Nose/Nasal Surgery (Rhinoplasty)
Dr. Steinbacher’s Expertise
Rhinoplasty is widely regarded as one of the most difficult procedures in plastic and cosmetic surgery. Dr. Steinbacher has written and published extensively on rhinoplasty, including representation of 3D results, graft types and nasal changes with time, enhancing and speeding a quick recovery, and many other topics. He is a member of “The Rhinoplasty Society”, a national and international select group dedicated to clinical application, research, and pursuit of rhinoplasty.
Dr. Steinbacher is involved and has presented his results on numerous occasions at the American Society for Aesthetic Plastic Surgery and American Society of Plastic Surgeons Rhinoplasty symposia. He is a frequently invited presenter at a number of rhinoplasty venues, and as a visiting professor on rhinoplasty and facial aesthetics. Dr. Steinbacher uses his aesthetic eye and artistic judgment, together with meticulous technical skills and attention to detail to give you the best rhinoplasty results in line with mutual goals and objectives.
The nose literally is the centrepiece of the face. The nasal shape and form defines a person’s facial features, yet the most well-balanced nose disappears, and blends almost seamlessly with the face. The nose is important both cosmetically and functionally (breathing, snoring, sinus function, smell, holding glasses, and so forth). An aesthetically pleasing nose imbues a sense of self confidence, and attractiveness, setting the stage for daily interactions, and being included in photographs.
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A disproportionate nose can occur due to congenital or genetic reasons (passed down in your family – “I have my father’s nose”, cleft lip and palate), or from trauma, poor facial support, masses or other injury. Asian versus Mediterranean, Middle Eastern, and African noses can all be quite different, and “ethnic rhinoplasty” refers to addressing these differences, with a variable amount of preservation of natural features.
Rhinoplasty (commonly known as a “nose job”) is a functional and facial aesthetic / cosmetic procedure that improves nasal breathing and enhances the appearance and balance of the nose. Nasal surgery can open passages and remove blockages that lead to snoring and trouble breathing during exertion, exercise, and walking up stairs. The appearance of the nose is central to the face and a person’s identity. Smoothing, straightening, and making the nasal components smaller or bigger and more symmetric are common goals with rhinoplasty and nasal surgery. Conditions treated include: cosmetic rhinoplasty, septal deviation, cleft rhinoplasty, ethnic rhinoplasty, gender affirming rhinoplasty, revision rhinoplasty, reconstructive, nasal obstruction, turbinate ablation, spreader grafts, internal valve correction, external valve correction, crooked nose, twisted nose, dorsal hump, nasal hump, saddle nose, post-traumatic deformity, or purely for appearance / aesthetics.
Regardless of the reason one seeks a nose job, rhinoplasty in Dr. Steinbacher’s hands is intended to maintain or improve breathing while creating a balanced, proportional, natural-appearing, and aesthetically attractive nose. Rhinoplasty is widely regarded as one of the most difficult procedures in plastic and cosmetic surgery. Dr. Steinbacher has written and published extensively on rhinoplasty, including representation of 3D results, graft types and nasal changes with time, enhancing and speeding a quick recovery, and many other topics. He is a member of “The rhinoplasty society” a national and international select group dedicated to clinical application, research, and pursuit of rhinoplasty. Dr. Steinbacher is involved and presented his results on numerous occasions at the American Society for Aesthetic Plastic Surgery and American Society of Plastic Surgeons Rhinoplasty symposia. He is a frequently invited presenter at a number of rhinoplasty venues, and as a visiting professor on rhinoplasty and facial aesthetics. Dr. Steinbacher uses his aesthetic eye, and artistic judgment, together with meticulous technical skills and attention to detail, to give you the best rhinoplasty result in line with mutual goals and objectives.
Revision rhinoplasty is also an area of principle focus for Dr. Steinbacher. In these challenging cases the primary (or original rhinoplasty) did not produce the desired result, due to healing issues, or created deformities from issues with cartilage removal or addition, scar contracture or other reasons. At your consultation we will discuss your goals and objectives, perform a 3D simulation, and discuss realistic options for your procedure. Dr. Steinbacher sees patients from all over the county and world, and we will facilitate your visit, consultation, next steps, and operative plan. >
Click on the images below to see the animated sequences. Note that these are actual results, not simulations.
