San Diego Nose Job Specialist | La Jolla Rhinoplasty Surgeon

Your nose is a prominent facial feature and plays a major role in determining how you look. Rhinoplasty (nose job) surgery is performed to improve the shape and  proportion of your nose. A well-defined, contoured nose will enhance and harmonize with your other facial features.  Dr. Kolstad’s most important goal with every rhinoplasty is achieving a perfectly natural result.  Period.  Your nose should be in balance with your eyes, cheeks, lips and chin.  

The changes you achieve with surgery should be for you to enjoy without other people knowing that you had something done.  When performed correctly rhinoplasty should lead to natural appearing results that even the best rhinoplasty surgeons are unable to tell if it was the nose you were born with or not.

In short, rhinoplasty surgery is complicated. Without question, rhinoplasty requires a surgeon who specializes in plastic surgery of the face. Dr. Kolstad will not take any shortcuts during your surgery, spending an average 3-3.5 hours making sure that your nose will look and function at its best.
Dr. Kolstad’s analytic approach distinguishes him from his colleagues. He believes in a customized approach that is specific to the way that your nose will harmonize with your face.

Dr. Kolstad learned his technique from one of the best rhinoplasty surgeons in the world. He spent an entire year in New York working exclusively with one of the world’s premier Facial Plastic Surgeons.

“You do not learn plastic surgery from a book or by watching a video. You learn to become the best rhinoplasty surgeon by working with the best rhinoplasty surgeons.”

He will illustrate his surgical goals and direction using state-of-the-art computer imaging software. During the image enhancement session, you will have the opportunity to express your likes and dislikes about the shape of your nose. Your aesthetic goals will be incorporated into the image enhancement. You will have the final say in determining if this is the right nose for you.

Remember, if it doesn’t look natural, it doesn’t look good. Dr. Kolstad’s goal is for you to enjoy the new shape and contours of your nose in the mirror and in photographs. Your friends and colleagues should compliment you on the shape of your nose without ever recognizing that it was done.

Look around, there are no pinched nasal tips on this site!

At Kolstad Facial Plastic Surgery our patient safety is paramount. Dr. Kolstad believes the safest place to perform a rhinoplasty is in a state-licensed surgery center staffed with board-certified anesthesiologists and nurses. Many doctors try to increase their revenue by performing surgeries in their offices without the assistance of anesthesiologists or nurses.

During his rhinoplasty procedures Dr. Kolstad prefers an “open approach” to the nasal framework. With this technique, incisions are primarily located inside of your nostrils, with only a small incision placed across the columellar skin. When sutured together properly the columellar incision heals so well that it is very inconspicuous.

The open approach allows for a direct view of the nasal structures leading to a more predictable result. During a rhinoplasty procedure Dr. Kolstad will use cartilage from your septum, (possibly ear or rib in revision cases) to enhance the definition of your nose and to provide support.
During your consultation Dr. Kolstad will evaluate the structure of your nose in relation to the shape of your face, the thickness of your skin, your height and your age. He will work with you to try to make your nose complement your other facial features.

IS SAN DIEGO RHINOPLASTY RIGHT FOR ME?

best rhinoplasty surgeon san diego

* Individual Results May Vary

The following are some concerns that can be addressed during rhinoplasty surgery:

  • A nasal tip that droops, is over projected, is asymmetric or is too broad.
  • Nostrils that flare when you smile or collapse when you breathe in.
  • A crooked bridge or dorsal deviations.
  • A hump on the bridge of the nose.
  • Deviated septum, inferior turbinate hypertrophy or difficulty breathing.

Frequently Asked Questions About San Diego Rhinoplasty Surgery

rhinoplasty-incision

The W-shaped incision used for open rhinoplasty is depicted in the image.

A) The external incision is placed on the narrowest part of the columella and shaped like a “W”. When repaired using plastic techniques this incision can be difficult to find and tends not to bother most patients.

B) There are two internal incisions hidden on the under surface of the nostrils and one internal incision on the septum.

incisions-for-nostril-and-alar-base-reduction

A) If the nostril is too large a “pie” shaped wedge is removed where the nostril inserts onto the face. Even when repaired using plastic techniques this incision will appear like a faint red line that can be visible to a viewer.

B) If the nostrils are too wide a “pie” shaped wedge is removed from the base of the nose. When closed using plastic surgery techniques this incision is sometimes visible as a faint red line.

