Rhinoplasty is a facial surgery procedure that is performed on people of all ages. Some seek this procedure because they are unhappy with the nose they were born with or with the manner in which aging has changed their nose.
Nothing has a greater impact on how a person looks than the size and shape of the nose. Because the nose is the most defining characteristic of the face, a slight alteration using nasal surgery can greatly improve one’s appearance. If you are dissatisfied with how your nose looks, seek out a Washington DC rhinoplasty procedure.
What Is a Rhinoplasty Procedure Meant to Do?
Some of the features that one may look to correct are the nasal profile, a bulbous tip, a crooked nose, or a deviated septum. For others, an injury may have distorted the nose and caused permanent deformity. In addition to desiring a cosmetic improvement to the nose, some may also be looking to improve obstructed breathing.
Meet Your Rhinoplasty Surgeon
This is one of the most complex and intricate procedures of the face. For this reason, one should go to a surgeon with a great deal of experience and knowledge of this procedure. Dr. Michael Somene is specially trained in plastic surgery of the face with a particular focus on rhinoplasty in Washington DC.
Dr. Somenek has extensive training and experience with this surgery. His fellowship training was under the tutelage of some of the best rhinoplasty surgeons in the country, Drs. Regan Thomas and Dean Toriumi at the University of Illinois at Chicago. Since 2018, Washingtonian Magazine has named him a Top Doctor and highlighted him as the “Face of Rhinoplasty.” Even more importantly, patients have taken notice too – Somenek+Pittman MD was the 2021 readers’ choice for plastic surgery and MedSpa services in DC Modern Luxury Magazine.
Dr. Somenek brings a unique perspective and understands how to not only make the nose look good but also preserve the structure for long-lasting and satisfactory results for the patient. Due to his vast expertise, Dr. Somenek is often sought by patients for some of the most complex rhinoplasty cases.
"Dr. Somenek is truly an artist and a master at what he does. I came in for a revision rhinoplasty and he fixed my deviated septum, added structure inside using ear cartilage, and created symmetry in my nostrils. I am less than three weeks out from my surgery and have zero swelling- my nose looks and feels fantastic. I am beyond happy with my results and couldn’t recommend Dr. Somenek and his team more. The office team is very warm, helpful and organized. The surgical suite is an oasis and I felt extremely comfortable before and after my surgery. Truly couldn’t be happier with my results. Thank you Dr. Somenek and his A-Team!"
Before the Rhinoplasty Surgery
During the initial consultation, Dr. Somenek uses this time to understand your motivation and expectations for nasal surgery. It is an opportunity to develop a mutual level of trust and understanding. A detailed physical examination is performed to determine the areas that will require correction in the nose to provide the best results.
Dr. Somenek will go over a thorough list of expectations and risks that are involved in surgery. He will explain the various structures in the nose, including bone and cartilage, and how sculpting these can alter the appearance of the nose.
Photos will be taken of the patient’s face, and with the help of sophisticated imaging software, computer imaging will be performed. This will aid in creating realistic expectations for the patient that are in line with the patient’s needs and desires based on their individual anatomy.
In addition, Dr. Somenek may suggest other procedures such as chin augmentation and blepharoplasty surgery that can enhance the overall harmony of the face. It is always beneficial for the patient to compile a list of questions to ask during the consultation, as this can clarify any concerns about the procedure and help better delineate if your expectations are in line with Dr. Somenek’s aesthetic goals for your nose.
Dr. Somenek believes in creating a natural-looking and aesthetically pleasing nose for the patient. Rhinoplasty is one of the most difficult operations in facial plastic surgery. The difficulty lies in the anatomy of the nose, as this varies from patient to patient. For this reason, Dr. Somenek creates an individualized surgical plan for each patient and utilizes comprehensive techniques to achieve this plan.
Different Approaches to Rhinoplasty
Since rhinoplasty procedures are individualized to a patient’s unique nasal structure and cosmetic goals, the operation could take several possible approaches to facilitate different results. The best strategy depends on the number of cosmetic changes that the patient wants, their nasal structure, and the length of recovery they are willing to go through. A person looking to get a nose job in Washington DC should consider any of the following types of procedures:
- Open Rhinoplasty: The typical surgical approach is an open rhinoplasty, in which Dr. Somenek surgically lifts the skin to allow for more substantial and visible cartilage and bone changes.
- Closed Rhinoplasty: When patients require fewer bone and cartilage alterations, a closed rhinoplasty that uses two incisions within the nostrils may be ideal.
- Septoplasty: A septoplasty procedure focuses exclusively on correcting issues with the nasal anatomy that disrupts breathing, such as a deviated septum.
- Tip Rhinoplasty: A nasal tip plasty makes cosmetic changes to the tip of the nose specifically, eliminating the need for bone and cartilage alterations.
- Cartilage Grafts: In some cases, cartilage grafts that are taken from the ribs or ears may replace volume loss in the nose, and strengthen support of the nasal anatomy.
Among these surgical approaches, an open rhinoplasty is the most common procedure as it allows for more cosmetic and structural changes to the nose than a closed or tip procedure. In addition, an open procedure allows Dr. Somenek to have more visibility of the bone and cartilage, making it easier for him to make more precise alterations.
In many cases, patients undergo a cosmetic rhinoplasty and a septoplasty simultaneously to correct breathing difficulties and improve aesthetics. Since the facial structure and cosmetic aims for a rhinoplasty will vary between patients, a thorough consultation with Dr. Somenek is necessary to determine the best approach.
