The central feature. Millimetric work.
Rhinoplasty is the most technically demanding procedure in cosmetic facial surgery. The nose sits at the visual center of the face, and small changes to its shape produce large changes to overall facial harmony. A well-performed rhinoplasty looks like the patient — only better — while a poorly-performed one looks unmistakably like surgery. The difference is measured in millimeters of intraoperative judgment.
Rhinoplasty at NCSS is performed by five of our affiliated surgeons, each experienced in both primary and revision cases. Rhinoplasty candidates typically fall into three groups: those wanting aesthetic reshaping (dorsal hump reduction, tip refinement, width narrowing), those wanting functional improvement (deviated septum, breathing obstruction), and those wanting both together — often called septorhinoplasty. Combined aesthetic and functional cases are common and typically the right approach when both concerns coexist.
Revision rhinoplasty — correcting the results of a previous nose surgery — is a distinct subspecialty with substantially higher technical demands than primary rhinoplasty. Patients considering revision should specifically discuss the surgeon's revision experience during consultation.
Who this procedure is designed for.
Rhinoplasty addresses the nose specifically — the central feature whose proportions define overall facial harmony.
Dorsal hump on profile view
A prominent bump along the bridge of the nose visible in profile. One of the most common aesthetic rhinoplasty concerns and typically well-addressed by rhinoplasty.
Bulbous, wide, or asymmetric nasal tip
Tip refinement is technically demanding but produces some of the most satisfying rhinoplasty results when done well.
Overall nose width or projection concerns
Narrowing the nasal base, adjusting overall projection off the face, or refining the nostril shape.
Deviated septum with breathing obstruction
Functional concerns typically warrant septoplasty — often combined with aesthetic rhinoplasty to address both in one procedure (septorhinoplasty).
Post-traumatic deformity
Correcting shape or airway problems after nasal fracture or other trauma.
Congenital or ethnic-specific concerns
Rhinoplasty candidacy that respects the patient's ethnic identity while addressing specific concerns — not 'one nose fits all' surgery.
Complete facial growth
Typically age 15+ for females, 17+ for males — the nose should have completed its growth before elective rhinoplasty.
Realistic expectations
Rhinoplasty produces meaningful improvement, not perfection. No honest surgeon promises exact outcomes; the goal is a harmonious, natural-looking nose that suits your face.
Every scheduled surgical patient is offered a free Rest-Assure pre-operative consultation with Dr. Rand Scott personally — medical history, medication planning, and discharge coordination before surgery day.
Three stages, one procedure.
Rhinoplasty technique varies substantially based on the specific goals. The key intraoperative decisions:
Open vs. closed technique
Closed (endonasal) technique places all incisions inside the nostrils — no external scar. Open technique adds a small incision across the columella (between the nostrils) for direct visualization. Neither is universally correct; the choice depends on the specific work needed.
Cartilage-preserving techniques
Modern rhinoplasty favors reshaping and repositioning cartilage rather than aggressive removal. Preserved cartilage produces more natural long-term results and reduces the risk of over-resection deformities.
Structural grafting
Small cartilage grafts (harvested from the septum, ear, or occasionally rib) support the reshaped nose and prevent post-operative collapse. The right grafting strategy is a defining rhinoplasty judgment.
Osteotomies (bone work)
Controlled fractures of the nasal bones to narrow the nose or correct deviation. Precise placement is critical for outcome and healing.
Combined septoplasty
Correction of a deviated septum for airway improvement, commonly performed with aesthetic rhinoplasty.
Time investment
Primary rhinoplasty typically 2–4 hours; revision cases often longer. Physician anesthesia coverage throughout.
Every case at NCSS is under physician anesthesia — no CRNAs — and Dr. Denise Scott (endocrinology) is on call for our surgical patients.
Two sites. One recovery.
Discharged the day of surgery with your nurse. External nasal splint in place. Internal splints or packing may be present for the first days. Head elevated for sleep.
Swelling and bruising most noticeable around the eyes and nose at 48–72 hours. Splint removed at day 7. Most patients stay home from work during this week.
Bruising resolves. Most patients return to work by day 10–14. Swelling continues to decrease but remains visible.
Return to full exercise (avoiding contact sports for longer). Nose contour becoming more defined, especially in the bridge.
Fine swelling of the nasal tip continues to resolve slowly. The tip is the last area to fully refine, and this can take up to a year in some patients.
Rhinoplasty results are essentially permanent, though the nose continues subtle age-related change over decades. Well-performed primary rhinoplasty rarely needs revision if the surgical judgment was sound.
Every rhinoplasty patient at NCSS is covered by our Rest-Assure program: physician anesthesia on the day of surgery, one nurse from arrival through discharge, and post-operative direct access to your surgeon — not an answering service.
Five surgeons. Millimetric judgment.
Rhinoplasty is the most technique-sensitive facial procedure. Meet more than one surgeon, especially for revision cases.
Dr. Toohey
All-UC · Full Facial PracticeAll-UC training; three decades of aesthetic practice; rhinoplasty as part of facial rejuvenation.
View surgeon →Dr. Nichter
Triple-Board · Craniofacial TrainingTriple-boarded with additional craniofacial fellowship; four decades in Newport Beach.
View surgeon →Dr. Horowitz
Craniofacial + Facial RejuvenationEmory + UVA under Milton Edgerton; craniofacial fellowship training.
View surgeon →Dr. Hendricks
Triple-Board · Facial PracticeTriple-boarded; rhinoplasty as part of full facial rejuvenation practice.
View surgeon →Dr. Andre
New Generation · Modern TechniqueCleveland Clinic + UC Davis + Loyola + Pacific Center; trained in modern cartilage-preserving rhinoplasty.
View surgeon →The right starting point is a conversation.
Every rhinoplasty consultation at NCSS begins with time — time to understand your specific concerns, review your anatomy, and determine whether primary or revision rhinoplasty, open or closed technique, is the right fit.
Call (949) 644-8182Monday–Thursday, 8am–3pm · Friday by appointment only.
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