Rhinoplasty in NYC

There are various types of rhinoplasty surgeries. The procedure may be categorized as functional or cosmetic, full rhinoplasty, primary or revision rhinoplasty, and open or closed. Dr. Rapaport customizes every procedure to the individual patient rather than offering only one type or technique. Rhinoplasty procedure options include:

• Full rhinoplasty vs. tipplasty: This is the most common form of rhinoplasty Dr. Rapaport performs. It typically involves working both on the nasal bridge and the tip of the nose. A tipplasty refers to surgery only on the tip of the nose.
• Cosmetic vs. functional rhinoplasty: Some patients undergo rhinoplasty to improve the appearance of their nose, such as reducing the size of an overly large nose, removing a bump, or minimizing flared nostrils. Others have had an injury to the nose and need surgery to improve function and breathing.
• Reduction rhinoplasty vs. augmentation rhinoplasty: Reduction rhinoplasty refers to a procedure that reduces the overall size of the nose, whereas an augmentation (enhancement) rhinoplasty increases or enhances the nose size with the patient’s own tissues or other materials, which are added to the bridge or tip of the nose. Dr. Rapaport most often performs reduction rhinoplasty.
• Primary vs. revision rhinoplasty: Primary rhinoplasty refers to a first-time rhinoplasty, while secondary or revision rhinoplasty means that the patient has had a rhinoplasty performed earlier and is having a revision.

Dr. Rapaport most often performs full reduction rhinoplasties. Typically, patients requiring this type of rhinoplasty have a bump on the bridge of their nose (dorsal hump) and wish to refine the tip of the nose. This procedure involves shaving or rasping the bone and cartilage that make up the bump. After the hump has been reduced, the bridge of the nose appears widened, referred to by plastic surgeons as an open roof deformity. This temporary intra-operative deformity is eliminated by moving or fracturing the nasal bones, thereby closing the open roof deformity.

The tip of the nose is typically treated with conservative cartilage removal or internal suturing to improve its shape. If the base of the nasal tip appears wide, alar base resections may be performed to narrow it. 

Open vs. Closed Rhinoplasty

For the past 15-20 years, there has been a continuous discussion and debate among rhinoplasty surgeons on whether the open or closed rhinoplasty technique is best. While some surgeons perform all of their rhinoplasties with only one of these techniques, Dr. Rapaport individualizes his approach depending on the anatomy, complexity, and goals raised in each case.

Open rhinoplasty involves a small incision on the tip of the nose between the nostrils (the columella), giving the surgeon a full view of the nasal tip cartilage. This open technique can allow for more precise suturing, grafting, and overall manipulation of the tip. However, “opening” the tip results in increased swelling, a prolonged healing period, and a columellar scar, though this is inconspicuous.

Closed rhinoplasty uses incisions within the nostrils. This offers faster healing, less pronounced swelling, and no visible scar. However, closed rhinoplasty limits the surgeon’s access and visibility, so it is not always suitable for complex cases.