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Rhinoplasty

Rhinoplasty

Your nose is an important feature that helps define your face and the way you present yourself to the world. If you are not satisfied with the way it looks, then rhinoplasty can help boost your self-confidence by altering your nose to better suit your face.

Whether you want to change the shape of your nose to correct a nasal birth defect or later injury, to relieve breathing problems, or simply to make it look more like you want it to, Dr. Ahmad, Dr. Lista and Dr. Austin will help you decide how rhinoplasty might benefit you.

What is a Rhinoplasty?

Rhinoplasty is one of the most common of all plastic surgery procedures. The actual operation may involve reducing or increasing the size of your nose, straightening a crooked nose, changing the shape of the tip or the bridge, narrowing the span of the nostrils, or changing the angle between your nose and your upper lip. In addition, some patients may require reconstruction of the nasal airway to improve their breathing for problems such as a deviated septum.

Experience and Innovation to Improve Patient Outcomes

At The Plastic Surgery Clinic, we perform approximately 75 to 100 rhinoplasty procedures per year, making Dr. Ahmad, Dr. Lista and Dr. Austin some of the most experienced cosmetic surgeons in Toronto and throughout Canada. Our main objective is to help you to achieve your goals while ensuring the highest standards of patient care and safety. We aim to reshape your nose so that it looks natural and improves the overall balance of your face. We have extensive experience in performing both types of rhinoplasty surgery: primary (the first surgery) and revision (surgeries that correct previous procedures). In addition, we can also perform nonsurgical rhinoplasty using soft tissue fillers.

Empower Yourself with Knowledge

If you have more questions about whether nose surgery is for you, please contact us at info@theplasticsurgeryclinic.com to set up a complimentary consultation with Dr. Lista, Dr. Ahmad or Dr. Austin.

How a Rhinoplasty is Performed

To start, Dr. Ahmad, Dr. Lista or Dr. Austin will make small, inconspicuous incisions. They will then lift the skin off the nose in order to reveal the supporting framework of bone and cartilage. Depending on your needs and expectations, Dr. Ahmad, Dr. Lista or Dr. Austin will reshape the bone and cartilage to create a nose that is more refined and in balance with your face.

Rhinoplasty usually takes from one to three hours, although complicated procedures may take longer.

Note: If you have difficulty breathing through your nose, you may also require septal reconstruction or reshaping of the nasal cavity to improve your breathing following rhinoplasty surgery.

Where Your Rhinoplasty is Performed

Your rhinoplasty can be performed right on site in the state-of-the-art facilities of The Plastic Surgery Clinic. The Clinic meets or exceeds national, provincial, and municipal health care facility standards in such important areas as equipment quality and infection control.

If you prefer, you can choose to have your surgery at one of the hospitals where the highly skilled Toronto plastic surgeons at The Plastic Surgery Clinic enjoy privileges. These include the Mississauga site of the Trillium Health Centre and the University Health Network in Toronto.

No matter where you choose to have your surgery, there is always a surgeon on call to respond to your concerns. In addition, a board-certified anesthesiologist will administer your local or general anaesthetic, stay with you during the entire operation, and be there as you wake up.

The Best Candidates for Rhinoplasty

The Best Candidates for RhinoplastyThe best candidates for rhinoplasty are physically healthy, psychologically stable, and realistic in their goals and expectations. Most of our rhinoplasty patients want to improve their appearance without drawing attention to the fact that they underwent a “nose job”. They want to look natural—as though they have a nose that they could have been born with. At The Plastic Surgery Clinic, we specialize in making your nose suit the rest of your face. You will notice the difference when you compare before and after photographs, but others will likely not be able to pinpoint the cause of your improved appearance.

Ideal candidates are also non-smokers without underlying health conditions that might make surgery riskier than normal. Smokers should quit for at least two weeks before and after surgery, because smoking inhibits healing. A rhinoplasty procedure can have a positive effect on your self-esteem. Feeling better about your appearance can make you feel better about yourself. Studies show that this kind of surgery often improves quality of life. Before you decide to have surgery, think carefully about your expectations and discuss them with an experienced rhinoplasty surgeon such as Dr. Ahmad, Dr. Lista or Dr. Austin.

