Rhinoplasty (Nose Job) Surgery

Toronto Rhinoplasty Specialist

Dr. Solomon makes Rhinoplasty a large focus of his practice in Toronto, Canada. He has extensive experience in both cosmetic and reconstructive nasal surgery.

New! Visit Dr. Solomon’s illustrated plastic surgery videos here.

Rhinoplasty and Nasal Surgery

Nasal surgery can have a dramatic effect on one's appearance. Patients are welcomed for a Rhinoplasty assessment at any age but it is important to bear in mind that nasal development is not fully achieved until 14-16 years of age. For this reason, our younger patients may be advised to wait until they have reached maturity before having Rhinoplasty surgery. To view a CBC video on ‘Teenage Rhinoplasty’ featuring Dr. Solomon, please visit the Media Gallery here .

Rhinoplasty and Breathing Problems

In cases where the primary goal of surgery is to correct internal structures of the nose causing breathing problems, some patients also elect to carry out cosmetic nose reshaping at the same time. When considering Rhinoplasty surgery (a Nose Job), it is invaluable for the patient and Dr. Solomon to develop a decisive concept of the desired changes to the nose. Equally vital, is for the patient to know that there may be several constraints as to what is achievable in cosmetic nasal plastic surgery, often depending on one’s ethnicity and skin type. In all cases of Rhinoplasty surgery, issues of aesthetics and function are equally paramount and require that each patient’s case be carefully considered and that the full range of one’s unique facial attributes be carefully assessed.

Rhinoplasty Assessment

Dr. Solomon , a Toronto Cosmetic and Reconstructive Facial Plastic Surgeon – Otolaryngologist Head and Neck Surgeon, will evaluate your nasal structure and assess your breathing. He will establish if you have structural deformities of the nose, a deviated septum or proneness to nasal allergies.

During your Rhinoplasty evaluation in Toronto, Dr. Solomon will externally and internally appraise your nose. The size, shape and skin quality of your nose, together with your overall facial features, will be carefully assessed and noted. Dr. Solomon offers Advanced Computer Imaging in which photographs are taken and digitally altered during the consultation to show potential plastic surgery results. The current fee is $200. For those patients who book surgery with Dr. Solomon, this fee is applied as a credit to the patient’s account. Please ask about this service when booking your consultation to ensure the appropriate amount of time will be reserved. Occasionally Dr. Solomon may suggest chin augmentation with the aim of achieving a pleasing facial balance.

Rhinoplasty Surgery

Primary Rhinoplasty surgery is nasal surgery performed on a nose not operated on before. It can vary in complexity from simple procedures where just a bump is reduced, to complex reshaping of the entire nose. No matter how simple the procedure, the surgery needs precision and skill to get the best results. Even the simplest Rhinoplasty operation done by an inexperienced surgeon can lead to poor results.

Reduction Rhinoplasty is a type of surgery with the aim of reducing the size and enhancing the shape of the nose. Generally in these cases, the Rhinoplasty can be achieved by reshaping the existing cartilage and bone on the nose and, if needed, use the excess cartilage from the nasal septum (the partition of the nose) to achieve the desired results. In the majority of reduction Rhinoplasty cases there is no need for foreign material or grafts from other parts of the body.

Augmentation / Addition Rhinoplasty . Augmentation or addition Rhinoplasty is a surgery with the aim of building up the nasal bridge and possibly adding strength to the nasal tip. In these cases, grafts or implants maybe needed, often in patients of African or Asian descent, to achieve the desired result. Read more on ethnic Rhinoplasty.

Rhinoplasty and Nasal Reconstruction

In some instances, the underlying nasal structure may require reconstruction. In such cases, amendments can be achieved by using cartilage grafts from a patient’s nose, ear or from another part of the body. While Dr. Solomon generally prefers using a patient’s own tissues if at all possible, in some augmentation Rhinoplasty procedures he may consider the use of implant material such as Gore-Tex or Medpore. Both materials are surgically reliable and used extensively worldwide. In some cases, using implant material is a good option especially when a patient has limited tissue to use as a result of prior Rhinoplasty surgery or if the patient does not accept the downside of removing cartilage from their ear or rib. The risks associated with Gore-Tex and Medpore implants will be discussed with you in detail if you are a candidate for its use. The main issue with such materials is the potential for infection or rejection of the implant

Cartilage grafts from the ear are good for nasal tip grafts but often lack strength and support needed for some Augmentation Rhinoplasties, revision Rhinoplasties and Reconstructive Rhinoplasties. In cases where multiple strong and large grafts are required, rib cartilage may be the most ideal source of cartilage. The downside of rib grafts is that there is discomfort from the procedure and the patient has to accept an incision on their chest. Cartilage grafts, especially rib, may potentially shrink or bend with time..