Dr. Kolstad recommends taking 1-2 weeks to recover from rhinoplasty surgery.  There are several visits during the first week to check on the healing and make sure that all of your questions are answered.  Many of our patients do not complain of significant discomfort during the recovery period.  Typically by two or three days after surgery many patients require only Tylenol for discomfort. Prescription pain medicine is made available to you and we recommend that you have it available in case it is needed.

For the majority of our patients the recovery follows a similar experience.

Day after surgery: Dr. Kolstad removes the small packing from the nose.  He reviews the instructions for cleaning and moisturizing the nose to prevent scarring.

Four days after surgery:  The external sutures are removed and the incision is covered using steri strips.

Seven days after surgery:  The rhinoplasty splint is typically removed seven days after surgery.  The nose will look swollen but many people feel comfortable enough to return to work. For people wanting to take extra time to make sure the bruising is gone we recommend taking two weeks to recover.    Dr. Kolstad reviews instructions including nasal taping and massaging exercises.  Dr. Kolstad advises initiating scar creams over the columellar incision.

Fourteen days after surgery: Dr. Kolstad meets with the patient, examines the internal incisions and clears them for full activity.

Three weeks after surgery: At this point it is safe for most patients to wear sunglasses or resume contact sports / activities.

Six weeks – 12 months after surgery:  Dr. Kolstad uses many injectable medicines to recontour the nose throughout the year.  Some patients are recommended to return every month for injectable steroids some are seen less frequently.  Dr. Kolstad takes a very hands-on approach during the recovery in order to achieve the best possible result.

It takes a full 12 months for 100% of the swelling to be completely gone. The nasal skin must shrink-wrap to the new framework and definition. This takes time. Throughout the postoperative period, Dr. Kolstad will use medicines to contour the nasal skin and enhance your result.
It is common for some bruising under your eyes after San Diego rhinoplasty surgery. With frequent use of ice packs the bruising is typically minimal and does not bother the majority of people. Dr. Kolstad recommends that his patients obtain cover-up make-up prior to surgery to help camouflage any postoperative bruising.

A frequent concern of our patients is looking “plastic” after a La Jolla rhinoplasty procedure. There are limitless examples of unnatural, operated results. When surgeons remove too much structure, the nasal tip can look overly narrow.

It is very important to choose a San Diego plastic surgeon that specializes in operating on the face. Dr. Kolstad is an expert in nasal cosmetic surgery and is known as the face specialist, because put simply, that is all he does.

The rhinoplasty cast will stay on for one week. After removal of the splint, your nose will be a little swollen and “puffy”. However, even when swollen, your nose will look better than it did before surgery.

rhinoplasty scar

A healed incision 12 months after open rhinoplasty is depicted in the image.  * Individual results may vary.

The internal incisions are on the undersurface of the nostrils and the septum and are rarely visible. The incision on the columella heals very well and is frequently only barely perceptible.

What Is The Best Rhinoplasty For Me?

Every face is unique. Dr. Kolstad’s expertise in rhinoplasty allows him to design a procedure that fits your features, ethnicity and background.

Open and closed rhinoplasty are different types of surgeries designed to improve the shape and appearance of the nose. Both procedures primarily use incisions placed inside of the nose to access the nasal cartilage. Open rhinoplasty indicates an incision placed on the columellar skin. The columella is the strip of skin located between the nostrils. The most common incision in this area is shaped like a “w” although a “z” or “inverted v” incisions can be used as well.

With the use of a columellar incision the skin can be elevated from the underlying cartilage and bone. This allows the surgeon to view the nasal framework in its natural orientation and position. Direct visualization of the nasal tip cartilage allows for more precise cuts and reshaping.

The disadvantages of open rhinoplasty are a visible scar on the skin and more swelling after surgery. For the majority of patients the external incision resembles a thin line on the skin and does not draw significant attention.

The earliest form of cosmetic nasal surgery popularized in the 1970s employed the closed rhinoplasty technique. Closed rhinoplasty places all of the incisions on the inside of the nose and avoids external scarring. Closed rhinoplasty can be performed in 90 minutes leading to less swelling after surgery. This type of rhinoplasty is still popular today and has many contemporary indications.

