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206-624-6200
THE SEATTLE FACIAL PLASTIC SURGERY CENTER™
1101 MADISON ST #1280 SEATTLE, WASHINGTON 98104 | (206) 624-6200
The Facial Plastic Surgery Center
Dr William Portuese - Board Certified Facial Plastic Surgeon

Rhinoplasty Seattle Washington – Nose Job – Nose Surgery

A Rhinoplasty, or ‘nose job,’ is a surgical procedure to alter and change the shape of the nose and enhance facial features. It is the most common surgical procedure performed in our medical practice. The goal by our board certified facial plastic surgeons (Dr William Portuese and Dr. Joseph Shvidler ) is to give a very natural appearance with all of the components of the face balanced with each other, and the entire new nose balanced with the facial features. Most facial cosmetic surgeons and patients would agree there are many undesirable features that can be changed with the help of surgery. If the nose is too wide, it can be narrowed, a dorsal hump ( bump ) can be removed, a wide and boxy tip can be refined, and if the nose crooked – which may have been broken – it can be narrowed. If there are functional breathing problems, it can also be addressed at the same time. Call our surgery center at (206) 624-6200 to schedule a consultation.

Good Candidate for  Straightening Noses

There are many issues contributing to a crooked nostril; a deviated septum, fractured and displaced bones and a deviation of the septum creating a crooked nostril in addition to a fracture of the septum off the maxillary crest and vomer. When an upper lateral cartilage has been fractured and dislocated off of the bone itself, it can create a concave midportion. Surgical treatment for this is usually includes osteotomies in the nasal bones to correct them back to their pre-injury state. A cartilaginous spreader graft, harvested from inside the nose, can accomplish correcting the midportion and building out the concave upper lateral cartilage. A tip-plasty is required on the cartilages when they are asymmetrical and cartilage grafting or cartilage removal may be required. A Septoplasty is required for a fracture and deviated septal cartilage itself. Any of these components can be accomplished using the closed rhinoplasty method as an out patient. Consider a  nose job in Seattle with these nose experts.

crooked nose

 

 

Reduction of the Bulbous Tip – Nose Job

The bulbous nose is created from a combination of wide, divergent and thick cartilages, known as the lower lateral cartilages of the nose. Sutures called inter-domal and intra-domal stitches are used to narrow the existing wide and boxy cartilages. In addition to these techniques to narrow the tip cartilages, a conservative amount of cartilage is also removed to improve the contour and maintain a vary natural outcome.

Rhinoplasty Seattle

Narrowing a Wide Nose

A wide nose is usually present due to the congenital development of nasal bones. Wide and splayed bones can also be present due to trauma and a fracture. Narrowing the bones requires medial and lateral osteotomies in the bones themselves. This  accomplishes the narrowing of the upper two thirds – the bones and the corresponding upper lateral cartilages. A cast or splint is over the bridge to hold the bones in their narrower position.

narrowing a wide nose

Lifting a Droopy Tip

A droopy nose is usually the result of downwardly pointing cartilages.  The drooping tip can also be caused from a downward deviation of the caudal as well. When the tip droops when smiling, “releasing” the depressor septi ligament is required. This prevents the tip of the nose from drooping dynamically when smiling. It is very important to lift the tip for both static and dynamic results.

Lifting a Droopy Nasal Tip

Shaving Down the Dorsal Hump

To remove the dorsal hump during a nose job is a very common reason for contouring Most dorsal humps are composed of about two thirds cartilage and one third bone, but it can quite a variable based on anatomy. The hump must be shaved down in order to remove it. Once the hump has been removed, osteotomies placed in the bones are required to close the open roof ( flat top) nasal deformity that is created from the hump removal.

dorsal hump removal

Breathing Difficulties – (Nose Obstruction)

There are many issues that can cause these difficulties; Allergies – treated with nasal sprays, antihistamines and decongestants and turbinate hypertrophy – treated medically as well. When a therapy has failed, consideration for turbinate may be made. Valve collapse and vestibular stenosis on the inside can be static or dynamic with inspiration, and are treated with spreader graft placement (from cartilage harvested) to bolster the nasal valve and upper lateral cartilage from falling inwards when. This is treated with a surgical septoplasty. Chronic sinusitis is caused from chronic sinus polyps located inside the sinuses and is treated with functional endoscopic sinus surgery.

Breathing Difficulties

Widening a Narrow Nose

Many people are born with a very narrow and inverted upper lateral cartilages creating an hourglass appearance along with thin bones. Reverse osteotomies and spreader graft placement are used to hold the bones in the new open and wider place. These methods are part of a closed method and used to widen a narrow nasal vault and narrow nose. A cast is applied for one week.

Rhinoplasty Seattle | Nose Surgery Bellevue WA | Nose Job Seattle

Chin Augmentation using an Implant – Facial Plastic Surgery Bellevue

A chin implant is performed when an overly projecting nose in combination with an under projecting chin is present. The under-projection of the chin makes the nose look more prominent than it really is and placement of a chin implant can augment the chin further to give better facial balance and proportion of the face, realized mostly from the side profile. Chin implants are manufactured in a large array of sizes, thickness and shape and the appropriate size is best determined at the time of the consultation and examination. Digital computer imaging of the face is also helpful to understand what can be accomplished with both procedures to give better facial harmony and balance or a more appealing nose.

