Marina del Rey
Dr. David Stoker
4640 Admiralty Way #1000
Marina del Rey, CA 90292
Sculpting a beautiful nose has more to do with balancing facial features than replicating society's idea of an attractive nose. In Los Angeles, rhinoplasty techniques need to be highly individualized to the patient's anatomy, ethnicity and desires. There is no single approach that will work for all patients.
Choosing the proper technique makes a huge difference in a patient's outcome. An expert rhinoplasty surgeon will help the patient understand how to achieve desired goals using his or her breadth of experience and techniques.
This 34-year-old woman desired a less prominent and more feminine nose. Dr. Stoker performed a rhinoplasty using a closed approach with all internal incisions. She is shown before and two years fol... View Case
At the beginning of each consultation, I listen to your goals and perform a thorough analysis to evaluate the proportions of your face and nose. Working together, we will discuss the techniques that are best suited to your needs and develop a personalized solution to help you improve the appearance and structure of your nose. For patients considering nose surgery in Los Angeles, it's important to understand the techniques that are available to you.
All incisions are placed inside the nose except for a tiny incision in the little column of skin that separates the nostrils. Open rhinoplasty allows me to lift up the skin and soft tissue to expose the underlying cartilage and bone for precise adjustments. Often, I describe this technique as "lifting the hood of a car to work on the engine." As you can imagine, this offers more visibility and access than working only "underneath the car." For patients who need significant tip alteration and for revision surgeries, open rhinoplasty is usually the best option.
This is the traditional technique that surgeons have been performing for many decades. All incisions are placed inside the nose, limiting access and visibility. The technique is most common for patients who want to narrow the nose, or to reduce or augment the bridge of the nose. Closed rhinoplasty is an excellent choice when significant changes to the nose tip are not required. I use this technique for about 30 percent of my patients.
You've probably heard the term "deviated septum" quite a bit. The septum is the internal cartilage that separates the nostrils. For patients who have deviated noses or obstructed nasal airways, a deviated septum is frequently the cause. Septoplasty is designed to open the nasal airways, straighten the septum, and possibly straighten the nose. The septum is also the best source of cartilage grafts when needed for more complex nose adjustments. Oftentimes, patients who opt for septoplasty have both cosmetic and functional goals for surgery.
Refining the nasal tip is one of the most challenging aspects of rhinoplasty. Tip grafts typically come from the septum, ears or ribs. They may be used to improve projection and contour of the nasal tip. Grafts allow the surgeon to achieve more substantial changes than would be possible only adjusting existing cartilage. This technique benefits patients who have flat or asymmetrical noses and is usually critical for revision rhinoplasty.
Imagine putting a clothespin on the soft portion of your nose and trying to breathe. That is what it's like for patients with obstructed nasal airways due to narrow internal valves. To remedy this I recommend spreader grafts. Spreader grafts are internal cartilage grafts used to widen the nasal airways and improve breathing function. The grafts are not visible externally unless desired, and are usually created with cartilage from the septum or ears.
Each person has finger-like structures on the inside of the nose that clean and moisten inhaled air. These structures are called the turbinates. In some cases, the turbinates become enlarged, making it difficult to breathe. Turbinate outfracture or reduction improves nasal airflow by reducing this obstruction. This technique is performed entirely through the nostrils, ensuring that incisions are not visible from the outside.
Expert rhinoplasty surgeons in Los Angeles have extensive experience with all of these techniques and will help you design the best plan to meet your goals.