Dr. Kolstad used the closed technique to address humps on the nose or crooked nasal bones. He does not perform changes to the nasal tip cartilage using closed rhinoplasty. Dr. Kolstad believes that the use of nasal tip grafts lead to superior outcomes and require an open approach.

Limitations of closed rhinoplasty are the inability to visualize nasal tip cartilage in it’s natural position while making incisions. Plastic appearing nose jobs, pinched, asymmetric tips and nasal obstructions are common shortcomings that can happen when using the wrong technique for the wrong nose. Securing cartilage grafts used to reshape and support the nose can be difficult to impossible when using the closed rhinoplasty approach.

The decision to perform an open or closed rhinoplasty is best determined by your surgeon. Both techniques have advantages and limitations. Depending on your features and goals you may a better candidate for either technique. Dr. Kolstad does not have one surgery for every nose and different options for your nose will be discussed during your consultation.

Advantages of open rhinoplasty:
– The cartilage is viewed in its natural orientation when cuts are made leading to more precise incisions.
– Cartilage grafts can be used to reshape and strengthen the nose.
– Only suitable approach for large revision rhinoplasties.
– Can correct anatomical breathing obstructions as well as improve the nasal appearance.

Disadvantages of open rhinoplasty:
– The surgery typically takes longer than closed rhinoplasty leading to more swelling and scar tissue after surgery.
– The “w” shaped incision creates an small scar on the skin.

Advantages of closed rhinoplasty:
– Less swelling after surgery.
– Less internal scarring of the nasal soft tissue.
– No external incisions or scarring.
– The surgery can be peformed in 90 minutes which should reduce the cost of surgery.

Disadvantages of closed rhinoplasty:
– Cannot visualize the cartilage or bone in it’s natural anatomical position. This leads to less precise cuts and refinements.
– Cannot suture bridge cartilage increasing the risk of collapses after surgery.
– Difficult to apply cartilage grafts used to reshape the nose.
– Difficult to impossible to perform challenging reconstructive rhinoplasty through a closed approach.

One of the most important aspects of cosmetic surgery is choosing the right surgeon. In California, and in particular Southern California there are hundreds of providers all seeming to offer the same service. The good news for patients is that most surgeons performing rhinoplasty are well-trained and can achieve good results. Also, being located in a region that has many providers allows patients to choose a surgeon that is the best fit for them instead of having to choose the only surgeon in town.

Finding the best rhinoplasty surgeon requires a bit of research, but all the necessary information is only a few clicks away.

1. Check out the results:

Dr. Kolstad always says that the most important thing a patient can research is the pictures. How do you find the best rhinoplasty surgeon? Study the before and after rhinoplasty images. A great rhinoplasty surgeon should have great results. More than any other plastic surgery rhinoplasty relies on artistic creation. Every surgeon will have a different philosophy on what makes a nose beautiful. Make sure that your surgeon creates noses that are consistent with your goals for the procedure.

2. Check for board certifications:

Dr. Kolstad believes the two medical boards that best regulate the credentials of their members are the American Board of Facial Plastic Surgery and the American Board of Plastic Surgery. Your surgeon should be board certified/eligible by one of these boards. Check the website of your state medical board to see if a surgeon has any actions / censures against them. Bad apples will typically have multiple complaints.

3. Check for hospital privileges:

Your surgeon should be able to perform the rhinoplasty at a local hospital. Hospitals go through lengthy review processes before granting surgical privileges. Even if the nose job surgery is scheduled to be done in an outpatient center, every surgeon should be credentialed at a nearby hospital.

4. Check out the doctors reviews:

Read what other people are saying about your surgeon. Both positive and negative reviews can be insightful. Two of the most common websites for reviews about plastic surgeons are:
1) Realself.com
2) Yelp

And finally, go with your intuition. If something doesn’t feel right, it probably isn’t. Be suspicious of a provider that offers the same procedure at half the cost of everyone else in town. Make sure that your surgeon is a person that you can trust and someone who will be with you through the end.

One of the most common questions we are asked about rhinoplasty is how long does it take to see the final results? The short answer is that it’s complicated. Every patient experiences a unique healing timeline. Dr. Kolstad typically advises patients that it takes a full year for the nose to take its final shape and form.

The good news is that most patients do not have to wait a full year for the nose to look good. They just have to wait a year for the nose to look its best. For example, the skin along the bridge of the nose is very thin. Profile views showing a hump reduction will look significantly better only 2 to 3 weeks after surgery.

