Rhinoplasty reshapes the size, shape, and proportions of the nose so it fits naturally with the rest of the face, and it can correct structural problems that make breathing difficult.
Many patients come to Dr. John Hilinski in San Diego wanting to fix a bump along the bridge, a tip that droops or reads as wide, a nose that leans off center, or a previous surgery that disappointed them. Dr. Hilinski limits his practice exclusively to the face and neck and starts every plan with your anatomy instead of a preset result. He is a Harvard-trained, double board-certified facial plastic surgeon with over 20 years of experience, and he performs every Rhinoplasty himself.
Often called a nose job, Rhinoplasty reshapes the bone, cartilage, and soft tissue that give the nose its outward form. It’s one of the most requested procedures among patients under 34 today.
Because the nose sits at the center of the face, even small changes, measured in millimeters, can noticeably change how balanced your face looks. That’s why the procedure rewards a surgeon who operates on noses constantly. The aim is a nose that still looks like yours, refreshed rather than obviously altered.
Curious how it actually works before you book a consultation? The Rhinoplasty Tutorial walks through the anatomy step by step.
Dr. Hilinski performs Rhinoplasty in an outpatient surgery center under deep sedation or general anesthesia, and most patients go home the same day. The procedure usually takes about two to two and a half hours.
He works through one of two approaches. Open Rhinoplasty uses a small incision on the columella, the strip of skin between the nostrils, which lets him shape the underlying framework directly. Closed Rhinoplasty places every incision inside the nose, so no external scar remains. From there he refines cartilage, adjusts bone, adds support where the structure is weak, and redrapes the skin over the new framework. Skin thickness, cartilage strength, and any prior surgery influence which approach he recommends.
Dr. Hilinski uses several techniques and chooses among them case by case.
This technique lowers the bridge by repositioning your own dorsal structure rather than removing it. Preservation Rhinoplasty suits some noses and not others, and Dr. Hilinski will tell you plainly whether it’s the right fit for yours.
This technique shapes nasal bone with an ultrasonic instrument that cuts bone while sparing nearby soft tissue. Piezo Rhinoplasty can mean less swelling and bruising during your recovery, compared to traditional bone-cutting methods.
When a nose lacks support, Dr. Hilinski rebuilds it with cartilage grafts, using rib cartilage where the septum cannot supply enough material. This technique, called Rib Rhinoplasty, matters most in collapsed, twisted, and previously operated noses.
Dr. Hilinski explains which approach he recommends, and why, at your consultation.
Frequently, yes. Functional Rhinoplasty addresses the internal structures that control airflow, like the nasal valves. It can be performed alongside or instead of changes to how your nose looks.
A functional rhinoplasty meta-analysis of 2,024 patients found improved nasal obstruction scores after Functional Rhinoplasty, sustained at 12 months.
Dr. Hilinski completed a Head and Neck Surgery residency before subspecializing in facial plastic surgery. That training lets him assess your breathing anatomy in the same visit where he discusses appearance. Airflow correction and shape refinement usually happen in one operation.
Strong Rhinoplasty candidates typically:
Healing risk deserves a frank conversation too. A nasal skin healing study of 384 open Rhinoplasty cases found skin healing problems in about seven percent of patients, with older age, smoking history, and prior nasal operations each raising the risk.
Plan to arrive at the outpatient surgery center a couple of hours before your procedure. You will meet with the anesthesiologist, confirm your surgical plan with Dr. Hilinski, and receive deep sedation or general anesthesia before the procedure begins.
Most patients wake up in a recovery room with a splint on the nose and light packing inside it, depending on the technique used. You will need a friend or family member to drive you home, since you cannot drive yourself after anesthesia. Grogginess, nasal congestion, and mild discomfort are normal for the rest of the day and manageable with the medication Dr. Hilinski prescribes.
Before you leave, his team walks you through exactly what to do for the first 24 hours, including how to sleep, what to avoid, and when to call the office with questions.
Plan on five to seven days before you feel ready to be seen. Dr. Hilinski removes the splint and stitches during that first week. Most patients return to work or school after about a week, resume regular activity at two weeks, and wait four to six weeks for strenuous exercise.
Swelling resolves in stages. The obvious swelling settles over the first several weeks, while the tip refines for a year or longer. You notice a real change early, and the finished result arrives gradually.
If your first Rhinoplasty didn’t give you the results you hoped for, you’re not alone. A revision rhinoplasty outcomes study of 102 cases found that revision patients often trace their concerns back to the original surgery. Common findings include structural issues, such as a collapsed nasal midsection, created during that first operation. Choosing the right surgeon the first time matters, but a careful, well-planned rebuild can still get you the result you wanted.
Revision Rhinoplasty calls for a different toolkit than a primary case. Dr. Hilinski rebuilds support in noses that have lost structure, including with rib cartilage grafting, and he regularly treats patients told their case was too complex elsewhere.
Dr. Hilinski built his practice around one focus: the face and neck. That focus, combined with over 20 years of experience, means he has worked with nearly every nose shape and concern, from a first cosmetic refinement to a complex revision. He walks you through your options honestly, sets realistic expectations, and performs every step of your surgery himself.
“My goal is to help patients feel a renewed sense of confidence by enhancing the facial areas that trouble them most.”
– Dr. John Hilinski, MD
Dr. Hilinski is a Harvard-trained, double board-certified facial plastic surgeon.
