Rhinoplasty

Are you looking for a trusted rhinoplasty cosmetic surgeon in the Bay Area? Dr. Evan Ransom is a renowned San Francisco rhinoplasty specialist who performs different forms of nose job surgery.

Rhinoplasty is the surgical modification of the shape of the nose, also known as “nose job surgery” or nose reshaping. This procedure uses a wide variety of approaches and techniques involving the internal structures of the nose to affect aesthetic improvements in the external appearance. Some common goals include removal of a bump (“dorsal hump”) on the bridge of the nose, reduction or modification of the nasal tip cartilages, narrowing the width of the nose, making the nostrils smaller, and lifting a droopy or hanging tip of the nose.

In the majority of cases, rhinoplasty is used to make the nose smaller or more refined (“reduction rhinoplasty”). Less commonly, rhinoplasty can also be used to make the nose larger (“augmentation rhinoplasty”) or to fix breathing problems or trauma (functional rhinoplasty). For patients who have breathing problems in addition to cosmetic concerns, a combined functional and cosmetic rhinoplasty can be performed. When a patient has undergone a prior rhinoplasty, but the results were unsatisfactory in some way, a revision rhinoplasty can be performed.

Choosing an Approach

San Francisco Rhinoplasty can be performed either “open” (using an external incision) or “closed” (using incisions only on the inside of the nose). This choice is dictated by the specific goals of the patient, as well as any functional or anatomic issues that would require a specific approach. In addition, most revision rhinoplasty (sometimes called “secondary rhinoplasty”) requires an open approach due to the complex nature of this procedure and the need to provide internal support for the nasal structures.

Open Rhinoplasty

Open rhinoplasty involves a small incision placed in the columella (the bottom of the nose or the skin between the two nostrils) and allows complete exposure of the nasal cartilages and bones. This facilitates precise assessment of the internal issues with the shape of the nose, as well as accurate diagnosis of functional problems. For the Bay Area rhinoplasty patients desiring significant change to the tip of the nose, an external approach is preferred – this allows Dr. Ransom, San Francisco rhinoplasty specialist, to reduce the size of the cartilages, make the two sides of the nose symmetric, and create a more aesthetically pleasing shape for the tip. Examples of problems that San Francisco Rhinoplasty Surgeon Dr. Evan Ransom can address via an open rhinoplasty approach include a “bulbous” or “boxy” tip, asymmetric tip cartilages, a crooked or twisted nose, and a nose that is too long (“hook” nose) or “droopy” (hanging columella or excessive columellar show).

Patients with a crooked nose, a history of nasal trauma (for example, an untreated fracture), or significant functional concerns (breathing problems), are better served with an open approach. Finally, patients who have had a previous rhinoplasty or who have complex structural issues in the middle part or tip of the nose, are best treated with an open rhinoplasty.

Closed Rhinoplasty

Closed rhinoplasty, sometimes called scarless rhinoplasty, eliminates the incision in the columella and places the remaining incisions between the nasal cartilages inside the nose. This technique is very useful for the Bay Area rhinoplasty patients with concerns about the bridge of the nose (nasal dorsum or “dorsal hump”) but who desire minimal or no change to the nasal tip. Narrowing of the nasal bones can also be performed easily through an open or closed approach. Septoplasty can be performed during any San Francisco rhinoplasty and can help to straighten a crooked nose, improve your breathing, or reduce snoring.

For patients who want smaller changes to their nose, especially when the main concern is a “bump” on the bridge, a closed rhinoplasty is a great option. This procedure is ideal for reshaping the upper and middle portions of the nose but is not the best option for refinement of the nasal tip.

Rhinoplasty Recovery

Recovery from closed rhinoplasty is generally very quick. In most patients, the majority of the swelling in the nose lasts for a few days to a week. Typically, San Francisco Bay Area rhinoplasty patients will have a flexible plastic cast on the nose for about a week. All the sutures in closed rhinoplasty are dissolvable, so no suture removal appointments are needed. Recovery from open rhinoplasty is similar to closed rhinoplasty, though the swelling of the nose may last for a few more days. Dr. Ransom, San Francisco rhinoplasty expert, does not use any nasal packing, which allows the patient to breathe normally after the surgery and significantly reduces postoperative discomfort. San Francisco rhinoplasty and septoplasty procedures may be combined with other aesthetic facial surgery or non-surgical treatments. Please visit the photo gallery for examples.

Revision Rhinoplasty

Revision rhinoplasty, also known as secondary rhinoplasty, is a very specialized and complex part of plastic surgery. Revision rhinoplasty improves upon inferior or unsatisfactory results and/or corrects complications from the primary surgery. When performing revision rhinoplasty, Dr. Ransom believes it is essential to address not only the aesthetic issues (the way the nose looks), but also the functional issues of breathing problems (such as deviated septum, septal spurs, nasal obstruction from enlarged turbinates, internal or external nasal valve collapse, nasal valve stenosis, or nostril stenosis). Dr. Ransom is a revision rhinoplasty specialist, and, with his background and specialty training in Facial Plastic Surgery, Facial Reconstructive Surgery, and nasal surgery, is uniquely qualified to help patients with aesthetic or functional issues from prior nasal surgery.