The actual time to reach the final result primarily depends on the skin thickness. Thicker skin takes longer to shrink. Most people describe the tip of the nose as looking “puffy” for the first several months after surgery. Throughout the year the ‘puffiness’ refines into a more narrow and contoured nose. People with average thickness of the nasal tip soft tissue will experience mature, final results in about 12 months. Patients with thinner nasal tip skin will heal sooner and those with thick soft tissue can take a year and a half to achieve final results.

The most challenging variable to control in every rhinoplasty surgery in San Diego is the skin. The best rhinoplasty results require an ideal skin thickness. Soft tissue that is too thin is difficult to fix and skin that is too thick is equally as challenging to change.

Nose job surgery is designed to reshape cartilage and bone. Every rhinoplasty surgeon redrapes the skin over the new cartilaginous framework and waits for the soft tissue to shrink wrap to the new form. Skin that is too thin will shrink too much and heal like saran rap. Dr. Kolstad believes one of the most striking changes to Michael Jackson’s nose was the skin becoming too thin. Thin skin accentuates irregularities and imperfections. Thin nasal skin needs to be thickened using open rhinoplasty grafting. Dr. Kolstad frequently ‘thickens’ thin skin with temporalis fascia (flexible soft tissue from the side of the head). The opposite side of the same coin is skin that is too thick.

Thick skin does not shrink. Thick skin frequently leads to an amorphous, round nasal tip blob. Thick skin will camouflage and hide all of the changes that were made to the nasal tip cartilage. For most people there are no liposuction or surgical techniques that can decrease thickness of the nasal skin. The most important way to control thick nasal skin is to identify it before surgery. Patients with thick soft tissue require special grafting techniques to achieve the best results. Dr. Kolstad will typically use shield grafts to make thick nasal tip skin more narrow and refined.

rhinoplasty before and after results

Dr. Kolstad – Double Board Certified Facial Plastic Surgeon

PDFRhinoplasty Before and After Surgery Instructions

Frequently Asked Questions With Picture Explanations:  San Diego Nose Job Surgery

Modern techniques in rhinoplasty use cartilage grafts to reshape, support and strengthen the nose. Earlier forms of rhinoplasty relied on removing cartilage to make the nose skinny. If too much cartilage is removed from the nose the results can be disasterous. Pinched, asymmetric nasal tips are frequently the result of over resected nasal tip cartilage. Nostril collapse and the inability to breathe through the nose are common when the nose is weakened at the time of surgery.
Dr. Kolstad practices the newest form of nose surgery called “open structural grafting rhinoplasty”. Dr. Kolstad borrows cartilage from the septum and sculpts it into tiny grafts applied to the nostrils, the nasal tip, the bridge and other areas of the nose. Cartilage grafting rhinoplasty strengthens the nose and minimizes the risk of nasal collapse or breathing difficulties after surgery.

nasal tip shield graft A nasal tip shield graft is cartilage sculpted into a shape resembling a triangular shield. This type of graft is only used in nasal tip rhinoplasty. The graft is attached to the lower part of the nasal tip cartilage (medial crura) with thin sutures. Dr. Kolstad typically uses cartilage from the septum to create grafts used during rhinoplasty. A shield graft has many useful applications.

1) Rotation: shield grafts can be used to increase or decrease the nasal tip angle of rotation.

2) Projection: shield grafts can increase the projection (the distance the nose sticks out) of the nasal tip. This technique is most commonly used for Asian rhinoplasty. Increasing the projection can make a round, flat nasal tip more refined and angular.

3) Support: strengthening nasal tip cartilages makes them less likely to twist, warp or buckle after surgery. Older rhinoplasty techniques were prone to asymmetric results due to scar contracture during the healing process. Frequently too much cartilage would be removed leaving the nasal tip in a weakened, unsupported state.

4) Symmetry: Dr. Kolstad will commonly use shied grafts to improve the nasal tip symmetry. The right and left tip cartilages can be secured midline at the same height, projection and angle of rotation. If you are concerned about nasal tip asymmetry a shield graft can frequently make the nose more symmetric.

