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Rhinoplasty (Nose Surgery) by Dr Maas

San Francisco rhinoplasty surgeon, Dr. Maas specializes in reconstructive and cosmetic surgery techniques in rhinoplasty, resulting in enhanced symmetry and alignment of the facial anatomy. Approximately 40 percent of the surgeries performed by Dr. Maas are rhinoplasty procedures, including revision rhinoplasties requested by patients that were not completely satisfied with their initial procedures.

Dr. Maas understands that revision of the nose is a very personal choice that should be made primarily by the patient, but involves the expert input of the plastic surgeon as well. It requires exceptional anatomical knowledge, surgical skill and the eye of an artist. An experienced plastic surgeon will take the time to understand the aesthetic goals of each patient and determine the best techniques and procedures to meet those goals.

Rhinoplasty Results

What is Rhinoplasty?

Rhinoplasty (cosmetic nose surgery) is the surgical procedure for changing the appearance of the nose by altering the shape, size or proportion in relation to the rest of the facial features. Nose surgery can have a profound impact on the entire appearance of the face, which is why rhinoplasty is such a significant procedure for some patients.

During rhinoplasty, incisions are often placed just inside the rim of the nostrils where post-operative scarring cannot be seen at all. In other situations, a W-incision may be placed across the columnella, the narrow area of tissue skin between the nostrils. While this incision is placed on the exterior of the nose, scarring after the procedure is minimal and rarely detected by others.

Through these incisions, the soft tissues of the nose are carefully separated from the underlying cartilage and bone. Excess bone and cartilage are appropriately adjusted to give a balanced, harmonious appearance to the face. The septum, the cartilage that divides the nose into two compartment, the nasal bones that lie above and the cartilage that makes up the tip are the most common areas to address during a rhinoplasty procedure.

When rhinoplasty is performed to relieve obstructions inside the nose, or in conjunction with surgery to reconstruct the nasal passages, the procedure is called septorhinoplasty. In this procedure the obstruction is removed through internal incisions and the interior of the nose is restructured. Because this procedure is often performed for medical reasons, insurance coverages may be available for at least a portion of the procedure. Patients can include cosmetic changes to the nose during this procedure as well, although insurance will not cover that part of the surgery.

A rhinoplasty can be performed right in our office at the Maas Clinic on an outpatient basis. These procedures usually last from two to three hours, depending on the amount of work to be done. Because minimal anesthesia is generally required for the procedure, patients tend to feel relatively alert after the procedure.

Revision rhinoplasty is effective in correcting concerns left behind by a previous procedure and producing the final aesthetic results the patient was originally hoping for.


About half of all the rhinoplasty procedures Dr. Maas performs are revision rhinoplasties. These procedures may be requested for purely cosmetic reasons or because the original surgery affected the function of the nose and requires correction. In either case, the revision procedure may be more complex than the initial surgery, which is why it is important to work with a plastic surgeon like Dr. Maas that is highly experienced in revision techniques and is qualified to make the necessary corrections to help you achieve the results you want.

Revision surgery may be more complicated for a number of reasons. First, there may be scar tissue from the initial procedure that has to be addressed in order to ensure the revision surgery produces the best possible results. Second, there may be less bone and cartilage to work with during the revision procedure, which may necessitate grafting from another area of the body to provide sufficient support for the nose after revision surgery.

Revision rhinoplasty results can take a bit longer for a patient to see, which may be distressing for patients that were unhappy with their initial results and anxious to see the corrections. While patients will see preliminary results within about two weeks once the cast comes off, there may still be significant swelling for a number of months that prohibits patients from viewing the final results. In fact, most will see those results within 12-18 months, which will become permanent at that time.

Post Operative Care

A small splint is usually placed on the external nose for a few days and a light internal dressing may be applied. After the procedure, some swelling and bruising of the nose and eyelids can be expected. The swelling usually subsides within the first several days, and the bruising subsides within a few weeks. Keeping the head elevated and avoiding bending over will help to minimize these side effects.Bleeding is always a concern after rhinoplasty. The nose has many blood vessels, which can lead to significant bleeding after surgery if the nose is bumped during the healing process. We encourage patients to use extra caution around children and pets during those first few weeks to prevent any potential impacts that could lead to bleeding.

There may be mild discomfort for a short time after surgery, but significant pain is quite rare. Any discomfort is usually controlled quite easily with medication. Patients do experience some stuffiness after surgery, but this eases up in a matter of days. Patients are encouraged to do nasal washing to clean out the nasal passages and relieve stuffiness, rather than blow the nose too hard and risk bleeding to the surgical area.
The majority of our patients are able to return to their normal activities within two weeks after the procedure.

Interested in learning more about a nose job in San Francisco? Call The Maas Clinic at (415) 567-7000 for more about Rhinoplasty San Francisco

Frequently Asked Questions

Can Rhinoplasty Reduce Nostril Flare?

When we’re doing alar base or nostril base reduction, it is extremely important to keep the very nice curvature of the outside part of the nose or the nostril, intact. We call this the ala and by rotating the ala inward toward the center portion of the face, we’re able to maintain that very nice curvature. There are number of techniques that take out wedges and other things that make the nostril look very straight up and down. Michael Jackson was a very good example of the wedge technique, which just looks very unnatural. So I would summarize by just letting everyone know that’s interested in alar based reduction or narrowing the nose that it’s very important preserve the curvature of the ala.

Do Celebrities Get Better Nose Jobs?

The answer to this question is simply “No”. In a good practice with good surgeons what you’ll find is that we’re trying to achieve perfection in every patient that we treat, whether they are a celebrity or not a celebrity. Anatomy doesn’t change with celebrity patients versus any other patient and so as we address the nose and the structural architecture of the nose and we refine it.

Help! I Bumped my Nose After Rhinoplasty

The simple answer is that with light bumps it’s unlikely, but with bigger bumps the nose is. With nasal bones, the nose is relatively susceptible to injury so we’re careful in our practice to keep a nasal cast on for the first week, and we’ll return that cast to the patient if they’re doing a lot of activities. If they’re going to be outside or in a place where they might be bumped, you can place the cast which doesn’t prevent the nose bones from being dislocated, specifically, but it does defuse any pressure that’s applied directly to the nose or specifically to an area of the nose. So there are some nice preventative ways to avoid injury post-rhinoplasty.

What is a Non-Surgical Nose Job?

Really, there’s been a lot of media attention with it, a lot of internet traffic about non-surgical nose jobs, and actually I have some examples of non-surgical rhinoplasty or nose jobs on my website at maasclinic.com. So if you want to visit and see that that would be a good way of, we getting a sense of it. But basically, it’s a very limited number of patients who are candidates for non-surgical nose jobs and they’re typically patients who either have a saddle depression of the bridge of their nose where (it) goes down slightly, or they have a very weak bridge of the nose and we can use and injectable filler product to improve the height of the bridge of the nose and to some extent the tip of the nose.

It is never too late, To be what you might have been.- George Eliot