Posted on January 28, 2012 in Facial Reconstruction, Nose Reshaping, Rhinoplasty, Skin Cancer Surgery
As a San Diego rhinoplasty and revision rhinoplasty expert, Dr. John Hilinski utilizes much of this expert knowledge and experience in nose surgery to help patients who require repair of nasal defects following removal of skin cancer. This is often times referred to as MOHS surgery of the nose, where skin cancers are carefully removed most commonly by dermatologists. In many of these patients, the defect or hole that is created from removal of the skin cancer can be quite extensive. In these situations, dermatologists will frequently refer these cases to Dr. Hilinski to repair the resulting defect. This case example provided here in the latest blog entry focuses on repair of a fairly extensive defect involving the nasal bridge in this female patient from San Diego who had MOHS surgery by a local dermatologist. She was then referred to Dr. Hilinski to help in the repair process because of his widespread reputation as one of the finest nose surgery experts in the region. Learn more about nasal reconstruction following MOHS surgery of the nose by linking here.
Posted on January 26, 2012 in Facial Plastic Surgery, News, Rhinoplasty
Facial Plastic Surgeon in San Diego Discusses Rhinoplasty Recovery
According to the latest statistics from the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), the most popular cosmetic surgical procedure in 2010 was rhinoplasty, with an average of 54 procedures performed per surgeon. Dr. John Hilinski, a facial plastic surgeon in San Diego who performs well over 100 procedures each year, says because of its popularity, rhinoplasty is subjected to several misconceptions regarding recovery and the surgical process. Dr. Hilinski discusses important factors for patients to consider when weighing the gravity of a surgical procedure such as rhinoplasty in San Diego.
San Diego facial plastic surgeon Dr. John Hilinski says rhinoplasty is the most common procedure he performs at his practice, with an average well over 100 procedures each year. While well above the average, this statistic is reflected in the most recent study from the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), which states that an average of 54 procedures were performed per surgeon during 2010.
According to the AAFPRS study, rhinoplasty was the most popular cosmetic surgical procedure performed in 2010, particularly among men where it was nearly twice as popular as any other surgical procedure. Dr. Hilinski says with the popularity of San Diego rhinoplasty comes a number of misconceptions patients need to be cautious of when considering the procedure. Because rhinoplasty affects both the cosmetic appearance of a central point in one’s facial symmetry, as well as essential airway passages and breathing structures, he says patients should be sure to discuss the entire surgical process and recovery with a board-certified facial plastic surgeon before undergoing any nasal reshaping surgery.
While the typical rhinoplasty procedure takes anywhere between an hour and a half to three hours to perform under general anesthesia, Dr. Hilinski says most patients expect the recovery process to be quick. However, because of the intricate nature of rhinoplasty, he says full healing and final shape of the nose may not occur until anywhere between six months to two years after surgery, depending on whether patients undergo an open or closed procedure. Dr. Hiliniski says many patients feel publicly presentable after 10-14 days, but rhinoplasty recovery is an ongoing process and patients need to be prepared for swelling, bruising, and puffiness that may realistically require a significant amount of healing before the final desired results take shape.
“In a majority of open rhinoplasty procedures, nearly 70-80% of the swelling has gone away by 2-3 months out from surgery. That leaves nearly 20-30% of the swelling that still has to go away over the next 1-2 years. This is a point that many rhinoplasty patients often times forget. Even at 9 months out from surgery, when patients think they are looking at the final result, the reality is they still have a decent amount of healing to go before the shape of the nose finally plateaus. In patients who have had a closed rhinoplasty procedure, it may take the final shape as early as 6-9 months out from surgery since there is less swelling involved with this type of rhinoplasty technique. Over this time they should see a progressive trend where the nose is taking on its new shape and size. However, rhinoplasty patients need to keep in mind that there may be periods of time (days to weeks) when the nose looks more swollen or puffy than it did previously.”
Dr. Hilinski says patients considering rhinoplasty must take into account all factors before deciding to undergo a procedure. He stresses the level of commitment patients need to prepare for with such a cosmetic enhancement and recommends talking about the options with an experienced and personal facial plastic surgeon so as to ensure the highest quality results, safety, and patient satisfaction are achieved.