5) Fix nasal tip bifidity: many patients will notice a cleft or shadow in the middle of the nasal tip. Placing a shield graft over the medial crura will eliminate the cleft and make the nose appear more uniform.

spreader graft rhinoplastyA spreader graft is cartilage applied to bridge of the nose. Spreader grafts are most commonly used to straighten a crooked nose or to fix internal valve obstructions. Spreader grafts need to be strong and can only be obtained from septal or rib cartilage. Auricular (ear) cartilage is not stiff or long enough to create spreader grafts.

Dr. Kolstad commonly uses spreader grafts in revision rhinoplasty to fix noses that are asymmetric, crooked or causing nasal obstructions. Nasal obstruction can be common after nose job surgeries if too much cartilage was removed at the time of surgery. The two most common sites causing nasal obstruction are the internal nasal valve (a narrowed bridge) and external nasal valve (nostril collapse). Both types of obstructions can be fixed using cartilage grafts during revision rhinoplasty in San Diego.

 

* Individual Results May Vary.

DCF graft diced cartilage fascia graftA diced cartilage fascia graft (DCF) is used to raise the height of the bridge during augmentation rhinoplasty. A DCF graft is most commonly used in Asian rhinoplasty or African American rhinoplasty make the bridge of the nose higher. DCF grafts are also used in revision rhinoplasty if the bridge of the nose was scooped or reduced too much.

A DCF graft has two components, rib cartilage and temporalis fascia, wrapped together resembling a sushi roll.

1) Costal cartilage: the first part of the procedure is to obtain enough rib cartilage for all of the grafts necessary to complete the rhinoplasty. Rib cartilage can be from the patients own body or from a cadaver. The cartilage is chopped into very tiny pieces, typically less than 1 mm in size. Cartilage pieces measuring more than 2 mm can result in contour irregularities or lumps along the bridge.

2) Temporalis fascia: the temporalis muscle is located on the side of the head. A 2.5 cm incision is created in the temple scalp. The incision is placed on the side of the head where hair can camouflage the scar. Temporalis fascia is a thin but strong material used to wrap tiny pieces of cartilage.

DCF grafts are one of many ways to add height to the bridge of the nose. The advantages of DCF grafts is that they are less likely to warp or bend after surgery. Compared to implants, DCF grafts are less likely to get infected.

Disadvantages of DCF grafts include losing height and widening over time. Temporalis fascia harvesting creates an additional surgical site with the potential for additional complications.

Are you a better candidate for DCF grafts or intact rib dorsal onlay grafts? During your consultation Dr. Kolstad can help you decide which technique is best for your nose.

alar strut graftAlar strut and alar batten grafts are used to support the nostrils in shape and function. Many patients complain of nasal obstruction and tightness in the nose. The most common causes of nasal obstruction are deviated septums and enlarged turbinates. Internal nasal obstruction caused by the septum and turbinates can be addressed during or without a rhinoplasty surgery.

External nasal obstructions are frequently caused by weak, floppy nostrils. If your nostrils collapse with moderate inspiration you my benefit from alar strut grafts. Dr. Kolstad uses cartilage to support and strengthen the nostrils to prevent their collapse. In addition to making the nostrils stronger alar batten grafts can be used to make the nostrils more symmetric. A nasal tip that is crooked and asymmetric can be reshaped using batten grafting.

Dr. Kolstad typically uses septal cartilage for tip grafting but rib (costal) and ear (auricular) are secondary sources.

* Individual Results May Vary.

radix graft rhinoplastyThe height and position of the radix vary across ethnicities. Persons of Asian and African descent tend to have a very low, flat radix. The highest part of the nose typically originates at the midpupil level. Middle Eastern, Hispanic and Caucasion noses have a higher radix, typically at the level of the upper eyelid.

Radix grafting refers to adding height to the highest part of the nose. Very soft cartilage can be placed in this area to straighten a very large dorsal hump. Dr. Kolstad typically uses morsalized septal cartilage or lower lateral cartilage for his radix grafting. Adding height to the top of the nose not only straightens the bridge of the nose but improves the nasofrontal angle.

* Individual Results May Vary.

The radix is the highest part of the nose. The radix blends into the frontal bone and should be the least projected part of the nasal bridge. Asian and African noses tend to have very low profile radices, frequently needing augmentation. Easter European and Middle Eastern noses can have very prominent radices, frequently needing reduction.

People with a prominent radix typically have a large dorsal hump as well. Removing the hump on the bridge of the nose is difficult in the setting of a projected radix.