Cartilage Grafts for the Nose
Not all cartilage grafts serve the same function and Dr. Somenek employs a number of different grafting techniques, allowing for multiple methods of nasal correction.
- Spreader Graft: Widens – or “spreads” – the middle portion of the nose. This addresses the internal nasal valve that can be narrowed in some patients and contribute to nasal obstruction.
- Septal Extension Graft: A piece of cartilage placed on the tip of the nose in order to extend and shape it. It adds greater long-term stability to the nasal tip.
- Columella Strut: Cartilage that is placed within the nasal tip structure to add support to the tip position.
- Rib Graft: Taking a piece of the patient’s rib cartilage and repurposing it to restructure the nose.
- Ear Cartilage Graft: Taking a piece of the patient’s ear cartilage and repurposing it to restructure the nose. (This does not alter the look of the ear in any significant way.)
- Lateral Crural Strut Graft: Grafts that can enhance breathing capability by reinforcing the existing cartilage within the nasal tip. It is particularly useful for cartilage that is weak or misshapen within the nasal tip.
- Shield Graft: A small shield-shaped graft that can add length to the nasal tip and project the nose further, contributing to the overall definition and refinement to the nasal tip.
- Onlay Graft: Grafts which can augment the shape of a nasal area which lacks sufficient cartilage.
- Batten Graft: Often used to treat collapsed nasal valves and improve a certain form of nasal obstruction.
Check out our blog on cartilage grafting to learn more about this process.
The Rhinoplasty Procedure in Washington DC
Dr. Somenek emphasizes preservation of the nasal structures and minimal excision of the supporting tissues. Removing more tissue and cartilage than necessary may lead to a pinched tip and nasal obstruction.
For primary rhinoplasty, Dr. Somenek uses cartilage grafts harvested from the nasal septum to reinforce critical structures and regions in the nose. These allow him to create a long-lasting result not only aesthetically but functionally for nasal breathing. In more complex cases, cartilage from the ear or rib may be used.
Skin thickness is an important consideration when thinking about getting a nose job. Special attention must be given to thin-skinned individuals, as they are at a higher risk for visible or palpable abnormalities post-operatively. Medium-skinned patients are more ideal candidates for rhinoplasty because as the skin contracts over the underlying cartilaginous structures, any abnormalities are more easily camouflaged.
After the Rhinoplasty Procedure
The surgery is typically performed on an outpatient basis under general anesthesia at our fully accredited, ambulatory surgery center in the West End. Dr. Somenek will see you the following day to clean the area around the nostrils and ensure that you are doing well. Dr. Somenek does not routinely use packing for the nose, as he believes it adds unnecessary discomfort for your recovery.
At your one-week post-op visit, the nasal cast and the fine sutures that were used to close the incision will be removed. It is important to realize that your nose will be swollen when the cast is removed. Dr. Somenek will place tape on the nose when necessary to decrease the overall amount of swelling. The majority of swelling will resolve within two weeks.
Your face will feel puffy, especially the first day after surgery. Dr. Somenek will advise you to avoid blowing your nose for seven days after surgery. In the days immediately following surgery, you may experience bruising and minor swelling in the eye area. Cold compresses often reduce the bruising and discomfort. Your nasal splints and sutures are removed seven days after surgery.
Following up with Dr. Somenek
Follow-up care is vital for this procedure to monitor healing, so it is essential that you keep your follow-up appointments with Dr. Somenek. Much of the swelling will decrease about two weeks post-operatively. However, the healing process will continue to occur for many months after surgery.
Persistent swelling of the nasal tip can occur in some patients depending on their individual anatomy and thickness of their skin. Throughout the follow-up period, Dr. Somenek may recommend steroid injections to the nose or nasal taping to aid in resolution of the swelling and produce the best outcome for his patients. Occasionally, a minor revision to the nose is required and will be discussed with the patient if needed.
Insurance does not generally cover surgery that is purely for cosmetic reasons. Surgery to correct or improve nasal function or surgery for major deformity or injury may be reimbursable in whole or in part. The office will work with the patient to provide the best care possible. Dr. Somenek looks forward to meeting you and working to provide the best aesthetic result to meet your needs.
Conditions That Limit Rhinoplasty Candidacy
Though many people who dislike the look of their nose or experience breathing difficulties due to nasal irregularities are suitable rhinoplasty candidates, some medical conditions might be disqualifying. Severe diabetes or blood disorders that impact the body’s healing process may prevent someone from getting a rhinoplasty procedure in Washington DC.
Further, individuals with severe cardiovascular concerns are at a higher risk of general anesthesia complications during surgery, limiting their candidacy. This is why Dr. Somenek performs a thorough review of the patient’s medical history during the consultation. Patients must also not be pregnant or actively smoking nicotine for at least several weeks before and after the procedure. Though a patient may resume smoking at least four weeks after rhinoplasty, the nose could take up to one year to fully recover, so refraining entirely from nicotine is the preferable option.
However, if a patient is generally healthy and has realistic expectations, they are suitable for this procedure. If this is not a patient’s first nose job, the secondary surgery must be at least 12 months after the initial one to ensure the nose is healed completely.
Contact Our Office About a Washington DC Rhinoplasty
Rhinoplasties are becoming more and more common, and Somenek + Pittman MD is proud to be your destination for nasal surgery and all other plastic surgery decisions. We are committed to your health and privacy, and can even schedule an overnight stay at a nearby hotel after your operation, for your convenience. If you have further questions regarding rhinoplasty in Washington DC, please call or contact our office today to schedule your initial consultation with Dr. Somenek.