Minimal Use of Nasal Packing

Dr. Solomon makes every effort to meticulously close all incisions in the nose so that nasal packing is rarely needed. Some surgeons rely on supportive packing in the nose to control bleeding and to internally push the tissues into place. By carefully closing all incisions, Dr. Solomon improves the chance that the patient's tissues will stay where positioned. Dr. Solomon's patients have an easier time with recovery from surgery and don't have the discomfort of removal of nasal packs. In some rare instances, Dr. Solomon will use small tampons in the nose overnight but these are slender and easy to remove.

After Rhinoplasty Surgery

Rhinoplasty surgery is generally a well-tolerated procedure. While many patients experience minimal post-operative discomfort, others may feel more comfortable taking oral pain medication for the first few days. In all cases, Dr. Solomon will provide a prescription along with instructions for managing your comfort.

A protective nasal splint remains in place for about 7-10 days. Bruising dissipates steadily throughout the first postoperative week and can be concealed using makeup if you wish. Swelling generally peaks within 48 hours after surgery then starts to lessen with each passing day; however, residual swelling can last for several weeks or months but typically only in the nasal tip area.

Skin numbness after Rhinoplasty (Nose Job) surgery may occur but typically resolves during the healing process. On occasion an additional, refining surgery may be necessary to optimize the Rhinoplasty result.

Rhinoplasty in Toronto, Ontario, Canada

In Ontario, nasal procedures to correct breathing difficulty or nasal deformity from trauma may be covered by OHIP. In these cases, Dr. Solomon will assess your condition and submit photos and breathing test results to the Ministry of Health to determine health insurance coverage.

Surgical Consent

Setting Realistic Goals

About Scar Formation

All wounds heal by scar formation. The surgeon has little control over this process after the operation has been performed. However, cosmetic plastic surgery techniques and incisions are carefully designed to minimize skin trauma and for both internal and external scars to be as fine and unnoticeable as possible.

Dr. Solomon is meticulous in his surgical techniques and suturing not only to lessen tissue trauma and risks but also to increase the probability that changes will remain stable and heal successfully. Should an unfavourable scar develop during the healing process, improvement may be possible using a small dose of steroids injected into the site or by laser therapy or dermabrasion, depending on the situation. It is important to attend all postoperative appointments with Dr. Solomon to monitor healing over the course of about a year.

Follow Instructions for your Surgery

Risks of Rhinoplasty (Nose Job) Surgery

• Pain, which may persist
• Skin numbness, which may persist
• Skin swelling and discolouration
• Nausea, dizziness
• Bleeding, recurring nose bleeds
• Accumulation of clear fluid beneath a wound (seroma) which may need to be drained
• Accumulation of blood beneath a closed incision (haematoma) which may have to be removed
• Infection
• Poor wound healing, slow healing
• Small surface vessel rupture of the nose
• Skin contour irregularities
• Unfavourable scarring, Keloid (heavy scar), internal scar/adhesions
• Involuntary emergence of sutures through the skin requiring removal
• Nose asymmetry
• Development of changes to nasal airway after surgery
• Septal perforation (a hole in the nasal septum) can occur from surgery and can possibly be repaired if small. Larger perforations are difficult to repair.  Septal perforations are more common if a patient uses cocaine or digitally traumatizes their nose after surgery.
• Reduced sense of smell
• Nerve Damage
• Depression
• Reactions to medications
• Sinusitis (treated with antibiotics and medications that shrink the nasal lining)
• Skin necrosis or skin death (1500% more likely with smokers)
• Possibility of revision Rhinoplasty to refine results
• Anaesthesia risks