Rhinoplasty, or nose reshaping, is the second most popular cosmetic surgery procedure performed in the U.S.A. Sometimes this operation is performed for cosmetic reasons and sometimes to improve breathing through the nose. At his clinic in San Francisco, CA board-certified plastic surgeon, Dr. Leonard Gray, performs the procedures for both reasons.
Rhinoplasty can be performed using either a closed or an open approach. Closed rhinoplasty is performed most often when the tip of the nose is neither very large nor very asymmetric. It is the more appropriate surgical approach when the tip is not excessively droopy or ptotic. With the closed approach, the tip’s cartilage can be trimmed from inside the nostrils. Open rhinoplasty is more suitable for patients that have a bulbous tip, a drooping tip, or an asymmetric tip. During this cosmetic procedure, the nose is opened with an incision between the nostrils. This exposes the cartilages of the tip where they can be worked on.
"Fantastic - Highly Recommend - So happy!!! My experience with Dr. Gray and staff has been phenomenal - very personable, professional, informative and attentive. I felt like I was in good hands throughout the entire process, and went into my surgery with utmost confidence. It has been approximately two weeks since my procedure, and I am absolutely thrilled with my results. Thank you, Dr. Gray!"- A. / RealSelf / Jan 02, 2018
"50 Shades of Grey - I went in for a breast revision to avoid any future complications. I switched from my 12 year old Saline implants to Silicone. I was very happy with my Saline implants plus there were no visible scars. In 2005 my Doctor was the first to innovative the nipple incision (not to be confused by the periareolar incision). Very pleased with my previous results without any hesitation I knew that Dr...."- X. / RealSelf / Dec 27, 2017
"BEST PLASTIC SURGEON EVER!!!!!! - There are no words that suffice to commend Dr. Gray's unbelievable work - truly impeccable and a work of artistry. I am incredibly hard to please, as I am a complete perfectionist myself. My family always teases me, as I never seem content with anything. I interviewed countless plastic surgeons and spent weeks on end researching doctors on the internet. Even though I am a mother of three..."- D. / RealSelf / Dec 25, 2017
"I would give 10stars if i could! Had my first set of implants about 10years ago that were utterly amazing by him. Always had comments how natural they were and best job anyone had seen. Fast forward, time to change and upgrade the girls. They are even more amazing than the first set. Went for the gummy bears high profile. So beautiful in everyway! Dr Gray knows what he is doing. I told him exactly what i Wanted in regards to size and cleavage and he made it happen!! I wanted to wait to write this review till i was a few months out and everything settled. I am not a big yelper but MUST give credit where it is due. My experience this go round was nothing short of stellar. I had breast aug and labiaplasty and everything looks amazing! I felt and feel so comfortable and confident in this man. Also i must share that I had a major medical emergency thru my healing process that had nothing to do with dr. Gray or plastic surgery. Was a female issue, that left me in critical condition. Had I not followed Dr Grays advise at a follow up and got directly to my ob/gyn it would have ended badly. I ended up in emergency surgery wich solved the issue that would have ended in devastation had i not gone to emergency on Dr Gs advice. I also wold like to mention, when i got the news i had to have emergency surgery i called Karen at the front desk, cuz no one knew of my private situation but Dr Grays office. I am BEYOND GREATFUL for the professionalism of this woman. I felt like i had a best friend who was a 911 operator on the phone. I was hysterical and she calmed me down as i drove myself to emergency surgery. It was one of the scariest experiences of my life, no family knew as i kept it private and she was like a guardian angel. Also Cherrise is like a breath of fresh air! Helped me with so much during this process and has such good energy and i know her word is GOLD! Anything i asked advice on was always on the money! Also Lalanya who i rmbr from 10 years ago is frgn awesome! i called panicking once about questions from healing and she soothed everything and everything she said was true.Shes been in the scene for a long time and KNOWS HER STUFF! STAFF IS BEYOND EXCEPTIONAL! energy is amazing. Dr Gray is IT in my eyes. He also is A MAGICIAN with ingectables! no one ever has been so thuro with botox or cheek fillers. and my lips! ARE GORGOUS! had disastorous results with lips and botox and this man lays you down like he is doing surgery for your ingectables and gets it perfect! He is a master at his craft. i will not go anywhere else for ingectables. Breasts and labiaplasty are GORGOUS! Thank you Dr Gray. YOU ALL ARE A GOD SEND! p.s. i feel Dr G is more than authentic. He spent so much time with me after my emergency surgery and i truly feel he cares. He was looking me in the eye and we had a long discussion, his concern was more than genuine .Also he overcame my fear with injectables so patient and he KNEW exactly what i wanted and delivered, this place will always hold a special place in my heart! THANK YOU! THIS MAN IS ON POINT!!!!"- K.B. / Yelp / Dec 11, 2017
"I would give 10stars if i could! Had my first set of implants about 10years ago that were utterly amazing by him. Always had comments how natural they were and best job anyone had seen. Fast..."- K.B. / Yahoo / Dec 11, 2017
There are several techniques used for rhinoplasty. The approach taken will be based on the complexity of the surgical case and the overall goal of the patient.
