ARC Plastic Surgery: Jeremy White, M.D

The nose can be made bigger either permanently with cartilage or fat grafting or temporarily in the office with hyaluronic acid fillers. Making the nose bigger can sometimes improve your overall look since the parts of the face may blend better in the right situation. The nostrils can be supported with cartilage grafts to stop them from caving in. This is often something that I need to do for patients who have had too much nasal tip cartilage removed in previous rhinoplasty and need revision rhinoplasty.

Open rhinoplasty makes a visible incision under the nasal tip in the area called the columella. It involves lifting up the skin from the cartilage and bone to gain an easier view of structures that need to get reduced, enlarged, or sutured together. The downsides are an external scar, more disruption of important attachments, and more prolonged swelling. Closed rhinoplasty involves incisions that are hidden inside the nose so that the nose job is essentially scarless. Closed (endonasal) rhinoplasty is a more targeted operation that disrupts less tissue and has less swelling. It can also be more challenging for some surgeons since there is a higher emphasis on only uncovering what needs to be seen or changed with a smaller field of vision. Both are excellent techniques depending on the comfort levels of the surgeons.

Although it can happen in science fiction movies, I cannot put someone else’s nose on your face. Nor would I want to. You were born with certain cartilage strength and skin thickness and we must use the building blocks at hand to achieve the final results. Also, a nose that looks good on one person does not fit or blend well on another patient’s face. Regarding risks, the most usual risks of rhinoplasty are bleeding, which lasts a day or two typically, infection, which is minimized with antibiotics during and after surgery, and need for further surgery.

There is a 5% chance of a post-procedure touch-up whether related to scar tissue, bone callus formation, or other issues.

Preoperative analysis is essential to planning and performing rhinoplasty. This is one of the most challenging operations in all of plastic surgery and, because of this, I inspect every detail of the nose from the outside and from within. We discuss the upper, middle, and lower thirds of the nose with regard to their proportions to each other and how they fit with the rest of your face. We will also discuss how certain maneuvers can help improve or preserve your nasal breathing, which is also important. This thoroughness is why we spend so much time with our patients at a rhinoplasty consultation. It is worth every minute as we custom design a rhinoplasty plan for each patient so that each patient can have a beautiful nose that fits the face appropriately.

Each surgery will have individualized instructions that the doctor and staff will review with you beforehand. Aside from the specifics, it is always helpful to buy any ointments or medications beforehand and to have the support of a friend or family member for your care.

Board certification means that the doctor has gone through a rigorous training process of many years followed by passing a series of examination. These examinations not only focus on the doctor’s mastery of medical knowledge, but also assess his or her ethics, safety, and commitment to excellence. This is essentially the mark of approval from peers of the highest esteem in the field.

Everything in life has risks, but going to a board certified plastic surgeon who is attentive to both the surgical and postoperative care is key to keeping plastic surgery as safe as possible.

If you are medically healthy and want to improve your appearance, we have a great variety of traditional surgery and minimally invasive options to help you reach your goals. You need to set up a consult with us to determine what plan is right for you and get you started on your journey.

The best age for plastic surgery depends on what it is that you want done. I will do rhinoplasty as young as 16 years old since this is when the nose has finished most of its growth. Otoplasty (ear pinning) can be done as early as 5 years old, so as to avoid teasing in school while maximizing ear growth, but can do non-surgical ear pinning for newborns less than 5 weeks old (the sooner the better). I advise patients to wait until they are 18 before any breast surgery to allow the breasts to grow properly, even though the breasts will continue to change over time. For a female tummy tuck (abdominoplasty) I advise patients to wait until they are done having children and to wait at least 6 months after the last pregnancy to allow the belly to soften and weight to stabilize. Liposuction is best for patients 18 and older. Regarding facelift and eyelid surgery, these can be done to reverse signs of aging and studies have shown that, for instance, facelifts last longer when done at younger ages (50s) as opposed to patients in their 70s. The other exciting thing is that we also offer some great minimally invasive options for facial rejuvenation such as Botox, fillers, chemical peels, and radiofrequency skin tightening and micro needling with Morpheus8, facetite, accutite, and bodytite.

Open rhinoplasty involves a scar under the nose on the columella, whereas closed rhinoplasty, which is my preferred approach, has all internal incisions. Both approaches can achieve fantastic rhinoplasty results in the right hands, but I believe that the ability to avoid a visible scar while creating less swelling and tissue trauma is well worth the additional technical challenges inherent to this finesse operation.

Hi Georgeanne! Smoking is not good for your scars or healing process, especially prior to a breast reduction surgery. We recommend that patients stop smoking at least 3 weeks prior to surgery and stay this way during their healing process to make healing as easy as possible. Please give us a call for more information :)