“I think one of the most important things that patients need to realize about rhinoplasty surgery is the healing process can be quite extensive when compared with other plastic surgery procedures (such as breast augmentation or eyelid surgery). Many patients are under the mistaken perception that their nose will be essentially healed 2-4 weeks out from surgery. When someone considers undergoing a rhinoplasty procedure, they are committing themselves to a long-term healing process that can take upwards of 1-2 years before the nose ultimately settles into its final shape and size. This is quite a commitment when it comes to surgical healing and one that needs to be considered very seriously by any potential rhinoplasty patient.”
About John M. Hilinski, MD
Dr. John Hilinski earned his medical degree from Harvard Medical School in Boston, after which he completed a General Surgery Internship followed by a Head and Neck Surgery residency at the University of California, San Diego (UCSD) Medical Center. He also completed a Facial Plastic and Reconstructive Surgery Fellowship at the University of Illinois, Chicago Medical Center and a National Institutes of Health Research Fellowship at the UCSD Cancer Center. Dr. Hilinski has served as a staff surgeon at Sharp Memorial Hospital and Scripps Clinic and Green Hospital, as well as a Clinical Faculty Instructor in Facial Plastic and Reconstructive Surgery at the UCSD Medical Center and Veterans Administration Medical Center. He is board-certified in Facial Plastic and Reconstructive Surgery and Head and Neck Surgery. Dr. Hilinski is also a member of the American Academy of Facial Plastic and Reconstructive Surgery, the American Academy of Otolaryngology-Head and Neck Surgery, the California Society of Facial Plastic Surgery, and the San Diego County Medical Society, in addition to having been published in several book chapters and medical journals.
Located at 3720 Fourth Avenue in San Diego, CA, Dr. Hilinski’s practice can be reached at (619) 296-3223. He can also be contacted online via the website www.drhilinski.com or www.facebook.com/drhilinski.
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Posted on January 8, 2012 in Nose Job, Nose Reshaping, Rhinoplasty
A common concern among rhinoplasty and revision rhinoplasty patients in San Diego, CA is their appearance in the short-term following cosmetic nose reshaping. This blog post here attempts to shed some light on this issue using a real patient example. This particular San Diego rhinoplasty patient happens to be a familiar face – she is the front office staff member of San Diego Face and Neck Specialties – Christine! This past month Christine underwent a cosmetic rhinoplasty procedure to reshape her nose. Specifically, she had her nasal tip lifted up and the bridge of the nose reduced slightly while being narrowed. These photos represents what our typical rhinoplasty patient looks like just 2 weeks out from surgery. As you can see, there has been an obvious change in the shape and size of her nose. In addition, you can appreciate that she still has swelling of the soft tissues of the nose that contribute to the nose still looking puffy. But overall she is quite presentable to the public eye at just 2 weeks out from surgery. In fact, she is already back to work here at the office! You can also see that she has minimal signs of bruising around the nose and eyes – something that often times concerns potential rhinoplasty patients who are having their nose broken like Christine did. It also helps that Christine was very compliant with her recovery process and post-rhinoplasty instructions. Hopefully this series of photos provides some further insight into the early healing period for anyone considering cosmetic rhinoplasty surgery here in San Diego and the surrounding regions.
Posted on January 4, 2012 in Nose Job, Nose Reshaping, Rhinoplasty
Dr. Hilinski continues to expand on one of the largest rhinoplasty photo galleries in San Diego with the addition of the latest example of finesse rhinoplasty surgery. This young female from San Diego desired cosmetic nose reshaping surgery to simply make her nose look more refined for her face. 
Specifically, her nasal bridge was too wide as seen from the frontal view (and she had a small bump on the bridge). If you look at the adjacent photo shown here, you can appreciate that her nose was too wide for her face. Overall, she is an attractive female, but her nose was out of balance with her surrounding facial features. This is shown in the diagrammed photo where the red lines indicate the actual width of her nose and the blue lines indicate the approximate desired width that would provide a more refined nasal appearance. Dr. Hilinski, an expert in finesse type of rhinoplasty surgery, performed the nose reshaping procedure to provide her with a nice cosmetic enhancement including narrowing of the nasal bridge. The rhinoplasty surgery was done in this case with a closed approach – where no incisions are made externally on the nose. Her nasal bridge was reshaped by gently sanding it down while the bones were moved inward. These rhinoplasty maneuvers were performed using a finesse technique so there was not a dramatic change in her appearance. In many ways, this type of finesse cosmetic nose surgery is actually more difficult than performing rhinoplasty where a significant hump, for instance, is reduced. This is predominantly because the margin of error is markedly less in someone with a face and nose like hers. Because of this, only finesse changes can be tolerated to create a nose that looks more shapely, yet natural looking. You can see in the before and after rhinoplasty photos in this case example how the nose now appears more narrow and refined on the frontal view. Look specifically at the width of her nasal bridge – she now has a more attractive nose that shadows much better than it had prior to rhinoplasty reshaping. This type of change is largely a result of the osteotomies that were performed during surgery – where the nasal bones are intentionally broken in a controlled manner and narrowed appropriately. As you can see in the photos, she still very much looks like her old self. But she now has a nose that is more in balance with her facial features with improved definition. If you have a nose that you think might benefit from finesse rhinoplasty surgery like this one, feel free to contact one of San Diego’s finest rhinoplasty surgeons today!