The radix requires specialized instruments to reduce. The frontal sinus can be located deep to the radix limiting the amount of radix reduction. The skin covering the radix is thick and does not always contract to the reduced radix projection.

What is the ideal amount of tip rotation for you? That is entirely dependent on what you think looks right for your nose and face. Period. Although rhinoplasty is not precise enough to choosbest nasal tip rotatione the exact angle of rotation, you can typically choose to keep the rotation the same, slightly increase or slightly decrease it. Simply changing the angle or rotation will not alter the width or definition of the nasal tip.

Nasal tip rotation is evaluated on profile view. It is the angle between the under side of the nose and the upper lip.   According to the ‘experts’ the ideal tip rotation is estimated to be between 95 – 115 degrees for women and 90 degrees for men.  Nasal tip angle frequently depends on ethnicity.  Noses of Asian descent can naturally have a very high degree of rotation, frequently over 120 degrees.  Middle Eastern and Hispanic rhinoplasty patients frequently complain of a drooping nasal tip.

Dr. Kolstad’s Rhinoplasty Blogs & Additional Information

Recovery from rhinoplasty is easier then you might think. It is uncommon for patients to complain of pain with many only using prescription pain medicine for the first two days.

Your procedure will be performed under anesthesia, and you will require a ride home after your surgery. Dr. Kolstad will call you or a family member on the night of surgery to make sure that you are feeling ok and to answer any questions.

Bruising and swelling after surgery should be expected. “Raccoon eyes” are almost always part of rhinoplasty surgery and improve over the course of a week or two. Dr. Kolstad recommends purchasing thick cover up make-up prior to the procedure if you are concerned about bruising. During the first few days after surgery ice packs placed around the nose will minimize any bruising.

You should refrain from strenuous activities for two to three weeks. Pushing the limits early in the recovery process can lead to delayed healing and difficulties. Dr. Kolstad will inform you when it is safe to resume exercising.

If you have questions about rhinoplasty surgery, please contact Kolstad Facial Plastic Surgery to schedule a consultation with Dr. Kolstad. You may call our office at 858.859.2563 to schedule your appointment today. We are conveniently located in in La Jolla between I5 and I 805. We serve men and women in La Jolla, Del Mar, San Diego, Rancho Santa Fe, Solano Beach, Encinitas and Southern California.

Recovering From Rhinoplasty

Nonsurgical Rhinoplasty

Can I have a nose job without going to surgery? What is injectable rhinoplasty? I have a small nasal bridge do I need surgery to fix it?

These are common questions asked in Dr. Kolstad’s San Diego plastic surgery office. The good news is that not everybody looking to enhance the appearance of their nose needs surgery. If you are happy with the shape of the tip of your nose and pleased with the size of the nostrils, you may be a candidate for nonsurgical rhinoplasty.

Nonsurgical rhinoplasty is a procedure performed in the office to increase the size of a nasal bridge or soften a nasal hump. This procedure is most often sought by Asian and African American patients looking to add volume and definition to the part of the nose that rests between the eyes.

Adding volume to a diminutive nasal bridge can have a dramatic impact on the entire face. Injectable rhinoplasty is most noticeable on profile view. Nonsurgical rhinoplasty can soften a nasal hump or add volume to a small nasal bridge.

WHAT CAN BE CORRECTED WITH NONSURGICAL RHINOPLASTY:

A nasal bridge with a hump can be straightened

A nasal bridge that is scooped...

If you have questions about injectable rhinoplasty surgery, please contact Kolstad Facial Plastic Surgery to schedule a consultation with Dr. Kolstad. You may call our office at 858.859.2563 to schedule your appointment today. We are conveniently located in in La Jolla between I5 and I 805. We serve men and women in La Jolla, Del Mar, San Diego, Rancho Santa Fe, Solano Beach, Encinitas and Southern California.

Bruising under your eyes should be expected with every rhinoplasty. When the nasal bones are narrowed there is almost always a little bleeding underneath the skin. Dark circles under the eyes usually don’t appear for at least 24 hours and typically peak within the first 2 days after surgery.

When the rhinoplasty cast is removed seven days after surgery the bruising has typically evolved into yellow-brown circles. At this point any residual dark circles under the eyes can be camouflaged with thick, cover-up make-up. Most people do not have any bruising 10 days after surgery.

