For most people, the nose is the most defining characteristic of the face, and even a slight alteration can provide a great improvement in a person's appearance. Cosmetic surgery of the nose, or rhinoplasty, is perhaps the most challenging plastic surgery procedure, not only for the prominence of the nose on the face, but also for the technical skill required to achieve consistent, long lasting results.
As a fellowship trained, doubly-board certified facial plastic surgeon originally trained in otolaryngology/head and neck surgery, and in practice for close to 20 years, Dr. Epstein performs on average 3 rhinoplasty surgeries weekly. This experience provides him with a unique perspective on the nose, understanding not only what makes it look good, 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 definition of an attractive nose is ultimately subjective for each individual. Many people are happy with the nose they have, despite such "irregularities" as a bump or a long 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. Undesirable features that can be improved include: a broad or poorly defined tip; a crooked or otherwise asymmetric appearance; a bump; a tip that droops, especially with smilings; a wide bridge; and more. These features may be ethnic traits that are inherited, the result of an accident or prior plastic surgery, or a consequence of aging.
As you can see from his before and after photos, Dr. Epstein's goal is to create a nose that is both in harmony with the rest of the face and natural appearing. To help assure that the patient is happy with the results of the surgery, Dr. Epstein utilizes computer imaging to better communicate with his patients. After taking the time in consultation to learn of the patient's goals, as well as to explain to the patient what can be accomplished and what he recommends, Dr. Epstein emails the computer image photos. This way, every patient has an opportunity not only to view these images from the privacy of their home, but also to provide feedback as to what he/she likes and what changes are needed in the image- a back-and-forth interaction that assures the best outcome. What makes this process so effective in Dr. Epstein's hands is that the computer images are realistic- a fact noted by many patients when they remark that many of the "real" after photos are more aesthetic than the computer imaging views.
The one to two hour procedure is usually performed on an out-patient basis in the office operating room. Working with the same anesthetist for more than 15 years, twilight sedation assures that the patient neither feels nor remembers anything, yet is breathing on his/her own. For patients who request it, the surgery can be performed under general anesthesia at the outpatient surgery center of South Miami Hospital, located across the street from the office.
Nearly all of Dr. Epstein's rhinoplasty procedures are done by the external, or "open" approach. With a single incision made right along the bottom of the nose, full visualization of the underlying structures permits the most accurate assessment of the anatomy and deficiencies of the nose. This then permits aesthetic correction through a variety of techniques, while leaving the support mechanisms of the tip intact, assuring the most stable and longest lasting results.
No where is this external approach more valuable than in revision rhinoplasty surgery. These usually challenging cases often require more sophisticated reparative techniques, as well as the experience and skill of a surgeon like Dr. Epstein in whom approximately one-third of his rhinoplasty practice consists of reparative procedures.
Dr. Epstein and his office staff are available to help you in whatever way they can, and look forward to making your experience as easy and comfortable as possible. We are committed to achieving the most aesthetic and natural appearing results for every one of our patients.