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The nose is the focal point of your face and considered one, if not the most defining features. A beautiful, balanced nose enhances one's appearance and compliments other facial features as well. When your nose is out of balance because it is too large, has a bump or is even too small, it likely attracts too much attention. It is my goal to create a natural beautiful nose that fits your face. Changes are often so subtle that your true beauty comes out without appearing operated; restoring the nose that you should have been born with. The one you deserve.
Rhinoplasty is the third most common cosmetic surgery procedure performed on women and the number one procedure performed on men. It is also the most complex operation in cosmetic surgery. Nasal anatomy is very intricate and facial structures vary from person to person. Procedures must be individualized for each and every patient. This is why you should trust a rhinoplasty specialist, one who understands the nuances of nasal surgery inside and out, and performs rhinoplasty as a large portion of their practice. The cookie cutter noses of the past are never performed in our practice. Dr. Pearlman frequently teaches, instructs and lectures on Rhinoplasty and Revision Rhinoplasty throughout the world.
For rhinoplasty, Dr. Pearlman prefers the intranasal or "closed" approach for most of his patients. He is one of the few remaining surgeons who routinely perform the intranasal technique. The nose is altered by use of hidden incisions inside the nostril. There is no chance of any visible scarring since all the incisions are concealed. As long as an un-operated nose is not severely twisted, equal if not superior results can be obtained without making an open rhinoplasty incision. In a few instances, we choose to use the "open" or external approach. The main reasons Dr. Pearlman may choose the open approach for a primary rhinoplasty are for very crooked noses, a nose that requires many grafts (pieces of cartilage to strengthen portions of your nose, to be discussed in more depth in revision rhinoplasty), and noses that are very short and need to be made longer. Of course the choice of incisions is discussed with all patients prior to surgery. Dr. Pearlman frequently uses the open approach for revision Rhinoplasty, which requires a broader viewscape for optimal results. When used, the open rhinoplasty incision heals quite well and is usually undetectable or barely visible. However, no incision across the bottom of the nose means that there is zero chance for a poor scar vs. a "very small" chance as quoted by surgeons who prefer the open approach for all rhinoplasties.
During surgery, the cartilage in the tip of the nose is reshaped. The tip can be rotated upward or downward, as well as brought closer or further from the face. The tip is altered by shaving cartilage yet leaving enough strength to withstand healing and aging changes. Humps in the upper part of the nose can be removed internally as well. A wide nose can be narrowed, to accentuate once overlooked attractive eyes. We may utilize grafts to add to some areas as well as remove tissue from another area, all in efforts to create a balanced, natural, strong look. These grafts are usually taken from the cartilage inside your own nose.
As an expert and teacher in both primary and revision rhinoplasty, Dr. Pearlman has found that teaching revision rhinoplasty has provided further insight into the reasons patients seek revision rhinoplasty. Teaching also keeps him at the forefront of the advances in the industry, and in individual techniques. If one can appreciate the causes for patients seeking revision rhinoplasty, it provides more knowledge on how to avoid the need for revision in the first place. Under Dr. Pearlman's knife, your primary rhinoplasty is usually your only rhinoplasty.
There has been a lot of press about a "non-surgical" rhinoplasty, which uses fillers such as Restylane and Radiesse that are injected to fill around bumps and camouflage the nose. This might be fine for small areas, but these are temporary fillers. Rhinoplasty is an artistic sculpting of the nose that involves removing and narrowing some areas and enhancing others. This can rarely be achieved with proper balance BY ONLY using fillers. Fillers are substances that are injected in lines, folds and hollow areas under the skin. When placed in the soft skin of the face, bumps are rarely seen. However, the skin of the nose is close to the underlying bony and cartilaginous structures. Placement of these fillers in large volumes can leave visible bumps and streaks. Fillers are more appropriate for tiny irregularities or for patients who are seeking revision surgery but for personal reasons cannot do so for a number of months. As in name, it is only "a filler."
Dr. Pearlman has been using computer imaging as an adjunct in rhinoplasty consultations for over 20 years. Being able to see what your face might look like after rhinoplasty can be very useful. Computer imaging makes this possible. Computer images help both the patient and doctor visualize potential changes in the face prior to surgery. Imaging also helps stimulate dialogue between the doctor and the patient in further understanding mutual goals from the operation. Computer imaging is an excellent tool for demonstrating possible enhancements to the nose and face. As a matter of fact, most patients feel their live results are better than the image they once saw on the computer, since it is still only a 2 dimensional graphic image and cannot fully simulate true personal results.
**All patients shown in the rhinoplasty gallery are actual surgical patients of Dr. Pearlman's and none of these are computer images that have been altered in any way.
Functional and breathing problems such as blockage of the nose from conditions like a deviated septum, nasal polyps and sinusitis can be addressed at the same time as cosmetic rhinoplasty. Dr. Pearlman is dual board certified in Facial Plastic and Reconstructive Surgery as well as Otolaryngology - Head and Neck Surgery (ENT). During your consultation with Dr. Pearlman, a thorough exam of the inside of the nose is performed using a specialized headlight for viewing the nose, occasionally utilizing nasal endoscopic equipment if indicated. After surgery, patients will not only look better, but have an improved nasal airway with enhanced energy and sense of smell.
One warning for patients seeking nasal surgery of any kind: a true specialist will examine the inside of your nose even if your procedure is cosmetic in nature. A doctor never knows if there are internal abnormalities if the nose is not thoroughly examined.
For those who have nasal obstruction or other nasal sinus conditions alone, correction of a deviated septum will not change the appearance of the nose. So, if you are happy with the appearance of your nose, septoplasty will leave it unchanged. If desired, cosmetic changes could be performed simultaneously with septoplasty if you have ever considered changing your nose. Any aesthetic change, however, is not covered by medical insurance. Depending on your insurance benefits, Dr. Pearlman will often work with your insurance company for the functional components. This can be discussed with the office staff at the time of your consultation.
Other nasal procedures that Dr. Pearlman performs: reconstruction of the skin and structures of the nose after removal of skin cancers and correction of nasal septal perforation.
ONE of the most satisfying comments I frequently hear from patients following surgery are that old friends will ask "did you change your hair? lose weight? I'm not sure what it is, but you look great!" So, if you are seeking to improve the appearance of your nose you should seek a rhinoplasty specialist.