Rhinoplasty

Although the nose is situated at the center of the face, an attractive nose is not one that draws attention to itself. Rather, the viewer’s attention should always be drawn to the most attractive facial feature: the eyes. A nose may be considered unattractive when it becomes the focus of attention and detracts from other pleasant features. To achieve the best nose job—or rhinoplasty—results, Montreal, Quebec, surgeon Dr. Mark Samaha reshapes the nose by modifying or softening its appearance to bring it into harmony with the remaining facial features.

Choose a Rhinoplasty Specialist

Rhinoplasty is arguably the most complex and technically challenging aesthetic surgical procedure. It requires intimate knowledge of not only external aesthetics but also the internal anatomy of the nose. The surgeon is required to execute the necessary refinements while predicting the healing process and how the final outcome will materialize several months later. Every rhinoplasty procedure demands that the entirety of the surgeon’s technical skills, knowledge, and experience be applied in order to achieve a pleasing, natural-looking, and long-lasting result. Therefore, it’s important to choose your rhinoplasty surgeon carefully to obtain the best results.

Dr. Samaha specializes in otolaryngology-Head and Neck surgery (ear, nose, and throat) as well as facial plastic surgery. His extensive experience in all types of nasal surgery—functional, aesthetic, and reconstructive—makes rhinoplasty a procedure of particular interest to him. Occasionally, patients consulting for aesthetic rhinoplasty also suffer from a respiratory problem which can be addressed at the same time.

Most patients consulting Dr. Samaha for rhinoplasty surgery are referred by friends or family members who have had surgery, or other plastic surgeons who feel that the patient’s case is very complex, requiring more advanced techniques. He is considered by many to be among the most experienced rhinoplasty surgeons in Montreal, having performed over 2500 rhinoplasty procedures.

How Is Open Rhinoplasty Performed?

In the open approach, incisions are made on the skin of the columella (the partition between the nostrils) and inside the nose. The skin is then peeled off the nasal cartilage, the structure of the nose is modified, the skin is replaced, and the incision is finally sutured to leave a small scar.

How Is Closed Rhinoplasty Performed?

The closed approach, also known as an “endonasal” approach, means that the necessary changes are performed by placing small incisions inside the nose only, without an external scar. The changes to the nasal cartilages and bones are then made by inserting the instruments in a way that Dr. Samaha compares to a “mouse under the rug.”

Is Open Rhinoplasty Better Than Closed?

Dr. Samaha favors the closed approach because the surgery itself is shorter and swelling and bruising are usually minimal after surgery as compared with the open approach. He has developed a honed expertise thanks to lots of experience and is, therefore, able to effect the necessary changes to achieve his patients’ goals using this less invasive approach.

Dr. Mark Samaha

Meet Dr. Mark Samaha

A double board-certified otolaryngologist whose practice focuses exclusively on facial plastic surgery, Dr. Samaha is highly qualified in facial aesthetics. Learn more about our physician and how he's carefully refined his skills to sculpt your beautiful face.

Meet Dr. Samaha Doctor credentials

Rhinoplasty Without Nasal Packing

Patients are able to go home within 1 hour following surgery. Upon leaving, patients do not have any “packing” or gauze in the nose. Instead, Dr. Samaha places a small piece of cotton dressing the size of a fingernail on either side at the tip of the nose, to be removed that evening or the next morning by the patient or a family member.

The absence of nasal packing makes a significant difference in recovery after surgery. When patients report pain, pressure, headaches, and discomfort after traditional rhinoplasty surgery, it is usually related to the presence of the packing, not the surgery itself. In addition, removing this packing a few days after surgery is reported as extremely unpleasant and painful by patients who have had the misfortune of being subjected to this experience. Therefore, the absence of packing after surgery makes the recovery much more easily tolerated and, for the large majority of his patients, painless.

There is a plastic splint dressing on the outside of the nose to minimize swelling and support the nose, allowing it to heal in the desired shape.

How Long Does It Take to Recover From a Nose Job?

Recovery time is usually about 7 to 10 days. The plastic splint is removed at the first postoperative visit, 1 week after surgery, after which patients are usually comfortable returning to work. The appearance of the nose at this point is not the final result. Nevertheless, the patient can expect the nose to look better than it did before the surgery.

The swelling from the surgery will gradually decrease over the ensuing months to reveal the fine details and refinements. An appointment is scheduled 6 months after surgery. The long-term result is assessed, and photos are taken. Other appointments are scheduled if needed.

The nose continues to heal and “settle” for about 18 months before the result is final, though this may vary depending on skin type and thickness.

Accessory Procedures

In addition to a rhinoplasty surgery, reshaping the chin (mentoplasty) can provide additional improvement to the overall facial aesthetics for some patients. This is particularly true of the profile in certain patients where a slight augmentation of the chin will harmonize the alignment and provide a significantly more balanced facial profile.

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Frequently Asked Questions

How much pain will I experience after rhinoplasty?

The overwhelming majority of our patients report no pain after surgery. Pain medication is prescribed to use as needed after surgery. However, our patients do not usually take it. The main reason is that Dr. Samaha does not place any packing after surgery, as mentioned earlier. Other reasons have to do with the surgical techniques used, and anti-inflammatory medications Dr. Samaha prescribes.

What are the activity restrictions after rhinoplasty?

The main restriction is the avoidance of strenuous activity, which includes vigorous exercise and heavy lifting, for 1 week. Other actions that increase the pressure in the nose are also to be avoided. These include nose-blowing and bending forward. Otherwise, patients may carry out usual activities.

How long does the bruising last after rhinoplasty?

Most of Dr. Samaha’s rhinoplasty patients experience minimal bruising that is usually 90% resolved by the first follow-up visit at 1 week. Most rhinoplasty surgeries are associated with some bruising under the eyes. This does not apply to patients who are having only modifications to the tip of the nose. The degree of bruising depends upon surgical technique and the patient’s own tendency to bruise. Dr. Samaha uses advanced, minimally invasive techniques to minimize bruising and swelling after surgery. Patients who have a natural tendency to bruise easily will experience slightly more bruising under the eyes after rhinoplasty surgery.

Does Dr. Samaha use nasal implants in rhinoplasty surgery?

Although foreign materials are routinely used in surgery for various parts of the body, the implantation of foreign material in the nose is associated with an increased risk of infection, rejection of the material, and scarring, even several years after surgery. For this reason, Dr. Samaha strictly avoids use of any foreign materials in the nose. Occasionally, adding tissue to support certain areas of the nose or modify its appearance is required. In these instances, Dr. Samaha will use some of the patient’s own tissue, which is very safe.

Would you like to learn more about rhinoplasty and how it can help you? Request your consultation with Dr. Samaha online, or call us at (514) 731-2525 to make your appointment.

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