A “Nose”-worthy Journey: Dr. Ruslan Zhuravsky’s Guide to a Successful Rhinoplasty
Rhinoplasty isn’t your typical errand or casual cosmetic procedure. When performed successfully, it can bring aesthetic harmony to the face and great joy to the patient. However, a poorly executed surgery can leave patients deeply disappointed. There are many factors to consider when preparing for rhinoplasty, but many people don’t even know where to begin this journey.
Dr. Ruslan Zhuravsky, a board-certified facial plastic surgeon with expertise in rhinoplasty, is very passionate about this type of surgery and the impact it has on patients. He has seen how the complexities of rhinoplasty and the abundance of both information and marketing have made it difficult for patients to achieve the best results. That’s why Dr. Z has put together a guide to help patients navigate the important aspects of this exciting yet sometimes overwhelming surgery.
Use the tips below to help set you on the right path to a successful rhinoplasty.
Tip 1: Recognize the complexity of rhinoplasty
Rhinoplasty is a unique surgery with many nuances, even when compared to other procedures in cosmetic plastic surgery. Most procedures have a set of steps a surgeon follows every time, and variation between surgeries comes from the overall approach a specialist goes for and how they perform the necessary steps. With rhinoplasty, regardless of the chosen approach, the steps themselves are unique to each patient’s anatomy.
When a surgeon follows a standardized set of steps for each surgery, I call it “generic” rhinoplasty. These are usually relatively quicker procedures because the chosen set of steps often relies on easier and simpler techniques. Such surgeries may actually yield decent results in a few cases. However, they can also produce results that are either fake, inadequate, or even botched.
For example, a bulbous (round) nose tip can be treated simply and quickly by cutting away some of the extra cartilage and using stitches to tighten the cartilage of the tip. This can give the desired effect when the anatomy is right. However, it can also result in retracted nostrils, collapsed nasal valves, a tip that is too sharp, or a tip that appears different but still too round.
This all sounds very intimidating and confusing, but rest assured, a successful rhinoplasty does not require you to know all the nuances that surgeons learn over many years of training. The takeaway is for you to recognize that these complexities exist. I find this to be an important point because I have come across many revisions where the patients expressed that their initial surgery was supposed to be “simple”.
They often say things like “it was just a tip reduction” or “it was just a hump”. The nose is rarely simple. It requires understanding the ideal outcome based on the patient’s goals and facial aesthetics, as well as how to achieve those goals based on the patient’s specific anatomy.
Tip 2: Talk anatomy
Although you don’t have to be a human physiology guru, it’s a good idea to learn the basics of nasal anatomy to be able to better understand what kind of procedure you’ll be undergoing.
Don’t be shy to ask your surgeon about the specific reasons behind your nose’s appearance and what can be done about them. This will help you figure out if the surgeon is approaching your nose (and likely all the other patients’ noses) from a generic perspective or genuinely taking your unique anatomy into account.
Are you dealing with a prominent hump? Or is it rather a shallow radix (that spot between the eyes)? Is your nose drooping or are the nostrils flared upwards? Perhaps the tip is too round due to wide cartilage, or perhaps the cartilages are too curved and misaligned. The possibilities are endless.
Again, it can be tough for you as a patient to navigate all these nuances and you certainly don’t have to. Just pay attention to how the surgeon answers your questions and compare responses from different surgeons. This will give you a sense of how well they understand your unique nose. Sometimes, the anatomy might not be crystal clear, and that’s okay. A good surgeon will explain different possibilities and variations. They should also be able to describe how they plan to address those potential issues.
When I evaluate a nose at a consultation, I make sure to clearly communicate my observations to the patient. I explain any concerns or suspicions I may have and outline my plan to address potential problems. While there may be uncertainties that can only be fully assessed during surgery, I assure my patients that I’m well-prepared to handle expected scenarios once we’re in the operating room.
The key takeaway here is to have a basic idea of nasal anatomy and not be afraid to discuss it with your surgeon.
Tip 3: Make sure your surgeon understands your rhinoplasty goals
I cannot stress enough how important it is to have clear communication when it comes to cosmetic surgery and nose jobs in particular. No matter how great a doctor is, if they don’t know what you want to get out of the surgery, chances are you might end up disappointed.
The aesthetic appearance of the nose and its harmony with your facial features can be just as complicated as the anatomy. It is important for you and the surgeon to understand the desired outcomes and how they would look on YOUR face.
Expressing specific areas of concern and describing the changes verbally is a good start, but it is not enough. Statements like “a more refined tip” or “removal of the hump” give an overall idea, but they can mean many different things. They can even look differently than you imagined when applied to your face. Pictures of other people’s noses provide information on the types of features that you find attractive in a nose, but they still fall short as they are not of your actual face.
I have found computer morphing software to be an invaluable tool for communicating with my patients. It allows me to really understand their desires and show them realistic possibilities. Those general statements can now be translated into a visual representation and patients can see how they would look. This is so very important because in most cases, when I show patients what they described, we often have to make additional changes and tweaks to make the nose natural and closer to what they had imagined.
For example, as we remove the hump and lower the bridge, we may find that we also have to deproject the nose, deepen the radix, or even derotate the tip. A good rhinoplasty surgeon will be able to use these images to guide the patient through realistic possibilities of what they described, pointing out important features and considerations along the way.
I find this process to be more like a journey that I take with each patient. I morph the images and guide the patient based on their comments and reactions. In the end, we arrive at an image that resonates with them and I can see the patient is excited. The process of morphing the photos together with the patient and their reaction to the final outcome help me know we have come to an understanding and achieved clear communication.
