Posted on April 16, 2011 in Asian Rhinoplasty, Ethnic Rhinoplasty, Nose Reshaping, Revision Rhinoplasty, Rhinoplasty
We at the Hilinski Clinic of Facial Plastic Surgery are quite proud of the fact that our San Diego nosejob patients love their rhinoplasty results. However, there is always the issue of whether or not patients should be smiling after a rhinoplasty procedure. I like to tell my rhinoplasty patients that they should refrain from smiling after their nosejob for at least 6-8 weeks. Instead, I suggest they try what I like to call a ‘Mona Lisa’ smile. When patients animate excessively after rhinoplasty surgery and have a wide grinned smile, they are putting unwanted tension on the bottom portion of their nose. If there was reshaping of the nasal tip and/or base, which is common in my San Diego rhinoplasty practice, this type of unwanted tension can detract from the final surgical outcome. This tension pulls on the nose and can disrupt the normal healing around sutures or grafts that were placed to reshape the nose. Therefore, rhinoplasty patients are recommended to minimize this type of facial movement until the nose can heal adequately. At 6-8 weeks out from a nosejob procedure, there is obviously still a good amount of healing that needs to take place. However, sufficient healing has taken place by this point in time such that you can begin smiling a little wider and showing just how much you love your rhinoplasty results! Happy healing. Dr. Hilinski
Posted on March 18, 2011 in Asian Rhinoplasty, Nose Job, Nose Reshaping, Revision Rhinoplasty, Rhinoplasty
San Diego rhinoplasty specialist and California revision rhinoplasty expert, Dr. John Hilinski, is proud to report that he now has one of if not the largest rhinoplasty photo galleries in all of San Diego. In fact, Dr. Hilinski likely has one of the largest galleries of rhinoplasty photos in all of Southern California. As a San Diego double board certified facial plastic surgeon, he has a specialty focus in rhinoplasty surgery – arguably the most challenging and complex plastic surgery procedure. Over the years, Dr. Hilinski has developed a reputation in San Diego and beyond as a regional plastic surgery expert in cosmetic nose reshaping. In addition, he is well-known as a specialist in reconstructive nose surgery that is commonly involved in rhinoplasty and revision rhinoplasty. To see actual rhinoplasty photos of patients who have undergone nasal reshaping surgery by Dr. John Hilinski, visit our San Diego rhinoplasty gallery and San Diego revision rhinoplasty gallery.
Posted on February 20, 2011 in Asian Rhinoplasty, Revision Rhinoplasty, Rhinoplasty
Many rhinoplasty patients out there are instructed to tape their nose on a regular basis to help the nasal skin shrink wrap down to the new shape of the nose. If you haven’t done so yet, please take a look at our online rhinoplasty tutorial on taping the nose following rhinoplasty and revision rhinoplasty. One helpful hint that I wanted to point out with regard to taping the nose has to do with removal of the tape. One recent San Diego rhinoplasty patient of mine inquired about anything she might be able to put on her nose that would aid in taking the tape off more gently. I recommended she try and get some Detachol topical solution. Detachol is an adhesive remover that can be dripped on to the tape, which helps break up the attachment to the skin surface. The tape can then be removed much easier from the nose. In this manner, you can be much more gentle with handling your nose following a delicate rhinoplasty or revision rhinoplasty surgery. You might need to search online to find where to buy Detachol or an equivalent adhesive removal product out there. Good luck and hope this helps some of you nose reshaping patients! Thanks to Danielle for reminding me to post this entry!
Posted on February 17, 2011 in Asian Rhinoplasty, Ethnic Rhinoplasty, Nose Reshaping, Revision Rhinoplasty
I just saw of one my many San Diego nose job (rhinoplasty) patients in the office today to take off her cast following nose reshaping 5 days ago. She was doing quite well with minimal bruising and very little swelling despite a full reshaping of the nose. She was pleasantly surprised how little of a recovery was involved with her rhinoplasty procedure. In addition, she was quite happy that her pain levels following the nose job were significantly less than she had envisioned prior to the rhinoplasty. As I told her and all my other San Diego nose job patients, there is a misunderstanding out there about pain levels following a rhinoplasty procedure. Most of my San Diego cosmetic nasal reshaping patients are on low dose narcotic pain medication, such as Vicodin, for about 2-3 days after their rhinoplasty or revision rhinoplasty surgery. In fact, there are many of my San Diego rhinoplasty patients who have recovered without taking any narcotic medication at all! The bottom line is that rhinoplasty patients are typically uncomfortable following nasal reshaping of the nose. However, significant pain requiring narcotic medication is quite uncommon following rhinoplasty performed at The Hilinski Clinic of Facial Plastic Surgery.
Posted on February 11, 2011 in Asian Rhinoplasty, Blepharoplasty, Ethnic Rhinoplasty, Facial Plastic Surgery, Nose Reshaping, Revision Rhinoplasty, Rhinoplasty
San Diego rhinoplasty specialist, Dr. John Hilinski, has just completed another chapter for his online rhinoplasty tutorial that helps current and prospective nasal reshaping patients better understand the entire process of nose surgery. This latest rhinoplasty chapter focuses on the use of nasal steroid injections in management of the nose surgery patient. To learn more about this rhinoplasty topic, click here to learn about our nasal reshaping tutorial on steroid injections for rhinoplasty patients.
