When I mention celebrity rhinoplasty, most people conjure images of Michael Jackson with his grossly deformed nose. Rhinoplasty, though, has been under taken by plenty of other celebrities with usually good outcomes. I rank Halle Berry and Ashley Simpson as those who have had good nose job surgery. In both cases, the nose is not overly small and it appears natural.

In the case of Lil Kim, though, the rhinoplasty is more reminisent of Micheal Jackson’s nose. In an effort to make the nose small and narrow, the plastic surgeon has gone too far. Lil Kim’s nose is too narrow and pinched. It appears unnatural and out of place on her nose. I would not be surprised if she chooses to undergo revision rhinoplasty to undo some of these problems.

Rhinoplasty surgery, as all cosmetic surgery, has gone through an evolution. Currently, the goal in plastic surgery is achiving a natural and seemless result that fits the patient both in in terms of age and  ethnicity. This has always been my guide in performing plastic or reconstructive facial surgery. I discuss my aesthetic goals with my patients during a consultation and use computer imaging to demonstrate my vision. The following case represents just this idea in one of my patients. The three photos (from left to right) show the pre operative picture, computer generated image during consultation, and the final post operative results of rhinoplasty. Note that the computer generated image in the middle is very close to the final result on the right.

I come across this question frequently. Patients want to know the best time of the year to undergo facelift, rhinoplasty, or other cosmetic procedures. The answer is “It depends”. The most important factor about timing of surgery is patient’s preferences, such as the ability to have time off from work, etc. Having said that, there are some advantages to having surgery in a particular time of the year.

In general, following a facelift operation, patients experience mild bruising in the lower face and upper neck. In the cooler months of the year, it’s easier to wear high neck sweaters and scarves which can hide the bruising. When it comes to rhinoplasty (nose job) though, things are a bit different. Dry air can be more irritating for patients who are recovering from rhinoplasty. Therefore, warmer months of the year with less dryness are prefered. No matter when the surgery is performed, I ask patients to refrain from significant sun exposure, especially during the first six post operative months.

In rhinoplasty (nose job), as in other medical treatments, I am constantly looking for ways to make the procedure simpler and the recovery easier. Obviously, since nasal shapes vary greatly, so do the treatments. There is now a simple “non-surgical rhinoplasty” aimed at improving an isolated nasal bump, or irregularity in the nasal profile. The treatment consists of injecting a filler such as Restylane or Radiesse, above and below the bump, to make the bump look smoother. In case of a depression, the filler is only injected into the depressed area to lift it.

Filler injections actually make the nose slightly larger, but the nasal contour is more smooth and aesthetically pleasing. When there are depressions in the profile of the nose, due to trauma or past surgery, the fillers can effectively straighten the nose. Obviously, this treatment is not intended to replace rhinoplasty, when the patient desires a smaller cuter nose, when the nasal tip needs to be refined, or the width of the nose narrowed. These limitations leave a very small subset of patients who will benefit form filler injections.

According to the FDA, filler injection into the nose is an off label use of the material and the patients need to give consent for such use. The downside of filler injections is that they are not permanent. Fillers such as Restylane and Radiesse last between six months to a year, and will need to be repeated.