be a difficult time for the patient as there will be an obvious deformity to the nose.

After the infection clears, the patient will undergo another revision rhinoplasty to repair the nose.  During this procedure, we will be using the patient’s own natural tissue.

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Major League Baseball Player Gets a Nose Job!

Wednesday, February 22nd, 2012

Jon Niese, a pitcher for the New York Mets, recently had a nose job.  One of his teammates jokingly said that if he got his nose fixed, he would pay for it.  It looks like his teammate is out some cash now.

Apparently, the cosmetic surgeon did a fantastic job, as Niese’s breathing has also improved!  Niese said that since having the procedure it is now easier for him to run.  This shows that a rhinoplasty can not only improve your appearance, but can also help with your breathing.

Check out the story on ESPN:

http://espn.go.com/new-york/mlb/story/_/id/7594929/new-york-mets-jon-niese-gets-nose-job-carlos-beltran-suggestion

I am a Beverly Hills trained nose job specialist.  I have offices in both Charlotte, North Carolina, and Columbia, South Carolina.  I pride myself in not only improving the look of the nose, but helping my patients breathe better after the surgery.

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Using Rib Cartilage in Revision Rhinoplasty

Friday, February 17th, 2012

Revision rhinoplasty is one of the most rewarding and challenging surgeries in facial cosmetic surgery.  Patients seeking a revision rhinoplasty in Charlotte normally come to my office with a different mindset than patients who are seeking their first nose job. For whatever the reason, patients seeking a revision are normally unhappy with their previous results. This unhappiness has normally led to a change in self confidence and a diminishing in their confidence and trust in doctors.  More than any other facial aesthetic surgery, a revision nose job should be done by a nasal specialist, due to the complex anatomy of the nose and importance of the appearance of the nose for the overall look of the face.

When seeing a patient at a consultation for a revision nose job, I inquire about their previous rhinoplasty(ies), their goals, and their desires. After establishing a trusting relationship between both parties, I develop a surgical approach to improve the nose.  I use two general approaches:

1)  Camouflage Revision Rhinoplasty

2)  Reverse Reconstructive Revision Rhinoplasty

In a camouflage revision nose job, the nose has proper underlying support, but has a poor appearance.  In this situation, I will use either an open or closed rhinoplasty approach to place tissue, grafts, and sutures to refine the nose and create an appealing appearance.

In a reverse reconstructive revision rhinoplasty, the nose has collapsed, lost its supporting foundation, and patients are normally unable to breath through the nose. These patients require the facial plastic surgeon to rebuild the underlying cartilaginous support to the nose and reconstruct it.  This may require a significant amount of straight and strong cartilage. The first option for cartilage is septal cartilage.  Often this cartilage is not available due to its removal during a previous surgery.  The next available option is ear cartilage in combination with a new product, PDS plate.  The ear cartilage is not straight or strong enough to reconstruct a nose.  The PDS plate is a sheet of suture material that straightens and strengthens the cartilage so it may be used in nasal reconstruction.

The final option for cartilage is to take it from the rib.  This cartilage is very strong and straight and is the best material to use when rebuilding a collapsed nose.  Typically, a small incision is hidden in the breast crease.  The patient will not experience any changes in their breathing or have a hole in their rib cage.  In fact, sometimes the rib will actually partially reform!  I will only use this procedure if it is absolutely necessary.  I believe as a rhinoplasty specialist, it is imperative to offer this procedure as there will be some patients that require rib cartilage.

Other surgeons will use foreign implants in the nose.  While this can be an option, I prefer to use the body’s natural material and believe using your own rib is safer in the long term.

Revision nose jobs in Charlotte should be done by a nasal specialist.  Dr. Kulbersh is a facial plastic and reconstructive surgeon who completed special training and has a vast interest in revision nose jobs.  He has offices in Charlotte and Columbia.

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Rhinoplasty Techniques to Narrow a Wide Nose

Wednesday, February 15th, 2012

One common goal during a nose job in Charlotte is to narrow a wide nose.  This is commonly a complaint in ethnic rhinoplasty including African American rhinoplasty patients.  When I examine a nose for its width, I want to see a gentle curve starting from the eyebrows going to the crease of the nostrils.  The nostril width should be about the same distance wide as the space between the eyes.  If this curve is not gentle or the nose is wider than the space between the eyes, then narrowing the nose during a rhinoplasty may be a good option for the patient.

The nose is most commonly narrowed by two techniques, alar base reduction and breaking the nasal bones (nasal osteotomies).  Alar base reduction is used to narrow wide nostrils.  Tissue has to be removed from the nostrils, so incisions have to be made on the skin.  I hide these incisions in the crease of the nose, so they are not noticeable.  This can be a powerful procedure to narrow the nostrils.

The width of the nose above the nostrils is not due to excess tissue, but secondary to wide nasal bones.  The only way to narrow this area of the nose is to break the bones. After breaking the bones, their position can be moved to narrow the nose.  This is routinely done in my rhinoplasties in Columbia and Charlotte. Breaking these bones may increase swelling and bruising after the nose job, but the results are worth it.

One final trick used to narrow the nose is to make the nose stick out farther from the face. A nose that is too close to the face is rounder and less triangular.  When the nose is viewed from the front, the round nose looks wider than it actually is.  If the nose is made less rounded and more triangular, then it will appear smaller than it actually is.  It is similar to viewing a tee-pee from the sky.  If a tee-pee is laying flat on the ground it will look round and wide.  If you put a pole in the middle of the tee-pee and make it into a tent, it will look smaller and narrower.  In some patients, the addition of a nasal projection to make the nose stick farther out from the face is the most important part of the rhinoplasty, making the nose appear more defined and narrow.  This is commonly the case in African American nose jobs in Charlotte.  

Dr. Jonathan Kulbersh is an ethnic rhinoplasty specialist.  He is a board certified doctor who trained with the best surgeons in Beverly Hills.  He has offices in Columbia and Charlotte serving all the Carolinas.  He specializes in only facial aesthetic surgery and facial reconstructive surgery.  

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