Straightening the Crooked Nose

One of the most common complaints that patients have is that their nose is crooked or deviated. Crookedness of the nose can range from mild to severe nasal deviation. A crooked nose is most commonly due to normal facial development and aging. However, a crooked nose may be as a result of trauma. Rhinoplasty or ‘nose job’ surgery can be performed to correct and straighten the crooked nose.

Patients may feel that their nose is off to one side or that the appearance of their nose is different when seen from the right and left sides. In some cases, patients come in for consultation for rhinoplasty to correct another deformity of the nose such as a bump on the bridge or bulbous tip and don’t realize that they have a twisted nose. To achieve the best possible result following nose job surgery, crookedness and symmetry should be improved during rhinoplasty.

Other common deformities that may accompany a crooked nose include a dorsal hump (bump) on the bridge of the nose, a large or poorly defined nasal tip, and asymmetry of the size or shape of the nostrils. Many of our patients presenting for cosmetic rhinoplasty also have difficulty breathing through their nose. If a deviated septum is also present, then septal reconstruction is performed at the same time as rhinoplasty so that both the cosmetic appearance and the function of the nose are improved simultaneously.

The patient shown in the photo above had severe crookedness of her nose with deviation of the tip to the right. In addition, she had a large, poorly defined tip, and significant nostril asymmetry. She had difficulty breathing through her nose. She underwent open rhinoplasty with septal reconstruction. She is shown over 1 year after surgery with a smooth, straight bridge both on frontal and profile views. Her tip is much more balanced, defined and located in the midline. Her nostrils are more symmetrical. She noticed a significant improvement in her breathing following surgery.

Rhinoplasty is performed as day surgery at the Plastic Surgery Clinic in Mississauga. Following straightening of the crooked nose, a nasal splint is worn for 1 week. After removal of the splint, results are noticeable immediately and breathing typically improves within a few weeks after surgery.

Rhinoplasty to Improve Breathing

Rhinoplasty or “nose job” surgery is one of the most commonly performed cosmetic procedures in plastic surgery. Many patients who come to The Plastic Surgery Clinic for cosmetic rhinoplasty also have difficulty breathing through the nose and report symptoms such as congestion and stuffiness. In general, nasal breathing difficulties are caused by functional problems like allergies, many of which can be treated with medications, and structural problems like a deviated septum. A deviated septum is a condition in which the nasal septum – the section of bone and cartilage that divides the nasal cavity in half – is crooked or off-center. This imbalance can obstruct breathing in one or both of the nasal passageways.

While an irregular septum is a common cause of breathing difficulties, irregularities in other areas of the nose like the internal and external nasal valves and the turbinates can similarly impede nasal airflow. The internal nasal valve is located in the middle third of the nose and is the narrowest part of the nasal passageway. Because it is so narrow, even a slight malformation of this area can affect breathing. The external nasal valve is what is commonly understood as the nostril opening. It can be narrowed due to problems with the septum and weaknesses on the outer sides of the nostrils. The turbinates are small, thin bones covered by soft tissue within the nose. Sometimes they can become enlarged and block nasal airflow.

These kinds of structural problems can all be treated surgically. During cosmetic rhinoplasty, structural causes of nasal airway obstruction can be corrected while improvements are made to the size and shape of the nose if desired. Structural corrections can include septoplasty or septal reconstruction, turbinate reduction, or adding your own cartilage borrowed from within your nose to strengthen internal or external nasal valves.

This patient had previous rhinoplasty with another surgeon but continued to experience severe nasal airway obstruction due to a deviated septum and both internal and external valve collapse. Her breathing was significantly improved after cosmetic rhinoplasty with septal reconstruction and valve reconstruction using cartilage grafts.

