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Steven J. Pearlman, MD, FACS Dual Board Certified in Facial Plastic Surgery

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Rhinoplasty Surgery

rhinoplastyAlso known as nose surgery, rhinoplasty is a surgical procedure that improves the appearance of the nose and can also correct breathing problems associated with deviations. With more than 240,000 rhinoplasty procedures performed in 2012, nose surgery became the second most performed cosmetic procedure according to a recent study. At his New York practice, Dr. Steven Pearlman regularly performs rhinoplasty for men and women from all over the world.

There are two techniques, Opened and Closed that can be performed depending on each patient’s specific needs and preferences.

Open Closed
Performed under general anesthesia or twilight sedation check check
Allows the surgeon the most visibility throughout the procedure when there is distorted anatomy such as revision rhinoplasty check
Incisions made on the under-side of the nose check
No chance of visible scarring, all incisions internal check

Although Dr. Pearlman can safely perform both types of rhinoplasty methods, he prefers the open technique the most because it is more precise and utilizes the cartilage and bone in the nose better throughout the entirety of a rhinoplasty procedure. Dr. Pearlman frequently teaches primary and revision rhinoplasty, which keeps him at the leading­ edge of the most up to­ date techniques that are used for nose surgery.


Some individuals choose to have their rhinoplasty completed without invasive surgery. To perform this type of treatment, fillers such as Restylane® and Radiesse® are injected into the nose to add volume and hide minor imperfections in the nose. Even though this type of procedure works short­ term for some patients, over time the effects are not long lasting like a surgical rhinoplasty.

These are the conditions that may be treatable by non-surgical rhinoplasty:

  • Bump on the bridge of the nose in patients who have a deep nasal root
  • Minor depressions on the nose
  • Asymmetry of the nose


Breathing problems will need to be addressed through surgical procedure known as septoplasty, and this procedure can correct these issues without altering the outward appearance of the nose. The size and position of the internal structures of the nose have a tremendous effect on the patient’s ability to breathe, and septoplasty can straighten a crooked septum to improve the nasal airways.


During a consultation with Dr Pearlman, he will examine the inside of the patient’s nose. Generally, he will be checking for one or more of the following conditions:

    • Deviated septum


  • Narrowing of the internal valve
  • Inflammation or swelling of the turbinates


Computer imaging is available for patients to view the projected outcome of their rhinoplasty during their consultation through Vectra 3D. The Vectra 3D system is a great resource that allows Dr. Pearlman and his patients to effectively communicate what they would like to achieve with surgery, and it gives patients a realistic expectation of the intended outcome of the surgery. Dr. Pearlman has been using computer imaging in conjunction with rhinoplasty for over 20 years.


Preoperative Before a rhinoplasty can be performed, patients should undergo a medical evaluation. Dr. Pearlman may also ask that individuals to refrain from smoking and taking certain medications in the weeks leading up to surgery to ensure a safe and effective procedure.
Surgery All rhinoplasty procedures are performed with the patient under general anesthesia or twilight sedation. Depending on what areas and problems of the nose need to be corrected will determine which technique (open or closed) is performed during surgery. After Dr. Pearlman reshapes the nose and sculpts it to a more attractive shape the incisions are closed up with sutures.
Recovery Once the rhinoplasty is complete, swelling and bruising will be apparent over the next few days. A splint will be used to hold the nose in place and bandages will also be applied. Prescribed medication will be administered to alleviate any pain or discomfort that exists. The sutures will be removed at a later date after the patient meets with Dr. Pearlman during a follow ­up appointment.
Postoperative After surgery, it is of the utmost importance that patients follow postoperative instructions throughout the recovery process.This includes:

  • Taking medication regularly
  • Changing bandages and dressings
  • Returning for follow­up appointments
  • Notify Pearlman Aesthetic Surgery if any problems or complications develop.
Results As the nose heals over the coming weeks and months, patients can anticipate an improved appearance that will be long ­lasting. The results of a rhinoplasty procedure are meant to be permanent, although the cartilage in the nose may move over time due to the natural process of aging.

If you have physical imperfections on your nose that you would like to improve or breathing problems that you wish to correct, we encourage you to get in touch with Pearlman Aesthetic Surgery. To schedule your initial consultation call (212) 223­8300 or fill out our online contact form today. Dr.Pearlman is dual board certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology–Head and Neck Surgery and looks forward to helping you achieve a nose that is in better harmony with the rest of your face.


Answers to frequently asked questions about the procedure

Q: Open vs. Closed Rhinoplasty?

This is a discussion about approach and not a technique. I prefer closed rhinoplasty for most of my primary operations and have been performing it for over 30 years. Equal, if not better, results can be obtained without an incision across the bottom of the nose if your surgeon has experience in thousands of rhinoplasties and knowledge of nasal anatomy.

Q: When do I choose open rhinoplasty?

Open rhinoplasty allows better visualization of distorted nasal anatomy when the nose is very crooked, or when performing a complex revision rhinoplasty. The incision is very tiny and visible only up close to the trained eye in most circumstances. With sunscreen protection, the scar fades almost completely.

Q: How long is there bruising?

For most patients bruising lasts up to two weeks, often less. Women can usually return to work or school by post-op day 8 with a little makeup. Gentle surgical technique, Arnica Montana, and good nutrition also helps.

Q: Do you need nasal packing?

Nasal packing is not necessary after most rhinoplasties. I usually use a light internal dressing called Telfa for the first night that is removed the next day. It's much smaller than the traditional nasal packing. Telfa is like a bandaid on a new cut, using it for a brief time results in less crusting for the following week.

Q: Is computer imaging accurate?

I have been using computer imaging since I started practice over 26 years ago. It is very useful for demonstrating potential results and excellent for discussing mutual goals with patients. Our 3-D Vectra imaging takes this to the next level. It's important to be honest with the patient to show realistic results when using computer imaging.

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