Rhinoplasty Chicago, IL

Rhinoplasty Results Before-and-After

The before and after gallery represents a small fraction of the patients Dr. Shah has operated on. He has many more example of his work in his office. The gallery is intended to show a variety of aesthetics. All pictures shown are patients of Dr. Anil Shah.

Philosophy: How Is Dr. Shah different?

Types of Nose Job

ETHNIC RHINOPLASTY

The term “ethnic” is often used to describe any patient who is of non-caucasian origin. Most patients are seeking a nose which will work with their facial features and ethnicity, not to change their racial identity. Dr. Shah has subdivided ethnic rhinoplasty into a few backgrounds because the differences between the nasal characteristics can be quite large. Even within specific ethnicities, there is a very wide range of what an unoperated nose will look like. Read more about Ethnic Rhinoplasty

SEPTOPLASTY

Septoplasty is the alteration of the nasal septum to straighten the airway and/or remove cartilage for cartilage grafting. The nasal septum is a structure composed of cartilage in bone in the middle of your nose. Ideally, the septum divides the nose in half so that equal and symmetric airflow can occur. In 80% of the population, the septum is deviated, meaning a portion of the septum goes into the airway. One third of those patients are symptomatic with signs such as mouth breathing with sleep, exercise,snoring, and a a dry mouth. Read more about Septoplasty

RHINOPLASTY WITHOUT USING AN OSTEOTOME

Rhinoplasties in the past have often used a traditional instrument known as an Osteotome, or chisel, to help shape the nose. The problem with using an Osteotome is its blunt nature. Typically, Osteotomes are used for control breaks and could lead unwanted outcomes for the patient. The delicate nature of the nose requires precision. Dr. Shah uses specialized tools to help achieve the nose that his patients seek. Read more about Osteome

PRESERVATION RHINOPLASTY

Preservation Rhinoplasty is an approach that uses three principles of preservation for patients seeking a rhinoplasty with natural results instead of being overly grafted and would require future revisions. When seeing his patients, Dr. Shah will implement these principles to give his patients the natural nose they want. Read more about Preservation Rhinoplasty

SCARLESS RHINOPLASTY

Scarless rhinoplasty is where an incision is made inside the nose instead of externally. This leaves the patient with no visible scarring. Dr. Shah uses this technique for patients seeking to adjust the bridge of their nose and maintain their nasal tip. Read more about Scarless rhinoplasty

NONSURGICAL OR LIQUID RHINOPLASTY

Nonsurgical Rhinoplasty, or Liquid Rhinoplasty, is when filler or gel is used to shape the nose instead of having a surgical approach. This procedure is often used for patients seeking to give their nose more volume and not a reduction. Dr. Shah is an expert injector who understands the facial anatomy and gives his patients that desired fuller look they have been looking for. Read more about Nonsurgical Rhinoplasty

THREAD RHINOPLASTY

Thread Rhinoplasty is the use of threads to help support the nose either along the tip of the nose along the bridge. Read more about Thread Rhinoplasty

INSTA RHINOPLASTY

Insta Rhinoplasty is a technique adopted and adapted by Dr. Shah to give his patients an immediate view of their nose immediately after surgery, while on the OR Table. This technique helps give Dr. Shah’s patients have peace of mind on what their outcomes are instead of waiting a year of healing. Read more about Insta Rhinoplasty

Open versus closed rhinoplasty

Open rhinoplasty and closed rhinoplasty are two approaches to reshaping the nasal tip. Open rhinoplasty means that there is an incision along the columella (soft tissue between the nostrils), while closed rhinoplasty means that all of the incisions are inside of the nostril. However, there are many more differences than just an incision and both approaches have pros and cons. How do you know what approach is right for you?

Open rhinoplasty has the distinct advantage of direct visualization of the cartilages. However, perhaps more important is the ability to manipulate and alter nasal shape with more control, precision, and even in ways not possible with closed rhinoplasty. Patients who need large amounts of projection (nose sticking out from face) or deprojection (pushing nose closer to face) are often better served with an open rhinoplasty.

Some nasal variants also warrant open rhinoplasty including cephalic oriented cartilages. Cartilages which are oriented to the top of the head rather than the ears (vertically oriented) will have weakness on the outside portion of the cartilage. With an endonasal approach, often times roundness is accentuated and patients develop pinching along the outside of their noses.

Closed rhinoplasty has the advantage of decreased operative time, less swelling and postoperative healing and avoidance of a scar along the columella. Many patients with closed rhinoplasty will have less swelling early on. In some patients with a minimal tip modification approach, patients will almost no nasal swelling by two weeks postoperatively. However, the goal of rhinoplasty is to shape the nose to the desired shape. Most patients will care more about their ultimate result than whether or not they had to contend with swelling.

The patient seeking rhinoplasty is best suited if his surgeon is able to perform closed and open rhinoplasty without bias. Closed rhinoplasty offers significant advantages in less downtime and swelling, while open rhinoplasty may be necessary in cases requiring increased structure or have variant nasal anatomy.

Rhinoplasty for Children

Functional nose surgery in children is fairly uncommon. The most common cause of nasal obstruction in children is enlarged adenoids. Clinically, deviated septums are really not seen as common causes of nasal obstruction until at least seven or eight. I performed a radiologic study which confirms that nasal deviation is not seen until after the ages of five. (See Radiologic Study). Most children would respond to surgery to fix either their adenoid pads or reduce their turbinates

The main reason why septoplasty is performed uncommonly in a child is that their hypothesized growth centers within the nasal septum. If these growth centers are disrupted, it is thought that there may be the potential for change in nasal shape.

On the other hand, if a child is having significant decrease in breathing which is effecting his or her ability to sleep at night, receive oxygen, exercise, etc. In addition, chronic mouth breathing can lead to skeletal changes in the face often called the adenoid facies, but can occur with any nasal obstruction.