Rhinoplasty is performed at the Plastic Surgery Clinic. Prior to surgery, we spend a lot of time with our patients to listen to their concerns and identify their goals. In addition, we identify any structural problems that may be making breathing difficult through the nose. In this way, the result after rhinoplasty will complement and enhance facial appearance while ensuring that breathing is as unimpeded and effortless as possible.

Preparing for a Rhinoplasty

Dr. Lista, Dr. Ahmad and Dr. Austin are proud to have helped so many rhinoplasty patients in Toronto and Mississauga realize the goal of having a nose that makes them happy and brings their facial features into balance.

Because surgery of any sort can make patients feel nervous or apprehensive, Dr. Lista, Dr. Ahmad and Dr. Austin listen carefully to each patient’s desires and provide expert guidance on what each type of surgery can and cannot do. They will carefully explain the potential benefits, as well as the risks, in order to make you feel secure and comfortable with the procedure.

Your consultation will involve a physical examination, including a thorough medical history, and a discussion about your goals with surgery. You will be asked to describe your ideal look; if you can, you should bring in pictures that show faces that you like. Dr. Lista, Dr. Ahmad and Dr. Austin use digital imaging software to show you what you might look like after rhinoplasty surgery.

Dr. Lista, Dr. Ahmad or Dr. Austin will spend as much time as you need to make sure both you and your surgeon know exactly what you want. It may not always be possible to meet all your expectations with surgery, so it is crucial that you understand what a realistic outcome is likely to be.

Dr. Lista, Dr. Ahmad or Dr. Austin will examine you to determine exactly what procedure or combination of procedures will best help you meet your goals. For a rhinoplasty, a very extensive discussion will occur around what you want your nose to look like and what might best suit your face. Your surgeon will work with you to recommend the procedure that will help you come closest to achieving your desired results.

Your surgeon will also instruct you on how to prepare for surgery in order to achieve the best result, including guidelines on eating, drinking, and taking certain vitamins and medications. Smokers should plan to stop smoking one month before surgery and for one month while in recovery. This is because smoking inhibits proper healing and can affect the recovery of facial incisions. You may also be asked to refrain from taking some over the counter medications such as aspirin, anti-inflammation drugs, or certain herbal supplements, as they may increase bleeding during the surgery.

Recovery Following a Rhinoplasty

Rhinoplasty surgery is performed at The Plastic Surgery Clinic as a day surgery procedure. A friend or relative will need to come and pick you up and stay with you at home for 24 hours. During this time your face may feel puffy, and your nose may ache or feel congested, all of which can be controlled by the pain medication prescribed to you. You should plan on taking it easy for several days following nose surgery.

A little bleeding is common during the first few days following this plastic surgery procedure, and you may continue to feel some stuffiness for several weeks. You should be careful not to blow your nose for several weeks to allow the tissues to heal. The external and internal nasal splints will be removed after one week, allowing you to feel much more comfortable.

Swelling and bruising around your eyes will reach a peak after two or three days, and can be reduced by applying cold compresses and sleeping with your head elevated. While major swelling and bruising should disappear within about two weeks, some subtle swelling – unnoticeable to anyone but you and your rhinoplasty surgeon – will remain for several months, especially in the tip of your nose.

Most of our rhinoplasty patients are up and about after two days, and able to return to school or sedentary work a week or so following surgery. It will be several weeks, however, before you return to your normal pace.

Risks and Complications of Rhinoplasty Surgery

Dr. Lista, Dr. Ahmad and Dr. Austin perform 75 to 100 rhinoplasty procedures each year. The results are ordinarily positive and complications are rare. Nevertheless, there are always risks associated with surgery, and there are specific complications associated with this procedure. Your surgeon will discuss these risks with you thoroughly during the consultation process.

After rhinoplasty surgery, you may have temporary difficulty breathing through your nose due to swelling, but permanent problems are rare. Dr. Ahmad, Dr. Lista and Dr. Austin are very experienced in performing functional airway reconstruction during rhinoplasty to address breathing problems (including a deviated septum), which will result in an improvement in your breathing.

