Dr. Steven Fagien & Dr. Elbert Vaca


Face Procedures

A Rhinoplasty, or “nose job”, can reshape the appearance of your nose including the dorsum (or bridge), the tip, nostrils, and width and overall size of the nose. Altering the shape of your nose can help create aesthetic balance and harmony with the rest of your face. In addition, a rhinoplasty can improve breathing by improving nasal airflow due to deviations of the nasal septum, large nasal turbinates, or poor structure and support of the nose. Therefore, rhinoplasty can have a significant impact on both the appearance and function of the nose. Changes in the shape of the nose can be subtle or more significant and depend on the individual goals and needs of each patient.

Rhinoplasty is one of the most complex procedures in plastic surgery and there are many surgical techniques that can be used; most importantly, rhinoplasty must be customized to each patient’s needs. Furthermore, other facial procedures can be performed at the same time to improve the overall balance of the nose with the rest of the facial profile.

Who is a good candidate for rhinoplasty?

The best candidates for rhinoplasty are healthy non-smokers who are looking for improvement, but not perfection in the appearance of their nose. Females age 16 or older and males age 18 or older are surgical candidates – this is because the face finishes growing earlier in females than in males.

What is the difference between “Open” & “Closed” rhinoplasty?

All forms of rhinoplasty require incisions, but rhinoplasty can be performed in a “closed” or “open” technique. An “open” technique involves an additional ~5 mm (approximately ¼ inch) incision along the inferior part of the nose known as the columella. This incision typically heals extremely well and is well concealed. The additional incision should not be the main reason to decide between “open” vs “closed” rhinoplasty. The advantage of “open” rhinoplasty is that it permits improved visibility and access to the nose during surgery – this may be more appropriate in many patients to address their nasal appearance concerns. The main advantage of “closed” rhinoplasty is faster healing and resolution of swelling after surgery. During your consultation, Dr. Vaca and you can discuss “open” vs “closed” rhinoplasty in detail to determine which is the better option for you.

Can insurance cover the cost of rhinoplasty?

Insurance may cover a portion of the cost of rhinoplasty if you have functional problems of your nose that affect your breathing. Policies on what is potentially covered by insurance can vary between insurance carriers.

How long is the procedure?

This is variable and depends on what is done during surgery to address your individual needs and goals. The surgical procedure can last between 2 and 6 hours.

Rhinoplasty Recovery

A nasal splint is typically placed after surgery and removed approximately 1 week after surgery. Most visible bruising resolves in 1 – 2 weeks and patients can typically return to work after this time. The majority of swelling subsides within a few weeks, however, the final appearance of the nose after rhinoplasty will continue to emerge up to 1 year after surgery.

What are the risks of Rhinoplasty surgery?

All surgical procedures carry a degree of uncertainty and risk. Thankfully, the risk of any major complication is rare.

Rhinoplasty incisions typically heal very well. Infection and bleeding are rare but can occur. It is important to avoid strenuous activity, blood thinning medications, and that your blood pressure is well controlled after surgery to decrease the risk of bleeding.

We all have natural asymmetries between each side of our nose and face – some people more than others. After a rhinoplasty, some asymmetries will still exist.

Occasionally, another procedure may be needed to make adjustments to the nose. If this is required, this is usually done at least 1 year after surgery.

Before and After Photos

Rhinoplasty – Case 1

Rhinoplasty – Case 2

Meet Dr. Vaca

Dr. Vaca

Dr. Elbert E. Vaca is a Plastic & Reconstructive Surgeon who completed his medical training at The Johns Hopkins University School of Medicine and Northwestern Memorial Hospital.
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Meet Dr. Fagien

Dr. Fagien

Dr. Steven Fagien is one of the foremost oculoplastic surgeons in the United States and the world. He completed his medical training at the University of Florida and a fellowship in oculoplastic surgery at the University of Illinois Eye and Ear Infirmary.
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