Rhinoplasty

Rhinoplasty in Dallas, TX with Dr. Ali Abtahi

Patients often want to improve the appearance or function of their noses for a variety of reasons. Rhinoplasty surgery, colloquially referred to as “nose surgery” or a “nose job,” is a highly technical plastic surgery procedure that can be customized to meet each patient’s unique needs. Rhinoplasty is a major surgical procedure, and to obtain the best results, the patient must partner with a surgeon with exceptional levels of artistry, technical skill, education, meticulous attention to detail, and the ability to communicate and listen thoughtfully.

When choosing Dr. Ali Abtahi, patients gain a highly trained professional who has their best interests at heart. To Dr. Abtahi, plastic surgery is a cog in the wheel of overall health. It is a stepping stone – not a solution. His role as a surgeon and good steward of medicine is to help patients obtain an overall healthy lifestyle, which includes looking and feeling better about themselves. 

Learn more about rhinoplasty surgery by reading on or scheduling a consultation with Dr. Abtahi today. We are located in Plano, TX, and proudly serve patients visiting from Highland Park, Dallas, Fort Worth, Southlake, Aledo, Keller, Frisco, Grapevine, Colleyville, Arlington, Alliance, Coppell, and other nearby areas. We also cater to patients traveling from outside the state of Texas from all parts of the country. Dr. Abtahi is licensed in over 30 states across the country and provides virtual consultations to discuss your specific goals.

What are Some Common Reasons a Person Might Want Rhinoplasty Surgery?

The second most common reason is dorsal hump prominence. If a patient looks at their side profile, the dorsal hump is the slope from the radix (i.e. Bridge) to the tip of their nose. On some people, the dorsal hump is very prominent. Patients bothered by this often want it to be smoothed out so that they have a much straighter or “ski sloped” dorsum.

Another common reason for rhinoplasty surgery is having the tip of the nose appear as if it’s downward-turned or “drooping”. This nose position can have an unappealing appearance and give an unwanted perception of the patient’s face that is not typically considered ideal.

A bulbous tip of the nose is very round in shape, and in general, patients desire a more refined tip. The problem with the appearance of a bulbous tip is often an imbalance between the upper and lower halves of the nose, specifically the upper and lower lateral cartilages.  Patients will often complain of the appearance of a “clown nose” or “ball-like” tip.  

Length can actually be two different factors that plastic surgeons must analyze to determine which measurement is truly the one that is “too long.” Dr. Abtahi will take both lengths into consideration when deciding if nasal shortening is indicated and the specific dimension which should be shortened.

Sometimes, the nose may appear disproportionately large or overprojected simply because the chin is set-back or recessed.  This is most notable in the patient’s side profile.  When the chin is undersized, it can be augmented to balance the face in a way that doesn’t require extensive shortening of the nose.

Overall, the number one reason patients pursue rhinoplasty is to correct functional breathing problems. When patients can’t breathe through their nose, it frequently prompts seeing someone to have it repaired. The issue may be that they can’t breathe through one or both sides of the nose, which forces them to breathe through the mouth.  

What are the Components of Rhinoplasty Surgery?

Rhinoplasty surgery entails multiple parts, and the procedural details depend on the patient’s overall aesthetic goals. The two main components addressed during each surgery are the following:

  • Functional (how well the nose works): Sometimes, patients pursue rhinoplasty because of difficulty breathing through their nose. If this is the case, Dr. Abtahi can address obstructions in the airway passage through each nostril. This may include widening an area called the internal nasal valve, resecting portions of the turbinates, or in some instances, correcting a deviated septum.  
  • Aesthetic (how the nose appears):  In many instances, patients may desire a more refined appearance to their nose.  For example, patients will often say they don’t like the appearance of the dorsal hump, which is essentially where the bridge of the nose is more prominent than the tip of the nose. If this is the case, Dr. Abtahi can address this and other aesthetic components at the time of surgery.

Any rhinoplasty procedure can address functional issues, aesthetic issues, or both, depending on the reason that the patient has come to our office.

Dr. Ali R. Abtahi of Amor Propio Aesthetic Surgery in dark suit

Meet Ali R. Abtahi, DO MSc

Dr. Ali R. Abtahi, DO MSc is a highly skilled surgeon with extensive training in Plastic and Reconstructive Surgery, Comprehensive Aesthetic Surgery, and General Surgery. Through his artistic vision and sincere passion for plastic surgery of the utmost quality, Dr. Abtahi is dedicated to delivering an elite, personalized experience.

What are the Basic Steps Involved in Dr. Abtahi’s Rhinoplasty Procedure?