Frequent problems addressed
- Nasal deformity (bump, irregularity, collapse)
- Nasal obstruction (snoring, mouth breathing)
- Nasal disproportions
- Crooked (“twisted”) nose
- Flat, under-projected nose
- Large, over-projecting nose
- Nasal defect (missing components following skin cancer removal or trauma)
Types of rhinoplasty performed
- Cosmetic rhinoplasty
- Revision rhinoplasty
- Augmentation rhinoplasty
- Reduction rhinoplasty
- Functional rhinoplasty
- “Ethnic” rhinoplasty
- Gender affirming rhinoplasty
- Asian rhinoplasty
- Middle eastern rhinoplasty
- Italian or Mediterranean rhinoplasty
- Rhinoplasty for snoring and sleep apnea
- Post-traumatic rhinoplasty
- Rhinoplasty for arrhinia, or reconstruction (for skin cancer)
- Any rhinoplasty
The Steinbacher Difference
Every nose is unique. Dr. Steinbacher understands the special anatomy of each nose, regardless of race and ethnicity. Dr. Steinbacher does not believe that there is a single “ideal”: nose, and that personal preference, goals, and ethnic/ cultural background play into the final product. His cultural and social sensibilities help him customize and refine each nose job to suit your specific vision while carefully listening to your requests and concerns, which is what makes him one of the most sought-after and best rhinoplasty surgeons in the world.
Before the Procedure: What to Expect
Dr. Steinbacher incorporates elements of facial and nasal balance, refinement, and improved function when reshaping the nose. He can emphasize which of your features can help enhance your uniqueness and natural beauty.
At the consultation we gather information regarding your nasal and medical history, and goals of treatment. We perform an examination and assessment of your existing nasal appearance, structure, and functional aspects. We want to hear your goals are and understand the type of result you are seeking. We will obtain a 3D photo and together look at the proportions, balances, imbalances, symmetries, depressions, asymmetries, and so on. From there we will modify the 3D image to simulate the result we mutually hope to achieve. We wish to communicate realistic expectations, and ensure we all understand what is possible, and what is not possible. We will discuss the overall risks and benefits of the procedure, technical aspects, and logistics of scheduling the surgery. In some cases cartilage grafting from other sites may be necessary. It is also important to understand that the final nasal form and function is not obtained for at least several months following the procedure. The first week or 10 days there may be some swelling and/or bruising.
After the Procedure: How to Recover
Rhinoplasty is normally a day surgery (outpatient procedure). This means you are able to go home following the procedure the same day. An external (surface) “splint” is taped on the bridge of your nose to stabilize and protect your new nose. Tape typically extends around the nasal tip as well. Inside your nose there is NO PACKING. We do use small rubber splints with channels in them – to allow some airflow through your nose. These “Doyle splints” keep your septum straight in the midline and help protect the inside of your nose. There are dissolving sutures within the nose. All incisions are hidden within the nose in a “closed rhinoplasty.” In other cases (“open”) a few blue sutures are placed at the divider between your nostrils (“columella”). This area heals well and typically fades to not be visible. In some cases a few blue stitches may be on the sides of your nose where it blends with the cheek. All of the splints and sutures are typically removed at your first follow-up appointment (typically 5-9 days after surgery).
The first week we give you nasal sprays to use, as well as ointment for the nostrils and columella. We ask you to keep your head elevated and apply ice to your eyes and cheeks (not wet ice, no moisture to lift off the tape please). Drinking pineapple juice and/or using Arnica may help curb any significant bruising. We ask that you refrain from heavy lifting or strenuous activity until we advise otherwise. The first week, while the external splint is on, you can where glasses. However, once the splint is removed we ask that you DO NOT wear glasses (for at least 4-6 weeks), as we do not want pressure on the bridge of the nose. There are few if any dietary restrictions after surgery. However, prior to surgery we may want you to avoid certain foods, supplements, or medications. You can return to full activity and sports by 6 weeks. You can return to school or work a few days after the surgery if you don’t mind people witnessing the splint (and as long as you are not doing heavy lifting); otherwise when the splint comes off 5-9 days later. At times we have you tape aspects of your nose at night for a period of weeks, and use nasal conformer or “nose cones” to your nostrils at night. These maneuverers help squeeze out any residual swelling, and serve like a “retainer” reminding and maintaining the nasal form achieved with surgery. We will obtain 3D photos following surgery, and usually see you at 6 week, 3 mo, 6 mo, and 1 year intervals. Remember the nose will change over time, with swelling decreasing, and more definition taking shape by 1-year.