Sometimes bruising does not ever completely go away and there can be dark circles under the eyes months after rhinoplasty. There is a genetic predisposition for permanent bruising typically found in Mediterranean ethnicities: Italians, Greeks, Spanish, Moroccans, ect. Instead of the bruise being resorbed back into the body, iron deposits are left behind in the skin. These hemosiderin deposits stain the skin brown and are permanent.

The good news is that like many pigmented lesions or sun spots, hemosiderin deposits have treatments. Six weeks of topical hydroquinone 4% followed by a Glycolic or TCA peel will typically remove even dark hemosiderin skin stains and have the skin looking refreshed and as good as new.

If you have questions about rhinoplasty surgery, please contact Kolstad Facial Plastic Surgery to schedule a consultation with Dr. Kolstad. You may call our office at 858.859.2563 to schedule your appointment today. We are conveniently located in in La Jolla between I5 and I 805. We serve men and women in La Jolla, Del Mar, San Diego, Rancho Santa Fe, Solano Beach, Encinitas and Southern California.

Why Do I Have Dark Circles Under My Eyes a Month After Rhinoplasty?

Surgical and Nonsurgical Asian Rhinoplasty San Diego

A common request at Kolstad Facial Plastic Surgery is to increase the size of the bridge of the nose. Many of our Asian patients have trouble getting glasses to fit because the bridge of the nose is relatively flat across the face. If you are happy with the size and proportions of your nasal tip and nostrils but would like to increase the size of the bridge of your nose, there are 2 options.

1) Nonsurgical rhinoplasty: In the office injectable fillers like Juvederm or Voluma can be placed along the bridge of your nose to add height. There is minimal downtime, it is economical, and the fillers last about a year.

2) Bridge Augmentation rhinoplasty: If you are only concerned with the bridge of your nose a limited rhinoplasty can be performed to place a graft to increase the height of the nasal bridge.

If you have questions about Asian rhinoplasty surgery, please contact Kolstad Facial Plastic Surgery to schedule a consultation with Dr. Kolstad. You may call our office at 858.859.2563 to schedule your appointment today. We are conveniently located in in La Jolla between I5 and I 805. We serve men and women in La Jolla, Del Mar, San Diego, Rancho Santa Fe, Solano Beach, Encinitas and Southern California.

Asian Rhinoplasty

How Much Does A Nosejob Cost?

There are a number of specific considerations which determine the cost of rhinoplasty, the cost of facelift surgery, or any other cosmetic procedure.

Generally speaking, prices will vary based on geographical region similar to housing prices. The operational costs of an office in Beverly Hills are greater than a similar office in South Dakota, and that difference will be reflected in the costs of cosmetic nose surgery.

The cost of rhinoplasty is also dependent on the unique characteristics of a patients nose as well as the complexity of the procedure. A revision surgery is significantly more challenging and will consequently cost more.

In addition, every surgeon will charge a little bit differently based on expertise, availability and reputation. It is important to remember that the cheapest option is frequently not the best deal. You only get one nose, you should only trust it to a specialist.

If you have questions about rhinoplasty surgery, please contact Kolstad Facial Plastic Surgery to schedule a consultation with Dr. Kolstad. You may call our office at 858.859.2563 to schedule your appointment today. We are conveniently located in in La Jolla between I5 and I 805. We serve men and women in La Jolla, Del Mar, San Diego, Rancho Santa Fe, Solano Beach, Encinitas and Southern California.

Revision Rhinoplasty

Revision rates with inexperienced physicians have been reported to be as high as 20%. Rhinoplasty surgery is complicated and without question requires an experienced surgeon who specializes in plastic surgery of the face. While a dissatisfying outcome in nasal cosmetic surgery is possible in the most skilled hands, more commonly it comes from the hands of the occasional nasal surgeon.

If you are unhappy with the outcome of your nose job, you may be a candidate for what’s called a revision rhinoplasty. Revision rhinoplasty tends to be far more challenging then a primary surgery for a variety of reasons. Revision rhinoplasty requires an ability to understand both the original structure of your nose and the alterations made during your initial surgery. Patients who have undergone nasal surgery in the past will have scar tissue which will increase the complexity of the procedure. In addition to scar tissue the cartilage that was removed to reshape a nose during the first surgery will no longer be available.