Posted on February 9, 2011 in Asian Rhinoplasty, Ethnic Rhinoplasty, Nose Reshaping, Rhinoplasty, Septal Reconstruction
One rhinoplasty topic that I see commonly discussed online is the issue of persistent nostril asymmetry following rhinoplasty. I think this is a topic that deserves some mention and clarification. Many rhinoplasty and revision rhinoplasty patients note some degree of nostril asymmetry following their nasal reshaping procedure. This is certainly more the rule than the exception. The real question is whether or not the persistent nostril asymmetry noted is easily visible on frontal view of the nose. Meaning, can people notice this when looking directly at you? Or is it just noticeable when looking from underneath the nose (called the base view)? Of course, all rhinoplasty experts and revision rhinoplasty specialists aim to achieve as much symmetry as possible. This includes creating a nose that is balanced and proportional from all views. However, the reality is that you are never going to have ‘the perfect’ nose even after a well performed rhinoplasty or revision rhinoplasty surgery. Given this fact, most rhinoplasty experts will prioritize their efforts when it comes to reshaping the nose. One of the top priorities in nasal reshaping surgery is to achieve as much symmetry and harmony as possible on frontal view since this is where most people see you. Obviously if you can correct the nostril asymmetry at the same time as achieving the desired frontal symmetry, then that would be ideal. But in some cases you simply cannot have both. There are definitely those rhinoplasty and revision rhinoplasty patients out there whose anatomy just doesn’t allow you to have perfectly symmetric nostrils as seen from below, unless you sacrifice symmetry of the nose on frontal view. What I tell many of my own San Diego rhinoplasty and San Diego revision rhinoplasty patients is that our main goal is to create as much symmetry as possible on the frontal view. If we achieve symmetry of the nostrils on base view that is great. But the priority is definitely the frontal view.
Case Example of Rhinoplasty Nostril Evaluation
Attached is a quick case example of rhinoplasty surgery as it relates to nostril asymmetry. This particular rhinoplasty patient presented with asymmetry of her nose including the nostrils as seen on frontal view. As you can see from her before rhinoplasty photo diagram (red arrow), her right nostril was much more narrow due to a segment of cartilage that was protruding into the nostril opening. This not only created asymmetry of her nostrils on base view, but also impacted her frontal view. I performed a closed rhinoplasty procedure on her to create more symmetry (as well as to improve her nasal breathing). My priority was to create a nose that looked more symmetric on frontal view. Although I definitely attempted to create nostril symmetry at the same time, I was not going to sacrifice her frontal appearance just for the sake of gaining more equivalent sized nostril openings. As you can see from her before and after rhinoplasty photos noted below, she has a nice overall improvement in her frontal view. Her bridge is more balanced and her nostrils and nasal base look more even now. I was able to remove the excess protruding cartilage without compromising her tip support. Overall, her frontal appearance looks quite symmetric. On base view, you can also see an improvement with better symmetry related to her nostril size and shape. I am the first to admit that she still has some degree of nostril asymmetry. However, in this particular rhinoplasty patient I would not have achieved as much symmetry in her frontal appearance had I attempted to do more work on nostrils as seen from below. It came down to a matter of priorities and being realistic when it comes to rhinoplasty results. I hope this helps in clarifying some of the debate and discussion ongoing out there in the rhinoplasty world regarding persistent asymmetry of the nostrils following nasal reshaping procedures.
Posted on February 3, 2011 in Asian Rhinoplasty, Nose Reshaping, Plastic Surgery, Revision Rhinoplasty, Rhinoplasty
One of the main reasons why we do so many rhinoplasty and revision rhinoplasty surgeries is the fact that my practice has extensive experience when it comes to cosmetic reshaping of the nose. In fact, a large part of my San Diego Facial Plastic Surgery practice is dedicated to rhinoplasty and revision rhinoplasty. Facial plastic surgeons who are rhinoplasty specialists are vastly different from what my colleague, Dr. Steven Dayan in Chicago, refers to as the ‘occasional’ rhinoplasty surgeon. I think this is a great term for those plastic surgeons out there who perform all different types of cosmetic surgery. For instance, a majority of plastic surgeons here in San Diego perform breast augmentation and body sculpting on a very regular basis. They might even perform facelift surgery as part of their practice. But a large majority of these San Diego plastic surgeons are truly ‘occasional’ rhinoplasty surgeons. They might do nasal reshaping or cosmetic enhancement of a nose once a month or even less frequently. As a rhinoplasty expert and revision rhinoplasty specialist I can tell you without any hesitation at all that this is a setup for disappointment for both surgeon and patient. I cannot stress enough how important it is to perform rhinoplasty and revision rhinoplasty surgery on a very consistent basis. Cosmetic nose reshaping is arguably the most difficult plastic surgery procedure to perform. If you do this occasionally, you will get the occasional successful outcome. If you are a rhinoplasty and revision rhinoplasty specialist, you are much more likely to achieve the best rhinoplasty outcomes with the highest chance of the desired rhinoplasty result.
