Closed Rhinoplasty

If you are healthy, have breathing obstruction, and/or desire an improvement in the appearance of your nose, regardless of whether you’ve had nasal surgery or procedures in the past, then you may be a good candidate for rhinoplasty, also known as nose job surgery. Dr. Rad focuses his rhinoplasty techniques on improving both aesthetic shape and airflow while minimizing tissue trauma, swelling, and recovery. Self-confidence and breathing can be significantly improved.

Functional goals:

• Correct a deviated septum (to improve breathing)
• Open collapsed nostrils (“external valve” problems)
• Open collapsed internal airways (“internal valve” problems)
• Enhance airflow through the nasal passages
• Improve comfort during nasal breathing

Aesthetic goals:

• Refine and define a bulbous or ball-shaped tip
• Reduce a large dorsal hump
• Elevate or rotate a dropping tip
• Narrow a widened nose
• Shorten a long nose
• Improve projection (not to increase the length) of the nasal tip
• Lift a hanging columella (the column of tissue between nostrils on the underside of the nose)
• Reduce nostril retraction
• Restore symmetry
• Straighten deviation

Rhinoplasty (“nose job”) surgery aims to improve external nasal appearance and to improve nasal breathing. Particularly in Washington DC, limiting downtime is often as important as the result itself. Dr. Rad specializes in minimally invasive rhinoplasty with “closed” (no external scar) “preservation” and “endonasal” approaches. These two different but related approaches offer multiple advantages: no visible scars, minimal tissue trauma, recovery time is minimized, nasal stability is optimal, and results can be excellent.

About 80% of people have a deviated septum, large turbinates or some other anatomical reason for impaired airflow. Poor nasal airflow impairs sleep which can lead to fatigue, lack of concentration and poor work performance. Rhinoplasty and septoplasty can significantly improve airflow through nasal passages which can improve sleep and restfulness. Even in the absence of a deviated septum, Dr. Rad employs airway preserving techniques, called “dorsal preservation,” as well as other methods such as “spreader grafts” (cartilage pieces placed in the internal nasal valve) to open the airways further. Improved breathing and beautiful aesthetic results are always Dr. Rad’s goal for his patients.

There are many methods for rhinoplasty and choice of technique depends on many factors. Surgeons-in-training are usually exposed first to the open method because the nasal skeleton is visible during surgery, whereas closed rhinoplasty can be challenging to learn because of limited visibility (by design to minimize invasiveness). However, many skilled rhinoplasty surgeons, especially those who perform rhinoplasty frequently, are capable of open and closed methods. While Dr. Rad has expertise in open methods, he chooses to specialize in closed and preservation techniques which gives patients access to the full spectrum of rhinoplasty surgery.

If you have concerns for improving other areas of the face then Dr. Rad will advise you. While rhinoplasty can improve the appearance of the nose itself, facial balance and proportion are crucial to consider. Dr. Rad will evaluate your facial architecture to determine if you would benefit from enhancement or refinement of other areas of your facial skeleton. The most popular adjunct to rhinoplasty is chin augmentation (genioplasty) for a receded or diminutive chin. When the chin is too small the nose often looks disproportionately large. Chin augmentation can improve the projection, shape, and size of the chin. In combination with rhinoplasty, the facial balance can be improved. Facial width is also important to consider: some patients benefit from enhancement of the cheekbones either through facial fat grafting or malar (cheek) implant augmentation, whereas others may benefit from slimming of “chipmunk” cheeks via buccal fat pad removal. Patients in later years may combine facelift or neck lift surgery with rhinoplasty. The bottom line is that combining surgeries is generally safe and requires careful assessment of your facial architecture and your goals. Overall combining procedures are generally safe, cost-effective, and involve one recovery period, making it a popular approach.

Particularly in rhinoplasty, surgery can’t be reversed and correcting inexperienced work is more challenging (but not impossible), so choose right the first time. When vetting a plastic surgeon, use this checklist: S/he should be certified by the American Board of Plastic Surgery, trained in an accredited (by ACGME) program at renowned institutions, have years of experience performing rhinoplasty regularly (every week), show extensive before/after photos of patients, and the surgeon’s aesthetic should resonate with you. Patients should always be well informed and it is important to spend time in consultation to discuss your goals, examine your nose, and answer questions and address concerns. Surgery is a significant undertaking with many details to review, and your consultation should be unhurried. Sometimes Dr. Rad offers computer simulations however primarily for hump reductions. Attention to detail is crucial. Note how the surgeon addresses the details of your surgery. Also pay attention to the cleanliness of the office, friendliness and competence of office staff, presentation of information on the website, and other clues to how attentive to detail the surgeon is. Rhinoplasty revision surgery is not uncommon and can be costly. Invest in quality rather than focusing solely on cost. This will give you the best chance of a successful result for the long term.

Cost is multifactorial and starts at $9,500, increasing with complexity and length of surgery. We cannot give detailed quotes before consultation.

Note that pricing is customized for each patient and these guidelines do not necessarily apply uniformly. These are approximate ranges and total cost depends on multiple factors: your unique anatomy, goals, complexity of the procedures, recommended techniques, whether corrective work is needed, in-office or hospital-based operating facility, and combining multiple procedures (increasing concessions apply for multiple procedures).

Although you may receive varying cost estimates from other practices, keep in mind that your surgeon’s education and training, plastic surgery board certification, his/her experience (at least 8 years of experience after residency is recommended), and aesthetic artistry and surgical skill (i.e., talent) of your surgeon are important factors in pricing. Dr. Rad’s practice is solely focused on facial aesthetic surgery and his artistry is unmatched. His goal for every patient is to achieve nuanced and natural results with minimal recovery, and we have mechanisms in place to bring them within financial reach.