With an open rhinoplasty, the incisions are made on the tissue between the nostrils or on the natural crease of the nose just above the lips. This allows for greater access and view of the confines of the nose. Dr. Gray precisely stitches, trims, and grafts the nose's cartilage to remake the tip. The dorsal hump and nasal bones are then treated the same as the closed approach. The hump can be reduced and the nasal bones can be made narrower. Stitches on the inside of the nose dissolve gradually on their own. Stitches in the area between the nostrils are removed at 5 days. During recovery time, a splint is also worn for 1 – 2 weeks.
During a closed rhinoplasty surgery, incisions are made to the inside of the nose through the nostrils to allow cartilage to be trimmed. As a result, the tip will be elevated conservatively, and become more refined. Dr. Gray will reduce the dorsal hump of the nose slowly and carefully. He neither wants to over reduce or under reduce the hump, and he takes it down until it is just right. Some people prefer a straight nose, while others prefer a very slight curve. In either case, Dr. Gray will adjust the dorsum to meet that patient’s expectations. Nasal bones can be made narrower, as well. Stitches are in the inside of the nose only, and dissolve slowly over time, and on their own. A splint is worn on the nose for a recovery time of 1 – 2 weeks.
For minor reshaping, some patients may opt to try an injectable filler to achieve results. These come in a variety of liquid substances, and sometimes a fat transfer can also be utilized. A filler can help add volume to hide small deformities, such as a bump or a bony appearance. It is important to note that fillers can only do so much in the reshaping process. For most patients, surgery is a better option and will offer a permanent solution.
Rhinoplasty is performed in an accredited surgical facility under general anesthesia. The procedure lasts up to 2 hours and is considered outpatient. After surgery, there will be swelling and soreness around the nose area. Bruising is also a side effect of surgery. The nose will be placed in a splint for additional support. During the first 7 – 10 days following surgery, the side effects will begin to disappear and the splint will be removed. Patients will be able to see their results immediately; however, it may take several months for the full results to appear.
Plan Your Procedure
- Average Cost
- $7,000 - $9,000
- Recovery Time
- 6 weeks
- Average Procedure Time
- 2-6 Hours
- Post-op Follow-up
- 12 Months
- Procedure Recovery Location
Is It Risky?
All surgical procedures carry some form of risk. These risks can be greatly minimized if an experienced nose surgeon is chosen to perform the surgery. While rhinoplasty is one of the most commonly performed procedures in the U.S., surgeon skill is critical so that a beautiful, satisfactory outcome can result.
Around half of all rhinoplasty cases will include some form of nose breaking in order to allow the surgeon to reshape the cartilage and bone. This is primarily intended for patients who have nasal asymmetry. The broken bone or cartilage will be reshaped and reattached, and then supported by splints during recovery.
Nasal packing is done to help with bleeding, especially if the surgery involves the septum. Gauze or cotton packs are inserted into the nasal chamber during this process. Patients find it uncomfortable, but the packing is only in for a short-term during the immediate recovery phase.
Surgical Or Nonsurgical?
This depends on the patient’s nose structure and what aesthetic result is trying to be achieved. For significant reshaping, the surgical approach will be performed as this allows the surgeon to manipulate the cartridges and bones. If the patient is looking for a subtle improvement, adding volume to the area may suffice.