Prior to the operation, Dr. Abtahi and the patient will decide on an open rhinoplasty or closed rhinoplasty approach.

Open Rhinoplasty: Approximately 70 to 90% of Dr. Abtahi’s patients are candidates for open rhinoplasty. This means that he will make a cut on the underside of the nose in an area called the columellar waist.  Once the incision heals, the scar is imperceptible and this allows the surgeon full access to the underlying cartilage and bones of the nose.

Closed Rhinoplasty: 10 to 30% of patients may be candidates for closed rhinoplasty, which means the operation can be performed through hidden incisions made inside of the nose. Closed rhinoplasty surgery may be appropriate for a smaller subset of patients which do not require extensive reshaping of their nasal dorsum and tip.

During rhinoplasty surgery, Dr. Abtahi will:

  • Open the nose, remove the skin envelope, and evaluate the lower lateral cartilages of the tip
  • Evaluate the nasal septum to see whether it’s straight or deviated and which way it needs to be moved (if at all)
  • Inspect the dorsum and decide at this time whether preservation or structural rhinoplasty is needed. Regardless of the technique he employs, Dr. Abtahi will reshape the dorsum to achieve the best aesthetic result
  • Harvest a portion of the septum and make cartilaginous grafts to shape and refine the nasal tip
  • Insert tip-defining sutures that will straighten, elevate, and sharpen the appearance of the nose
  • Perform osteotomies (i.e. cut the bones of the nose) in order to mobilize and straighten the upper vault. 
  • Wash everything out and close the incisions

Unlike the vast majority of rhinoplasty surgeons, Dr. Abtahi uses only external splints and taping during the postoperative period. Patients rarely require the more cumbersome internal splints inside each nostril.  All patients are seen one week postoperatively for external splint removal and evaluation. Patients will then be seen at 3 weeks, 6 weeks, 12 weeks, 6 months, and 12 months to monitor for resolution of swelling, complications, and changes in the nasal shape. 

What is Preservation Rhinoplasty?

Preservation rhinoplasty is a powerful new technique developed and popularized by rhinoplasty leaders in France and Turkey.  Known for its incredible results and rapid recovery, the technique has only recently made its way into the United States surgical community. Dr. Abtahi has had extensive training in preservation rhinoplasty.  Not every patient, however, is a candidate for this technique and after initial evaluation in the office, Dr. Abtahi will make the final decision intraoperatively once the internal structures of the nose have been revealed. From there, Dr. Abtahi can perform minimal dissection and keep the entirety of the dorsal unit together. In contrast to traditional structural rhinoplasty, patients experience an easier recovery and overall less likelihood of dorsal complications such as an inverted V deformity.

Choosing the Right Rhinoplasty Surgeon

Choosing a rhinoplasty surgeon can be a daunting task. Oftentimes, patients may be lured by extravagant marketing or prominent academic names like Harvard, Yale, Hopkins, etc.  The truth is, finding “the best” rhinoplasty surgeon is MUCH more involved and requires a bit of work and research.  Click the button below to learn tips to help you navigate the plastic surgery market.

What Should Patients Understand Before Considering Rhinoplasty?

Our goal is to make things better, not perfect.

Perfection simply doesn't exist in nature. Instead, we strive for improvement and refinement of the natural features of your nose. Medicine is an imprecise science where multiple factors can contribute to your postoperative result. Unfortunately, surgery is not like apps like face lab or face tune whereby every minute detail can be dialed in to perfection. Mild asymmetries and minimal irregularities may occur in addition to palpable differences of the nose after surgery. As seen with split-face studies (one side of the face is mirrored to create the opposite side), faces appear odd when they are perfectly symmetrical.  However, improvements can be made to make the nose appear more balanced and harmonious with other facial features. Patients must understand that even the best rhinoplasty surgeons can only achieve 80 to 90 percent of your dream nose. Having realistic expectations will set patients up for success as opposed to a huge let down.

Full results take time.

Rhinoplasty results don't truly manifest until at least 12 months after surgery, so patients should be aware of the lengthy time commitment involved. Initially, patients may see some degree of change from before to after, but it may be engulfed in swelling that takes months and up to a year to finally resolve.  Additionally, the skin envelope takes a lot of time to shrink down to its new underlying framework and is dependent on how thick and sebaceous the nasal skin is. The bottom line - patients need patience! Remember…Rome was not built in a day!

Revision rhinoplasty is a possibility.

It is expected that a certain percentage of individuals (national average 10 to 15 percent) will require some degree of major or minor revision surgery. Although we love to see great before and afters on social media, oftentimes these photos do not tell the entire story. Some patient’s transformational journey is an easy and direct straight line, and others are a more cumbersome zigzag.  Regardless of the path, we are always focused on the end result.  But it should be understood that with any plastic surgery, revisions may be needed.  

