Rhinoplasty Surgeon in Beverly Hills | Best Nose Surgeon Celebrity Noses

Nose surgery can be both cosmetic and reconstructive. The technical term for a nose job is Rhinoplasty, which basically identifies a set of plastic surgery procedures that are designed to reshape and recontour the nose. Patients who request cosmetic rhinoplasty surgery are usually concerned with their overall nasal shape, nasal contour, size of the nostrils, and overall width of the nose.

Since noses come in all shapes and sizes, not all rhinoplasty procedures are the same. An astute nasal plastic surgery will custom-select their technique to the individual needs of his patient.

In rhinoplasty surgery, it is the surgeon’s obligation to perform a customized cosmetic procedure to improve the nose on a case by case basis. Dr. Raffy Karamanoukian is a Beverly Hills and Santa Monica plastic surgeon who performs rhinoplasty, septorhinoplasty, and septoplasty procedures. He uses meticulous surgical technique to identify the anatomy of the nose prior to surgery and reshape the bone, cartilage, and soft tissue of the nose to achieve a more proportionate and harmonious shape.

In his Los Angeles office, Dr. Karamanoukian also performs reconstructive rhinoplasty surgery for patients who have had broken noses in the past, nasal fractures, nasal injuries, developmental nasal deformities or genetically-predisposed aesthetic issues of the nose.

The typical nasal features that can be improved with rhinoplasty include a large nasal dorsal hump, wide nostrils, wide alar base, hooked nose, a downwardly deviated nasal tip and poor nasal tip definition.

During your consultation, Dr. Karamanoukian will assess your ability to breathe by examining the nasal airway. The goal of surgery is to maintain the function of the nose as well as the overall aesthetic contour.

The first step in nasal surgery involves choosing the right surgeon. Dr. Karamanoukian is a double board certified plastic surgeon who has extensive training in nasal reconstruction, cosmetic nasal surgery, secondary and tertiary nasal reconstruction, and surgical management of complex nasal disorders. He is available for consultation in his two Los Angeles offices. He has traveled around the world to perfect his nasal surgery techniques including micro fellowships in Montreal, Canada and Oslo, Norway to learn specific element of the Caucasian nose.

The importance of finding a surgeon who can listen to your needs is crucial. During your consultation, Dr. Karamanoukian will identify the elements of your nose that can be improved with nasal surgery and will listen to your specific needs and aesthetic desires. At that time, a review of nasal aesthetics and nasal harmony will be made with before and after pictures. In addition, you will receive a comprehensive evaluation of your nasal profile and your ability to breathe so that both will be improved with surgery.

A well-shaped nose that is harmonious with the rest of the face contributes to a youthful, attractive appearance. The key to a successful nose surgery is making it look natural, where no one can even tell that you’ve had it done. This can only happen by choosing an experienced plastic surgeon.

You may be a candidate for nasal surgery if:

1) You have a large bump or hump on your nose.
2) Your nose is too large or too small.
3) Your nasal tip is too low.
4) Your nostrils are too large.
5) You nose is crooked.
6) You can’t breathe correctly.

Rhinoplasty or septorhinoplasty is performed for purely cosmetic reasons or for medical reasons to improve breathing. A thorough examination will allow Dr. Karamanoukian to diagnose your specific needs and provide you with different options for surgery. The goal is to make your nose look as natural as possible. Results are highly dependent on experience, technique, and attention to detail.

Rhinoplasty Techniques - Los Angeles

Dorsal Reduction of the Nose

Middle Vault Dorsal Reduction of the Nose

Osseous Reduction of the Nose

Nasal Tip Elevation - Rhinoplasty

Alar Base Reduction

Nostril Reduction

Spreader Graft Placement

Anesthesia Choices for Rhinoplasty:

Nasal surgery, depending on the amount of changes to be made, can be performed under local anesthesia, IV sedation, or general anesthesia.

Recovery:

Recovery from rhinoplasty is relatively quick. The recovery time usually ranges from 1 to 2 weeks. After surgery is complete, a cast is placed on your nose and taken off during your first or second clinic appointment.

Primary or Secondary Rhinoplasty for a Flat Nose - Depressed Nasal Dorsum - Santa Monica, Los Angeles

Patients who have a flat appearing nose may be candidates for primary or secondary rhinoplasty. A flat or punched-in nose may present as a significant facial deformity, or may be subtle in nature. A flat appearing nose may also have very little projection on lateral profile and may cause patient embarrassment in social circles; especially if the nose appears to have been injured during trauma. Patients often complain that they have been asked by others whether they ever had a broken nose or any other facial injury.

The characteristics of a flat nose include a low lying dorsum, a broad nose on anterior-posterior profile, a pseudohump that is caused by a mismatch between the nasal bone and a depressed cartilaginous dorsum, wide nasal base, and minimal projection of the nasal dorsum and nasal tip.

We begin the evaluation of a flat nose or punched in nose or broken nose by examining the history of the patient and their current medical status. A history of childhood trauma may go unnoticed for years, and may cause significant deformity of the nose. Adult injuries, such as a broken nose, trauma, loss of nasal support, septal deformity, or septal deviation are all significant contributors to the flat appearing nose.

Of note, one of the most common reasons to have a flat nose is as a result of previous rhinoplasty surgery with over resection of the nasal dorsum or aggressive osteotomy of the nasal bones. This results in a low lying nasal dorsum and a wide or a broadened nasal tip. If you have had previous rhinoplasty and are concerned that your nose lacks projection, you may be a candidate for repair of your flat nose.