In most revision procedures cartilage will need to be borrowed from the patient’s ear or rib in order to improve nasal form and function. Occasionally implants made of Gortex or Porex can be placed to restore height to the nasal bridge. If a patient wishes to avoid additional surgical scars or procedures, cadaveric rib can be sculpted and used to recreate the nasal framework. In short, revision rhinoplasty is an advanced procedure that requires highly sophisticated training, expert techniques and the hands of a specialist.

If you have questions about revision rhinoplasty surgery, please contact Kolstad Facial Plastic Surgery to schedule a consultation with Dr. Kolstad. You may call our office at 858.859.2563 to schedule your appointment today. We are conveniently located in in La Jolla between I5 and I 805. We serve men and women in La Jolla, Del Mar, San Diego, Rancho Santa Fe, Solano Beach, Encinitas and Southern California.

Nose surgery (rhinoplasty) can be performed for many reasons. Many times patients are not concerned with the size and shape of their nose, but have a difficulty breathing through one or both sides of their nose. When the goal of surgery is to improve the way the nose works it is termed a “functional rhinoplasty”. The following complaints can be addressed with San Diego functional rhinoplasty:

FUNCTIONAL RHINOPLASTY

A deviated septum
A crooked nose resulting from trauma (broken nose)
Difficulty breathing from either side of the nose
Nostrils that collapse when taking a deep breath
A bumpy or humped nose

Rhinoplasty can also be performed to change the nasal appearance. By recontouring the nasal bones and cartilage the nose can be brought into balance with the rest of the face. A nose that is not ideally suited to a particular face can leave someone feeling self-conscious. The following are some concerns that can be addressed during La Jolla cosmetic rhinoplasty:

COSMETIC RHINOPLASTY
A nasal tip that droops, protrudes, or is too wide...

If you have questions about rhinoplasty surgery, please contact Kolstad Facial Plastic Surgery to schedule a consultation with Dr. Kolstad. You may call our office at 858.859.2563 to schedule your appointment today. We are conveniently located in in La Jolla between I5 and I 805. We serve men and women in La Jolla, Del Mar, San Diego, Rancho Santa Fe, Solano Beach, Encinitas and Southern California.

What is Rhinoplasty?

Asian Rhinoplasty in San Diego

Every nose is unique and requires specific alterations to bring it into balance with the rest of the face. This is even more true in ethnic rhinoplasty. In California ethnic rhinoplasty is a general term commonly referring to noses of Asian descent.

Asian noses tend to have fewer growth centers across the midface. This genetic predisposition reduces the height of the nose in relation to the cheeks, eyes and lips. A small nasal bridge can make wearing glasses difficult. A small nasal bridge can also make the midface appear relatively flat on the profile view. Asian noses tend to have thicker skin and nostrils that are a little wider. The nasal tips are less pointed and have less rotation These inherent differences make Asian rhinoplasty very different then nose jobs for Caucasians.

Many of our Asian patients are not looking to Westernize their nose. Instead they are seeking to augment a diminutive nasal bridge. Adding volume to a diminutive nasal bridge can have a dramatic impact on the entire face. The nasal bridge can be permanently enhanced during surgery or temporarily augmented using nonsurgical rhinoplasty. Injectable rhinoplasty is performed in the office and uses fillers such as Juvederm or Radiesse to add volume to a small nasal bridge.

The goal of Asian rhinoplasty is simple: to enhance one’s natural features and refine the others in a way that balances the nose in harmony with the rest of the face. Achieving this goal is best performed by the hands of a specialist.

Dr. Kolstad is a San Diego Facial Plastic Surgeon specializing in rhinoplasty that improves both the nasal shape and function . If you are considering Asian rhinoplasty in San Diego please contact Kolstad Facial Plastic Surgery to schedule a consultation with Dr. Kolstad. You may call our office at 858.859.2563 to schedule your appointment today. We are conveniently located in in La Jolla between I5 and I 805. We serve men and women in La Jolla, Del Mar, San Diego, Rancho Santa Fe, Solano Beach, Encinitas and Southern California.

PREPARING FOR THE PROCEDURE: RHINOPLASTY

HOW TO CLEAN INCISIONS AFTER RHINOPLASTY

HOW TO REDUCE SWELLING AFTER RHINOPLASTY

HOW TO TAPE YOUR NOSE AFTER RHINOPLASTY

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To schedule an appointment call us at (858) 859-2563 or get in touch with the form below.

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