Schedule Your Dallas Rhinoplasty Consultation Today

Contact Amor Propio Aesthetic Surgery to schedule a consultation for rhinoplasty with Dr. Ali Abtahi. After a physical examination and brief interview to understand your goals, Dr. Abtahi will provide you with his recommendations for the safest and most powerful approach to help you achieve your desired results.  He’ll explain the pros and cons, what to expect at each stage of the process, and most importantly, will invest in getting to know you as an individual! Dr. Abtahi would love to guide you along your plastic surgery journey and help cultivate your overall commitment to health and wellness.

Call us at (469) 293-2533 or reach us online today!

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Dallas Rhinoplasty FAQs

Athletes who play contact sports, such as wrestling, football, soccer, volleyball, basketball, MMA, Boxing, etc. are certainly prone to injury. But motor vehicle accidents, particularly with airbag deployment, also contribute to a significant portion accidents.  Unfortunately, domestic violence and drug abuse of inhalants such as cocaine make up another cohort of patients requiring septorhinoplasty.  In some instances, patients cannot recall the exact event that contributed to a broken nose or fractured/deviated septum and instead may have sustained repeated microtraumas over the course of childhood that ultimately lead to deviations, asymmetries, or blockage.  Lastly, environmental allergies and repeated long-term use of nasal sprays such as Afrin may contribute to problems with the nose requiring septorhinoplasty.  

In addition to the cosmetic component, rhinoplasty can drastically improve the functional airflow through the nose, leading to better breathing. The procedure can also significantly enhance your self-perception and improve self-confidence when taking photos, doing social media, or communicating with others via video chat such as zoom or facetime.

Enhancing facial harmony requires evaluation of the face in several angles.  Adding or subtracting volume from one area may affect the balance of surrounding features.  For the nose, this balance is achieved with the chin. Chin augmentation is sometimes required for individuals who may have disproportion between the nose and chin, particularly in the side profile. If the chin is too prominent or too far forward, it will make the nose look too short, and vice versa. Another feature is the appearance of the nose with smiling, specifically a plunging tip or significant widening of the nostrils. In these instances, a muscle called the Depressor Septi Nasi (DSN) can be divided to prevent a plunging tip and curling of the lip.  The nostril width can also be decreased and dynamic muscles divided to prevent excessive widening with smiling. At the level of the eyebrows, the area between the eyes called the Radix, may also be underdeveloped, contributing to an exaggerated appearance of a dorsal hump.  This area can either be filled with cartilage or soft tissue during surgery, and is often the target for filler treatments in “Liquid Rhinoplasty”.

Liquid rhinoplasty is the use of Hyaluronic Acid Fillers (similar to the ones used in lips and cheeks) to shape and contour the nose.  In many instances, this treatment can be performed in 30-45 minutes, can last about 6-12 months, and can create subtle, refined changes that mimic a rhinoplasty.  Though the changes are not as powerful and are temporary, it can be a good “test drive” to see if rhinoplasty is right for you. 

No surgery is benign. Even the simplest procedures have very real risks for major and minor complications, even in the hands of the world’s best surgeons. Dr. Abtahi makes every effort to optimize you for surgery and mitigate any foreseable risks to ensure a smooth intraoperative and postoperative course.  Though we will conduct the procedure with the utmost caution and safety, it is important to know some of the complications specific to rhinoplasty.  They include: 

  • Cerebral spinal fluid leak secondary to basilar skull injury
  • Septal perforation, which occurs when the patient develops a hole in the midline division between the left and right nares. This can cause crusting, irritation, and whistling while breathing  
  • Specific to preservation rhinoplasty, the dorsal hump can recur requiring revision surgery to resolve
  • Difficulty breathing secondary to narrowing or blocking the airway
  • Asymmetry or deviation of the cartilage 
  • Unfavorable scarring 
  • Infection
  • Massive bleeding

For patients’ safety and peace of mind, Dr. Abtahi enrolls 100% of his patients in CosmetAssure, which is a unique type of insurance that covers complications after elective plastic surgery.  This added benefit ensures that should an unexpected complication arise requiring an emergency department visit, hospitalization, or urgent surgery, portions of those costs will be covered.  More information about the benefits of this fantastic program can be found at https://cosmetassure.com/for-the-patient/?amp=1 

Septoplasty is different from rhinoplasty in the sense that ONLY the septum is addressed during a septoplasty. The septum is the cartilaginous division between the left and right nasal airways. Individuals who may have had previous trauma can fracture that cartilage or portions of their nose, causing the septum to deviate to one side or the other in an “S” shape or “C” shape. In severe instances, this can actually obstruct the nose making it difficult to breath.  