Besides assisting with communication, computer-morphed images also help the patient understand what they really want. Some patients say they want to look like themselves but with a different nose, others say they only want minimal changes, and yet others believe the nose will make them look like a completely different person. Morphed imaging allows patients to see the impact that their desired changes will have on their overall appearance.
Bottom line: both you and the surgeon must have a clear understanding of what you want out of your nose job. Computer-morphed images, especially when done together with the surgeon, can be a very powerful tool here.
Tip 4: Choose a specialized rhinoplasty surgeon
A nose job is a complex surgery with many nuances. It requires skill, experience, and – this is also key – aesthetic savviness. You will want to find a specialist who knows what they’re doing and have profound expertise in rhinoplasty. And this task can be harder than patients think.
Some cosmetic surgeons may be more well-versed in other types of procedures such as breast augmentation or facelifts. Yes, they have done nose jobs before but they might not be familiar with the wide array of aesthetic possibilities and techniques required for a high-quality rhinoplasty. This is the type of surgery surgeons must be deeply immersed in and perform frequently to be able to produce consistently great results.
On the other hand, some doctors who perform a large number of rhinoplasties might prioritize quantity over quality. They churn out procedures like an assembly line, using generic techniques that might work okay for some patients, but end up giving not-so-great results for others.
Another common mistake patients make is choosing their surgeon based on location, hospital affiliations, background, and other factors that do not really play a role in that particular surgeon’s actual abilities in rhinoplasty. You have to evaluate each surgeon for their own expertise.
Bottom line: it’s crucial to find a surgeon who specializes in rhinoplasty and does it frequently. The surgeon should be able to examine your nose, explain their detailed and individualized assessment, understand your goals, and come up with a surgical plan for treatment. They must also be familiar with many different techniques as noses can be tricky and may require a change along the way.
Tip 5: See how you feel about (and around) the surgeon
Yes, aligning your expectations and figuring out the technical aspects of the rhinoplasty is key, but there’s one more ingredient to a successful nose job. You should trust your doc and feel comfortable around them. It will put your mind at ease and make the surgery a more pleasant experience.
It’s important to note here that not every skilled surgeon is a ray of sunshine. A specialist might be too quiet, too straightforward, or too cold to a patient’s liking – after all, plastic surgeons are people too. What’s really important is that you should at least feel confident that your surgeon is genuinely invested in achieving the best possible outcome for you. You should have an unspoken (and spoken) understanding that the doctor will go above and beyond to make it happen.
Since rhinoplasty is difficult, even the most experienced surgeons run into difficulties during surgery. You want a surgeon who not only has the abilities and knowledge to solve those problems, but also one who will dedicate the necessary time and effort to achieve the results you want.
So, trust your gut and choose a rhinoplasty surgeon who not only has the expertise but also gives you that sense of reassurance.
Tip 6: Cut through the marketing noise
It’s easy to get caught up in all the fancy marketing tricks plastic surgery clinics use these days. They love to lure you in with different approaches, like open or closed rhinoplasty, preservation techniques, and other vague words. Others attract new clients with shiny new equipment or even fancy interior design of the clinic space.
But here’s the scoop: all that stuff doesn’t really determine if you’ll end up with a great result. The real magic happens when your surgeon truly gets what you want and knows how to find the right approach to your unique nose. So don’t be swayed by the marketing hype. Focus on finding a surgeon who understands your goals and knows how to make them a reality. That’s the real deal for a successful rhinoplasty.
Tip 7: Look closely at the before and after photos
Naturally, you’ll want to see the before and after pictures of a rhinoplasty surgeon’s work. If you know what to look for, you can spot if the specialist is a good fit for you.
The first rule is: ask for more than a traditional frontal and side view combos. Yes, the side profile picture is the easiest way to show the transformation a nose has undergone during rhinoplasty but it doesn’t tell you the whole story. So don’t just get fixated on that nose bump magically disappearing. Instead, focus on whether the new nose harmonizes with the face and looks natural from all angles in different pictures.
Also, keep an eye out for cookie-cutter results that seem like they’re off an assembly line. Patients have different rhinoplasty expectations, so it’s unlikely they all asked for the same nose. If you spot too many similarities, it could mean the surgeon is sticking to a one-size-fits-all approach or they may be showcasing only the few cases that turned out well. Be on the lookout for any signs of an “obviously operated” appearance.
Tip 8: Go on several field trips (aka consultations)
Don’t rush your decision. Take your time and schedule consultations with several different rhinoplasty surgeons. Yes, there may be a cost involved in these field trips since good surgeons take the time to analyze and explain your unique situation. But believe me, it’s an investment that will pay off because you’ll get a very clear idea of which specialist is the right fit for you.
Multiple consultations not only give you the ability to “feel out” different surgeons, but also the opportunity to better understand your nose and what you want. You may have different surgeons with different opinions on how best to approach your nose and receive different suggestions as to the final aesthetic. In any case, each consultation is a learning opportunity for you because you can compare the responses.
When patients are reasonably close (a few hour drive), an in-person consultation is the best option. This allows surgeons to feel the nose and examine it internally. However, a video call can also be fine, especially with the ability to share screens and perform computer-morphed imaging.
So don’t hesitate to gather multiple opinions to see which surgeon aligns with your needs and makes you feel most at ease.
Aaand that’s a wrap! I hope this advice helps you find the right rhinoplasty surgeon and achieve the fantastic surgery results you’re going after.
About Dr. Ruslan Zhuravsky
Dr. Ruslan Zhuravsky is a facial plastic surgeon and the leading specialist of the Miami-based Z Face Plastic Surgery. Dr. Zhuravsky and his team are assisting patients in attaining facial balance, resulting in increased confidence, higher self-esteem, and better quality of life.
Request a consultation with Dr. Zhuravsky and begin your journey toward the face of your dreams.