Post-operative complications such as infection and blood clots are rare. Infection can be treated with drainage and antibiotics, but may require a hospital stay. You can minimize the risk of blood clots by moving around as soon as possible after the surgery. At our state-of-the-art plastic surgery clinic in Toronto, patients are given anti-embolic stockings that they are asked to wear for one week following surgery. We also have a specialized device called a sequential compression pump that gently massages the patient’s legs during surgery and, combined with the stockings, greatly decreases the risk of blood clots in the legs.

Poor healing, which can result in conspicuous scars, may require a second operation. Smokers are advised to quit, as smoking may increase the risk of complications and delay healing.

You can reduce your risk of complications by closely following your surgeon’s instructions before and after the surgery, especially with regard to when and how you should resume physical activity.

In about one out of twenty cases, a second rhinoplasty procedure may be required. For example, a minor deformity may appear after surgery. Such cases are unpredictable and even patients of the most skilled rhinoplasty surgeons might require a second procedure.

Please keep in mind that at The Plastic Surgery Clinic, we will treat any complication that may arise. If you have an unsatisfactory result and we think additional surgery will help solve the issue, we will usually perform the surgery for no additional charge.

Rhinoplasty Before & After Photos

The following are some results following rhinoplasty by Dr. Ahmad, Dr. Lista and Dr. Austin. More results are available to see during your consultation for rhinoplasty in Mississauga or Toronto.

The Photos

These photos show the actual results of our rhinoplasty patients. If you’re interested in seeing more photos than the collection here, there are more available at our office that you can view during a free consultation. To see the before and after pictures from all procedures, take a look at our before and after gallery.

Rhinoplasty Surgery Results

In the days following your rhinoplasty surgery, when your face is bruised and swollen, it might be easy to forget that your physical appearance will improve. It is quite normal and understandable that many nose surgery patients may feel unhappy immediately following plastic surgery. Your appearance will gradually improve with each passing day, and within a week or two you will no longer look as if you have just had surgery. Keep in mind that healing is a gradual process and the final results of rhinoplasty may not be apparent for a year or more. As time passes, you will continue to see more and more definition and refinement.

Rhinoplasty may also have an impact on your friends or family. They may not see a major difference in your nose or they may act resentful, especially if you have changed something they view as a family or ethnic trait. If this happens, you might have to remind yourself of the goals you had going into surgery and recognize that you did this for yourself, not to please your friends or family.

More result photos are available to see during your consultation.

Dr. Ahmad's Rhinoplasty Publications

Dr. Ahmad's Rhinoplasty PublicationsAs Director of Research and Education at The Plastic Surgery Clinic, Dr. Ahmad is an active participant in current research and education. His outstanding contributions are a major asset to the field, particularly when it comes to nasal surgery.

Because it is one of the most difficult procedures performed by aesthetic plastic surgeons, rhinoplasty requires high levels of experience and expertise. One of the difficulties posed by this surgery is the fact that no two noses are exactly alike. In some cases, patients seek out a secondary or revision rhinoplasty procedure as a result of unpredictable healing after a first operation, natural asymmetry of the face, or their high expectations not being met adequately. In 2016, Dr. Ahmad’s book Secondary Rhinoplasty by the Global Masters was published. This indispensable surgical resource provides surgeons everywhere with exceptional contributions from nearly 50 experts and covers operative principles and personal techniques. With over 1,800 pages of information and 13 hours of surgical video showcasing 30 revision rhinoplasty procedures, the two volume set expands on the extensive body of reference material Dr. Ahmad has contributed to fellow rhinoplasty surgeons.

Learn more about this important publication in our blog.

Dr. Ahmad's Rhinoplasty PublicationsIn 2014, Dr. Ahmad’s book Dallas Rhinoplasty: Nasal Surgery by the Masters, 3rd Edition, was published. This medical textbook is a renowned rhinoplasty reference used by nasal surgeons around the world. This two-volume set is over 1,700 pages in length and presents the work of recognized pioneers in the field of rhinoplasty surgery. It provides comprehensive coverage of topics relating to primary and revision rhinoplasty. From basic fundamentals and anatomy to the latest refinements and advances in technique, the book includes comprehensive case analyses to facilitate clinical decision making-supplying rhinoplasty surgeons with all the tools needed for achieving superb results. The book includes 68 chapters and 4 DVDs containing videos of operative procedures and surgical technique.