Common problems include a nasal hump being partially or completely left behind (bump on the bridge, sometimes called a “Polly beak” deformity because it results in the nose looking like a parrot’s beak in profile), a tip that remains too wide (“bulbous tip” or “boxy tip”) or lacks definition, a tip that is still droopy (tip ptosis), or nostrils that are too large or too widely spread apart (nostril or alar flare). Given that the problems encountered in revision rhinoplasty are different for each patient, the surgery must be customized for each patient’s unique anatomy and function. Whenever possible, Dr. Ransom prefers to use the patient’s own tissue for nasal reconstruction or revision rhinoplasty. Materials commonly used include the septal cartilage, ear cartilage (from the “bowl” of the ear), or even rib cartilage in extreme cases or with multiple revisions.

Deciding on the Right Nose for You

San Francisco Rhinoplasty Cosmetic Surgeon Dr. Ransom works with each individual patient to create the nose that he or she wants. Different noses work for different faces, and Dr. Ransom is sensitive to patients’ personal preferences and sense of identity. Dr. Ransom is experienced at helping nasal surgery patients of all ages and types. Our goals are to provide natural-appearing enhancement of the nose, in harmony with the other facial features, while preserving or improving the nasal function (breathing). Undergoing rhinoplasty is a very personal decision and requires a true understanding between the doctor and the patient.

Ethnic Rhinoplasty

This philosophy is especially important in what is often called ethnic rhinoplasty. So-called “ethnic rhinoplasty” is a surgical procedure designed to reshape a non-Caucasian nose, and deals with the anatomical issues specific to these noses. This procedure can be performed either “open” (using an external incision) or “closed” (using incisions only on the inside of the nose). Most ethnic rhinoplasty requires an open approach due to the complex nature of this procedure and the need to provide internal support for the nasal structures.

In addition, some patients will desire a change in the size or shape of the nostrils. Dr. Ransom is happy to perform alar base modification or alar repositioning to treat asymmetric, large, or overly flared nostrils. Dr. Ransom works closely with all of his patients, to make sure that the changes made to your nose reflect your aesthetic goals – and keep “you” looking like “you” after the procedure. Ethnic rhinoplasty details can be discussed with Dr. Ransom during your confidential consultation in his office in the Bay Area.

Choosing the Right Doctor

Undergoing rhinoplasty is a very personal decision and requires a true understanding between the doctor and the patient. It’s also a procedure that calls for a highly skilled surgeon. San Francisco Rhinoplasty Cosmetic Surgeon Dr. Ransom is experienced at helping nasal surgery patients meet their goals and fulfill their dreams of being more comfortable and confident. He cares about your San Francisco rhinoplasty being successful every bit as much as you do and is known for the personal approach he takes toward every procedure. Take the first step in reaching your goals and join us for a rhinoplasty consultation at our office in the Bay Area today!

Who Is A Candidate?

Anyone who wants to change the shape of their nose is a candidate for San Francisco rhinoplasty (nose reshaping). Examples of problems that are frequently addressed in cosmetic rhinoplasty include a “bulbous” or “boxy” tip, an asymmetric tip, a crooked or twisted nose, a wide nasal bridge, overly broad or flared nostrils, a short or flat nose, and a nose that is too long (“hook” nose) or “droopy” (hanging columella). Narrowing of the nasal bones can also be performed easily through an open or closed approach. Septoplasty can be performed during any rhinoplasty and can help to straighten a crooked nose, improve your breathing, or reduce snoring in some cases.

In addition, patients with a history of nasal trauma (for example, an untreated fracture), or significant functional concerns (breathing problems), may choose rhinoplasty as a surgical remedy for these issues. Finally, patients who have had a previous rhinoplasty but were left unsatisfied by the aesthetic result or have had functional issues may be a candidate for revision rhinoplasty.

Medical Necessity

Many facial plastic surgery procedures are performed because they are medically necessary, whether they serve to repair a congenital defect or a scar after a trauma. Dr. Ransom is knowledgeable and experienced with several medically necessary procedures.

Functional Nasal Surgery

A functional rhinoplasty is a nasal surgery that is designed to correct a specific anatomic issue and improve the nasal airway (breathing). Patients with significant breathing problems and nasal obstruction, and who have not undergone a previous cosmetic rhinoplasty, are candidates for functional rhinoplasty.

Septoplasty

Septoplasty is the surgical modification of the structure of the nasal septum. Patients with significant breathing problems, snoring, and nasal obstruction which are derived from a crooked or fractured nasal septum are candidates for septoplasty.

Rhinophyma

Rhinophyma is a condition of the nose, predominantly in the thicker skin at the tip, that manifests as an obvious enlargement – which is sometimes dramatic. Treatment of rhinophyma can help to improve the appearance of the nose and reduce the growth and thickness of the skin at the tip. Among the common approaches are ablative laser resurfacing (using a CO2 laser), cold knife resection, and electrocautery.

Please note that all patients are different and individual healing times and results may vary. The statements regarding procedures and recovery made here are general rules.

Dr. Ransom, a renowned San Francisco rhinoplasty surgeon, sees patients from all over Bay Area, including Mill Valley/Marin County, Napa/Sonoma, San Rafael/Petaluma, Hillsborough, San Mateo, Menlo Park, Orinda, Palo Alto, Piedmont, Walnut Creek, and the world.

Frequently Asked Questions