Posted on November 22, 2011 in Nose Job, Revision Rhinoplasty, Rhinoplasty
We just updated our San Diego rhinoplasty gallery this past week with additional examples of cosmetic nose reshaping patients who had their nose job performed by Dr. Hilinski. Our rhinoplasty and revision rhinoplasty galleries are among the largest online examples of cosmetic nose surgery in southern California. As an experienced and dedicated rhinoplasty expert, Dr. John Hilinski performs this type of facial plastic surgery on a very regular basis – in fact, much, much more frequently than most plastic surgeons in San Diego. As a result, Dr. Hilinski’s rhinoplasty gallery and revision rhinoplasty gallery are quite expansive demonstrating the wide variety of cosmetic nose procedures that he does. If you look at a good number of board certified plastic surgeon websites here in San Diego, you will likely see a limited number of rhinoplasty patient examples. In most of these cases, this is because that particular plastic surgeon simply hasn’t done a lot of rhinoplasty and, therefore, does not have a very robust portfolio of rhinoplasty examples. When you see over a hundred photo examples of rhinoplasty as in Dr. Hilinski’s San Diego rhinoplasty gallery, you know you are consulting with an expert in cosmetic nose surgery. The latest additions to the rhinoplasty photo gallery include three new cases of ethnic rhinoplasty surgery – two females and one male. These patient examples represent the essence of good rhinoplasty surgery – making very specific changes to the shape of one’s nose without changing their identity. In these three cases, Dr. Hilinski performed ethnic rhinoplasty surgery to get rid of features of their nose that they disliked while keeping harmony with their Hispanic facial features. Unless you happen to perform Hispanic rhinoplasty on a consistent basis, you are unlikely to achieve these type of natural appearing cosmetic nose surgery results. Take a look for yourself and see how this type of plastic surgery on the nose can provide an enhanced facial appearance.
Posted on October 9, 2011 in Nose Job, Nose Reshaping, Rhinoplasty
This is great example of tip rhinoplasty, or nasal tip reshaping, in a patient who had an obvious deformity following skin cancer involving her nose. This patient underwent removal of a skin cancer in the nasal tip region, which was performed by a different plastic surgery years prior. Unfortunately, the area where the skin cancer was removed from the nose did not heal well – leaving the patient with a very visible depression. As you can see in this preoperative photo, there is an obvious area of her left nasal tip that is missing, which translates into an abnormal cosmetic contour. Looking at a 45 degree angle from her right side, you can easily appreciate what was bothering her in terms of the nasal tip shape. In addition, this type of collapse of the nasal tip created difficulty in breathing through the nose as well. She was ultimately referred to our rhinoplasty clinic in San Diego, CA because of Dr. Hilinski’s known expertise as one of the regions best rhinoplasty specialists.
Rhinoplasty to Reshape the Nasal Tip
Dr. Hilinski recommended an open rhinoplasty procedure to reshape the nasal tip region. This included use of septal cartilage from inside of the nose to graft the tip. In addition, he used temporal fascia grafting to help bolster or soften the skin overlying the defect. The rhinoplasty surgery was performed by first lifting the skin off of the nose. The septal cartilage grafts were then used to literally rebuild the nasal tip concentrating on creating a more symmetric looking nose. The fascia graft was finally layered over the cartilage grafts before the nose was closed. The final results of this type of tip rhinoplasty surgery are shown herein. As you can see, there has been a significant improvement in terms of her tip shape – especially in terms of symmetry of the nose. As one will also appreciate, her right angled view demonstrates how her nasal tip is now better contoured with a more natural looking rhinoplasty result.
Rhinoplasty Consultation in San Diego, CA
If you have had prior cancer of the nose and are considering further reconstructive surgery to help restore a more normal appearance, feel free to contact one of San Diego’s busiest and most experienced rhinoplasty clinics – the office of Dr. John Hilinski.
