Rhinoplasty (Nose Job) Surgery
Toronto Rhinoplasty Surgeon – Otolaryngologist Head and Neck Surgeon
Toronto Rhinoplasty Specialist
Toronto Rhinoplasty Specialist
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.
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.
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.
Rhinoplasty surgery is either ‘reduction’ or ‘augmentation/addition’ in nature
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. 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/ Non Caucasian 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, cartilage grafts or synthetic implants maybe needed. Augmentation rhinoplasty describes the rhinoplasty procedure required by most patients of African or Asian descent. Read more on ethnic Rhinoplasty. See examples of Ethnic Rhinoplasty Before And After Gallery
Noses that have sustained trauma, prior nasal surgery, or have a congenital deformity may require nasal Reconstruction.
Nasal reconstructive surgery generally requires rebuilding damages nasal structure with cartilage grafts from a patient’s nose, ear or rib. In certain situations fibrous tissue known as fascia which is taken from a small incision in the scalp is utilized as a soft graft to reshape the nasal tip or fill in imperfections along the nasal bridge. Dr.Solomon prefers using a patient’s own natural tissue, but in some reconstructive or augmentation Rhinoplasty procedures the use of implant material such as Gore-Tex or Medpore may be a good option. Cartilage from the ear is good for the nasal tip reshaping and reconstruction, but it often lacks strength and support needed for certain reconstructive Rhinoplasties, Revision Rhinoplasties and augmentation rhinoplasty procedures. Ear cartilage grafting is performed through a small incision in front of the bowl of the ear or from an incision from the back of the ear. The scar typically heals nicely and is generally not noticeable. Ear cartilage grafting does not typically change the shape of the ear. Rib cartilage is the most ideal source for cartilage if multiple, sturdy or large grafts are required. Grafting cartilage has its downside: harvesting a rib for a cartilage graft can cause chest wall discomfort for a number of weeks. Patient’s may be unwilling to accept a chest incision; and the graft may potentially shrink or bend with time. Typically Dr Solomon performs rib graft incisions just below the breast so as they heal they are not noticeable. However in certain cases where a large portion of rib including boney rib and cartilaginous rib are needed the incision may be lower down on the chest wall. Over the years the use of rib cartilage, has become recognized as a reliable, safe choice for cartilage grafting in complex reconstructive, augmentation and revision rhinoplasty procedures.
Some patients choose to use surgical grade implant material because of limited natural tissue or an unwillingness to remove cartilage from their ear or rib. Synthetic implants especially gortex can in some cases be ideal for nasal augmentation. Synthetic implant material does carry a small potential risk of rejection or infection quoted as between one to three in a hundred or “one to three percent”.. These risks will be discussed with you by Dr. Solomon if you are a candidate for its use. The two commonly used implant materials for reconstructive or augmentation rhinoplasty procedures are Gortex and Medpore. These materials are very different. Gortex has been used for many years for vascular surgery and has a high safety record. It comes in one to two millimeter sheets and can be sutured and cut to specific shapes to achieve extremely natural cosmetic results. Gortex is a soft material and should be used for nasal bridge augmentation and not be used in the nasal tip. Medpore is a firmer substance which has been used in craniofacial surgery for many years. It is ideal for providing strength and support to the nasal tip. In Dr Solomons opinion it must be covered by cartilage to ensure that it is not in direct contact with the patients skin. When used appropriately these surgical grade materials can be extremely useful in rhinoplasty surgery. Dr Solomon often uses these materials in Asian, and African American augmentation Rhinoplasty procedures. To see examples of Non Caucasian Rhinoplasty surgery.
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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. 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.
Setting Realistic Goals
A realistic goal of any plastic surgery is to seek improvement rather than perfection. No surgeon can guarantee results because surgery depends not only on a surgeon’s experience and skill, but also on the nature of a patient’s particular problem, state of health, skin texture, nasal anatomy and ability to heal.
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.
The choice to have nasal surgery is a very personal one and patients will need to decide if the surgical options available will fulfill their expectations. Along with the benefits, patients need to have a clear understanding of the risks and possible complications prior to reading and signing a surgical consent form.
Dr. Solomon will discuss the risks associated with your procedure during your consultation. Please review the risks below and bring any questions to your consultation with Dr. Solomon. If you have any further questions at any time, please contact Dr. Solomon at (866) 293-0616.
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About Scar Formation
It is normal for wounds to heal through scar formation and the surgeon has little control over this natural process after the operation is complete. However, cosmetic plastic surgery techniques and incisions are designed to minimize skin trauma and skin tension which allows for both internal and external scars to be as fine and unnoticeable as possible. To learn about treatments of scars see
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
No surgery is without the risk of complications and undesirable results. Choosing a highly competent, experienced, board certified surgeon will minimize the probability of many risks from occurring. You can lessen your risks by carefully following Dr. Solomon’s instructions both before and after surgery.
The Risks Associated with Rhinoplasty Surgery Include:
- Pain, which may persist
- Skin numbness, which may persist
- Skin swelling and discolouration
- Nausea, dizziness
- 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
- 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
- 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
View: Rhinoplasty Photos
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