Learn More About Dr. Hilinski“I had a rhinoplasty here and couldn’t be happier with my results. Dr. Hilinski was super thorough, transparent, and made me feel really comfortable throughout the whole process. I actually recommended him to a friend who also got a nose job, and we both agree he’s amazing! Overall, they really care about their patients, want the best results, and don’t nickel and dime you. Highly recommend!”
– Alana H., Google Review ★★★★★
“Dr. Hilinski is truly an exceptional cosmetic and reconstructive surgeon. I first had rhinoplasty with him in 2013. Several years later, I developed collapsing nasal valves and was having serious difficulty breathing. The moment he examined my nose, he immediately understood the problem and clearly explained the plan to fix it. I felt completely confident in his care. I love my nose already, but most importantly, I can breathe again. Thank you to the entire staff and especially to Dr. Hilinski. You truly are a top surgeon, and I am beyond grateful for your care.”
– Iris, V., Google Review ★★★★★
“I had the most wonderful experience I could have asked for working with Dr. Hilinski and his team for my rhinoplasty and septoplasty. Dr. Hilinski is so knowledgeable, kind, thoughtful, and an exceptional doctor. His work enabled me to breathe better than I ever knew was possible, resulting in me going from being sick four to five times a year with a sinus infection to zero in the year since my surgery. From an aesthetic standpoint, he made the very bulbous tip of my nose fit my face much better, and I’m so pleased with his work. I have received numerous compliments, with friends saying they would’ve had no idea I got work done because that’s how natural it looks. I recommend Dr. Hilinski for anyone considering plastic surgery!”
– Bianca L., Google Review ★★★★★
“Dr. Hilinski and his team have provided great care and expertise in addressing issues with my crooked nose. It looks better and helps with breathing too. I would highly recommend Dr. Hilinski.”
– David W., Google Review ★★★★★
You will spend roughly 45 minutes with Dr. Hilinski reviewing your nasal anatomy, your breathing, and the changes you want. He tells you what he can accomplish, what he cannot, and which technique fits your nose. San Diego patients choose Dr. Hilinski for natural-looking, harmonious results from a surgeon devoted entirely to facial surgery.
Cost depends on the complexity of your case, whether grafting is required, and whether breathing correction is part of the plan. Dr. Hilinski provides a specific quote at your consultation, and financing options through CareCredit and Patient-Fi are available.
Dr. Hilinski typically schedules procedures one to two months out. If you are working toward a date such as a wedding or a semester break, bring it to your consultation so he can build the timeline backward.
Teen Rhinoplasty is evaluated case by case rather than against a fixed age cutoff. Dr. Hilinski looks for completed facial growth, a teenager who wants the surgery for their own reasons, and involved parents, and he recommends waiting when that is the better choice.
Most patients feel more pressure and congestion than sharp pain in the days after surgery. Dr. Hilinski prescribes medication to keep you comfortable, and discomfort typically eases significantly within the first 24-48 hours..
Closed Rhinoplasty leaves no external scar. Open Rhinoplasty leaves a small scar on the columella that fades significantly within a few months and is barely visible within a year for most patients. Dr. Hilinski can show you examples of healed results at your consultation.
Yes. Chin Augmentation is the most common pairing, because chin projection strongly influences how prominent the nose appears in profile.
Yes. Virtual consultations are available, and the practice supports out-of-town patients through scheduling and follow-up.
Liquid Rhinoplasty is a non-surgical option that uses dermal filler to smooth minor irregularities without surgery. Injection rhinoplasty works best for small refinements rather than structural correction.
1. AAFPRS. 2023 Member Survey press release, February 1, 2024. https://www.aafprs.org/Media/Press_Releases/2024_02_01_PressRelease.aspx
2. Zhao R, Chen K, Tang Y. Effects of Functional Rhinoplasty on Nasal Obstruction: A Meta-Analysis. Aesthetic Plast Surg. 2022;46(2):873-885. https://pubmed.ncbi.nlm.nih.gov/35099579/
3. Irvine LE, Azizzadeh B, Kerulos JL, Nassif PS. Outcomes of a Treatment Protocol for Compromised Nasal Skin. Facial Plast Surg Aesthet Med. 2021;23(2):118-125. https://pubmed.ncbi.nlm.nih.gov/33054380/
4. Suresh R, Doval AF, Newstrom E, Pham T, Alford EL. Primary and Revision Rhinoplasty: A Single Surgeon Experience and Patient Satisfaction. Plast Reconstr Surg Glob Open. 2021;9(9):e3798. https://pubmed.ncbi.nlm.nih.gov/34522571/
Dr. Hilinski, Nicole, and team are absolutely amazing! Dr. Hilinski is very knowledgeable, takes the time to thoroughly explain procedures, and has gone above and beyond with patient care during my procedure and throughout all of my follow-ups.Alaina
I can’t believe that it has been a year since you did my surgery! I am so happy with the results. I don’t think I can truly express how thankful I am and what a positive impact it has made on me.Sarah
Dr. Hilinski is truly committed to the care and healing of his patients. The after care following my procedure has been exceptional- he effectively communicates his care plan, and he is very knowledgeable regarding the procedure and the delicate process of healing related to his practice.Jamie
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131 Orange Ave Suite 106
Coronado, CA 92118
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