So, in summary either way it seems the surgeon and patient seem to be trading one problem for another. So what can be done. First of all, if surgery is determined to be beneficial for the patient it can be done in a specialized format. The growth centers of the nose can be avoided if possible. Now no one really knows where the growth centers are humans but it has been studied in animals. Extrapolation from that data, has lead most scientists to believe that the growth centers are located along the nasal floor posteriorly. If the surgeon can avoid disrupting this center, long term cosmetic nasal issues will theoretically be minimized. In addition, if the surgeon replaces the crooked portion of the septum after straightening it, the cartilage of the nose is now straighter but still intact.

Cosmetic issues are a completely different story altogether. Due to the potential for disruption of growth centers of the nose (see link), surgeons need to determine when has the nose stopped growing. A simple, yet surprisingly accurate method is to determine when the patient’s shoe size has changed last. If it has been over two years, there is a strong likelihood that the patient’s nose has also stopped growing and that a nasal operation would be possible.

However, the physical component of changing a patient’s nasal appearance is not the only factor. Emotional and mental maturity are probably the rate limiting factor in most teenagers. Patients must be the driving force behind wanting the rhinoplasty and not parents. The surgeon should explain to the patient that this is surgery and is a permanent action. The evaluation of teenagers at this point is extraordinarily complex. Some are highly mature and are very clear about what portions of their nose they wish to change. Others bring in pictures of the latest pop star and explain that this is the nose that they desire. The surgery is not intended to create a trendy nose, but a nose which will continue to look good with age.

Tip Reshaping in Rhinoplasty

The nasal tip represents one of the most important aspects of change in rhinoplasty. It is said that he who masters the nasal tip masters the nose. So what makes transforming the nasal tip such a difficult endeavor? 

The nasal tip is composed of lower lateral cartilages. These cartilages can take a variety of nasal shapes, which includes convexity, concavity and excessive fullness. The bulbous nasal tip can be one of the more difficult endeavors because it requires appropriate diagnosis of the root cause of bulbosity or fullness of the nasal tip. 

Causes of the bulbous nasal tip:

• excessively thick nasal skin
• excessively convex nasal tip cartilages
• too much cartilage along nasal tip

Changing the shape of the nasal tip is often described in the rhinoplasty literature in terms of 2d terminology. This includes such descriptors as projection, nasal tip rotation, length of nose, etc. The problem with this terminology is that it does not accurately describe what the patient may or may not like about his or her nose.

The nose is best described and seen in three dimensions. Three dimensional intrepretation of the nose is how we see our noses in real life and how we see others. 

Photographs do play a role in describing the nose, but they do not do it as well as how we look in person. As is the case, sometimes a patient will note how his/her nose may not be photogenic with some cameras. The reason for this may have more to do with light, shadowing, and lens distortion than it does of an actual interpretation of the nose. A cell phone camera lens will not accurately depict a nose. This is why standardized photographs play such an important role in looking at nose and nasal anatomy.

So if seeing the nose in 3 dimensions is the best way to see the nose, how does one see the nose. This requires a vision of the nose to help reshape the size AND shape of the nose so that the appearance of the nose can be altered. 

Nasal tip bulbosity as a result of thick skin will often require projection of the nose. This is to have the nose stick out further. While some patients may not desire a more projected nose, it may be the best option for patients with thicker skin.

Nose Job Alternatives

Every nose is different, and thus, every rhinoplasty is different as well. Learn about various types of rhinoplasty including Male Rhinoplasty, Alar Base Reduction, Deviated/Crooked Nose, Septoplasty, Finesse Rhinoplasty, Saddle Nose Deformity, Broken Nose and more.

Nose Job resources

KNOW YOUR NOSE

Nasal anatomy plays an important role in both diagnosis and the underlying cause of the nasal problem. A simplified version of external points on the nose are illustrated to facilitate communication. Nasal analysis is where a series of measures are taken to help see how a nose compares to an ideal nose. While this may provide both the patient and surgeon with some useful information, it definitely should not be interpreted as cold hard science or facts. These angles are meant merely to serve as a guide. In fact, some of the angles and measures are disputed by surgeons, myself included. It serves a purpose in communication amongst surgeons and patients. A beautiful nose can not be created by formula and needs an artistic vision and collaboration between surgeon and patient.

NASAL PHYSICS

For many patients who can’t breathe from their nose, the last thing they want to think about is physics. However, it is the precise understanding of several principles in physics which allows a nose to function and breathe as ideally as possible.
Read more.

PROCEDURE TIMELINE

Many of our rhinoplasty Chicago patients ask at what age can a patient have a rhinoplasty (or other procedure)? This timeline is intended to serve as general information on the ages at which patients may seek a procedure such as a rhinoplasty. See more.

RHINOPLASTY INCISIONS

Incisions play a significant role in rhinoplasty. Learn about the different types of incisions used in rhinoplasty. Read more

GUIDE TO GRAFTS

What are grafts? Do I need them in my nose? Dr. Shah has authored an informative guide to help patients better understand what a graft is. See more.

Nose Job Recovery time

PRE AND POST OPERATIVE INSTRUCTIONS

Dr. Shah’s office will help you through you pre and post operative preparation and recovery. On this page, you will find an overview of instructions, as well as medications to avoid before and after a procedure and more. Read more.

ARTICLES BY DR. SHAH

We’re constantly updating our Rhinoplasty to keep you up-to-date on new procedures and answer any questions we hear regularly. Read more

RHINOPLASTY GLOSSARY

Understanding your nose can seem daunting. Use this guide to help to know your alar base from your bridge or your glabella from your columella. Understanding your nose can seem dauntingLearn more.