Perhaps no other plastic surgery procedure is as challenging as rhinoplasty, or cosmetic surgery of the nose. Obtaining consistent, excellent results require the careful sculpting of cartilage and bone to create a nose that appears natural and aesthetically appealing. As a board certified facial plastic surgeon originally trained and board certified in otolaryngology, performing on average four to five rhinoplasties weekly, Dr. Epstein understands not only what makes the nose look attractive, but also how to preserve its structure and support to assure clear breathing passages and long lasting cosmetic results.
While there are certain standards of beauty with the nose, the reality is, the definition of an attractive nose is largely subjective. Many people are happy with the nose they have, despite such “imperfections” as a bump or protruding tip. However, if an individual is bothered by the appearance of the nose, rhinoplasty can, when performed properly, create a nose that is much more attractive to the individual. Undesirable features that can be improved include: a wide or undefined tip; a crooked or curved appearance; an overly large bump; a tip that droops, especially with smiling; a wide bridge; and others. Some of these features are ethnic traits that are inherited, others the result of prior plastic surgery or non-surgical prior trauma.
With his 20 years’ experience performing primary and revision rhinoplasty, Dr. Epstein’s approach is to create a nose that is in harmony with the rest of the face, is natural appearing, and is attractive most importantly to the individual. In order to facilitate communication between surgeon and patient, Dr. Epstein utilizes computer imaging to provide a visual component to the dialogue, showing the patient what is both a realistic and aesthetic result of the surgery based upon the patient’s goals. The patient will receive these imaging photos by email usually within two days of the consultation, and has the opportunity to provide feedback on what is liked and what changes are desired. This back-and-forth communication is invaluable in the planning of the procedure.
Rhinoplasty is an outpatient procedure usually performed in our accredited office operating rooms under twilight sedation. Provided safely by his anesthetist of more than 15 years, twilight sedation assures that the patient neither feels nor remembers anything, yet breathes on his/her own. Dr. Epstein also has privileges at South Miami Hospital, located across the street from the office, where procedures are performed when requested or medically indicated.
Nearly all of his procedures are performed by the external, or “open” approach. With a single incision made right along the bottom of the nose, excellent visibility of the entire nose enables Dr. Epstein to more accurately assess the anatomy and deficiencies of the bone and cartilage, permitting correction through sculpting, suturing, rasping, and other techniques, while leaving the support mechanisms of the tip intact, assuring the most stable and longest lasting results.