In 2002, the first edition of Dallas Rhinoplasty: Nasal Surgery by the Masters was published to compile the knowledge and concepts that had been, in large part, developed by faculty who have attended the Annual Dallas Rhinoplasty Symposium that began in 1984. A second edition followed in 2007, with updates to existing chapters and new chapters covering the latest advances in rhinoplasty. Given Dr. Ahmad’s significant experience performing rhinoplasty, academic involvement in teaching rhinoplasty and contributions at the Annual Dallas Rhinoplasty Symposium, he was invited by Drs. Rod J. Rohrich, William P. Adams, Jr., and Jack P. Gunter to be a co-editor of the most recent edition of this textbook-considered by nasal surgeons as the premier rhinoplasty educational resource. In addition to co-editing the book, Dr. Ahmad co-authored 29 of the chapters included in this textbook.

Dr. Ahmad performs both primary and revision rhinoplasty, and both cosmetic and functional nasal surgery. He is known for his thorough and friendly approach with his patients and he is sought after for achieving natural results after rhinoplasty surgery.

For more information on Dallas Rhinoplasty: Nasal Surgeons by the Masters, 3rd Edition, please visit: https://www.amazon.ca/Dallas-Rhinoplasty-Nasal-Surgery-Masters/dp/1576263843

The Rhinoplasty Society

The Rhinoplasty SocietyIn 2013, Dr. Ahmad became one of only a few rhinoplasty surgeons in Canada to become a member of the international Rhinoplasty Society. The Rhinoplasty Society consists of top surgeons throughout the world who specialize in rhinoplasty. Members must be board certified as specialists in plastic surgery or otolaryngology. These surgeons must go through an extensive vetting process in order to be part of this nonprofit organization. Members are considered innovators in their field and deeply committed to aesthetic and reconstructive nasal surgery. One of the criteria for membership is that surgeons must perform at least 30 nasal surgeries per year.

Given Dr. Ahmad’s significant experience performing rhinoplasty and academic involvement in teaching rhinoplasty, he was accepted as a member after the minimum requirement of 2 years of practice. Amongst his accomplishments in rhinoplasty, he has coauthored multiple journal articles and chapters discussing many aspects of rhinoplasty, he is a regularly invited faculty and speaker at the annual Dallas Rhinoplasty Symposium, and he is the course director of the annual University of Toronto Aesthetic Plastic Surgery Symposium. Dr. Ahmad is currently working on his first textbook on rhinoplasty. Dr. Ahmad attends the annual meeting of the Rhinoplasty Society every year to discuss the latest techniques and innovations in rhinoplasty surgery with colleagues from around the world.

Dr. Ahmad performs both primary and revision rhinoplasty, and both cosmetic and functional nasal surgery. He is known for his thorough and friendly approach with his patients and he is sought after for achieving natural results after rhinoplasty surgery.

For more information on the Rhinoplasty Society, please see http://www.rhinoplastysociety.org/

How Much Does a Rhinoplasty Cost?

If your rhinoplasty is not covered by your provincial health plan or corporate benefits, thinking about the cost can be stressful. At The Plastic Surgery Clinic we put patient care first and we want your experience with us to be as stress-free as possible. To begin with, we schedule you in for a free consultation with one of our expert plastic surgeons to discuss the goals of your rhinoplasty, then we give you all of the information you need to make a decision, including our excellent financing and payment plans that make your rhinoplasty costs more manageable. After this consultation your plastic surgeon will have a better idea of the specifics involved in your surgery, and we will be able to give you a more accurate estimate of cost. We love helping our patients achieve their goals and are happy to answer any questions you might have.

To find out more about the cost of a rhinoplasty, please contact us by phone or e-mail or by filling out the Request for Information form on the right.

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