Dr. Levens' Parkland Life Magazine Articles

Anatomy of a "Nose Job"
By David J. Levens, MD, PA, FACS       

Nasal reshaping (rhinoplasty) is the 4th most popular cosmetic surgery in the U.S. and it has one of the highest ratings for patient satisfaction.
           
That’s probably because It can dramatically change the overall appearance of the face by creating a better balance of facial features.  It can correct results of aging such as a drooping nose tip, or deformities such as a large hump or bulbous tip.  It can change the size of the nasal bridge, reduce nose size and width, change nostril shape or the angle between nose and upper lip, and reshape the tip. 
           
Who is a candidate for rhinoplasty?  While nose reshaping is often associated with teenagers, national statistics show that 89% of all rhinoplasties are performed on men and women over 18.  Indeed, rhinoplasty is a growing favorite among adult males desiring a younger, more attractive look for career purposes.  Generally, any healthy person aged 16 or older who is dissatisfied with the appearance of his/her nose is a good candidate for this procedure.
           
Because changes to the nose can so significantly alter a person’s appearance, a great deal of care must taken to evaluate, plan and execute the rhinoplasty.  The first step is a candid talk with your plastic surgeon to discuss specific changes you wish to make and find out how those changes will impact other facial features.  Overly corrected noses can appear unattractive and unnatural.  The goal is to correct negative elements while preserving the patient’s individuality so the reshaped nose will blend more aesthetically with other features.  Ideally, after the surgery, the patient will hear comments like, “Gee, you look great”, and not “Hey, you got a nose job.”
             
Also, the particular characteristics of the patient’s skin and cartilage impact the degree of correction possible.  For example, thick or oily skin may somewhat limit the amount of definition that can be produced in such areas as the nasal tip.  Since many nasal structures are vital to overall support and function of the nose, changes must be made cautiously, and in some cases may have to be limited in order to preserve support and nasal function. 
          
Here’s a brief summary of the procedure:
           
Rhinoplasty is an out-patient surgery.  It begins with the plastic surgeon making small incisions, sometimes inside the nose, sometime externally (in which case they are placed in concealed areas.) Then the surgeon carefully alters and reshapes the structures which make up the framework of the nose, including cartilage and bone. The skin is then re-draped over the new framework to achieve the desired appearance. Internally, deviated areas of the nasal septum are straightened to maximally open the airways while preserving the support function of the septum.  Finally, tape, a nasal splint and packing are applied to secure and cushion the changes made to the framework of the nose.
           
The packing is removed 1-2 days after surgery, and the splint is removed within a week.  The patient can see the refinements in the nose immediately after the splint is removed. Improvement in definition will continue for several weeks or months. Some swelling and bruising will develop in the first 24 hours after surgery, but will begin to decrease rapidly by the third day.  Patients report very little discomfort following nose reshaping surgery.  Most describe a sensation of fullness or very mild discomfort, which lasts a day or two. 
           
The vast majority of patients return to work and normal social activity within 7-14 days or less.  We recommend that aerobic or strenuous activity not be resumed for 2-3weeks. 
           
Now for those who might be wondering which procedures are even more popular than #4 rhinoplasty, the answers are, in order:  liposuction, breast augmentation and eyelid surgery.

Interested in seeing past articles? See our archived Parkland Life Articles page.

David Levens, MD, PA, FACS has been practicing cosmetic surgery in Coral Springs since 1989.  In addition to his private practice at 1725 University Drive, Dr. Levens has served as Vice Chief of Staff and Chief of Surgery at the Coral Springs Medical Center. He is Certified by the American Board of Plastic Surgery and is a member of the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons.  Dr. Levens has been cited repeatedly in Miami Metro Magazine’s annual lists of “Best Doctors in South Florida”.  He earned his medical degree at Columbia University, New York, and served residencies in general surgery and plastic surgery at Montefiore Hospital & Medical Center, New York.  He lives in Coral Springs with his wife, Linda, and their two children, Danielle and Ben. He can be reached at 954-752-1020 or www.DrLevens.com