Dr. Karamanoukian is an expert on rhinoplasty, primary rhinoplasty, secondary rhinoplasty, and functional nasal surgery, including septoplasty. He has received his undergraduate and medical education at UCLA and is board certified in plastic and reconstructive surgery. He is now on faculty at the University of California, Irvine Department of Plastic Surgery. He has also had an additional training in rhinoplasty surgery in Canada and Norway.

Your consultation for a flat nose or nasal reconstruction will begin with a comprehensive medical history to document any functional problems with breathing. The examination performed by Dr. Karamanoukian will comprehensively determine the anatomic characteristics of your nose, including the examination of your facial profile from the lateral, anterior, posterior and oblique profiles. Examination of the nose will also be made in context with your forehead, eyes, cheeks, mouth, lips and chin, as these all contribute to the profile of the face on lateral and oblique angles.

Dr. Karamanoukian will also examine the nasal bones and make measurements to determine nasal bone width and height. The cartilaginous dorsum will be examined with respect to the nasal tip, width of the nose, and nasal tip. An internasal examination will be performed to evaluate septal deviation, the absence of the septum, and the anatomic proportions of the septum and septal mucosa. Vestibular examination will be performed to evaluate intranasal scar tissue and iatrogenic deformity as a result of previous nasal surgery.

Surgery for a flat nose entails either a primary or secondary rhinoplasty, depending on the history of the patient's condition. Surgery will be performed to correct the flat nose or nasal deformity during surgery.

Dr. Karamanoukian will design a specific rhinoplasty procedure to accomplish all the elements of your surgical repair. This may be performed as an open rhinoplasty or a close rhinoplasty with the addition of a septoplasty, if necessary. In rare cases, a rib graft will have to be harvested to reconstruct the nasal dorsum. Rib grafts are used in severe cases of nasal fracture and broken noses. Most of this cartilaginous support will be obtained by a septal graft or ear cartilage graft to reconstruct the nasal dorsum and nasal profile.

Osteotomies may or may not be performed to restructure the height width ratio of the nasal bone. Dr. Karamanoukian will do his best to perform a definitive surgery to reconstruct the cosmetic and reconstructive elements of the nose including the cosmetic profile and functional airway. Rather than attempting a staged reconstruction, most cases will be performed in a more comprehensive fashion to avoid further surgery.

Patients who have previously undergone a silicone implantation of the nose, whether by injection or silicone implant may also be candidates for nasal reconstruction. Dr. Karamanoukian performs silicone implant explantation of the nose and autologous tissue reconstruction.

If you are candidate for primary or secondary rhinoplasty for correction of your flat nose or punched in nose please contact our office at 310-998-5534.

Rhinoplasty Questions and Answers: FAQ

Is there a difference between a flat nose because of trauma and a flat ethnic nose? Yes. In the case of trauma, there may be elements of the nasal bones and cartilage that are displaced, but still present. This makes the job of nasal reconstruction easier because there are tissues that can be used to support the nose after surgery. In the case of an ethnic nose (Asian or African-American), there is a deficiency of native cartilage and bony vault and this lends to a more difficult surgery in that we have to find tissue that can be used to reconstruct and recreate the nasal anatomy.

Rhinoplasty FAQ: Rhinoplasty in Los Angeles

What is the youngest age to have rhinoplasty? Rhinoplasty in children? Rhinoplasty or nasal surgery can be performed for cosmetic reasons or for reconstructive purposes. Sometimes there is overlap in the two types of nasal surgery. Typically, plastic surgeons like to wait until the nose has reached some degree of maturity. This is usually around the age of 17 or 18. There is, however, no minimum age of rhinoplasty for reconstructive reason. Dr. Karamanoukian has performed nasal surgery on young children as young as 1 or 2 years of age. He is a board certified plastic surgeon who performs cosmetic nasal surgery and reconstructive nasal surgery.

Who is a good candidate for rhinoplasty? Rhinoplasty procedures are not all the same. Dr. Karamanoukian individualizes his rhinoplasty procedure to the particular aesthetic and functional breathing concerns of each candidate. A good candidate for the procedure is someone who is unhappy about the cosmetic appearance of their nose, or someone who has nasal airway breathing problems that can be improved by a nose job.

What are the risks of a rhinoplasty? All surgical procedures have risk, including rhinoplasty and septoplasty procedures. In Los Angeles, Dr. Karamanoukian performs rhinoplasty procedures in an accredited outpatient surgical center in order to minimize risks to the patient. Risks associated with surgery include bleeding, swelling, discomfort, pain, scar, and need for revisional surgery. Dr. Karamanoukian is board certified and will make every effort to maximize your safety.

When can I remove my stitches after a nose surgery / rhinoplasty? Typically, Dr. Karamanoukian will remove sutures from an open rhinoplasty about 5 days after your initial surgery. The sutures are micro-fiber monofilament sutures that are as thin as a human hair. They are barely noticeable for the first 5 days.

Will rhinoplast (nose job) surgery leave visible scars? There are basically two types of rhinoplasty performed: One requiring an external incision at the base of the nose and one performed through the nostril. Well positioned incisions by Dr. Karamanoukian or another experienced surgeon lessens the risks that a surgical scar will ever be seen. Discuss these issues with Dr. Karamanoukian during your consultation for nasal surgery.

What type of nasal (rhinoplasty) grafts does Dr. Karamanoukian perform? Sometimes, a nasal graft is needed due to a deficiency in the amount of cartilage in the nose. Dr. Karamanoukian will design a procedure that incorporates reconstructive nasal grafts. The grafts can include cartilage from the ears, nasal septum, or a rib graft from the cartilaginous part of the ribs. These autologous nasal grafts can be used to reconstruct the nasal tip, nasal dorsum, and septum of the nose.