A septoplasty often addresses ONLY the functional component of the nose and rarely changes the cosmesis of the outside.  Rhinoplasty on the other hand (aka Septo-Rhinoplasty) addresses BOTH the functional and aesthetic components of the nose and are performed in tandem in the same procedure. For example, sometimes, people with a more bulbous nose want it sculpted into a more refined tip.  In this instance, cartilage may be harvested from the septum in order to change the outward appearance of the nose — hence the name septo-rhinoplasty.

The short answer — YES!!!  Multiple procedures can be combined with rhinoplasty, whether it’s other facial aesthetic procedures (brow lift, eyelid surgery, etc), neck contouring, breast augmentation, or body contouring. The caveat, however, is the total length of the surgery, which ultimately determines the upper limit of what can be done in combination. Other logistics must be considered as well, such as a Brazilian Butt Lift (BBL) in combination with a rhinoplasty, which would likely NOT be a good combination since the patient would be required to lay face down to perform fat transfer to the buttock.  Since Dr. Abtahi is well versed in aesthetic surgery for the entire body, he is more than happy to work with each patient to develop their unique surgical gameplan that meets their goals in the least number of surgeries possible. 

Every nose is different and providing a baseline cost is very challenging.  Before determing price, Dr. Abtahi really values the opportunity to meet and evaluate his patients to determine their specific goals, review their medical history, and establish a unique plan that will provide the best results.  Consults can be conducted in the office or virtually, with more accurate prices provided after the consultation as estimates can vary wideley based on anticipated time in the operating room, the operating room facility costs, and other factors such as the use of cadaveric rib graft. Since procedures are catered to each patient, the price can vary from $10,000 total fees to as high as $30,000 or more.

Functional rhinoplasty can be covered by insurance in some cases. However, in very few instances, aesthetic rhinoplasty MAY be covered, most frequently for congenital disorders such as cleft palates that affect nasal appearance. 

Rhinoplasty results should last a lifetime!

We encourage our patients to review the following forms before scheduling a procedure: 

We try to make the preparatory process very simple for you. Prior to your surgery date, we will meet for a pre-operative visit, during which we will give you a detailed list of medications to avoid, your post-operative instructions, a bag of all the supplies you’ll need to take care of yourself, as well as send in prescriptions to your pharmacy.  It’s best to fill the prescriptions prior to your surgery date, so it’s one less thing you have to do after the fact.  Be sure to share your post-op instructions with whoever is helping to take care of you so that you are both familiar with the instructions and restrictions before the surgery even takes place.  Meal prepping is also beneficial.

Most patients feel comfortable returning to work or social obligations 7-10 days following their rhinoplasty. On average, at one week, about 50% of your swelling will be gone. At two weeks, about 70-80% of your swelling will be gone. At two months, about 80-90% of your swelling will be gone — most of which will reside in the tip because of the dependent nature of the lymphatic flow.

While most patients feel comfortable returning to work around 7-10 days after rhinoplasty, this timeline may depend on the type of work you do. Patients with desk jobs or patients who work from home will easily be able to fit in this timeline. Patients with strenuous jobs or jobs that put the nose at risk of an injury should wait at least two weeks to return to work, knowing that the nose is more fragile than normal for 4-6 weeks post-op.

In spite of what most people think, the majority of our patients have very little pain following their rhinoplasty procedure. Many patients are able to get by with over-the-counter medications or non-narcotic prescriptions. However, you will receive a prescription narcotic just in case you need it.

Rhinoplasty obviously serves to improve the appearance of the nose, but it often enhances the function of the nose simultaneously. Having a nose that functions well in addition to looking good is the ultimate goal. Additionally, the extra level of confidence and boost in self-esteem that many patients experience after rhinoplasty should not be overlooked.

Patients often get “hung up” on this inconsequential designation. The only thing that separates the two is a small well-camouflaged incision across the columella of the nose. Most of Dr. Abtahi’s rhinoplasties are performed “open” because he feels that it allows for more exposure and precision when structurally contouring and refining the nose (particularly the tip).

The function of the nose is always addressed during every rhinoplasty that Dr. Abtahi performs.  Having a nose that functions well in addition to looking good is the ultimate goal. Most of the time, Dr. Abtahi performs a septoplasty if for no other reason than to harvest cartilage for building structure during the rhinoplasty. Additionally, he usually supports the airway with additional grafts.