Rhinoplasty Seattle | Nose Surgery Bellevue WA | Nose Job Seattle

Nasal Reduction of the Hanging Columella

The hanging columella can be the result of a previous plastic surgery procedure, although many people are born with excess cartilage in that location. When there is excess skin and cartilage creating a “bottom heavy” look, a columella-plasty can be performed. This involves surgical removal of cartilage on the inside of the nostrils. This cosmetic surgery procedure, in addition to just simply tucking the columella inward can also help raise or lower the tip when necessary . Columella-plasty is usually an integral part of this procedure.

reduction of the hanging columella

What is Revision Rhinoplasty?

Revisional Rhinoplasty is more difficult than a primary surgical rhinoplasty due to the fact that there is scar tissue present and previous alterations to the normal anatomy. There are many reasons; a residual dorsal hump, polybeak deformity, a hanging columella, twisted and asymmetric bones or concavities somewhere which requires a cartilage graft.

Rhinoplasty Seattle | Nose Surgery Bellevue WA | Nose Job Seattle

Sports Related Injuries – What Should You Do? Nose Surgery ?

Basketball, football and soccer tend to be the most common sports-related injuries. Males typically desire a stronger profile which keeps the nose masculine, yet refined while females may desire a subtle feminization. Call (206) 624-6200 to schedule reconstructive surgery with a  specialist today.

Rhinoplasty Seattle | Nose Surgery Bellevue WA | Nose Job Seattle

Closed or Open Nasal Surgical Technique?

In a Closed Rhinoplasty all of the incisions are inside of the nose, with no visible external incisions on the nose. An Open Rhinoplasty means there is an incision across the columella to access the tip and the bridge and it is done by lifting the entire surface up off of the cartilages. Our  board-certified facial surgeons with years of experience use the closed technique to obtain natural and balanced results. View some of our before and after photo gallery. Learn more about scars, skin discomfort, structure, symmetry of the face, reshaping, the consultation, concerns, medication and more.

Anesthesia Used in Seattle Medical Center WA by Plastic Surgeons

All surgeries are performed by  Dr. William Portuese or Dr. Joseph Shvidler under general anesthesia by a board certified physician anesthesiologists. Surgery is available in our Medicare certified out patient surgical center / clinic / office adjacent to Swedish Medi Center.

Recovery

A cast is placed across the bridge which will stay on for one week. There is no painful packing placed on the inside of the nose, and all the incisions are internal with dissolvable stitches. It is important to understand that there will be 2 weeks of visible bruising on the skin and swelling and patients must refrain from any physical exercise during that time. Desired visible end results show around 3 months post op and a full year of healing and recovery is to be expected.

Nose Job cost?

Rhinoplasty Cost (Regular) Price:
$8,350 – $9,350 (Facial Surgeon & Operating Room) + $980 (Anesthesia)

Rhinoplasty (Complex/Revision) Price:
$10,000 – $11,500 (Facial Surgeon & Operating Room) + $1176 (Anesthesia)

Is Surgery Worth it?

Fortunately, most of these issues can be addressed by an experienced and trained  doctor for the proper client and patient. It can improve a person’s self-esteem, beauty, balance, harmony and confidence, allowing them to live a happier life.

What is the Best Age For Rhinoplasty?

The best ages to have nasal surgery . While there is no set age for treatment, it is often believed to be between the ages of 18 and 40. You’ve matured physically and emotionally to the point where you’re an excellent candidate for  surgery.

Is this covered by Insurance? Schedule a Consultation

Plastic surgery services like rhinoplasty are often considered elective and are not covered by insurance. If there is a functional, structure or component to the operation, such as a breathing problem or another reason, that element of the reconstructive surgical procedure may be covered by an individual’s insurance plan.

If you are looking for a rhinoplasty procedure or other plastic surgery service or face treatment or skin rejuvenation by our rhinoplasty surgeons to enhance your facial features in Washington State for improvement or nose augmentation schedule a staff / nurse consultation or a Doctor’s visit / appointment with our facial surgeons at 206-624-6200 We are located in downtown Seattle a city on Puget Sound in the Pacific Northwest. Our facial doctors see patient for nose issues from Issaquah, Bellevue WA, Kirkland, Redmond, Lynnwood, Renton, Kent , Federal Way, and surrounding areas. Our  nose job surgeons do not offer non surgical rhinoplasty. Patient care at its finest. Call to schedule with the best rhinoplasty surgeon at  (206) 624-6200.

We also offer blepharoplasty, facial rejuvenation services, brow lift, facial reconstruction, injectables for facial rejuvenation, facial fillers, eyelid treatment ( fat removal ) , face lift surgery, botox, otoplasty, eyelid surgery, neck lift surgery, fat transfer, lip augmentation, facelifts and other nasal issues more.

Useful Links and Resources
Frequently Asked Questions About The Nose – Form, Function, Pain
Plastic and Safety Issue Information and Surgery Diagrams
Sinus Brochure
Facial Revision Rejuvenation Treatment

Rhinoplasty Seattle | Nose Surgery Bellevue WA | Nose Job Seattle

Washington Ambulatory Surgery Center Association Washington State Medical Association American Academy of Facial Plastic and Reconstructive Surgery Real Self