Posted on September 14, 2011 in Nose Job, Nose Reshaping, Rhinoplasty
Management of the over-projected nasal tip is one of the more challenging types of cosmetic nose reshaping. This is a good example of this type of nosejob procedure where the tip of the nose is brought back closer to the face. In this particular case, the nasal tip stuck out too far from the plane of the face, disrupting theharmony and balance of the nose. The goal of the nasal reshaping surgery was to bring the tip in closer, thus making the entire nose smaller but more proportional for her face. This is called deprojection in rhinoplastyterminology. As you can in her before and after photos, there has been a dramatic change to the shape of her nose as seen on side view. On frontal view of the nose, however, there has been much less change since the primary alteration was more front to back rather than side to side. She still has some degree of mild swelling in her tip and bridge in these photos, which should continue to improve as the months of healing go on. From the side and oblique (angled) views, you can see a rather obvious improvement in the balance and harmony of her nose. The nasal tip has now been deprojected and is in much more harmony with the surrounding facial features. In fact, this type of rhinoplasty surgery has really enhanced her inherently beautiful facial features. To learn more about deprojection of the nasal tip, use this link here to see our San Diego Rhinoplasty topic discussion page.
Before and After Tip Deprojection
Posted on September 1, 2011 in Nose Job, Nose Reshaping, Rhinoplasty
Dr. John Hilinski is proud to announce the latest addition to his SanDiegoRhinoplasty.com website – management of the Hispanic nose in cosmetic rhinoplasty. San Diego being the border city it is has a significant number of Hispanic patients interested in having cosmetic nose reshaping. Dr. John Hilinski happens to see a great number of these Hispanic rhinoplasty patients for nose job surgery. This is a very specific form of ethnic rhinoplasty that requires expert knowledge and dedicated experience in reshaping the Hispanic nose. To learn more about this type of ethnic rhinoplasty from a cosmetic nose specialist in San Diego, CA, use this link here to be taken to the SanDiegoRhinoplasty.com discussion on the Hispanic nose.
Posted on August 30, 2011 in Facial Plastic Surgery, Nose Job, Nose Reshaping, Revision Rhinoplasty, Revision Rhinoplasty Specialist, Rhinoplasty
Dr. John Hilinski and his staff are proud to announce the launch of SanDiegoRhinoplasty.com – a website dedicated to educating potential rhinoplasty and revision rhinoplasty patients. SanDiegoRhinoplasty.com is intended to complement our main website – drhilinski.com – as a specialized online resource for those considering cosmetic nose reshaping. The new site also contains an online rhinoplasty patient primer that is similar but distinct from our current rhinoplasty tutorial. As an authority and regional expert in rhinoplasty and revision rhinoplasty, Dr. Hilinski felt compelled to develop SanDiegoRhinoplasty.com so that those considering plastic surgery of the nose would have a fully dedicated educational and reference guide. We hope you enjoy the new site!
Posted on June 22, 2011 in Nose Job, Nose Reshaping, Rhinoplasty
This is a great example of a finesse rhinoplasty procedure that we recently saw back in the office for a follow-up appointment. This young San Diego patient came in with a desire to have a nose job because she felt as if her nose was too wide and looked too big for her face. We discussed with her at length the potential benefits of a cosmetic rhinoplasty procedure to reshape her nose. Specifically, we talked about bringing her bridge height down while narrowing the nasal bones and tip region. She was fairly concerned, like many potential rhinoplasty patients, about maintaining a natural look following nasal reshaping. I outlined for her a surgical plan to help improve the esthetic appearance of her nose largely based on a finesse approach – meaning, doing a few millimeters here and there in certain rhinoplasty patients can translate into a very nice improvement while preserving the overall look of the nose. In the before and after rhinoplasty photos shown below, you can appreciate the changes that are seen in her nose following the finesse nose job. Her front view shows a more narrow bridge and tip without looking fake or surgically done. On the oblique view you can appreciate the finesse changes to her tip shape and bridge height while maintaining a natural curvature from the radix down to the nasal tip. The same can be said on the lateral view of the nose. And on her base view, you can see how her new nasal tip shape looks more triangular following the rhinoplasty procedure. And also keep in mind that this particular rhinoplasty patient had fairly thin skin, making the operation much more difficult overall. If you are considering a finesse rhinoplasty procedure to improve your nasal appearance, contact our San Diego office today – trust your nose to a rhinoplasty specialist.
Before & After San Diego Rhinoplasty
